Evidence map›Paper›PMID 39694327›Full record

Observational studyEndocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists2025

A Predictive Model for Graves' Disease Recurrence After Antithyroid Drug Therapy: A Retrospective Multicenter Cohort Study.

Omar El Kawkgi, David Toro-Tobon, Freddy J K Toloza, Sebastian Vallejo, Cristian Soto Jacome, Ivan N Ayala, Bryan A Vallejo, Camila Wenczenovicz, Olivia Tzeng, Horace J Spencer and 9 more

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 2025. 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

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

2 citing papers in PubMed.

  1. Review
  2. Review
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

19 authors.

Omar El KawkgiDivision of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Mayo Clinic, Rochester, Minnesota; Department of Endocrinology, Mayo Clinic Health System, Eau Claire, Wisconsin.
David Toro-TobonDivision of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Mayo Clinic, Rochester, Minnesota.
Freddy J K TolozaDivision of Endocrinology and Metabolism, Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas; Knowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, Minnesota; Diabetes and Endocrinology and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Disorders, National Institutes of Health, Bethesda, Maryland.
Sebastian VallejoKnowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, Minnesota.
Cristian Soto JacomeDivision of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Mayo Clinic, Rochester, Minnesota; Knowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, Minnesota.
Ivan N AyalaKnowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, Minnesota.
Bryan A VallejoDepartment of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota.
Camila WenczenoviczKnowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, Minnesota.
Olivia TzengCollege of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Horace J SpencerDepartment of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Jeff D ThostensonDepartment of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Dingfeng LiDepartment of Endocrinology, Endocrinology and Metabolism Institute, Cleveland Clinic, Cleveland, Ohio.
Jacob KohlenbergDivision of Diabetes, Endocrinology and Metabolism, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota.
Eddy LincangoKnowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, Minnesota.
Sneha MohanDivision of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Mayo Clinic, Rochester, Minnesota.
Jessica Castellanos-DiazDivision of Endocrinology, Department of Medicine, University of Florida, Gainesville, Florida.
Spyridoula MarakaKnowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, Minnesota; Section of Endocrinology, Medicine Service, Central Arkansas Veterans Healthcare System, Little Rock, Arkansas; Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Naykky Singh OspinaDivision of Endocrinology, Department of Medicine, University of Florida, Gainesville, Florida.
Juan P BritoDivision of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Mayo Clinic, Rochester, Minnesota; Knowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, Minnesota. Electronic address: brito.juan@mayo.edu.

Funding

Using social networks to map and evaluate team science across CTSA hubsUL1TR001427 · NCATS · UNIVERSITY OF FLORIDA · PI MITCHELL, DUANE A. · 2015 to 2024
$37.2M
Expanding Translational Research in ArkansasUL1TR003107 · NCATS · UNIV OF ARKANSAS FOR MED SCIS · PI JAMES, LAURA P · 2019 to 2023
$21.6M
Diabetes-Docs: Physician-Scientist Career Development Program (DiabDocs)K12DK133995 · NIDDK · STANFORD UNIVERSITY · PI LINDA A DIMEGLIO, David Matthew Maahs · 2022 to 2026
$16.0M
UF Clinical and Translational Science AwardUL1TR000064 · NCATS · UNIVERSITY OF FLORIDA · PI NELSON, DAVID R · 2012 to 2014
$12.2M
Adequate selection of patients for thyroid biopsy: evaluation of a shared decision making conversation aidK08CA248972 · NCI · UNIVERSITY OF FLORIDA · PI SINGH OSPINA, NAYKKY · 2020 to 2024
$1.1M
HSRD VA I21 HX003268NCATS NIH HHS UL1 TR000064NCATS NIH HHS UL1 TR001427NCATS NIH HHS UL1 TR003107NCI NIH HHS K08 CA248972NIDDK NIH HHS K12 DK133995
6 · The paper itself

Abstract

objectivesPredicting recurrence after antithyroid drug (ATD) cessation is crucial for optimal treatment decision-making in patients with Graves' disease (GD). We aimed to identify factors associated with GD recurrence and to develop a model using routine pretherapeutic clinical parameters to predict GD recurrence risk during the first year following ATD discontinuation.

methodsThis electronic health records-based observational cohort study analyzed patients with GD treated with ATDs at 3 U.S. academic centers. Demographic, clinical characteristics, and GD recurrence within 1 year following ATD discontinuation were assessed. Univariable and multivariable analyses were performed. A predictive model for GD recurrence was developed and visualized as a nomogram.

resultsAmong the 523 patients included in the study, 211 (40.34%) discontinued treatment. Of these, the 142 (67.29%) that had a follow-up period exceeding 12 months after stopping ATD were used for the development of the predictive model. Among the patients included in the model, the majority were women (n = 111, 78.16%), with a mean age of 49.29 years (standard deviation 16.31) and baseline free thyroxine (FT4) levels averaging 3.39 ng/dl (standard deviation 2.25). Additionally, 79 of 211 patients (37.44%) experienced recurrence within 1 year. Multivariable analysis indicated a 31% increased risk of GD recurrence per additional decade of age (odds ratio 1.31, 95% confidence interval 1.03-1.66, P = .0258), and a 65% increased risk of GD recurrence for every 2.0 ng/dL rise in baseline FT4 (odds ratio 1.65, 95% confidence interval 1.08-2.50, P = .0192). The recurrence predictive model's area under the curve was 0.69 in the derivation dataset and 0.65 in cross-validation.

conclusionsThis study introduced a practical model that can be used during the initial therapeutic decision-making process. It utilizes easily accessible baseline clinical data to predict the likelihood of GD recurrence after 1 year of ATD therapy. Further research is needed to identify other factors affecting risk of recurrence and develop more precise predictive models.

Indexed as

Antithyroid AgentsGraves DiseaseAdultAgedCohort StudiesFemaleHumansMaleMiddle AgedNomogramsRecurrenceRetrospective StudiesAntithyroid Agentsanti-thyroid drugGraves’ diseasehyperthyroidismrecurrence

Identifiers

PMID39694327
PMCPMC12005976

What OpenQuestion holds

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Registered trials

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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.