Influence of educational level on test and treatment for incident hypothyroidism
Research output: Contribution to journal › Journal article › Research › peer-review
Standard
Influence of educational level on test and treatment for incident hypothyroidism. / Møllehave, Line Tang; Jacobsen, Rikke Kart; Linneberg, Allan; Skaaby, Tea; Knudsen, Nils; Jørgensen, Torben; Kårhus, Line Lund; Kriegbaum, Margit; Grand, Mia Klinten; Siersma, Volkert; Lind, Bent; Andersen, Christen Lykkegaard; Nygaard, Birte; Medici, Bjarke Borregaard; Pedersen, Inge Bülow; Ravn-Haren, Gitte; Thuesen, Betina Heinsbæk.
In: Clinical Endocrinology, Vol. 94, No. 6, 2021, p. 1025-1034.Research output: Contribution to journal › Journal article › Research › peer-review
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Influence of educational level on test and treatment for incident hypothyroidism
AU - Møllehave, Line Tang
AU - Jacobsen, Rikke Kart
AU - Linneberg, Allan
AU - Skaaby, Tea
AU - Knudsen, Nils
AU - Jørgensen, Torben
AU - Kårhus, Line Lund
AU - Kriegbaum, Margit
AU - Grand, Mia Klinten
AU - Siersma, Volkert
AU - Lind, Bent
AU - Andersen, Christen Lykkegaard
AU - Nygaard, Birte
AU - Medici, Bjarke Borregaard
AU - Pedersen, Inge Bülow
AU - Ravn-Haren, Gitte
AU - Thuesen, Betina Heinsbæk
PY - 2021
Y1 - 2021
N2 - Objective: The incidence of hypothyroidism is not expected to differ by socioeconomic factors. However, the decision to test and initiate treatment may differ. We aimed to examine whether educational level influences the probability of thyroid stimulation hormone (TSH)-measurement and initiation of levothyroxine treatment. Design: Citizens in the greater Copenhagen Area during 2001-2015 were included. Individual-level data on educational level, diagnoses, GP-contact, TSH-measurement and medication were derived from administrative and healthcare registers. The relative risks (RR) between educational levels of annual TSH-measurement and treatment initiation following a TSH-measurement were analysed in Poisson regression models with generalized estimation equations. Results: A TSH-measurement was performed in 19% of 9,390,052 person years. The probability of TSH-measurement was higher with short (RR 1.16 [95% CI 1.15–1.16]) and medium (RR 1.11 [95% CI 1.06–1.12]) compared with long education. Treatment was initiated after 0.8% of 2,049,888 TSH-measurements. For TSH < 5 mIU/L, RR for treatment initiation ranged between 0.47 (95%CI 0.39–0.57) and 0.78 (95%CI 0.67–0.91) for short and medium compared with long education. For TSH 5–10 mIU/L, there was no statistically significant difference. For TSH > 10 mIU/L, RR was 1.07 (95% CI 1.02–1.12) for short and 1.08 (95% CI 1.03–1.13) for medium compared with long education. Conclusion: The probability of TSH-measurement was higher with shorter education, and the probability of treatment initiation with TSH > 10 mIU/L was marginally higher with short-medium education compared with long education. However, the probability of treatment initiation with TSH < 5 mIU/L, that is treatment incongruous with guidelines, was substantially higher in persons with long education.
AB - Objective: The incidence of hypothyroidism is not expected to differ by socioeconomic factors. However, the decision to test and initiate treatment may differ. We aimed to examine whether educational level influences the probability of thyroid stimulation hormone (TSH)-measurement and initiation of levothyroxine treatment. Design: Citizens in the greater Copenhagen Area during 2001-2015 were included. Individual-level data on educational level, diagnoses, GP-contact, TSH-measurement and medication were derived from administrative and healthcare registers. The relative risks (RR) between educational levels of annual TSH-measurement and treatment initiation following a TSH-measurement were analysed in Poisson regression models with generalized estimation equations. Results: A TSH-measurement was performed in 19% of 9,390,052 person years. The probability of TSH-measurement was higher with short (RR 1.16 [95% CI 1.15–1.16]) and medium (RR 1.11 [95% CI 1.06–1.12]) compared with long education. Treatment was initiated after 0.8% of 2,049,888 TSH-measurements. For TSH < 5 mIU/L, RR for treatment initiation ranged between 0.47 (95%CI 0.39–0.57) and 0.78 (95%CI 0.67–0.91) for short and medium compared with long education. For TSH 5–10 mIU/L, there was no statistically significant difference. For TSH > 10 mIU/L, RR was 1.07 (95% CI 1.02–1.12) for short and 1.08 (95% CI 1.03–1.13) for medium compared with long education. Conclusion: The probability of TSH-measurement was higher with shorter education, and the probability of treatment initiation with TSH > 10 mIU/L was marginally higher with short-medium education compared with long education. However, the probability of treatment initiation with TSH < 5 mIU/L, that is treatment incongruous with guidelines, was substantially higher in persons with long education.
KW - hypothyroidism
KW - levothyroxine
KW - socioeconomic factors
KW - thyroid function tests
U2 - 10.1111/cen.14429
DO - 10.1111/cen.14429
M3 - Journal article
C2 - 33512012
AN - SCOPUS:85100585372
VL - 94
SP - 1025
EP - 1034
JO - Clinical Endocrinology
JF - Clinical Endocrinology
SN - 0300-0664
IS - 6
ER -
ID: 257647362