title: The management of Graves' disease in New Zealand 2014.
abstract: BACKGROUND
  Treatment options for Graves' disease (GD), namely anti-thyroid drugs (ATD), surgery or radioiodine (RAI), have not changed over the past two decades. There is no 'gold-standard' treatment for GD.
  
  
  OBJECTIVE
  To assess whether the management of GD in New Zealand has changed since the previous 1991 New Zealand survey and compare current management with that of contemporary international studies.
  
  
  METHODS
  We conducted an online survey of New Zealand physicians currently practising internal medicine, diabetes and/or endocrinology, using the cases and questions from the original European and 1991 New Zealand studies.
  
  
  RESULTS
  The first-line use of RAI was 5.5%, compared to 41% in the 1991 New Zealand survey. This corresponded to an increase in ATD use, while the rates of surgery as a first-line treatment have remained static over time. New Zealand physicians use technetium scanning for diagnosis, whereas ultrasound and radioiodine uptake were the most commonly selected investigations by European and North American physicians, respectively. The pattern of ATD use in pregnancy was similar to international practice.
  
  
  CONCLUSIONS
  Treatment of GD in New Zealand has shifted away from the use of RAI as first line treatment. There are significant differences in the investigation and treatment of Grave's disease between New Zealand, Europe and North America.
authors.affiliation: Department of Endocrinology, Waikato Hospital, Private Bag 3200 Hamilton, 3420, New Zealand. stephaniec@adhb.govt.nz.
authors.forename: Stephanie C
authors.initials: SC
authors.lastname: Cox
authors.forename: Jade Au
authors.initials: JA
authors.lastname: Tamatea
authors.forename: John V
authors.initials: JV
authors.lastname: Conaglen
authors.forename: Marianne S
authors.initials: MS
authors.lastname: Elston
mesh_terms: D013956:Antithyroid Agents / Q000627:therapeutic use*; D019468:Disease Management; D000072097:Endocrinologists; D006111:Graves Disease / Q000097:blood / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D007388:Internal Medicine; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D009520:New Zealand; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011877:Radionuclide Imaging; D011795:Surveys and Questionnaires; D013965:Thyroidectomy; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood; D014284:Triiodothyronine / Q000097:blood; D014463:Ultrasonography
chemical_list: D013956:Antithyroid Agents; D007457:Iodine Radioisotopes; D014284:Triiodothyronine; D013972:Thyrotropin; D013974:Thyroxine