ArticleSurgery2021
Undertreatment of primary hyperparathyroidism in a privately insured US population: Decreasing utilization of parathyroidectomy despite expanding surgical guidelines.
Article in Surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
What it found
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Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 40 citations in OpenAlex.
- Systematic review of the risk of urolithiasis following parathyroidectomy in patients with primary hyperparathyroidism.International urology and nephrology · 2024Pooled it
- Risk of fractures in primary hyperparathyroidism: a systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2021Pooled it
- End-Organ Damage Associated With Primary Hyperparathyroidism.JAMA surgery · 2026Article
- Understanding Low Motivation for Treatment in Primary Hyperparathyroidism: A Qualitative Study of Patients and Providers in the United States.World journal of surgery · 2026Article
- Patient-Reported Outcome Measures Used in Primary Hyperparathyroidism: A Scoping Review.Annals of surgical oncology · 2026Article
- Opportunistic Assessment for Parathyroid Adenoma on CT: A Retrospective Cohort Study Evaluating Primary Hyperparathyroidism-Associated Morbidity Over 10 Years of Follow-Up.AJR. American journal of roentgenology · 2025Article
- Bone Mineral Density and First Line Imaging with [Diagnostics (Basel, Switzerland) · 2024Article
- Patient Neighborhood Adversity Associated With Access Not Wait Time to Parathyroidectomy.The Journal of surgical research · 2024Article
- Opportunities to improve the diagnosis and treatment of primary hyperparathyroidism: retrospective cohort study.Gland surgery · 2024Article
- Patient Characteristics, Management, and Outcomes in a Novel Cohort of Primary Hyperparathyroidism.Journal of the Endocrine Society · 2024Article
- Focus on Non-osteoporotic Post-menopausal Women with Asymptomatic Primary Hyperparathyroidism: A Monocentric Series.Endocrine, metabolic & immune disorders drug targets · 2024Article
- Sex-Stratified Predictors of Prolonged Operative Time and Hospital Admission in Outpatient Parathyroidectomy.Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India · 2024Article
- Older Patients With Asymptomatic Primary Hyperparathyroidism: Should Criteria for Surgery Be Expanded?Journal of the Endocrine Society · 2023Article
- Estimated Effect of Parathyroidectomy on Long-Term Kidney Function in Adults With Primary Hyperparathyroidism.Annals of internal medicine · 2023Observational
- Kidney Stone Events Following Parathyroidectomy vs Nonoperative Management for Primary Hyperparathyroidism.The Journal of clinical endocrinology and metabolism · 2022Article
- Article
- Use and disparities in parathyroidectomy for symptomatic primary hyperparathyroidism in the Medicare population.Surgery · 2021Article
- Advances in the diagnosis and the management of primary hyperparathyroidism.Therapeutic advances in chronic disease · 2021Review
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundPrimary hyperparathyroidism is associated with substantial morbidity, including osteoporosis, nephrolithiasis, and chronic kidney disease. Parathyroidectomy can prevent these sequelae but is poorly utilized in many practice settings.
methodsWe performed a retrospective cohort study using the national Optum de-identified Clinformatics Data Mart Database. We identified patients aged ≥35 with a first observed primary hyperparathyroidism diagnosis from 2004 to 2016. Multivariable logistic regression was used to determine patient/provider characteristics associated with parathyroidectomy.
resultsOf 26,522 patients with primary hyperparathyroidism, 10,101 (38.1%) underwent parathyroidectomy. Of the 14,896 patients with any operative indication, 5,791 (38.9%) underwent parathyroidectomy. Over time, there was a decreasing trend in the rate of parathyroidectomy overall (2004: 54.4% to 2016: 32.4%, P < .001) and among groups with and without an operative indication. On multivariable analysis, increasing age and comorbidities were strongly, inversely associated with parathyroidectomy (age 75-84, odds ratio 0.50 [95% confidence interval 0.45-0.55]; age ≥85, odds ratio 0.21 [95% confidence interval 0.17-0.26] vs age 35-49; Charlson Comorbidity Index ≥2 vs 0 odds ratio 0.62 [95% confidence interval 0.58-0.66]).
conclusionThe majority of US privately insured patients with primary hyperparathyroidism are not treated with parathyroidectomy. Having an operative indication only modestly increases the likelihood of parathyroidectomy. Further research is needed to address barriers to treatment and the gap between guidelines and clinical care in primary hyperparathyroidism.
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Registered trials
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