Evidence map›Paper›PMID 32124267›Full record

Observational studyJournal of endocrinological investigation2020

Influence of common clinical variables on intraoperative parathyroid hormone monitoring during surgery for primary hyperparathyroidism.

M S Shawky, M F Sakr, A S Nabawi, T E Abdel-Aziz, M C De Jong, V Rozalén García, F Lam, C Soromani, J Smart, J W Honour and 1 more

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Journal of endocrinological investigation, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.6field-weighted citation impact, top 35% 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

6 citing papers in PubMed, 11 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
  4. Surgical challenges of giant parathyroid adenomas weighing 10 g or more.Journal of endocrinological investigation · 2023
    Article
  5. Article
  6. Article
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

11 authors at 2 institutions in 2 countries.

M S ShawkyCentre for Endocrine Surgery, University College London Hospital and London Clinic, 250 Euston Road, London, NW1 2PG, UK. michael.s.shawky@gmail.com.ORCID http://orcid.org/0000-0002-3230-5154
M F SakrDepartment of General Surgery, Alexandria University, Alexandria, Egypt.
A S NabawiDepartment of General Surgery, Alexandria University, Alexandria, Egypt.
T E Abdel-AzizCentre for Endocrine Surgery, University College London Hospital and London Clinic, 250 Euston Road, London, NW1 2PG, UK.
M C De JongCentre for Endocrine Surgery, University College London Hospital and London Clinic, 250 Euston Road, London, NW1 2PG, UK.
V Rozalén GarcíaCentre for Endocrine Surgery, University College London Hospital and London Clinic, 250 Euston Road, London, NW1 2PG, UK.
F LamDepartment of Clinical Biochemistry, University College London Hospital, London, UK.
C SoromaniDepartment of Clinical Biochemistry, University College London Hospital, London, UK.
J SmartDepartment of Anaesthesia, University College London Hospital, London, UK.
J W HonourDepartment of Clinical Biochemistry, University College London Hospital, London, UK.
T R KurzawinskiCentre for Endocrine Surgery, University College London Hospital and London Clinic, 250 Euston Road, London, NW1 2PG, UK.
University College Hospital · GBAlexandria University · EG

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIntraoperative monitoring of parathyroid hormone (IOPTH) is a reliable method of predicting the cure of primary hyperparathyroidism (PHPT). The aim of this study is to assess whether common clinical variables (CCV) frequently encountered in patients with PHPT may affect the magnitude of PTH drop or the likelihood of patients meeting the intraoperative cure criterion.

designPatients who were surgically cured from PHPT caused by single gland disease (SGD) and had full IOPTH protocol (4 measurements) were stratified according to age, gland weight, renal function, vitamin D status and severity of hypercalcemia. The percentage of IOPTH drop and the frequency of patients who had true positive IOPTH test results were compared among groups.

results762 patients had surgery for PHPT, of whom 746 were (98%) cured. Of these 746 patients, 511 who had SGD and a full IOPTH protocol were included in this study. The median IOPTH drop was significantly higher among younger patients, those with severe hypercalcaemia at 5, 10, 15 min after gland excision, giant glands (at 5-min only), patients with vitamin D deficiency (at 10, 15 min), and those with normal renal function (at 15 min only). The likelihood of the patients meeting the intraoperative cure criterion was not significantly affected among the groups except in patients with mild hypercalcaemia, who were significantly less likely to have 50% IOPTH drop than those with severe hypercalcaemia at all time points. The frequency of mildly hypercalcaemic patients who met cure criterion was significantly improved by extending measurement to 15 min.

conclusionsIOPTH monitoring has the ability to mitigate the variability of IOPTH kinetics associated with most clinical variables. Mildly hypercalcemic patients in particular may benefit from waiting for 15-min measurement before any surgical decision is made.

Indexed as

Monitoring, IntraoperativeParathyroidectomyAdenomaAdultAgedAged, 80 and overAge FactorsBiological Variation, PopulationComorbidityFemaleHumansHypercalcemiaHyperparathyroidism, PrimaryKineticsMaleMiddle AgedParathyroid HormoneVitamin DIntraoperative parathyroid hormone monitoringParathyroidectomyPrimary hyperparathyroidism

Identifiers

PMID32124267
OpenAlexW3009328160

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.