title: Surgery versus radioiodine therapy as definitive management for graves' disease: the role of patient preference.
abstract: BACKGROUND
  Thyroidectomy is an option for the definitive management of Graves' disease. The aim of this study was to examine the role of patient preference for selecting surgery as definitive treatment.
  
  
  METHODS
  This is a retrospective cohort study comprising all patients (n = 63) presenting to a single surgeon for surgical management of Graves' disease over 3 years. Documented reasons for surgery were compared with accepted indications, as well as patients' perceptions as assessed by questionnaire.
  
  
  RESULTS
  The most frequent absolute indication was the presence of a large goiter (n = 8; 13%) or associated thyroid nodule (n = 6; 10%). Ophthalmopathy, a relative indication, comprised the largest single group overall (n = 18; 29%); however, a significant number of patients (n = 17; 27%) elected surgery in the absence of a recognized indication. There was strong concordance (73%) between the recorded indication and the patients' survey response. Overall, there was a high level of satisfaction with surgery with 88% of respondents giving a satisfaction score of 7 or greater on a visual analog scale (VAS) (0-10).
  
  
  CONCLUSIONS
  One-third of all patients electing surgery as definitive management do so in the absence of a specific indication. Overall, there is a high level of satisfaction with the decision for surgery as definitive management of Graves' disease.
authors.affiliation: University of Sydney Endocrine Surgical Unit and Kolling Institute of Medical Research, University of Sydney, Sydney, Australia.
authors.forename: Simon
authors.initials: S
authors.lastname: Grodski
authors.forename: Peter
authors.initials: P
authors.lastname: Stalberg
authors.forename: Bruce G
authors.initials: BG
authors.lastname: Robinson
authors.forename: Leigh W
authors.initials: LW
authors.lastname: Delbridge
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D006111:Graves Disease / Q000532:radiotherapy* / Q000601:surgery*; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D013965:Thyroidectomy
chemical_list: D007457:Iodine Radioisotopes