Department of Laboratory Medicine, Endocrine Laboratory, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Department of Laboratory Medicine, Endocrine Laboratory, Amsterdam UMC Location University of Amsterdam, Academic Medical Center, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands.
J Endocrinol Invest. 2024 Oct;47(10):2499-2505. doi: 10.1007/s40618-024-02358-7. Epub 2024 Mar 25.
Graves' disease (GD) is an auto-immune cause of hyperthyroidism. First-line treatment often consists of a 12-18 month course of antithyroid drugs (ATD). After discontinuation of ATD, GD relapses in approximately 50% of patients. The 'Graves recurrent event after therapy+ ' (GREAT+) score may predict individual relapse chances after ATD discontinuation more accurately based on clinical and laboratory parameters at diagnosis. We investigated the need for the GREAT+ score through an online questionnaire among GD patients and physicians treating GD.
An anonymous online questionnaire was distributed to patients and physicians between June 2022 and August 2023.
The questionnaire was completed by 532 patients and 44 physicians. Results showed that 94% of patients were interested in knowing their GREAT+ score at the start of treatment. 55% would consider definite treatment (radioiodine/thyroidectomy) as first-line treatment in case of a high relapse chance. 98% of the physicians indicated the GREAT + score would support patient counseling. 84% may change their advice for first-line treatment if a patient has a high relapse chance based on the score.
Patients and physicians considered the GREAT+ score as a valuable addition to the current available information which could change treatment decisions. Therefore, external validation of the GREAT+ score is justified to implement this score in clinical practice.
格雷夫斯病（GD）是一种自身免疫性甲状腺功能亢进症。一线治疗通常包括 12-18 个月的抗甲状腺药物（ATD）治疗。停止 ATD 治疗后，约有 50%的患者会复发。基于诊断时的临床和实验室参数，“治疗后格雷夫斯病复发事件+（GREAT+）评分”可能更准确地预测 ATD 停药后个体的复发机会。我们通过一项针对 GD 患者和治疗 GD 的医生的在线问卷调查，研究了 GREAT+评分的必要性。
在 2022 年 6 月至 2023 年 8 月期间，我们向患者和医生分发了匿名在线问卷。
共有 532 名患者和 44 名医生完成了问卷。结果表明，94%的患者在治疗开始时就有兴趣了解自己的 GREAT+评分。如果复发几率高，55%的患者会考虑将放射性碘/甲状腺切除术作为一线治疗。98%的医生表示 GREAT+评分将支持对患者进行咨询。如果根据评分患者的复发几率较高，84%的医生可能会改变对一线治疗的建议。
患者和医生认为 GREAT+评分是当前可用信息的有益补充，可能会改变治疗决策。因此，有必要对 GREAT+评分进行外部验证，以便在临床实践中实施该评分。
