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Published in: Orphanet Journal of Rare Diseases 1/2024

Open Access 01-12-2024 | Research

Implementation of thyroid eye disease registry in Iran: rationale and research protocol

Authors: Shadi Akbarian, Abbas Sheikhtaheri, Farid Khorrami, Hossein Ghahvechian, Nasser Karimi, Mohsen Bahmani Kashkouli

Published in: Orphanet Journal of Rare Diseases | Issue 1/2024

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Abstract

Background

To describe the implementation of a registry system for patients with thyroid eye disease (TED) in Iran to obtain more information about its nature, prevalence, and annual incidence, as well as extend insight into the etiology, pathogenesis, and eventually make an accurate prognosis of different medical or surgical treatment methods.

Methods

After receiving approval from the Disease Registry Committee of Iran University of Medical Sciences (IUMS) in 2019 and the Ministry of Health and Medical Education (MOHME) in 2020, the protocol was introduced in three consecutive phases at regional, provincial and national levels. The establishment of a registry committee in Rassoul Akram Hospital, one of the medical centers affiliated to IUMS, was the first step to organizing the registry project's main core. The steering committee included six subgroups of required subject fields. The members are experts in developing a guideline, providing a new dataset, drawing an outline for the next steps, and structuring user-friendly software through several panel discussion meetings. The data is collected from clinical and para-clinical/imaging findings, laboratory evaluations, and their selected treatment strategy, retrospectively and prospectively.

Results

The purpose is to broaden our knowledge about the profile of TED; accordingly, data related to patients’ demographics, thyroid gland disease (status, duration, treatments, and function tests), general medical and ocular history, along with visual/ocular exams resulting TED status are collected and recorded in a 2- language software. The web-based software system is accessible at https://​orc.​iums.​ac.​ir. To maintain data security, prioritized user access was defined for different members. Furthermore, diverse methods, such as employing trained staff and utilizing software validation rules, were implemented to control data quality in every step of data collection, entry, and registration. Medical records of retrospective subjects were also evaluated and entered after accuracy verification.

Conclusion

Iran's TED registry provides practitioners with comprehensive data on natural history and phenotype variations in clinical features and outcomes. It facilitates patient recruitment and, consequently, earlier diagnosis on a large scale which helps improve treatment and quality of life for patients.
Literature
2.
go back to reference Kendall-Taylor P, Perros P. Clinical presentation of thyroid associated orbitopathy. Thyroid. 1998;8:427–8.CrossRefPubMed Kendall-Taylor P, Perros P. Clinical presentation of thyroid associated orbitopathy. Thyroid. 1998;8:427–8.CrossRefPubMed
3.
go back to reference Rootman J. Thyroid orbitopathy. In: Rootman J, editor. Diseases of the Orbit. A Multidisciplinary Approach. United Kingdom: Lippincott Williams Wilkins; 2003. p. 169–212. Rootman J. Thyroid orbitopathy. In: Rootman J, editor. Diseases of the Orbit. A Multidisciplinary Approach. United Kingdom: Lippincott Williams Wilkins; 2003. p. 169–212.
5.
go back to reference Wiersinga WM, Bartalena L. Epidemiology and prevention of Graves’ ophthalmopathy. Thyroid. 2002;12(10):855–60.CrossRefPubMed Wiersinga WM, Bartalena L. Epidemiology and prevention of Graves’ ophthalmopathy. Thyroid. 2002;12(10):855–60.CrossRefPubMed
6.
go back to reference Turck N, Eperon S, De Gracia LAM, Obéric A, Hamédani M. Thyroid-associated orbitopathy and biomarkers: where we are and what we can hope for the future. Dis Markers. 2018;2018:7010196.CrossRefPubMedPubMedCentral Turck N, Eperon S, De Gracia LAM, Obéric A, Hamédani M. Thyroid-associated orbitopathy and biomarkers: where we are and what we can hope for the future. Dis Markers. 2018;2018:7010196.CrossRefPubMedPubMedCentral
7.
go back to reference Muñoz-Ortiz J, Sierra-Cote MC, Zapata-Bravo E, Valenzuela-Vallejo L, Marin-Noriega MA, Uribe-Reina P, et al. Prevalence of hyperthyroidism, hypothyroidism, and euthyroidism in thyroid eye disease: a systematic review of the literature. Syst Rev. 2020;9(1):201.CrossRefPubMedPubMedCentral Muñoz-Ortiz J, Sierra-Cote MC, Zapata-Bravo E, Valenzuela-Vallejo L, Marin-Noriega MA, Uribe-Reina P, et al. Prevalence of hyperthyroidism, hypothyroidism, and euthyroidism in thyroid eye disease: a systematic review of the literature. Syst Rev. 2020;9(1):201.CrossRefPubMedPubMedCentral
8.
go back to reference Eckstein AK, Lösch C, Glowacka D, Schott M, Mann K, Esser J, et al. Euthyroid and primarily hypothyroid patients develop milder and significantly more asymmetrical Graves ophthalmopathy. Br J Ophthalmol. 2009;93:1052–6.CrossRefPubMed Eckstein AK, Lösch C, Glowacka D, Schott M, Mann K, Esser J, et al. Euthyroid and primarily hypothyroid patients develop milder and significantly more asymmetrical Graves ophthalmopathy. Br J Ophthalmol. 2009;93:1052–6.CrossRefPubMed
9.
go back to reference Ponto KA, Schuppan D, Zwiener I, Binder H, Mirshahi A, Diana T, et al. Thyroid-associated orbitopathy is linked to gastrointestinal autoimmunity. Clin Exp Immunol. 2014;178(1):57–64.CrossRefPubMedPubMedCentral Ponto KA, Schuppan D, Zwiener I, Binder H, Mirshahi A, Diana T, et al. Thyroid-associated orbitopathy is linked to gastrointestinal autoimmunity. Clin Exp Immunol. 2014;178(1):57–64.CrossRefPubMedPubMedCentral
10.
go back to reference Ponto KA, Binder H, Diana T, Matheis N, Otto AF, Pitz S, et al. Prevalence, phenotype, and psychosocial well-being in euthyroid/hypothyroid thyroid-associated orbitopathy. Thyroid. 2015;25(8):942–8.CrossRefPubMed Ponto KA, Binder H, Diana T, Matheis N, Otto AF, Pitz S, et al. Prevalence, phenotype, and psychosocial well-being in euthyroid/hypothyroid thyroid-associated orbitopathy. Thyroid. 2015;25(8):942–8.CrossRefPubMed
11.
go back to reference McKeag D, Lane C, Lazarus JH, Baldeschi L, Boboridis K, Dickinson AJ, et al. Clinical features of dysthyroid optic neuropathy: a European Group on Graves’ Orbitopathy (EUGOGO) survey. Br J Ophthalmol. 2007;91(4):455–8.CrossRefPubMed McKeag D, Lane C, Lazarus JH, Baldeschi L, Boboridis K, Dickinson AJ, et al. Clinical features of dysthyroid optic neuropathy: a European Group on Graves’ Orbitopathy (EUGOGO) survey. Br J Ophthalmol. 2007;91(4):455–8.CrossRefPubMed
12.
go back to reference Cozma I, Cozma LS, Boyce RL, Ludgate ME, Lazarus JH, Lane C. Variation in thyroid status in patients with graves’orbitopathy. Acta Endocrinol. 2009;5(2):191–8. Cozma I, Cozma LS, Boyce RL, Ludgate ME, Lazarus JH, Lane C. Variation in thyroid status in patients with graves’orbitopathy. Acta Endocrinol. 2009;5(2):191–8.
13.
go back to reference Alhambra Expósito MR, Gálvez Moreno MÁ, Moreno Moreno P, Prior Sánchez I, Muñoz Jiménez C, Benito LP. Clinical efficacy of intravenous glucocorticoid treatment in Graves’ ophtalmopathy. Endocrinol Nutr. 2013;60(1):10–4.CrossRefPubMed Alhambra Expósito MR, Gálvez Moreno MÁ, Moreno Moreno P, Prior Sánchez I, Muñoz Jiménez C, Benito LP. Clinical efficacy of intravenous glucocorticoid treatment in Graves’ ophtalmopathy. Endocrinol Nutr. 2013;60(1):10–4.CrossRefPubMed
14.
go back to reference Bartley GB, Fatourechi V, Kadrmas EF, Jacobsen SJ, Ilstrup DM, Garrity JA, et al. Clinical features of Graves’ ophthalmopathy in an incidence cohort. Am J Ophthalmol. 1996;121(3):284–90.CrossRefPubMed Bartley GB, Fatourechi V, Kadrmas EF, Jacobsen SJ, Ilstrup DM, Garrity JA, et al. Clinical features of Graves’ ophthalmopathy in an incidence cohort. Am J Ophthalmol. 1996;121(3):284–90.CrossRefPubMed
15.
go back to reference Khoo DH, Eng PH, Ho SC, Tai ES, Morgenthaler NG, Seah LL, et al. Graves’ ophthalmopathy in the absence of elevated free thyroxine and triiodothyronine levels: prevalence, natural history, and thyrotropin receptor antibody levels. Thyroid. 2000;10(12):1093–100.CrossRefPubMed Khoo DH, Eng PH, Ho SC, Tai ES, Morgenthaler NG, Seah LL, et al. Graves’ ophthalmopathy in the absence of elevated free thyroxine and triiodothyronine levels: prevalence, natural history, and thyrotropin receptor antibody levels. Thyroid. 2000;10(12):1093–100.CrossRefPubMed
16.
go back to reference Jang SY, Lee SY, Lee EJ, Yoon JS. Clinical features of thyroid-associated ophthalmopathy in clinically euthyroid Korean patients. Eye (Lond). 2012;26(9):1263–9.CrossRefPubMed Jang SY, Lee SY, Lee EJ, Yoon JS. Clinical features of thyroid-associated ophthalmopathy in clinically euthyroid Korean patients. Eye (Lond). 2012;26(9):1263–9.CrossRefPubMed
17.
go back to reference Mukasa K, Noh JY, Kouzaki A, Ohye H, Kunii Y, Watanabe N, et al. TSH receptor antibody titers measured with a third-generation assay did not reflect the activity of Graves’ ophthalmopathy in untreated Japanese Graves’ disease patients. Endocr J. 2016;63(2):151–7.CrossRefPubMed Mukasa K, Noh JY, Kouzaki A, Ohye H, Kunii Y, Watanabe N, et al. TSH receptor antibody titers measured with a third-generation assay did not reflect the activity of Graves’ ophthalmopathy in untreated Japanese Graves’ disease patients. Endocr J. 2016;63(2):151–7.CrossRefPubMed
18.
go back to reference Laurberg P, Berman DC, Bulow Pedersen I, Andersen S, Carle A. Incidence and clinical presentation of moderate to severe graves’ orbitopathy in a Danish population before and after iodine fortification of salt. J Clin Endocrinol Metabol. 2012;97(7):2325–32.CrossRef Laurberg P, Berman DC, Bulow Pedersen I, Andersen S, Carle A. Incidence and clinical presentation of moderate to severe graves’ orbitopathy in a Danish population before and after iodine fortification of salt. J Clin Endocrinol Metabol. 2012;97(7):2325–32.CrossRef
19.
go back to reference Abraham-Nordling M, Byström K, Törring O, Lantz M, Berg G, Calissendorff J, et al. Incidence of hyperthyroidism in Sweden. Eur J Endocrinol. 2011;165(6):899–905.CrossRefPubMed Abraham-Nordling M, Byström K, Törring O, Lantz M, Berg G, Calissendorff J, et al. Incidence of hyperthyroidism in Sweden. Eur J Endocrinol. 2011;165(6):899–905.CrossRefPubMed
20.
go back to reference Ackuaku-Dogbe EM, Akpalu J, Abaidoo B. Epidemiology and clinical features of thyroid-associated orbitopathy in Accra. Middle East Afr J Ophthalmol. 2017;24(4):183–9.CrossRefPubMedPubMedCentral Ackuaku-Dogbe EM, Akpalu J, Abaidoo B. Epidemiology and clinical features of thyroid-associated orbitopathy in Accra. Middle East Afr J Ophthalmol. 2017;24(4):183–9.CrossRefPubMedPubMedCentral
21.
go back to reference Razavi ME, Abotoraby RB, Kakhki RD, Ghanavati SZ, Layegh P, Taghavi M, et al. Clinical evaluation of Graves ophthalmopathy in north-east Islamic Republic of Iran. East Mediterr Health J. 2008;14(4):841–9.PubMed Razavi ME, Abotoraby RB, Kakhki RD, Ghanavati SZ, Layegh P, Taghavi M, et al. Clinical evaluation of Graves ophthalmopathy in north-east Islamic Republic of Iran. East Mediterr Health J. 2008;14(4):841–9.PubMed
22.
go back to reference Kashkouli MB, Jam S, Sabzvari D, Ketabi N, Azarinia S, SeyedAlinaghi S, et al. Thyroid-associated ophthalmopathy in Iranian patients. Acta Med Iran. 2011;49(9):612–8.PubMed Kashkouli MB, Jam S, Sabzvari D, Ketabi N, Azarinia S, SeyedAlinaghi S, et al. Thyroid-associated ophthalmopathy in Iranian patients. Acta Med Iran. 2011;49(9):612–8.PubMed
23.
go back to reference Kashkouli MB, Pakdel F, Kiavash V, Heidari I, Heirati A, Jam S. Hyperthyroid vs hypothyroid eye disease: the same severity and activity. Eye (Lond). 2011;25(11):1442–6.CrossRefPubMed Kashkouli MB, Pakdel F, Kiavash V, Heidari I, Heirati A, Jam S. Hyperthyroid vs hypothyroid eye disease: the same severity and activity. Eye (Lond). 2011;25(11):1442–6.CrossRefPubMed
24.
go back to reference Medghalchi A, Akbari M, Alizadeh Y, Moghadam RS. The epidemiological characteristics of patients with thyroid eye disease in a referral center in northern Iran. J Curr Ophthalmol. 2018;30(4):353–8.CrossRefPubMedPubMedCentral Medghalchi A, Akbari M, Alizadeh Y, Moghadam RS. The epidemiological characteristics of patients with thyroid eye disease in a referral center in northern Iran. J Curr Ophthalmol. 2018;30(4):353–8.CrossRefPubMedPubMedCentral
26.
go back to reference Bellgard MI, Napier K, Render L, Radochonski M, Lamont L, Graham C, et al. A registry framework enabling patient-centred care. Stud Health Technol Inform. 2015;214:8–14.PubMed Bellgard MI, Napier K, Render L, Radochonski M, Lamont L, Graham C, et al. A registry framework enabling patient-centred care. Stud Health Technol Inform. 2015;214:8–14.PubMed
27.
go back to reference Workman TA. Engaging Patients in Information Sharing and Data Collection: The Role of Patient-Powered Registries and Research Networks [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2013 Workman TA. Engaging Patients in Information Sharing and Data Collection: The Role of Patient-Powered Registries and Research Networks [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2013
28.
go back to reference Gliklich RE, Dreyer NA, Leavy MB, editors. Registries for Evaluating Patient Outcomes: A User's Guide [Internet]. 3rd ed. Rockville (MD): Agency for Healthcare Research and Quality (US); 2014 Gliklich RE, Dreyer NA, Leavy MB, editors. Registries for Evaluating Patient Outcomes: A User's Guide [Internet]. 3rd ed. Rockville (MD): Agency for Healthcare Research and Quality (US); 2014
29.
go back to reference Tan JCK, Ferdi AC, Gillies MC, Watson SL. Clinical registries in ophthalmology. Ophthalmology. 2019;126(5):655–62.CrossRefPubMed Tan JCK, Ferdi AC, Gillies MC, Watson SL. Clinical registries in ophthalmology. Ophthalmology. 2019;126(5):655–62.CrossRefPubMed
30.
go back to reference Hyman L, Penne R, Fujino D, Ramesh D, Zhang Q, Kelly S, et al. Prevalence and associated factors for thyroid eye disease (TED) in the AAO IRIS® Registry. Invest Ophthalmol Vis Sci. 2020;61(7):5425. Hyman L, Penne R, Fujino D, Ramesh D, Zhang Q, Kelly S, et al. Prevalence and associated factors for thyroid eye disease (TED) in the AAO IRIS® Registry. Invest Ophthalmol Vis Sci. 2020;61(7):5425.
31.
go back to reference Mehra S, Tuttle RM, Milas M, Orloff L, Bergman D, Bernet V, et al. Database and registry research in thyroid cancer: Striving for a new and improved national thyroid cancer database. Thyroid. 2015;25(2):157–68.CrossRefPubMed Mehra S, Tuttle RM, Milas M, Orloff L, Bergman D, Bernet V, et al. Database and registry research in thyroid cancer: Striving for a new and improved national thyroid cancer database. Thyroid. 2015;25(2):157–68.CrossRefPubMed
32.
go back to reference Bilimoria KY, Stewart AK, Winchester DP, Ko CY. The national cancer data base: a powerful initiative to improve cancer care in the United States. Ann Surg Oncol. 2008;15(3):683–90.CrossRefPubMedPubMedCentral Bilimoria KY, Stewart AK, Winchester DP, Ko CY. The national cancer data base: a powerful initiative to improve cancer care in the United States. Ann Surg Oncol. 2008;15(3):683–90.CrossRefPubMedPubMedCentral
33.
go back to reference Lazem M, Sheikhtaheri A. Barriers and facilitators for disease registry systems: a mixed-method study. BMC Med Inform Decis Mak. 2022;22(1):1–9.CrossRef Lazem M, Sheikhtaheri A. Barriers and facilitators for disease registry systems: a mixed-method study. BMC Med Inform Decis Mak. 2022;22(1):1–9.CrossRef
34.
go back to reference Lazem M, Sheikhtaheri A. Barriers and facilitators for the implementation of health condition and outcome registry systems: a systematic literature review. J Am Med Informatics Assoc. 2022;29(4):723–34.CrossRef Lazem M, Sheikhtaheri A. Barriers and facilitators for the implementation of health condition and outcome registry systems: a systematic literature review. J Am Med Informatics Assoc. 2022;29(4):723–34.CrossRef
35.
Metadata
Title
Implementation of thyroid eye disease registry in Iran: rationale and research protocol
Authors
Shadi Akbarian
Abbas Sheikhtaheri
Farid Khorrami
Hossein Ghahvechian
Nasser Karimi
Mohsen Bahmani Kashkouli
Publication date
01-12-2024
Publisher
BioMed Central
Published in
Orphanet Journal of Rare Diseases / Issue 1/2024
Electronic ISSN: 1750-1172
DOI
https://doi.org/10.1186/s13023-024-03053-9

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