Diagnosis of Graves' orbitopathy (DiaGO): results of a pilot study to assess the utility of an office tool for practicing endocrinologists

2.50
Hdl Handle:
http://hdl.handle.net/11287/593932
Title:
Diagnosis of Graves' orbitopathy (DiaGO): results of a pilot study to assess the utility of an office tool for practicing endocrinologists
Authors:
Mitchell, A. L.; Goss, Lynne; Mathiopoulou, L.; Morris, M.; Vaidya, Bijay; Dickinson, A. J.; Quinn, Anthony; Dayan, C.; McLaren, J.; Hickey, J. L.; Lazarus, J. H.; Rose, G. E.; Foley, P.; MacEwen, C. J.; Perros, P.
Abstract:
CONTEXT: In active Graves' orbitopathy (GO), treatment can improve the final cosmetic and visual outcome. Diagnostic delay results in significant morbidity and increases patient dissatisfaction. However, it can be challenging for endocrinologists to recognize GO and decide who should be referred for ophthalmic care. OBJECTIVE: DiaGO, a clinical assessment tool, was developed for use in patients with Graves' disease (GD). The tool is designed to alert clinicians to the possibility of GO and prompt early ophthalmic assessment. DESIGN AND SETTING: A 20-point assessment tool was devised and tested on 104 GD patients: 27 "positive controls" with GO and 77 people with GD attending endocrine clinics over 17 months. Those scoring positively in endocrine clinics were referred for ophthalmic assessment. Both the appropriateness of the referral and subsequent treatment were assessed. RESULTS: Eighty-eight of the 104 patients (85%) were female (mean age, 48.5 y; range, 18-76 y). All 27 "controls" scored positively. Of the 77 people evaluated with GD, 27 (35%) scored above the threshold for referral and GO was confirmed in 24/26 (92%) who attended for specialist ophthalmic assessment. Twelve of these 24 (50%) were offered specific treatment following ophthalmology review. CONCLUSIONS: The timely diagnosis of GO is important because early intervention in active disease can improve prognosis. DiaGO alerts clinicians to the possibility of GO and prompts referral to specialist ophthalmic care. It is quick and easy to use and does not require specialist ophthalmic skills. Overall, half of those referred after use of DiaGO were offered specific treatment, suggesting its use might significantly improve the management of patients.
Citation:
J Clin Endocrinol Metab. 2015 Mar;100(3):E458-62.
Publisher:
Endocrine Society
Journal:
The Journal of clinical endocrinology and metabolism
Issue Date:
1-Mar-2015
URI:
http://hdl.handle.net/11287/593932
DOI:
10.1210/jc.2014-3146
PubMed ID:
25485725
Additional Links:
http://press.endocrine.org/doi/10.1210/jc.2014-3146?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed
Type:
Journal Article; Evaluation Studies; Research Support, Non-U.S. Gov't
Language:
eng
ISSN:
1945-7197
Appears in Collections:
2015 RD&E publications; Diabetes/Endocrine Services

Full metadata record

DC FieldValue Language
dc.contributor.authorMitchell, A. L.en
dc.contributor.authorGoss, Lynneen
dc.contributor.authorMathiopoulou, L.en
dc.contributor.authorMorris, M.en
dc.contributor.authorVaidya, Bijayen
dc.contributor.authorDickinson, A. J.en
dc.contributor.authorQuinn, Anthonyen
dc.contributor.authorDayan, C.en
dc.contributor.authorMcLaren, J.en
dc.contributor.authorHickey, J. L.en
dc.contributor.authorLazarus, J. H.en
dc.contributor.authorRose, G. E.en
dc.contributor.authorFoley, P.en
dc.contributor.authorMacEwen, C. J.en
dc.contributor.authorPerros, P.en
dc.date.accessioned2016-01-19T12:37:31Zen
dc.date.available2016-01-19T12:37:31Zen
dc.date.issued2015-03-01en
dc.identifier.citationJ Clin Endocrinol Metab. 2015 Mar;100(3):E458-62.en
dc.identifier.issn1945-7197en
dc.identifier.pmid25485725en
dc.identifier.doi10.1210/jc.2014-3146en
dc.identifier.urihttp://hdl.handle.net/11287/593932en
dc.description.abstractCONTEXT: In active Graves' orbitopathy (GO), treatment can improve the final cosmetic and visual outcome. Diagnostic delay results in significant morbidity and increases patient dissatisfaction. However, it can be challenging for endocrinologists to recognize GO and decide who should be referred for ophthalmic care. OBJECTIVE: DiaGO, a clinical assessment tool, was developed for use in patients with Graves' disease (GD). The tool is designed to alert clinicians to the possibility of GO and prompt early ophthalmic assessment. DESIGN AND SETTING: A 20-point assessment tool was devised and tested on 104 GD patients: 27 "positive controls" with GO and 77 people with GD attending endocrine clinics over 17 months. Those scoring positively in endocrine clinics were referred for ophthalmic assessment. Both the appropriateness of the referral and subsequent treatment were assessed. RESULTS: Eighty-eight of the 104 patients (85%) were female (mean age, 48.5 y; range, 18-76 y). All 27 "controls" scored positively. Of the 77 people evaluated with GD, 27 (35%) scored above the threshold for referral and GO was confirmed in 24/26 (92%) who attended for specialist ophthalmic assessment. Twelve of these 24 (50%) were offered specific treatment following ophthalmology review. CONCLUSIONS: The timely diagnosis of GO is important because early intervention in active disease can improve prognosis. DiaGO alerts clinicians to the possibility of GO and prompts referral to specialist ophthalmic care. It is quick and easy to use and does not require specialist ophthalmic skills. Overall, half of those referred after use of DiaGO were offered specific treatment, suggesting its use might significantly improve the management of patients.en
dc.language.isoengen
dc.publisherEndocrine Societyen
dc.relation.urlhttp://press.endocrine.org/doi/10.1210/jc.2014-3146?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmeden
dc.titleDiagnosis of Graves' orbitopathy (DiaGO): results of a pilot study to assess the utility of an office tool for practicing endocrinologistsen
dc.typeJournal Articleen
dc.typeEvaluation Studiesen
dc.typeResearch Support, Non-U.S. Gov'ten
dc.identifier.journalThe Journal of clinical endocrinology and metabolismen

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