{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T21:32:46Z","timestamp":1783459966419,"version":"3.55.0"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T00:00:00Z","timestamp":1730678400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T00:00:00Z","timestamp":1730678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100007837","name":"Universit\u00e4t Bremen","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100007837","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Following implementation of a national prevention program against iodine deficiency-related disorders in 1993 in Germany, the prevalence of thyroid disorders declined, but aggregated drug dispensation data suggested a recent increase in thyroid hormone use. We aimed to systematically investigate trends in the use of thyroid diagnostic and treatment measures between 2008 and 2019 in Germany. Using the GePaRD database (claims data from ~\u200920% of the German population), we determined the annual age-specific and age-standardized prevalence of the use of thyroid diagnostics (thyroid-stimulating hormone (TSH) measurement, thyroid ultrasound, scintiscan, biopsy) and treatment (medication, surgery, radioiodine therapy) from 2008 to 2019 stratified by sex. Between 2008 and 2019, the age-standardized prevalence of TSH measurement increased by 36% in males (from 165 to 225 per 1,000 persons) and by 24% in females (from 295 to 367 per 1,000). The prevalence of thyroid ultrasound use showed no clear time trend, while there was a decrease in the prevalence of scintiscan use (males\/females: decrease by 42\/43%) and biopsy (males\/females: decrease by 42\/34%). The prevalence of levothyroxine use increased by ~\u200931% both in males (from 36 to 47 per 1,000) and females (from 134 to 175 per 1,000), while the prevalence of thionamide use, iodine use, thyroidectomy, and radioiodine therapy decreased. Our study suggests a continued decline in the prevalence of clinically significant thyroid disorders between 2008 and 2019. The substantial increase in the prevalence of TSH measurement and levothyroxine use during this time period might indicate overuse of diagnostics and overtreatment, warranting further investigation.<\/jats:p>","DOI":"10.1038\/s41598-024-77896-4","type":"journal-article","created":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T18:02:15Z","timestamp":1730743335000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Trends in the use of thyroid diagnostics and treatments between 2008 and 2019 in Germany"],"prefix":"10.1038","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0413-1599","authenticated-orcid":false,"given":"Arulmani","family":"Thiyagarajan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4623-8271","authenticated-orcid":false,"given":"Niklas","family":"Koenen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0154-7353","authenticated-orcid":false,"given":"Till","family":"Ittermann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7003-399X","authenticated-orcid":false,"given":"Henry","family":"V\u00f6lzke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1886-2923","authenticated-orcid":false,"given":"Ulrike","family":"Haug","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,11,4]]},"reference":[{"key":"77896_CR1","doi-asserted-by":"publisher","first-page":"744","DOI":"10.1007\/s00103-007-0236-4","volume":"50","author":"M Thamm","year":"2007","unstructured":"Thamm, M., Ellert, U., Thierfelder, W., Liesenk\u00f6tter, K. P. & V\u00f6lzke, H. Jodversorgung in Deutschland. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 50, 744\u2013749. https:\/\/doi.org\/10.1007\/s00103-007-0236-4 (2007).","journal-title":"Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz"},{"key":"77896_CR2","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1186\/s12963-016-0111-3","volume":"14","author":"RM Khattak","year":"2016","unstructured":"Khattak, R. M., Ittermann, T., Nauck, M., Below, H. & V\u00f6lzke, H. Monitoring the prevalence of thyroid disorders in the adult population of Northeast Germany. Popul. Health Metrics. 14, 39. https:\/\/doi.org\/10.1186\/s12963-016-0111-3 (2016).","journal-title":"Popul. Health Metrics"},{"key":"77896_CR3","doi-asserted-by":"publisher","first-page":"737","DOI":"10.1089\/thy.2011.0525","volume":"22","author":"H V\u00f6lzke","year":"2012","unstructured":"V\u00f6lzke, H. et al. Five-year change in morphological and functional alterations of the thyroid gland: The study of health in Pomerania. Thyroid. 22, 737\u2013746. https:\/\/doi.org\/10.1089\/thy.2011.0525 (2012).","journal-title":"Thyroid"},{"key":"77896_CR4","doi-asserted-by":"publisher","first-page":"744","DOI":"10.1007\/s00103-007-0236-4","volume":"50","author":"M Thamm","year":"2007","unstructured":"Thamm, M., Ellert, U., Thierfelder, W., Liesenk\u00f6tter, K. P. & V\u00f6lzke, H. Iodine intake in Germany. Results of iodine monitoring in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). 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Unrelated to this study, BIPS occasionally conducts studies financed by the pharmaceutical industry. Almost exclusively, these are post-authorization safety studies (PASS) requested by health authorities. The design and conduct of these studies as well as the interpretation and publication are not influenced by the pharmaceutical industry. The study presented was not funded by the pharmaceutical industry and was performed in line with the ENCePP Code of Conduct. TI and HV have no conflict of interest to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"In terms of ethics approval, the Ethics Committee of the University of Bremen stated that studies based on GePaRD are exempt from institutional review board review. Apart from this, it is required to obtain approval from health insurance providers and their governmental authorities when using health insurance data for scientific purposes. The utilization of health insurance data for scientific research is regulated by the Code of Social Law in Germany. All involved health insurance providers as well as the German Federal Office for Social Security and the Senator for Health, Women and Consumer Protection in Bremen as their responsible authorities approved the use of GePaRD data for this study. According to the \u00a7\u00a075 of the Code of Social Law X, informed consent for studies based on health insurance data is required by law unless obtaining consent appears unacceptable and would bias results. For this study, the responsible authorities approved the use of the data without informed consent as informed consent was deemed to be unacceptable and to bias results. The study was performed according to the institutional guidelines of the Leibniz Institute for Prevention Research and Epidemiology \u2013 BIPS as well as the \u201cGood Practice in Secondary Data Analysis (GPS)\u201d guideline (Third Revision 2012\/2014).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participate"}}],"article-number":"26710"}}