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. 2023 Nov 7:14:1225202.
doi: 10.3389/fendo.2023.1225202. eCollection 2023.

Characteristics of specialists treating hypothyroid patients: the "THESIS" collaborative

Miloš Žarković  1   2 , Roberto Attanasio  3 , Endre V Nagy  4 , Roberto Negro  5 , Enrico Papini  6 , Petros Perros  7 , Chagit Adler Cohen  8 , Ersin Akarsu  9 , Maria Alevizaki  10 , Göksun Ayvaz  11 , Tomasz Bednarczuk  12 , Eszter Berta  4 , Miklos Bodor  4 , Anna Maria Borissova  13 , Mihail Boyanov  14 , Camille Buffet  15 , Maria-Cristina Burlacu  16 , Jasmina Ćirić  1   2 , Juan J Díez  17   18   19 , Harald Dobnig  20 , Valentin Fadeyev  21 , Benjamin C T Field  22 , Eric Fliers  23 , Jacob Stampe Frølich  24 , Dagmar Führer  25 , Juan Carlos Galofré  26 , Tommi Hakala  27 , Jan Jiskra  28 , Peter Kopp  29 , Michael Krebs  30 , Michal Kršek  28 , Martin Kužma  31 , Mikael Lantz  32 , Ivica Lazúrová  33 , Laurence Leenhardt  34 , Vitaliy Luchytskiy  35 , Anne McGowan  36 , Miguel Melo  37 , Saara Metso  38 , Carla Moran  39   40 , Tatyana Morgunova  21 , Tronko Mykola  41 , Biljana Nedeljković Beleslin  1   2 , Dan Alexandru Niculescu  42 , Božidar Perić  43 , Tereza Planck  32 , Catalina Poiana  42 , Francisca Marques Puga  44 , Eyal Robenshtok  45 , Patrick Rosselet  46 , Marek Ruchala  47 , Kamilla Ryom Riis  24 , Alla Shepelkevich  48 , David Unuane  49 , Irfan Vardarli  50   51 , W Edward Visser  52 , Andromachi Vrionidou  53 , Younes R Younes  54 , Elena Yurenya  55 , Laszlo Hegedüs  24
Affiliations

Characteristics of specialists treating hypothyroid patients: the "THESIS" collaborative

Miloš Žarković et al. Front Endocrinol (Lausanne). .

Abstract

Introduction: Thyroid specialists influence how hypothyroid patients are treated, including patients managed in primary care. Given that physician characteristics influence patient care, this study aimed to explore thyroid specialist profiles and associations with geo-economic factors.

Methods: Thyroid specialists from 28 countries were invited to respond to a questionnaire, Treatment of Hypothyroidism in Europe by Specialists: an International Survey (THESIS). Geographic regions were defined according to the United Nations Statistics Division. The national economic status was estimated using World Bank data on the gross national income per capita (GNI per capita).

Results: 5,695 valid responses were received (response rate 33·0%). The mean age was 49 years, and 65·0% were female. The proportion of female respondents was lowest in Northern (45·6%) and highest in Eastern Europe (77·2%) (p <0·001). Respondent work volume, university affiliation and private practice differed significantly between countries (p<0·001). Age and GNI per capita were correlated inversely with the proportion of female respondents (p<0·01). GNI per capita was inversely related to the proportion of respondents working exclusively in private practice (p<0·011) and the proportion of respondents who treated >100 patients annually (p<0·01).

Discussion: THESIS has demonstrated differences in characteristics of thyroid specialists at national and regional levels, strongly associated with GNI per capita. Hypothyroid patients in middle-income countries are more likely to encounter female thyroid specialists working in private practice, with a high workload, compared to high-income countries. Whether these differences influence the quality of care and patient satisfaction is unknown, but merits further study.

Keywords: Europe; endocrinologists; healthcare delivery; hypothyroidism; questionnaire.

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Conflict of interest statement

LH, PP, EP, EN received consultancy fees from IBSA Biochimique SA. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer PM declared a shared affiliation with the author TB to the handling editor at the time of review.

Figures

Figure 1
Figure 1
Flow chart of the THESIS survey.
Figure 2
Figure 2
Responses to the questionnaire by country. The height of the bars represents the total number of invitees. The number of respondents is grey, and the response rate (%) is the number on the top of each bar. Bars are sorted by the response rate, from low to high.
Figure 3
Figure 3
Relation between the proportion of female respondents and gross national income per capita (GNI per capita).
Figure 4
Figure 4
Relation between gross national income per capita (GNI per capita) and proportion of private practitioners.
See this image and copyright information in PMC

References

    1. Razvi S, Korevaar TIM, Taylor P. Trends, determinants, and associations of treated hypothyroidism in the United Kingdom, 2005–2014. Thyroid (2019) 29(2):174–82. doi: 10.1089/thy.2018.0251 - DOI - PubMed
    1. Somwaru LL, Arnold AM, Joshi N, Fried LP, Cappola AR. High frequency of and factors associated with thyroid hormone over-replacement and under-replacement in men and women aged 65 and over. J Clin Endocrinol Metab (2009) 94(4):1342–5. doi: 10.1210/jc.2008-1696 - DOI - PMC - PubMed
    1. Lillevang-Johansen M, Abrahamsen B, Jørgensen HL, Brix TH, Hegedüs L. Over- and under-treatment of hypothyroidism is associated with excess mortality: A register-based cohort study. Thyroid (2018) 28(5):566–74. doi: 10.1089/thy.2017.0517 - DOI - PubMed
    1. Carlé A, Laurberg P, Pedersen IB, Knudsen N, Perrild H, Ovesen L, et al. Mainly the younger hypothyroid patients are referred to hospital — Evidence for referral bias. J Clin Epidemiol (2009) 62(4):446–51. doi: 10.1016/j.jclinepi.2008.06.016 - DOI - PubMed
    1. Hegedüs L, Bianco AC, Jonklaas J, Pearce SH, Weetman AP, Perros P. Primary hypothyroidism and quality of life. Nat Rev Endocrinol (2022) 18(4):230–42. doi: 10.1038/s41574-021-00625-8 - DOI - PMC - PubMed

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