Evidence map›Paper›PMID 38323883›Full record

ArticleBJS open2024

Regional variations in the management of primary hyperparathyroidism in Sweden: population-based case-control study.

David Thorsteinsson, Fredrik Granath, Robert Bränström, Anna Koman, Jan Zedenius, Inga-Lena Nilsson

Abstract read
In one paragraph

Article in BJS open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

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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

2 citing papers in PubMed.

  1. Article
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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.

David ThorsteinssonDepartment of Breast, Endocrine Tumours and Sarcoma, Karolinska University Hospital, Stockholm, Sweden.ORCID 0009-0004-1043-1733
Fredrik GranathDepartment of Medicine Solna, Division of Clinical Epidemiology, Karolinska Institutet, Stockholm, Sweden.
Robert BränströmDepartment of Breast, Endocrine Tumours and Sarcoma, Karolinska University Hospital, Stockholm, Sweden.
Anna KomanDepartment of Breast, Endocrine Tumours and Sarcoma, Karolinska University Hospital, Stockholm, Sweden.ORCID 0000-0003-3196-7057
Jan ZedeniusDepartment of Breast, Endocrine Tumours and Sarcoma, Karolinska University Hospital, Stockholm, Sweden.
Inga-Lena NilssonDepartment of Breast, Endocrine Tumours and Sarcoma, Karolinska University Hospital, Stockholm, Sweden.

Funding

Karolinska InstituteThe Stockholm Regional Council
6 · The paper itself

Abstract

backgroundSubstantial disparities in the utilization of parathyroidectomy for primary hyperparathyroidism have been reported. This study aimed to analyse regional variations in parathyroidectomy incidence with respect to the patient's disease burden and socioeconomic status.

methodsA population-based case-control study included all patients with primary hyperparathyroidism who underwent parathyroidectomy in Sweden between 2008 and 2017 and 10 matched controls. Data on demographic and socioeconomic variables, co-morbidities and drug prescriptions were collected from relevant national registers. Conditional logistic regression was used to analyse predictors of parathyroidectomy.

resultsA total of 8626 patients with primary hyperparathyroidism (77% women) underwent parathyroidectomy during the study interval. The annual incidence of parathyroidectomy was 9.0 per 100 000 persons. The annual age-adjusted regional incidences of parathyroidectomy varied between 3.3 and 16.9 operations per 100 000 inhabitants. Except for a small underrepresentation of patients with lower education, no effect of socioeconomic variables was observed. Compared with matched controls, the parathyroidectomy group had increased odds ratios of having developed classical symptoms of primary hyperparathyroidism and being prescribed medication against cardiovascular disorders and psychiatric illness at the time of parathyroidectomy. Increased risks of kidney stones and osteoporosis were observed 5 years before parathyroidectomy. Patients with primary hyperparathyroidism selected for parathyroidectomy from regions with a low incidence of operations had a higher prevalence of kidney stones, osteoporosis and hypertension, as well as larger adenomas and higher calcium levels at the time of parathyroidectomy compared with patients in high-incidence regions.

conclusionThe considerable variation in parathyroidectomy seems more likely associated with different clinical thresholds for detection of primary hyperparathyroidism and referral to surgery than socioeconomic disparities.

Indexed as

Hyperparathyroidism, PrimaryKidney CalculiOsteoporosisCase-Control StudiesFemaleHumansMaleSweden

Identifiers

PMID38323883
PMCPMC10848304

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