Evidence map›Paper›PMID 30283735›Full record

ArticleEuropean thyroid journal2018

2018 European Thyroid Association Guideline for the Management of Graves' Hyperthyroidism.

George J Kahaly, Luigi Bartalena, Lazlo Hegedüs, Laurence Leenhardt, Kris Poppe, Simon H Pearce

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European thyroid journal, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 403 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
403citing papers in PubMed, 9 pooled it
56.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

403 citing papers in PubMed, 9 syntheses or guidelines pooled it, 908 citations in OpenAlex.

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343 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 6 institutions in 6 countries.

George J KahalyDepartment of Medicine I, Johannes Gutenberg University (JGU) Medical Center, Mainz, Germany.
Luigi BartalenaDepartment of Medicine and Surgery, University of Insubria, Varese, Italy.
Lazlo HegedüsDepartment of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark.
Laurence LeenhardtThyroid and Endocrine Tumors Unit, Pitié Salpêtrière Hospital, Sorbonne University, Paris, France.
Kris PoppeEndocrine Unit, CHU Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium.
Simon H PearceDepartment of Endocrinology, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom.
Johannes Gutenberg University Mainz · DENewcastle University · GBOdense University Hospital · DKSorbonne Université · FRUniversité Libre de Bruxelles · BEUniversity of Insubria · IT

Funding

Medical Research Council G0500783
6 · The paper itself

Abstract

Graves' disease (GD) is a systemic autoimmune disorder characterized by the infiltration of thyroid antigen-specific T cells into thyroid-stimulating hormone receptor (TSH-R)-expressing tissues. Stimulatory autoantibodies (Ab) in GD activate the TSH-R leading to thyroid hyperplasia and unregulated thyroid hormone production and secretion. Diagnosis of GD is straightforward in a patient with biochemically confirmed thyrotoxicosis, positive TSH-R-Ab, a hypervascular and hypoechoic thyroid gland (ultrasound), and associated orbitopathy. In GD, measurement of TSH-R-Ab is recommended for an accurate diagnosis/differential diagnosis, prior to stopping antithyroid drug (ATD) treatment and during pregnancy. Graves' hyperthyroidism is treated by decreasing thyroid hormone synthesis with the use of ATD, or by reducing the amount of thyroid tissue with radioactive iodine (RAI) treatment or total thyroidectomy. Patients with newly diagnosed Graves' hyperthyroidism are usually medically treated for 12-18 months with methimazole (MMI) as the preferred drug. In children with GD, a 24- to 36-month course of MMI is recommended. Patients with persistently high TSH-R-Ab at 12-18 months can continue MMI treatment, repeating the TSH-R-Ab measurement after an additional 12 months, or opt for therapy with RAI or thyroidectomy. Women treated with MMI should be switched to propylthiouracil when planning pregnancy and during the first trimester of pregnancy. If a patient relapses after completing a course of ATD, definitive treatment is recommended; however, continued long-term low-dose MMI can be considered. Thyroidectomy should be performed by an experienced high-volume thyroid surgeon. RAI is contraindicated in Graves' patients with active/severe orbitopathy, and steroid prophylaxis is warranted in Graves' patients with mild/active orbitopathy receiving RAI.

Indexed as

Antithyroid drugsGraves' hyperthyroidismGraves' orbitopathyManagementRadioiodine therapyThyroidectomy

Identifiers

PMID30283735
PMCPMC6140607
OpenAlexW2884675353

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.