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Heleen I Jansen Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam, The Netherlands
Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, The Netherlands
Amsterdam UMC location University of Amsterdam, Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam, The Netherlands

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Marijn M Bult Amsterdam UMC location University of Amsterdam, Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam, The Netherlands

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Peter H Bisschop Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, The Netherlands
Amsterdam UMC location University of Amsterdam, Department of Endocrinology and Metabolism, Amsterdam, The Netherlands

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Anita Boelen Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, The Netherlands
Amsterdam UMC location University of Amsterdam, Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam, The Netherlands
Amsterdam Reproduction & Development Research Institute, Amsterdam, The Netherlands

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Annemieke C Heijboer Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam, The Netherlands
Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, The Netherlands
Amsterdam UMC location University of Amsterdam, Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam, The Netherlands
Amsterdam Reproduction & Development Research Institute, Amsterdam, The Netherlands

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Jacquelien J Hillebrand Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, The Netherlands
Amsterdam UMC location University of Amsterdam, Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam, The Netherlands

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, physicians in our hospital noticed a discrepancy between TSH and fT4 concentrations in the laboratory, more specifically high fT4 concentrations (above the upper limit of normal, ULN) without complete suppression of TSH (complete suppression meaning TSH ≤ 0

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Stephanie E Baldeweg Department of Endocrinology, University College Hospital, London, UK
National Hospital for Neurology and Neurosurgery, London, UK

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Mark Vanderpump Physicians’ Clinic, London, UK

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Will Drake Department of Endocrinology, St Bartholomew’s Hospital, London, UK

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Narendra Reddy Endocrinology/General Medicine, University Hospitals Coventry and Warwickshire NHS Trust, University of Warwick, Coventry, UK

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Andrew Markey The Lister Hospital, London, UK

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Gordon T Plant Department of Endocrinology, University College Hospital, London, UK
National Hospital for Neurology and Neurosurgery, London, UK

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Michael Powell National Hospital for Neurology and Neurosurgery, London, UK

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Saurabh Sinha Royal Hallamshire Hospital, Sheffield, UK

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John Wass Department of Endocrinology, Oxford Centre for Diabetes Endocrinology and Metabolism, The Churchill, Oxford University, Oxford, UK

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the Society for Endocrinology Clinical Committee The Society for Endocrinology, 22 Apex Court, Woodlands, Bradley Stoke, Bristol, UK

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Thabiso R P Mofokeng Department of Medicine, University of the Free State, Bloemfontein, South Africa

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Salem A Beshyah Department of Medicine, Dubai Medical College, Duabi, United Arab Emirates
Department of Endocrinology, Mediclinic Airport Road Hospital, Abu Dhabi, United Arab Emirates

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Fazleh Mahomed Department of Medicine, University of the Free State, Bloemfontein, South Africa

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Kwazi C Z Ndlovu Department of Medicine, University of the Free State, Bloemfontein, South Africa

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Ian L Ross Division of Endocrinology, Department of Medicine, University of Cape Town, Cape Town, South Africa

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sought to identify challenges in the diagnosis and management of PAI in SSA and MENA region. We attempted to evaluate this through the perceptions and practices of a large sample of physicians in these regions using an online questionnaire. We

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Dirk-Jan van Beek Department of Endocrine Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands

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Rachel S van Leeuwaarde Department of Endocrine Oncology, University Medical Center Utrecht, Utrecht, The Netherlands

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Carolina R C Pieterman Department of Endocrine Oncology, University Medical Center Utrecht, Utrecht, The Netherlands

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Menno R Vriens Department of Endocrine Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands

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Gerlof D Valk Department of Endocrine Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
Parelsnoer Institute, Utrecht, The Netherlands

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the DutchMEN Study Group
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Introduction Rare diseases that affect less than one in 2000 people, pose challenges in supporting patients and physicians with evidence-based guidelines of sufficient quality ( 1 ). Medical decision making becomes challenging when guidelines

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E K White Division of Endocrinology and Centre for Endocrine Tumors, Department of Medicine, Leiden University Medical Centre, Leiden, The Netherlands
Faculty of Medicine Division 2, Internal Medicine Endocrinology, Leiden University Medical Centre, Leiden, The Netherlands

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I V Wagner Department of Endocrinology & Metabolism, Amsterdam University Medical Centre, Amsterdam, The Netherlands

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C van Beuzekom Division of Endocrinology and Centre for Endocrine Tumors, Department of Medicine, Leiden University Medical Centre, Leiden, The Netherlands
Faculty of Medicine Division 2, Internal Medicine Endocrinology, Leiden University Medical Centre, Leiden, The Netherlands

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V Iotova Division of Paediatric Endocrinology and Diabetes, Department of Paediatrics and Adolescent Medicine, University of Lübeck, Lübeck, Germany

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S F Ahmed Office for Rare Conditions, University of Glasgow, Glasgow, UK
Department of Paediatrics, UMHAT ‘Sveta Marina’ Varna, Medical University of Varna, Varna, Bulgaria

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O Hiort Department of Endocrinology & Metabolism, Amsterdam University Medical Centre, Amsterdam, The Netherlands

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A M Pereira Faculty of Medicine Division 2, Internal Medicine Endocrinology, Leiden University Medical Centre, Leiden, The Netherlands

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and their local physicians ( 3 , 5 ). Therefore, in this paper, we critically evaluate the usefulness and effectiveness of the changes implemented to effect this change and critically analyze the system from the member’s perspective while considering

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Alicia Romano Department of Pediatrics, New York Medical College, Valhalla, New York, USA

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Juan Pablo Kaski Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital & UCL Institute of Cardiovascular Science, London, UK

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Jovanna Dahlgren Department of Paediatrics, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden

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Nicky Kelepouris US Medical Affairs, Novo Nordisk Inc., Plainsboro, New Jersey, USA

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Alberto Pietropoli Global Medical Affairs, Novo Nordisk Health Care AG, Zurich, Switzerland

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Tilman R Rohrer Department of Pediatric Endocrinology, University Children’s Hospital, Saarland University Medical Center, Homburg, Germany

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Michel Polak Paediatric Endocrinology, Diabetology and Gynaecology Department, Hôpital Universitaire Necker Enfants-Malades, AP-HP, Université de Paris, Imagine Institute, Paris, France

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Helsinki, Guideline for Good Pharmacoepidemiology Practices and regulatory requirements. Safety assessments Safety events were reported by treating physicians in a case report form and are defined as a collection of serious adverse events (SAEs

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Ekaterina Koledova Biopharma Global Medical Affairs, General Medicine and Endocrinology, Merck KGaA, Darmstadt, Germany

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George Stoyanov Biopharma Global Medical Affairs, General Medicine and Endocrinology, Merck KGaA, Darmstadt, Germany

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Leroy Ovbude Business & Decision Life Sciences, Brussels, Woluwe-Saint-Lambert, Belgium

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Peter S W Davies Children’s Nutrition Research Centre, Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia

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tend to forget doses but are unaware of the number actually missed and has been described as a novel example of triage between patient, carer and healthcare professional ( 11 ). In particular, it enables physicians to closely monitor adherence rates and

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Majunath R Goroshi Department of Endocrinology, Seth G S Medical College and KEM Hospital, Mumbai, Maharashtra, India

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Swati S Jadhav Department of Endocrinology, Seth G S Medical College and KEM Hospital, Mumbai, Maharashtra, India

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Anurag R Lila Department of Endocrinology, Seth G S Medical College and KEM Hospital, Mumbai, Maharashtra, India

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Rajeev Kasaliwal Department of Endocrinology, Seth G S Medical College and KEM Hospital, Mumbai, Maharashtra, India

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Shruti Khare Department of Endocrinology, Seth G S Medical College and KEM Hospital, Mumbai, Maharashtra, India

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Chaitanya G Yerawar Department of Endocrinology, Seth G S Medical College and KEM Hospital, Mumbai, Maharashtra, India

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Priya Hira Department of Radiology, Seth G S Medical College and KEM Hospital, Mumbai, Maharashtra, India

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Uday Phadke Ruby Hall Clinic, Pune, Maharashtra, India

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Hina Shah Department of Nuclear Medicine and Positron Emission Tomography/Computed Tomography, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India

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Vikram R Lele Department of Nuclear Medicine and Positron Emission Tomography/Computed Tomography, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India

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Gaurav Malhotra Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Centre, Annexe, Parel, Mumbai, Maharashtra, India

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Tushar Bandgar Department of Endocrinology, Seth G S Medical College and KEM Hospital, Mumbai, Maharashtra, India

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Nalini S Shah Department of Endocrinology, Seth G S Medical College and KEM Hospital, Mumbai, Maharashtra, India

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features and contrast enhancement (difference between postcontrast Hounsfield units (HU) at 60s and baseline HU). Similarly, 68 Ga-DOTANOC PET/CT images were retrospectively reviewed by a nuclear medicine physician who was blinded to patient outcomes

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Eugenie S Lim Barts Health NHS Trust, Barts and the London School of Medicine and Dentistry, London, UK

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Shanty G Shah Barts and the London School of Medicine and Dentistry, QMUL, London, UK

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Mona Waterhouse Barts Health NHS Trust, Barts and the London School of Medicine and Dentistry, London, UK

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Scott Akker Barts Health NHS Trust, Barts and the London School of Medicine and Dentistry, London, UK
Barts and the London School of Medicine and Dentistry, QMUL, London, UK

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William Drake Barts Health NHS Trust, Barts and the London School of Medicine and Dentistry, London, UK
Barts and the London School of Medicine and Dentistry, QMUL, London, UK

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Nick Plowman Barts Health NHS Trust, Barts and the London School of Medicine and Dentistry, London, UK
Barts and the London School of Medicine and Dentistry, QMUL, London, UK

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Daniel M Berney Barts Health NHS Trust, Barts and the London School of Medicine and Dentistry, London, UK
Barts and the London School of Medicine and Dentistry, QMUL, London, UK

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Polly Richards Barts Health NHS Trust, Barts and the London School of Medicine and Dentistry, London, UK

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Ashok Adams Barts Health NHS Trust, Barts and the London School of Medicine and Dentistry, London, UK

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Ewa Nowosinska Barts Health NHS Trust, Barts and the London School of Medicine and Dentistry, London, UK

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Carmel Brennan Barts Health NHS Trust, Barts and the London School of Medicine and Dentistry, London, UK

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Maralyn Druce Barts Health NHS Trust, Barts and the London School of Medicine and Dentistry, London, UK
Barts and the London School of Medicine and Dentistry, QMUL, London, UK

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medicine physician unaware of the results of the pathology report at the time of reporting. Statistical analysis All statistical analyses were performed using SPSS, version 23 and Microsoft Office Excel 2016. Demographic data were analysed using

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Gudmundur Johannsson Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

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Martin Bidlingmaier Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, Germany

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Beverly M K Biller Neuroendocrine Unit, Massachusetts General Hospital, Boston, Massachusetts, USA

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Margaret Boguszewski Federal University of Parana, Curitiba, Brazil

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Felipe F Casanueva Department of Medicine, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain

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Philippe Chanson Assistance Publique-Hôpitaux de Paris, and Inserm, Paris, France

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Peter E Clayton Developmental Biology & Medicine, Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK

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Catherine S Choong Department of Endocrinology, Princess Margaret Hospital & School of Medicine, University of Western Australia, Western Australia, Australia

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David Clemmons Department of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA

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Mehul Dattani Great Ormond Street Institute of Child Health, London, UK

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Jan Frystyk Department of Endocrinology, Odense University Hospital, Odense, Denmark

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Ken Ho Princess Alexandra Hospital and University of Queensland, Brisbane, Australia

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Andrew R Hoffman Department of Medicine, Stanford University and VA Palo Health Care System, Palo Alto, California, USA

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Reiko Horikawa National Center for Child Health and Development, Tokyo, Japan

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Anders Juul Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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John J Kopchick Edison Biotechnology Institute and Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, USA

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Xiaoping Luo Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China

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Sebastian Neggers Section of Endocrinology, Department of Medicine, Pituitary Centre Rotterdam, Erasmus University Medical Centre, Rotterdam, the Netherlands

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Irene Netchine Service d’Explorations Fonctionnelles Endocriniennes, AP-HP, Hôpital Trousseau, Sorbonne Université, INSERM UMRs 938, Paris, France

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Daniel S Olsson Department of Endocrinology, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden

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Sally Radovick Rutgers University-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA

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Ron Rosenfeld Department of Pediatrics, Oregon Health Science University, Portland, Oregon, USA

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Richard J Ross University of Sheffield, Sheffield, UK

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Katharina Schilbach Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, Germany

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Paulo Solberg Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil

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Christian Strasburger Charité-Universitätsmedizin, Berlin, Germany

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Peter Trainer The Christie NHS Foundation Trust, University of Manchester, Manchester, UK

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Kevin C J Yuen Barrow Pituitary Center, Barrow Neurological Institute, Department of Neuroendocrinology, University of Arizona College of Medicine, Phoenix, Arizona, USA

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Kerstin Wickstrom Medical Products Agency, Uppsala, Sweden

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Jens O L Jorgensen Aarhus University Hospital, Aarhus, Denmark

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on behalf of the Growth Hormone Research Society
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international leaders from twelve countries across five continents participated. These included paediatric and adult endocrinologists, basic scientists, a European medicines regulator and physicians from the pharmaceutical industry. A review of the current

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