ArticleAnnals of surgical oncology2015
Clinical and socioeconomic factors influence treatment decisions in Graves' disease.
Article in Annals of surgical oncology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 43 citations in OpenAlex.
- Prospective Intervention of a Novel Levothyroxine Dosing Protocol Based on Body Mass Index after Thyroidectomy.Journal of the American College of Surgeons · 2016Trial
- Disparities in utilization of high-volume thyroid surgeons for Graves disease: a statewide analysis.Journal of the Endocrine Society · 2026Article
- Assessing the Quality of Care of Pregnant Patients With Thyrotoxicosis at an Urban Safety Net Hospital.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2025Article
- 2022 Update on Clinical Management of Graves Disease and Thyroid Eye Disease.Endocrinology and metabolism clinics of North America · 2022Review
- Disparities in Thyroid Care.Endocrinology and metabolism clinics of North America · 2022Review
- Secular Trends in Ablation Therapy for Graves' Disease: An Analysis of a 15-Year Experience at a Tertiary Hospital in South Korea.Journal of clinical medicine · 2021Article
- Shifting Trends and Informed Decision-Making in the Management of Graves' Disease.Thyroid : official journal of the American Thyroid Association · 2020Article
- Hyperthyroidism.Gland surgery · 2020Review
- Assessing American Thyroid Association Guidelines for Total Thyroidectomy in Graves' Disease.The Journal of surgical research · 2020Article
- Diagnosis and Management of Graves' Disease in Thailand: A Survey of Current Practice.Journal of thyroid research · 2020Article
- The value of total thyroidectomy as the definitive treatment for Graves' disease: A single centre experience of 594 cases.Journal of clinical & translational endocrinology · 2019Article
- Rapid Relief: Thyroidectomy is a Quicker Cure than Radioactive Iodine Ablation (RAI) in Patients with Hyperthyroidism.World journal of surgery · 2019Article
- Factors Predicting Time to TSH Normalization and Persistence of TSH Suppression After Total Thyroidectomy for Graves' Disease.Frontiers in endocrinology · 2019Article
- Impact of potassium iodide on thyroidectomy for Graves' disease: Implications for safety and operative difficulty.Surgery · 2018Article
- Comparative analysis of radioactive iodine versus thyroidectomy for definitive treatment of Graves disease.Surgery · 2017Article
- Thyroidectomy for Graves' disease in children: Indications and complications.Journal of pediatric surgery · 2016Article
- A review of treatment options for Graves' disease: why total thyroidectomy is a viable option in selected patients.Journal of community hospital internal medicine perspectives · 2016Article
- Thyroid carcinoma in patients with Graves' disease: an institutional experience.Endocrine pathology · 2015Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
backgroundDefinitive treatment of Graves' disease includes radioactive iodine (RAI) and thyroidectomy, but utilization varies. We hypothesize that, in addition to clinical reasons, there are socioeconomic factors that influence whether a patient undergoes thyroidectomy or RAI.
methodsPatients treated for Graves' disease between August 2007 and September 2013 at our university hospital were included. A comparative analysis of clinical and socioeconomic factors was completed.
resultsOf 427 patients, 300 (70 %) underwent RAI, whereas 127 (30 %) underwent surgery. Multiple factors were associated with surgery: younger age (mean 36 vs. 41 years, p < 0.01), female gender (33 vs. 19 % males, p = 0.01), black race (56 vs. 28 % nonblack, p < 0.01), Medicaid or uninsured (43 vs. 27 % private insurance or Medicare, p < 0.01), ophthalmopathy (38 vs. 26 %, p < 0.01), goiter (35 vs. 23 %, p < 0.01), and lowest quartile of median household income (38 vs. 27 % upper three quartiles, p = 0.03). Thyroidectomy increased annually, with 52 % undergoing surgery during the final year (p < 0.01). Adjusting for confounding, younger age (odds ratio [OR] 1.04; 95 % confidence interval [CI] 1.02, 1.05), female gender (OR 2.06; 95 % CI 1.06, 4.01), ophthalmopathy (OR 2.35; 95 % CI 1.40, 3.96), and later year of treatment (OR 1.66; 95 % CI 1.41, 1.95) remained significantly associated with surgery.
conclusionsSurgery has now become the primary treatment modality of choice for Graves' disease at our institution. Clinical factors are the main drivers behind treatment choice, but patients with lower SES are more likely to have clinical features best treated with surgery, underlying the importance of improving access to quality surgical care for all patients.
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