Schilddrüsenveränderungen: Ein Vergleich ambulanter Abrechnungsdaten mit Daten einer populationsbasierten Studie

Kiel, Simone; Ittermann, Till; Völzke, Henry; Chenot, Jean‐François; Angelow, Aniela

doi:10.1007/s00103-019-02983-1

Cited by 9 publications

(6 citation statements)

References 19 publications

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“…Thyroid disorders are common in the adult German population [1][2][3]. Undiagnosed thyroid disorders (morphological or functional) are found in up to 75% of the population [4,5]. Thyroid nodules are detected in 30 to 68% [4,6,7], most of them as incidental findings [2,8,9].…”

Section: Introductionmentioning

confidence: 99%

Frequency of thyroid function tests and examinations in participants of a population-based study

Kiel

Ittermann

Völzke

et al. 2020

BMC Health Serv Res

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Background: Thyroid disorders are common in the adult German population. Little is known about guideline implementation in clinical practice and the prevalence of diagnostic procedures in ambulatory care. The study aims to investigate the use of thyroid hormone measurements, thyroid ultrasound, thyroid scintiscan and associated costs in ambulatory care at population level.Methods: Data were derived from two independent population-based cohorts of the Study of Health In Pomerania (SHIP). Ambulatory billing data from the Association of Statutory Health Insurance Physicians Mecklenburg-Vorpommern were individually linked for the period 2002-2016 with SHIP data. The main outcomes were the frequency of outpatient ultrasound, scintiscan, serum TSH level measurement, free triiodothyronine (fT3) and free thyroxine (fT4) measurement, TSH-receptor-antibodies and microsomal antibodies measurement within 1 year and 3 years prior to the study entrance of the participants. Multinomial logistic regression models were used to assess the association of age, sex, thyroid medication intake and Charlson-Comorbidity-Index with frequency of TSH measurements and ultrasound examinations.Results: A total of 5552 participants (47% male, median age 55) were included in the analysis. 25% (1409/5552) had a diagnosed thyroid disorder or treatment, 40% (2191/5552) had clinical findings based on ultrasound or laboratory testing in SHIP only and 35% (1952/5552) neither a coded thyroid disorder or clinical finding nor thyroid medication. In the total study population 30% (1626/5552) received at least one TSH measurement, 6.8% (378/5552) at least one thyroid ultrasound and 2.6% (146/5552) at least one scintiscan within the past year before the study examination. Tests were performed more frequently in patients with thyroid medication and coded thyroid disorders. Hence, this group caused the highest expenditures. Conclusions:Given the high prevalence of thyroid disorders, diagnostic and monitoring tests should be used rationally with regard to costs. TSH levels should be monitored regularly in patients on thyroid medication. A consensus on monitoring frequency and iteration of monitoring of morphological thyroid disorders with TSH and ultrasound and specific guideline recommendations are needed. Trial registration: Versorgungsforschung Deutschland (VfD_17_003880).

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Section: Introductionmentioning

confidence: 99%

Frequency of thyroid function tests and examinations in participants of a population-based study

Kiel

Ittermann

Völzke

et al. 2020

BMC Health Serv Res

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“…In large, US-based, epidemiological studies, the prevalence of thyroid nodules in Germany ranges from 35 to 60% ( 6 ). Only about a third of these cases were found to be diagnosed as part of the routine work-up by general practitioners (GPs) in a recent direct comparison of epidemiological and GP data of the same region ( 6 , 26 ). GP diagnosis would thus reveal at least 8,000,000 patients with a thyroid nodule in a population of 83,000,000 in Germany.…”

Section: Discussionmentioning

confidence: 99%

Malignancy rates in thyroid nodules: a long-term cohort study of 17,592 patients

Grußendorf

Ruschenburg²,

Brabant

2022

European Thyroid Journal

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Objectives Ultrasound diagnosis of thyroid nodules has greatly increased their detection rate. Their risk for malignancy is estimated between 7 and 15% in data from specialized centers which are used for guidelines recommendations. This high rate causes considerable anxiety to patients upon first diagnosis. Here we retrospectively analyzed the malignancy rate of sonographically diagnosed nodules larger 1cm from a primary/secondary care center when long-term longitudinal follow-up was included. Patients/Methods 17,592 patients were diagnosed with a thyroid nodule larger than 1cm, of whom 7,776 were assessed by fine needle aspiration cytology (FNAC) and 9,816 by sonography alone. 9568 patients were discharged following initial diagnosis due to innocent results of FNAC and/or ultrasound. In 1,904 patients definitive histology was obtained and 6,731 cases were included in long-term follow-up (up to 23 years with a median of 5 years). Results Malignancy was histologically confirmed in 189 patients (1.1% of all) when excluding accidentally diagnosed papillary microcarcinomas. 155 were diagnosed during the first year of management, 25 in years 2-5 of follow-up, 9 in years 6-10 and nil in 1,165 patients followed beyond 10 years. Conclusions Malignancy rate of thyroid nodules from primary/secondary care was much lower than that previously reported. During follow-up for more than 5 years their rate rapidly dropped to less than 1/1000 cases. This low malignancy rate may help to reassure patients first confronted with the diagnosis of a thyroid nodule, substantially reduce their anxiety and avoid unwarranted diagnostic and therapeutic procedures

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“…Erwachsene im Alter von 18 -65 Jahren Schilddrüsenknoten [1]. Neuere Daten einer repräsentativen Studie im Nordosten Deutschlands (SHIP-Studie, Study of Health in Pomerania) zeigen sogar, dass 41 % der Teilnehmer in der Altersgruppe von 20 -93 Jahre mindestens einen Schilddrüsenknoten haben [2]. Zudem steigt die Häufigkeit mit zunehmendem Alter.…”

Section: Epidemiologieunclassified

Zufallsbefund Schilddrüsenknoten: Bewertung des Krebsrisikos

Kiel¹,

Angelow²

2021

Allgemeinmedizin up2date

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Schilddrüsenveränderungen: Ein Vergleich ambulanter Abrechnungsdaten mit Daten einer populationsbasierten Studie

Cited by 9 publications

References 19 publications

Frequency of thyroid function tests and examinations in participants of a population-based study

Frequency of thyroid function tests and examinations in participants of a population-based study

Malignancy rates in thyroid nodules: a long-term cohort study of 17,592 patients

Zufallsbefund Schilddrüsenknoten: Bewertung des Krebsrisikos

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