title: PREGO (presentation of Graves' orbitopathy) study: changes in referral patterns to European Group On Graves' Orbitopathy (EUGOGO) centres over the period from 2000 to 2012.
abstract: OBJECTIVE
  The epidemiology of Graves' orbitopathy (GO) may be changing. The aim of the study was to identify trends in presentation of GO to tertiary centres and initial management over time.
  
  
  METHODS
  Prospective observational study of European Group On Graves' Orbitopathy (EUGOGO) centres. All new referrals with a diagnosis of GO over a 4-month period in 2012 were included. Clinical and demographic characteristics, referral timelines and initial decisions about management were recorded. The data were compared with a similar EUGOGO survey performed in 2000.
  
  
  RESULTS
  The demographic characteristics of 269 patients studied in 2012 were similar to those collected in the year 2000, including smoking rates (40.0% vs 40.2%). Mild (60.5% vs 41.2%, p<0.01) and inactive GO (63.2% vs 39.9%, p<0.01) were more prevalent in 2012. The times from diagnosis of thyroid disease to being seen in EUGOGO centres (6 vs 16 months) and from first symptoms of GO (9 vs 16 months) or from diagnosis of GO (6 vs 12 months) to first consultation in EUGOGO centres were shorter in 2012 (p<0.01). The initial management plans for GO were no different except surgical treatments for patients with mild inactive disease were more frequently offered in the 2012 cohort than in 2000 (27.3% vs 17%, p<0.05), and selenium supplements were offered only in the 2012 cohort (21.2% vs 0%, p<0.01).
  
  
  CONCLUSIONS
  These findings suggest that the clinical manifestations of patients with GO may be changing over time in Europe.
authors.affiliation: Department of Endocrinology, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Petros
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authors.lastname: Perros
authors.affiliation: Department of Endocrinology, School of Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: Miloš
authors.initials: M
authors.lastname: Žarković
authors.affiliation: Department of Surgical and Morphological Sciences, Section of Ophthalmology, School of Medicine, University of Insubria, Varese, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Azzolini
authors.affiliation: Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Göksun
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authors.lastname: Ayvaz
authors.affiliation: Department of Ophthalmology, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
authors.forename: Lelio
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authors.lastname: Baldeschi
authors.affiliation: Endocrine Unit, Ospedale di Circolo, University of Insubria, Varese, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Bartalena
authors.affiliation: Department of Ophthalmology, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
authors.forename: Antonella
authors.initials: A
authors.lastname: Boschi
authors.affiliation: Department of Endocrinology and Nuclear Medicine, GHE-Hospices Civils de Lyon and Lyon 1 University, Lyon, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Bournaud
authors.affiliation: Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark.
authors.forename: Thomas Heiberg
authors.initials: TH
authors.lastname: Brix
authors.affiliation: Graves' Orbitopathy Unit, Department of Clinical Sciences and Community Health, Fondazione Ca'Granda IRCCS, University of Milan, Milan, Italy.
authors.forename: Danila
authors.initials: D
authors.lastname: Covelli
authors.affiliation: Department of Endocrinology, School of Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: Slavica
authors.initials: S
authors.lastname: Ćirić
authors.affiliation: Department of Endocrinology, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
authors.forename: Chantal
authors.initials: C
authors.lastname: Daumerie
authors.affiliation: Department of Ophthalmology, University of Duisburg-Essen, Essen, Germany.
authors.forename: Anja
authors.initials: A
authors.lastname: Eckstein
authors.affiliation: Department of Ophthalmology, Interdisciplinary Centre for Graves' Orbitopathy, Olten, Switzerland.
authors.forename: Nicole
authors.initials: N
authors.lastname: Fichter
authors.affiliation: Department of Endocrinology and Metabolism, University of Duisburg-Essen, Essen, Germany.
authors.forename: Dagmar
authors.initials: D
authors.lastname: Führer
authors.affiliation: Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark.
authors.forename: Laszlo
authors.initials: L
authors.lastname: Hegedüs
authors.affiliation: Department of Medicine I, Johannes Gutenberg University Medical Center, Mainz, Germany.
authors.forename: George J
authors.initials: GJ
authors.lastname: Kahaly
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Onur
authors.initials: O
authors.lastname: Konuk
authors.affiliation: Department of Ophthalmology, Interdisciplinary Centre for Graves' Orbitopathy, Olten, Switzerland.
authors.forename: Jürg
authors.initials: J
authors.lastname: Lareida
authors.affiliation: Department of Endocrinology, Institute of Molecular and Experimental Medicine, Cardiff University School of Medicine, Cardiff, UK.
authors.forename: John
authors.initials: J
authors.lastname: Lazarus
authors.affiliation: Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
authors.forename: Marenza
authors.initials: M
authors.lastname: Leo
authors.affiliation: Department of Endocrinology, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
authors.forename: Lemonia
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authors.lastname: Mathiopoulou
authors.affiliation: Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Menconi
authors.affiliation: Cardiff Eye Unit, University Hospital of Wales, Cardiff, UK.
authors.forename: Daniel
authors.initials: D
authors.lastname: Morris
authors.affiliation: Department of Endocrinology, Institute of Molecular and Experimental Medicine, Cardiff University School of Medicine, Cardiff, UK.
authors.forename: Onyebuchi
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authors.lastname: Okosieme
authors.affiliation: Department of Endocrinology, Centre Hospitalier Lyon-Sud, Lyon, France.
authors.forename: Jaques
authors.initials: J
authors.lastname: Orgiazzi
authors.affiliation: Department of Ophthalmology, Johannes Gutenberg University Medical Center, Mainz, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Pitz
authors.affiliation: Graves' Orbitopathy Unit, Department of Clinical Sciences and Community Health, Fondazione Ca'Granda IRCCS, University of Milan, Milan, Italy.
authors.forename: Mario
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authors.lastname: Salvi
authors.affiliation: Unité de Neuro-ophtalmologie, Hôpital Neurologique, Hospices Civils de Lyon, Lyon, France.
authors.forename: Cristina
authors.initials: C
authors.lastname: Vardanian-Vartin
authors.affiliation: Department of Endocrinology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Wilmar
authors.initials: W
authors.lastname: Wiersinga
authors.affiliation: Neuro-Ophthalmology Outpatient Clinics, GHE-Hospices Civils de Lyon and Lyon 1 University, Lyon, France.
authors.forename: Martine
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authors.lastname: Bernard
authors.affiliation: Department of Ophthalmology, Newcastle Eye Centre, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
authors.forename: Lucy
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authors.lastname: Clarke
authors.affiliation: Department of Ophthalmology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Nicola
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authors.lastname: Currò
authors.affiliation: Department of Endocrinology, Institute of Molecular and Experimental Medicine, Cardiff University School of Medicine, Cardiff, UK.
authors.forename: Colin
authors.initials: C
authors.lastname: Dayan
authors.affiliation: Department of Ophthalmology, Newcastle Eye Centre, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
authors.forename: Jane
authors.initials: J
authors.lastname: Dickinson
authors.affiliation: Department of Ophthalmology, Medical School, Clinic for Ophthalmology, Clinical Center of Serbia, University of Belgrade, Belgrade, Serbia.
authors.forename: Miroslav
authors.initials: M
authors.lastname: Knežević
authors.affiliation: Cardiff Eye Unit, University Hospital of Wales, Cardiff, UK.
authors.forename: Carol
authors.initials: C
authors.lastname: Lane
authors.affiliation: Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Marcocci
authors.affiliation: Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Marinò
authors.affiliation: Department of Endocrinology and Metabolism, University of Duisburg-Essen, Essen, Germany.
authors.forename: Lars
authors.initials: L
authors.lastname: Möller
authors.affiliation: Dipartimento di Patologia Chirurgica Medica, Molecolare e dell'Area Critica, Università di Pisa, Pisa, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Nardi
authors.affiliation: Department of Ophthalmology, Newcastle Eye Centre, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: Neoh
authors.affiliation: Department of Endocrinology, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Pearce
authors.affiliation: Department of Ophthalmology, Interdisciplinary Centre for Graves' Orbitopathy, Olten, Switzerland.
authors.forename: George
authors.initials: G
authors.lastname: von Arx
authors.affiliation: Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Fosun Baloş
authors.initials: FB
authors.lastname: Törüner
mesh_terms: D000328:Adult; D005060:Europe / Q000453:epidemiology; D005260:Female; D049970:Graves Ophthalmopathy / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009885:Ophthalmology / Q000706:statistics & numerical data; D015995:Prevalence; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D062606:Tertiary Care Centers / Q000706:statistics & numerical data
keywords: Epidemiology; Orbit