Endocrine Abstracts

Background

In 2008 EUGOGO (European group on Graves’ orbitopathy) published consensus statement on the management of Graves’ orbitopathy (GO) that was widespread ever since. Having in mind unknown general perception and practical usage of the statement amongst Croatian clinicians, we conducted a survey evaluating the awareness and practical usage of the EUGOGO guidelines among physicians treating Graves’ disease in daily practice. Also, the idea was to explore their attitude towards importance of smoking as a risk factor for GO.

Participants and methods

An internet based, anonymous online survey was conducted among 40 ophthalmologist, 36 endocrinologists and 24 nuclear medicine specialists, members of Croatian national societies. Median age of participants was 51.15 yrs., 68% were females. From 100 participants 46% worked at Clinical Hospitals, 28% at County Hospitals and 27% at Outpatient Clinics. Two questions we concentrated on were: “Do you use EUGOGO guidelines in daily practice for diagnosis and treatment of GO?” and “Do you know which factors according to EUGOGO guidelines are associated with progression and outcome of the treatment in GO?”

Results

Results of the survey showed that 26% of the participants are not using EUGOGO guidelines; 22.5% of all ophthalmologist (9 of 40 participants), 27.8% of all endocrinologists (10 of 36 participants) and 29.2% nuclear medicine specialists (7 of 24 participants). Even 30% of all participants did not recognize smoking as risk factors determining the outcome of the disease; 37.5% of all ophthalmologist (15 of 40 participants), 16.7% of all endocrinologists (6 of 36 participants) and 37.5% nuclear medicine specialists (9 of 24 participants).

conclusion

EUGOGO guidelines were made with the aim to provide proper diagnosis and treatment for patients with GO; a third of Croatian clinicians involved in treatment of the disease still do not use it. Similar percentage of them were not aware of the clear causal association between smoking and development of GO. There is unambiguous recommendation in the EUGOGO statement for the physicians to urge all patients with Graves’ disease, irrespective of the presence or absence of the GO, to refrain from smoking. Following the guidelines represents best clinical practice for the physicians treating GO. Smoking, the strongest risk factor of the progression of the GO, is easy to modify.