IMS Health, Alexandria, VA, USA.
J Bone Miner Res. 2013 Dec;28(12):2570-6. doi: 10.1002/jbmr.2004.
Hypoparathyroidism is a rare endocrine disorder whose incidence and prevalence have not been well defined. This study aimed to 1) estimate the number of insured adult patients with hypoparathyroidism in the United States and 2) obtain physician assessment of disease severity and chronicity. Prevalence was estimated through calculation of diagnoses of hypoparathyroidism in a large proprietary health plan claims database over a 12-month period from October 2007 through September 2008 and projected to the US insured population. Incidence was also calculated from the same database by determining the proportion of total neck surgeries resulting in either transient (≤6 months) or chronic (>6 months) hypoparathyroidism. A physician primary market research study was conducted to assess disease severity and determine the percentage of new nonsurgical patients with hypoparathyroidism. Incidence data were entered into an epidemiologic model to derive an estimate of prevalence. The diagnosis-based prevalence approach estimated 58,793 insured patients with chronic hypoparathyroidism in the United States. The surgical-based incidence approach yielded 117,342 relevant surgeries resulting in 8901 cases over 12 months. Overall, 7.6% of surgeries resulted in hypoparathyroidism (75% transient, 25% chronic). The prevalence of chronic hypoparathyroidism among insured patients included in the surgical database was estimated to be 58,625. The physician survey found that 75% of cases treated over the past 12 months were reported due to surgery and, among all thyroidectomies and parathyroidectomies and neck dissections performed in a year, 26% resulted in transient hypoparathyroidism and 5% progressed to a chronic state. In conclusion, the two claims-based methods yielded similar estimates of the number of insured patients with chronic hypoparathyroidism in the United States (~58,700). The physician survey was consistent with those calculations and confirmed the burden imposed by hypoparathyroidism.
甲状旁腺功能减退症是一种罕见的内分泌疾病，其发病率和患病率尚未得到明确界定。本研究旨在：1）估计美国患有甲状旁腺功能减退症的参保成年患者人数；2）获得医生对疾病严重程度和慢性程度的评估。通过计算 2007 年 10 月至 2008 年 9 月期间在一个大型专有的健康计划理赔数据库中甲状旁腺功能减退症的诊断，对患病率进行了估计，并将其外推至美国参保人群。发病率也是通过确定导致暂时性（≤6 个月）或慢性（>6 个月）甲状旁腺功能减退症的总颈部手术的比例，从同一数据库中计算得出。进行了一项医生主要市场研究，以评估疾病严重程度，并确定新的非手术甲状旁腺功能减退症患者的百分比。将发病率数据输入到一个流行病学模型中，以得出患病率的估计值。基于诊断的患病率方法估计在美国有 58793 名患有慢性甲状旁腺功能减退症的参保患者。基于手术的发病率方法在 12 个月内得出了 117342 例相关手术，导致 8901 例病例。总的来说，7.6%的手术导致甲状旁腺功能减退症（75%为暂时性，25%为慢性）。在手术数据库中包含的参保患者中，慢性甲状旁腺功能减退症的患病率估计为 58625。医生调查发现，过去 12 个月内治疗的 75%的病例是由于手术引起的，在一年内进行的所有甲状腺切除术、甲状旁腺切除术和颈部解剖术中，26%导致暂时性甲状旁腺功能减退症，5%进展为慢性状态。总之，两种基于理赔的方法得出了类似的估计结果，即美国患有慢性甲状旁腺功能减退症的参保患者人数约为 58700 人。医生调查与这些计算结果一致，并证实了甲状旁腺功能减退症带来的负担。
