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Line Tang Møllehave Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark

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Marie Holm Eliasen Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark

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Ieva Strēle The Institute of Occupational Safety and Environmental Health, Riga Stradiņš University, Riga, Latvia

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Allan Linneberg Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Rodrigo Moreno-Reyes Nuclear Medicine Department, Erasme Hospital, Brussels, Belgium
Université Libre de Bruxelles, Bruxelles, Belgium

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Ludmila B Ivanova Faculty of Medicine, Sofia University St. Kl. Ohridski, Sofia, Bulgaria

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Zvonko Kusić Croatian Academy of Sciences and Arts, Zagreb, Croatia
School of Medicine, Zagreb, Croatia

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Iris Erlund Department of Government Services, Finnish Institute for Health and Welfare, Helsinki, Finland

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Till Ittermann Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany

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Endre V Nagy Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary

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Ingibjorg Gunnarsdottir Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
Department of Clinical Nutrition, Landspitali-National University Hospital, Reykjavik, Iceland

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Jonathan Eli Arbelle Division of Medicine, Maccabi Healthcare Services, Tel Aviv, Israel
Goldman School of Medicine, Ben Gurion University of the Negev, Beer Sheva, Israel

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Aaron Milton Troen The Institute of Biochemistry Food Science and Nutrition, The Hebrew University of Jerusalem, Rehovot, Israel

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Valdis Pīrāgs Internal Medicine, University of Latvia, Riga, Latvia

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Lisbeth Dahl Seafood, Nutrition and Environmental State, Institute of Marine Research (IMR), Bergen, Norway

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Alicja Hubalewska-Dydejczyk Chair and Department of Endocrinology, Jagiellonian University, Medical College, Cracow, Poland

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Malgorzata Trofimiuk-Müldner Chair and Department of Endocrinology, Jagiellonian University, Medical College, Cracow, Poland

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João Jacome de Castro Endocrine Department, Armed Forces Hospital, Lisbon, Portugal

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Mafalda Marcelino Endocrine Department, Armed Forces Hospital, Lisbon, Portugal

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Simona Gaberšček Department of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

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Katja Zaltel Department of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

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Manuel Puig-Domingo Department of Endocrinology and Nutrition, Germans Trias Research Institute and Hospital, Badalona, Spain
Universitat Autònoma de Barcelona, Barcelona, Spain

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Lluis Vila Endocrinology and Nutrition Service, Hospital Moisés Broggi, Sant Juan Despi, Barcelona, Spain

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Sofia Manousou Sahlgrenska Academy, Institute of Medicine, Gothenburg, Sweden
Frölunda Specialist Hospital, Västra Frölunda, Sweden

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Helena Filipsson Nyström Department of Endocrinology, Specialist Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Wallenberg Centre of Molecular and Translational Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden

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Michael Bruce Zimmermann Health Sciences and Technology, ETH Zurich, Zurich, Switzerland

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Karen R Mullan Regional Centre for Endocrinology and Diabetes, Belfast Health and Social Care Trust, Belfast, UK

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Jayne Valerie Woodside Centre for Public Health, Queen’s University Belfast, Belfast, UK

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Henry Völzke Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany

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Betina Heinsbæk Thuesen Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark

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Objective

Registers of diagnoses and treatments exist in different forms in the European countries and are potential sources to answer important research questions. Prevalence and incidence of thyroid diseases are highly dependent on iodine intake and, thus, iodine deficiency disease prevention programs. We aimed to collect European register data on thyroid outcomes to compare the rates between countries/regions with different iodine status and prevention programs.

Design

Register-based cross-sectional study.

Methods

National register data on thyroid diagnoses and treatments were requested from 23 European countries/regions. The provided data were critically assessed for suitability for comparison between countries/regions. Sex- and age-standardized rates were calculated.

Results

Register data on ≥1 thyroid diagnoses or treatments were available from 22 countries/regions. After critical assessment, data on medication, surgery, and cancer were found suitable for comparison between 9, 10, and 13 countries/regions, respectively. Higher rates of antithyroid medication and thyroid surgery for benign disease and lower rates of thyroid hormone therapy were found for countries with iodine insufficiency before approx. 2001, and no relationship was observed with recent iodine intake or prevention programs.

Conclusions

The collation of register data on thyroid outcomes from European countries is impeded by a high degree of heterogeneity in the availability and quality of data between countries. Nevertheless, a relationship between historic iodine intake and rates of treatments for hyper- and hypothyroid disorders is indicated. This study illustrates both the challenges and the potential for the application of register data of thyroid outcomes across Europe.

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Hanneke J C M Wouters Department of Endocrinology, University of Groningen, University Medical Center Groningen, The Netherlands
Department of Hematology, University of Groningen, University Medical Center Groningen, The Netherlands

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Bruce H R Wolffenbuttel Department of Endocrinology, University of Groningen, University Medical Center Groningen, The Netherlands

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Anneke C Muller Kobold Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, The Netherlands

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Thera P Links Department of Endocrinology, University of Groningen, University Medical Center Groningen, The Netherlands

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Gerwin Huls Department of Hematology, University of Groningen, University Medical Center Groningen, The Netherlands

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Melanie M van der Klauw Department of Endocrinology, University of Groningen, University Medical Center Groningen, The Netherlands

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disorders (defined as present when they were affirmatively answered and as being absent when answered negatively or missing), medication list, physical examination, biochemical measurements and MINI were collectively used to determine the presence of disease

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Carmen Sydlik Division of Pediatric Endocrinology, Center for Pediatric and Adolescent Medicine Inn-Salzach-Rott, Altoetting, Germany

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Ilja Dubinski Division of Pediatric Endocrinology, Dr. von Hauner Children's Hospital, University Hospital Munich, LMU Munich, Munich, Germany

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Susanne Bechtold Division of Pediatric Endocrinology, Dr. von Hauner Children's Hospital, University Hospital Munich, LMU Munich, Munich, Germany

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Heinrich Schmidt Division of Pediatric Endocrinology, Dr. von Hauner Children's Hospital, University Hospital Munich, LMU Munich, Munich, Germany

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decreased values for fT3 in peripheral tissue. To answer this question, we compared the levels of fT3, fT4, TSH and the fT3/fT4 ratio of children with cH under LT4 treatment and healthy children. Here, we found significantly lower fT3/ fT4 ratios in

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Sara Ahmadi Thyroid Section Brigham & Women’s Hospital & Harvard Medical School, Boston, Massachusetts, USA

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Alexandra Coleman Thyroid Section Brigham & Women’s Hospital & Harvard Medical School, Boston, Massachusetts, USA

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Nathalie Silva de Morais Thyroid Section Brigham & Women’s Hospital & Harvard Medical School, Boston, Massachusetts, USA
Endocrinology Service, Instituto Nacional de Câncer, Rio de Janeiro, Brazil

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Iñigo Landa Thyroid Section Brigham & Women’s Hospital & Harvard Medical School, Boston, Massachusetts, USA

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Theodora Pappa Thyroid Section Brigham & Women’s Hospital & Harvard Medical School, Boston, Massachusetts, USA

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Alex Kang Thyroid Section Brigham & Women’s Hospital & Harvard Medical School, Boston, Massachusetts, USA

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Matthew I Kim Thyroid Section Brigham & Women’s Hospital & Harvard Medical School, Boston, Massachusetts, USA

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Ellen Marqusee Thyroid Section Brigham & Women’s Hospital & Harvard Medical School, Boston, Massachusetts, USA

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Erik K Alexander Thyroid Section Brigham & Women’s Hospital & Harvard Medical School, Boston, Massachusetts, USA

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non-thyroidal findings on SPECT-CT. This was defined as any finding reported by the radiologist in his/her impression that was not thyroid or thyroid cancer-related. From this, we sought answers to three principal study questions: Did SPECT-CT improve

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S C Clement Department of Pediatrics, Emma Children’s Hospital, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
Department of Pediatric Endocrinology, Wilhelmina Children’s Hospital/ University Medical Center Utrecht, Utrecht, The Netherlands

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W E Visser Academic Center For Thyroid Disease, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands

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C A Lebbink Department of Pediatric Endocrinology, Wilhelmina Children’s Hospital/ University Medical Center Utrecht, Utrecht, The Netherlands
Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands

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D Albano Department of Nuclear Medicine, University of Brescia and Spedali Civili of Brescia, Brescia, Italy

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H L Claahsen-van der Grinten Department of Pediatrics, Radboud University Medical Center, Amalia Children's Hospital, Nijmegen, The Netherlands

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A Czarniecka The Oncologic and Reconstructive Surgery Clinic, M. Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland

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R P Dias Department of Endocrinology and Diabetes, Birmingham Children’s Hospital, Birmingham Women’s, and Children’s NHS Foundation Trust, Birmingham, UK
Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK

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M P Dierselhuis Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands

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I Dzivite-Krisane Department of Pediatric Endocrinology, Children's Clinical University Hospital, Riga, Latvia

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R Elisei Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy

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A Garcia-Burillo Nuclear Medicine Department, Vall d'Hebron University Hospital, Barcelona, Spain

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L Izatt Department of Clinical Genetics, Guy's and St Thomas’ NHS Foundation Trust, London, UK

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C Kanaka-Gantenbein Division of Endocrinology, Diabetes, and Metabolism, First Department of Pediatrics National and Kapodistrian University of Athens Medical School, Aghia Sophia Children's Hospital, Athens, Greece

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H Krude Institute of Experimental Pediatric Endocrinology, Charité - Universitätsmedizin, Berlin, Germany

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L Lamartina Department of Endocrine Oncology, Gustave Roussy, Villejuif, France

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K Lorenz Department of Visceral, Vascular and Endocrine Surgery, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany

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M Luster Department of Nuclear Medicine, University Hospital Marburg, Marburg, Germany

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R Navardauskaitė Department of Endocrinology, Lithuanian University of Health Sciences, Kaunas, Lithuania

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M Negre Busó Nuclear Medicine Service - Institut de diagnòstic per la Imatge, Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain

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K Newbold Thyroid Therapy Unit, The Royal Marsden NHS Foundation Trust Hospital, London, UK

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R P Peeters Academic Center For Thyroid Disease, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands

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G Pellegriti Endocrinology, Endocrinology Division, Garibaldi-Nesima Medical Center, Catania, Italy

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A Piccardo Department of Nuclear Medicine, EO Ospedali Galliera, Genoa, Italy

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A L Priego Department of Medicine, Division of Endocrinology, Leiden, University medical Center, Leiden, The Netherlands

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A Redlich Pediatric Oncology Department, Otto von Guericke University Children's Hospital, Magdeburg, Germany

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L de Sanctis Regina Margherita Children Hospital - Department of Public Health and Pediatric Sciences, University of Torino, Torino, Italy

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M Sobrinho-Simões University Hospital of São João, Medical Faculty and Institute of Molecular Pathology and Immunology, University of Porto, Porto, Portugal

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A S P van Trotsenburg Department of Pediatric Endocrinology, Emma Children’s Hospital, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands

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F A Verburg Department of Radiology & Nuclear Medicine, Erasmus MC Rotterdam, Rotterdam, The Netherlands

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M Vriens Department of Endocrine Surgery, University Medical Center Utrecht, Utrecht, The Netherlands

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T P Links Department of Endocrinology, University Medical Center Groningen, Groningen, The Netherlands

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S F Ahmed Endocrinology, Endocrinology Division, Garibaldi-Nesima Medical Center, Catania, Italy
Developmental Endocrinology Research Group, Royal Hospital for Children, University of Glasgow, Glasgow, UK
Office for Rare Conditions, University of Glasgow, Glasgow, UK

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H M van Santen Department of Pediatric Endocrinology, Wilhelmina Children’s Hospital/ University Medical Center Utrecht, Utrecht, The Netherlands
Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands

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the position to obtain clinical data in sufficient numbers to conduct conclusive studies. The European ped-DTC registry is a cooperative effort that will provide large enough clinical datasets to answer questions conclusively by conducting well

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Xiaoyi Qi Departments of Cardiology, Peking University Shenzhen Hospital, Shenzhen, China
Medical College, Shantou University, Shantou, China

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Liangxian Qiu Departments of Cardiology, Peking University Shenzhen Hospital, Shenzhen, China

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Shijia Wang Departments of Cardiology, Peking University Shenzhen Hospital, Shenzhen, China

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Xiongbiao Chen Departments of Cardiology, Peking University Shenzhen Hospital, Shenzhen, China

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Qianwen Huang Departments of Cardiology, Peking University Shenzhen Hospital, Shenzhen, China

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Yixuan Zhao Departments of Cardiology, Peking University Shenzhen Hospital, Shenzhen, China
Medical College, Shantou University, Shantou, China

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Kunfu Ouyang Department of Cardiovascular Surgery, Peking University Shenzhen Hospital, School of Chemical Biology and Biotechnology, State Key Laboratory of Chemical Oncogenomics, Peking University Shenzhen Graduate School, Shenzhen, China

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Yanjun Chen Departments of Cardiology, Peking University Shenzhen Hospital, Shenzhen, China

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& Rocco M . Nonthyroidal illness syndrome: to treat or not to treat? Have We Answered the Question? A Review of Metanalyses . Frontiers in Endocrinology 2022 13 850328. ( https://doi.org/10.3389/fendo.2022.850328 ) 5 Wang B Liu S Li L Yao Q

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Lian Duan Department of Nuclear Medicine, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi, China

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Han-Yu Zhang Changzhi Medical College, Changzhi, Shanxi, China

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Min Lv Department of Nuclear Medicine, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi, China

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Han Zhang Changzhi Medical College, Changzhi, Shanxi, China

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Yao Chen Changzhi Medical College, Changzhi, Shanxi, China

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Ting Wang Department of Nuclear Medicine, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi, China

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Yan Li Department of Nuclear Medicine, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi, China

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Yan Wu Department of Clinical Laboratory, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China

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Junfeng Li Department of Radiology, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi, China

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Kefeng Li School of Medicine, University of California, San Diego, California, USA

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EW . Artificial intelligence in medical practice: the question to the answer? American Journal of Medicine 2018 131 129 – 133 . ( https://doi.org/10.1016/j.amjmed.2017.10.035 ) 15 Dimopoulos AC Nikolaidou M Caballero FF Engchuan W Sanchez

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Danzhou Fang Department of Nuclear Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China

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Shiying Li Department of Infectious Diseases, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China

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Changgu Zhou Department of Infectious Diseases, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China

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Yirui Wang Department of Nuclear Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China

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Gengbiao Yuan Department of Nuclear Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China

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HuiHui Zhang Department of Nuclear Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China

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Maohua Rao Department of Nuclear Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China

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. ( https://doi.org/10.2967/jnumed.120.243170 ) 8 Bartalena L Chiovato L & Vitti P . Management of hyperthyroidism due to Graves’ disease: frequently asked questions and answers (if any) . Journal of Endocrinological Investigation 2016 39 1105

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Irfan Vardarli 5th Medical Department, Division of Endocrinology and Diabetes, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany

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Susanne Tan Department of Endocrinology, Diabetes and Metabolism, Clinical Chemistry – Division of Laboratory Research Endocrine Tumor Center at WTZ/Comprehensive Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

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Rainer Görges Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

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Bernhard K Krämer 5th Medical Department, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany

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Ken Herrmann Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

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Christoph Brochhausen Institue of Pathology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany

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: 0.26–0.35)), which we could confirm; they stated that this makes it an excellent rule out malignancy. To avoid unnecessary surgery and answer the question, if the patient could be followed up, a rule-out test aimed to predict benign nodules should

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Huixing Liu Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China

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Daoquan Peng Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China

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are positively related to TC, LDL-C in patients with morbid obesity and type 2 diabetes ( 131 ), but whether it is related to hypothyroidism or not, the answer remains uncertain. ANGPTL6, also known as AGF, does not bind to angiogenin receptors. In

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