The need for the GREAT+ score to predict relapse in Graves' disease: a questionnaire among patients and internal medicine specialists.

IF 5.4 2区 医学 Q1 Medicine Journal of Endocrinological Investigation Pub Date : 2024-10-01 Epub Date: 2024-03-25 DOI:10.1007/s40618-024-02358-7
H I Jansen, C Heuveling van Beek, P H Bisschop, A C Heijboer, E Bruinstroop, A Boelen
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Abstract

Purpose: Graves' disease (GD) is an auto-immune cause of hyperthyroidism. First-line treatment often consists of a 12-18 month course of antithyroid drugs (ATD). After discontinuation of ATD, GD relapses in approximately 50% of patients. The 'Graves recurrent event after therapy+ ' (GREAT+) score may predict individual relapse chances after ATD discontinuation more accurately based on clinical and laboratory parameters at diagnosis. We investigated the need for the GREAT+ score through an online questionnaire among GD patients and physicians treating GD.

Methods: An anonymous online questionnaire was distributed to patients and physicians between June 2022 and August 2023.

Results: The questionnaire was completed by 532 patients and 44 physicians. Results showed that 94% of patients were interested in knowing their GREAT+ score at the start of treatment. 55% would consider definite treatment (radioiodine/thyroidectomy) as first-line treatment in case of a high relapse chance. 98% of the physicians indicated the GREAT + score would support patient counseling. 84% may change their advice for first-line treatment if a patient has a high relapse chance based on the score.

Conclusion: Patients and physicians considered the GREAT+ score as a valuable addition to the current available information which could change treatment decisions. Therefore, external validation of the GREAT+ score is justified to implement this score in clinical practice.

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用 GREAT+ 评分预测巴塞杜氏病复发的必要性:患者和内科专家问卷调查。
目的:巴塞杜氏病(GD)是导致甲状腺功能亢进的自身免疫性疾病。一线治疗通常包括为期12-18个月的抗甲状腺药物(ATD)疗程。停用抗甲状腺药物后,约有50%的患者会复发。根据诊断时的临床和实验室参数,"治疗后巴塞杜氏复发事件+"(GREAT+)评分可以更准确地预测停用ATD后的复发几率。我们通过在线问卷调查了 GD 患者和治疗 GD 的医生对 GREAT+ 评分的需求:方法:我们在 2022 年 6 月至 2023 年 8 月期间向患者和医生发放了一份匿名在线问卷:共有 532 名患者和 44 名医生填写了问卷。结果显示,94% 的患者有兴趣在治疗开始时了解自己的 GREAT+ 分数。55%的患者在复发几率较高的情况下会考虑将明确治疗(放射性碘/甲状腺切除术)作为一线治疗。98% 的医生表示,GREAT + 分数将有助于为患者提供咨询。如果患者的复发几率很高,84%的医生可能会根据评分改变他们的一线治疗建议:患者和医生认为 GREAT+ 评分是对现有信息的宝贵补充,可改变治疗决策。因此,有必要对 GREAT+ 评分进行外部验证,以便在临床实践中使用该评分。
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来源期刊
Journal of Endocrinological Investigation
Journal of Endocrinological Investigation ENDOCRINOLOGY & METABOLISM-
CiteScore
8.10
自引率
7.40%
发文量
242
期刊介绍: The Journal of Endocrinological Investigation is a well-established, e-only endocrine journal founded 36 years ago in 1978. It is the official journal of the Italian Society of Endocrinology (SIE), established in 1964. Other Italian societies in the endocrinology and metabolism field are affiliated to the journal: Italian Society of Andrology and Sexual Medicine, Italian Society of Obesity, Italian Society of Pediatric Endocrinology and Diabetology, Clinical Endocrinologists’ Association, Thyroid Association, Endocrine Surgical Units Association, Italian Society of Pharmacology.
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