title: Quality of Life After Surgery or Surveillance for Asymptomatic Primary Hyperparathyroidism: A Meta-Analysis of Randomized Controlled Trials.
abstract: A number of studies have investigated the effects of surgery on symptoms and quality of life in patients with hyperparathyroidism. However, the results are inconsistent. We conducted this meta-analysis to quantitatively assess changes in quality of life among patients with asymptomatic primary hyperparathyroidism. Different databases were searched for randomized controlled trials comparing surgery with surveillance. Quality of life was measured by the Short Form-36 general health survey. The pooled random-effects estimates of standardized mean difference (SMD) and 95% confidence intervals (CIs) were calculated. Three trials involving 294 participants were included. At 1 year, patients undergoing parathyroidectomy had significantly better physical role functioning (SMD, 0.31; 95% CI 0.04-0.57; P = 0.02) and emotional role functioning (SMD, 0.29; 95% CI 0.02-0.55; P = 0.03). At 2 years, the surgery group had significantly better emotional role functioning (SMD, 0.35; 95% CI 0.02-0.67; P = 0.04) than the surveillance group. Furthermore, compared with baseline, emotional role functioning improved after surgery (SMD, 0.31; 95% CI 0.02-0.60; P = 0.04), whereas emotional role functioning tended to get worse in patients assigned to medical surveillance (SMD, -0.27; 95% CI -0.55 to 0.02; P = 0.07). Although Short Form-36 is a generic instrument, our results suggest that parathyroidectomy may be associated with better quality of life, especially in the emotional aspects of well-being.
authors.affiliation: From the Department of Surgery, MacKay Memorial Hospital and Mackay Medical College (S-PC, J-JL, T-PL, P-SY, C-LL); Division of Endocrinology and Metabolism, Department of Medicine, MacKay Memorial Hospital and Mackay Medical College (S-CL); Mackay Junior College of Medicine, Nursing, and Management (J-JL, T-PL, S-CL, C-LL); Department of Pharmacology and Graduate Institute of Medical Sciences, Taipei Medical University (S-PC, J-JL); and Institute of Statistical Science, Academia Sinica, Taipei, Taiwan (Y-CH).
authors.forename: Shih-Ping
authors.initials: SP
authors.lastname: Cheng
authors.forename: Jie-Jen
authors.initials: JJ
authors.lastname: Lee
authors.forename: Tsang-Pai
authors.initials: TP
authors.lastname: Liu
authors.forename: Po-Sheng
authors.initials: PS
authors.lastname: Yang
authors.forename: Sung-Chen
authors.initials: SC
authors.lastname: Liu
authors.forename: Yi-Chiung
authors.initials: YC
authors.lastname: Hsu
authors.forename: Chien-Liang
authors.initials: CL
authors.lastname: Liu
mesh_terms: D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000601:surgery / Q000628:therapy*; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D057832:Watchful Waiting