Survey of Post-thyroidectomy Parathyroid Hormone (PTH) Assay Use by American vs European Thyroid Surgeons

Objective: 1) Identify differences in PTH assay usage by European vs American physicians. 2) Analyze factors that correlate with these differences. Method: Anonymous surveys of physicians regarding their use of post-thyroidectomy PTH assay were collected in 2009 from members of the American Academies of Otolaryngology and Endocrine Surgery and compared with 2010 survey data from members of the European, Italian, French, Spanish, and British Societies of Endocrine Surgery. Results: European respondents returned 61 surveys that were compared with 356 received from American physicians (11% vs 3% response rate). A total of 40.1% of the European physicians used the PTH assay vs 29.8% of the American physicians (chi-square P = .083). A total of 63% of US respondents were otolaryngologists, compared with 7% of the Europeans, but usage among US physicians was not significantly correlated with specialty. Fewer American physicians were fellowship trained (26.6% vs 44.3% (chi-square P = .003)). Using Mann-Whitney testing, estimates of the rate of temporary hypocalcemia were similar, median 10% to 20% (P = .708), but American respondents provided a lower estimated rate of permanent hypocalcemia (P = .007). Conclusion: We found a trend suggesting that more European physicians obtain PTH levels than US physicians and report higher rates of permanent hypocalcemia among thyroidectomy patients, perhaps accounting for their more frequent use of PTH assays