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Conference Coverage: American Thyroid Association (ATA) 2023

October 13, 2023

The American Thyroid Association’s 2023 meeting included hundreds of posters and original research abstracts. Below are five studies you'll want to know about.

How do varying clinical practice recommendations affect treatment of hypothyroidism?

Multiple clinical practice guidelines address which patients with subclinical hypothyroidism (SCH) should receive treatment. In this study, researchers examined how those differing recommendations impacted clinical practice in a multicenter cohort study of patients diagnosed with SCH from 2016 – 2018. This study provides empiric evidence of the estimated proportion of patients for which treatment for SCH is recommended, if guidelines were strictly followed, ranging from 4.9% to 49.6%. This wide range highlights the potential impact of recommendations on clinical practice variation and the potential challenge to the implementation of clinical practice guidelines by practitioners, when multiple conflicting recommendations exist. Learn More

High prevalence of thyroid cancer observed in transgender female veterans

Transgender women experience higher-than-average rates of multiple medical conditions compared to cisgender women. In this poster, authors evaluated data from the comprehensive, nationwide Veterans Administration Informatics and Computing Infrastructure (VINCI) database and found that the prevalence of thyroid cancer among transgender female veterans was 0.341% (95% CI: 0.223% ‐ 0.459%). About one‐third of our patients had been receiving estrogen for an average of over 5 years before diagnosis, which suggests estrogen gender‐affirming hormone therapy is a potentially important risk factor. Learn More

Is the incidence of thyroid eye disease increasing in the U.S.?

Thyroid eye disease (TED) is the most common extrathyroidal manifestation of Graves’ disease, but estimates of its evidence in the U.S. are lacking, partly because a specific ICD code does not exist. This retrospective study used Inovalan data from 2016 – 2020, which covers nearly 170 million individuals and contains professional and institutional medical claims from Commercial, Medicare Advantage, and Medicaid payers, to identify patients with TED. For specific incidence, researchers found a raw rate of 4.15 patients per 100,000 patients‐years, with an age and gender adjusted rate of 2.05 per 100,000 in men and 6.59 in women. When adjusted for age and gender, this produced a rate of 4.27 per 100,000 in men and 13.49 per 100,000 in women. Based on this data, authors conclude that TED incidence has not increased significantly over the years and that a specific ICD code for TED should be created to advance health care planning and management of the disease. Learn More

What’s the impact of hypothyroidism on cardiovascular-associated health care utilization for diabetic patients?

Suboptimal treatment of hypothyroidism (HT) is associated with adverse cardiovascular outcomes, for which patients with diabetes mellitus (DM) are at increased risk. This study compared health care utilization outcomes associated with cardiovascular disease in DM patients with and without HT. Participant data was collected from the Medical Expenditure Panel Survey (MEPS) over 10 years (2011 – 2020). A total of 15,294 adult participants with DM were identified, representing a population of approximately 14.1 million US adults, of which 1.7 million (11.8%) had HT. HT as a comorbidity with DM was associated with increased healthcare utilization related to cardiovascular diseases, specifically visits associated with stroke, specialty care, and the use of diuretics (including SGLT‐2 inhibitors) and cholesterol‐lowering medications. Learn More

Can artificial intelligence identify cancerous thyroid nodules in children?

Thyroid cancer, though less common in children than adults, is the most common pediatric endocrine malignancy. Artificial intelligence (AI) models have proven effective at predicting malignant thyroid nodules in adult patients. This study looked at the feasibility of using AI to evaluate thyroid cancer in pediatric patients and found that AI-Thyroid, a deep learning model for identifying malignant thyroid nodules, resulted in high sensitivity and specificity. The authors suggest that future investigations could include additional approaches to optimizing AI‐Thyroid, tailored to pediatric population, as well as the implications of AI as an adjunct tool alongside tissue sampling in ENT clinics. Learn More