title: Ensuring Effective Prevention of Iodine Deficiency Disorders.
abstract: BACKGROUND
  Programs initiated to prevent iodine deficiency disorders (IDD) may not remain effective due to changes in government policies, commercial factors, and human behavior that may affect the efficacy of IDD prevention programs in unpredictable directions. Monitoring and outcome studies are needed to optimize the effectiveness of IDD prevention.
  
  
  CONCLUSIONS
  Although the need for monitoring is compelling, the current reality in Europe is less than optimal. Regular and systematic monitoring surveys have only been established in a few countries, and comparability across the studies is hampered by the lack of centralized standardization procedures. In addition, data on outcomes and the cost of achieving them are needed in order to provide evidence of the beneficial effects of IDD prevention in countries with mild iodine deficiency.
  
  
  CONCLUSIONS
  Monitoring studies can be optimized by including centralized standardization procedures that improve the comparison between studies. No study of iodine consumption can replace the direct measurement of health outcomes and the evaluation of the costs and benefits of the program. It is particularly important that health economic evaluation should be conducted in mildly iodine-deficient areas and that it should include populations from regions with different environmental, ethnic, and cultural backgrounds.
authors.affiliation: 1 Institute for Community Medicine, University Medicine Greifswald , Greifswald, Germany .
authors.forename: Henry
authors.initials: H
authors.lastname: Völzke
authors.affiliation: 2 Department of Endocrinology, Centre Hospitalier Universitaire de Larrey , Toulouse, France .
authors.forename: Philippe
authors.initials: P
authors.lastname: Caron
authors.affiliation: 3 Human Studies, National Institute of Nutrition and Seafood Research , Bergen, Norway .
authors.forename: Lisbeth
authors.initials: L
authors.lastname: Dahl
authors.affiliation: 4 Department of Endocrinology, Hospital das Forças Armadas , Lisbon, Portugal .
authors.forename: João J
authors.initials: JJ
authors.lastname: de Castro
authors.affiliation: 5 Disease Risk Unit, National Institute for Health and Welfare , Helsinki, Finland .
authors.forename: Iris
authors.initials: I
authors.lastname: Erlund
authors.affiliation: 6 Department of Nuclear Medicine, University Medical Centre , Ljubljana, Slovenia .
authors.forename: Simona
authors.initials: S
authors.lastname: Gaberšček
authors.affiliation: 7 Unit for Nutrition Research, University of Iceland and Landspitali National University Hospital , Reykjavik, Iceland .
authors.forename: Ingibjörg
authors.initials: I
authors.lastname: Gunnarsdottir
authors.affiliation: 8 Department of Endocrinology, Jagiellonian University Medical College , Krakow, Poland .
authors.forename: Alicja
authors.initials: A
authors.lastname: Hubalewska-Dydejczyk
authors.affiliation: 1 Institute for Community Medicine, University Medicine Greifswald , Greifswald, Germany .
authors.forename: Till
authors.initials: T
authors.lastname: Ittermann
authors.affiliation: 9 Faculty of Medicine, Sofia University Sv. Kliment Ohridski , Sofia, Bulgaria .
authors.forename: Ludmila
authors.initials: L
authors.lastname: Ivanova
authors.affiliation: 10 Centre for Regional Policy Research and Cooperation "Studiorum," Skopje, Macedonia .
authors.forename: Borislav
authors.initials: B
authors.lastname: Karanfilski
authors.affiliation: 1 Institute for Community Medicine, University Medicine Greifswald , Greifswald, Germany .
authors.forename: Rehman M
authors.initials: RM
authors.lastname: Khattak
authors.affiliation: 11 University of Zagreb, School of Medicine, Department of Oncology and Nuclear Medicine, University Hospital Centre Sestre Milosrdnice , Zagreb, Croatia .
authors.forename: Zvonko
authors.initials: Z
authors.lastname: Kusić
authors.affiliation: 12 Departments of Endocrinology and Clinical Medicine, Aalborg University Hospital and Aalborg University , Aalborg, Denmark .
authors.forename: Peter
authors.initials: P
authors.lastname: Laurberg
authors.affiliation: 13 Institute of Molecular Medicine, Cardiff University , Cardiff, United Kingdom .
authors.forename: John H
authors.initials: JH
authors.lastname: Lazarus
authors.affiliation: 14 Department of Endocrinology, Institute University of Patras Medical School , Patras, Greece .
authors.forename: Kostas B
authors.initials: KB
authors.lastname: Markou
authors.affiliation: 15 Nuclear Medicine Department, Erasme Hospital, Université Libre de Bruxelles , Brussels, Belgium .
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Moreno-Reyes
authors.affiliation: 16 Division of Endocrinology, University of Debrecen , Debrecen, Hungary .
authors.forename: Endre V
authors.initials: EV
authors.lastname: Nagy
authors.affiliation: 17 Department of Internal Medicine, Rotterdam Thyroid Center , Erasmus Medical Centre, Rotterdam, The Netherlands .
authors.forename: Robin P
authors.initials: RP
authors.lastname: Peeters
authors.affiliation: 18 Department of Internal Medicine, University of Latvia , Riga, Latvia .
authors.forename: Valdis
authors.initials: V
authors.lastname: Pīrāgs
authors.affiliation: 19 Department of Endocrinology, Slovakian Medical University , Bratislava, Slovakia .
authors.forename: Ján
authors.initials: J
authors.lastname: Podoba
authors.affiliation: 20 Department of Nutritional Sciences, Faculty Health and Medical Sciences, University of Surrey , Guildford, United Kingdom .
authors.forename: Margaret P
authors.initials: MP
authors.lastname: Rayman
authors.affiliation: 21 Department of Public Health, Health Services Research and Health Technology Assessment, UMIT-University for Health Science , Medical Informatics and Technology, Hall, Austria .
authors.forename: Ursula
authors.initials: U
authors.lastname: Rochau
authors.affiliation: 21 Department of Public Health, Health Services Research and Health Technology Assessment, UMIT-University for Health Science , Medical Informatics and Technology, Hall, Austria .
authors.forename: Uwe
authors.initials: U
authors.lastname: Siebert
authors.affiliation: 22 National University of Ireland, Galway and Centre for Public Health, Queen's University , Belfast, North Ireland .
authors.forename: Peter P
authors.initials: PP
authors.lastname: Smyth
authors.affiliation: 23 Research Centre for Prevention and Health , The Capital Region of Denmark, Rigshospitalet, Glostrup, Denmark .
authors.forename: Betina H
authors.initials: BH
authors.lastname: Thuesen
authors.affiliation: 24 Institute of Biochemistry, Food Science and Nutrition, The Hebrew University of Jerusalem , Jerusalem, Israel .
authors.forename: Aron
authors.initials: A
authors.lastname: Troen
authors.affiliation: 25 Department of Endocrinology and Nutrition, Hospital de Sant Joan Despi Moisès Broggi , Barcelona, Spain .
authors.forename: Lluís
authors.initials: L
authors.lastname: Vila
authors.affiliation: 26 Department of Clinical and Experimental Medicine, University of Pisa , Pisa, Italy .
authors.forename: Paolo
authors.initials: P
authors.lastname: Vitti
authors.affiliation: 27 Institute of Endocrinology , Prague, Czech Republic .
authors.forename: Vaclav
authors.initials: V
authors.lastname: Zamrazil
authors.affiliation: 28 Swiss Federal Institute of Technology , Zürich Department of Health Sciences and Technology, Zürich, Switzerland .
authors.forename: Michael B
authors.initials: MB
authors.lastname: Zimmermann
mesh_terms: D004032:Diet; D005060:Europe; D017048:Health Care Costs; D006801:Humans; D007037:Hypothyroidism / Q000453:epidemiology / Q000517:prevention & control; D007391:International Cooperation; D007455:Iodine / Q000009:adverse effects / Q000172:deficiency* / Q000627:therapeutic use; D017063:Outcome Assessment, Health Care; D011315:Preventive Medicine / Q000191:economics / Q000379:methods; D012107:Research Design; D013959:Thyroid Diseases / Q000453:epidemiology* / Q000517:prevention & control*
chemical_list: D007455:Iodine