{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T20:13:57Z","timestamp":1787170437765,"version":"build-2736575974"},"reference-count":47,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2022,2,7]],"date-time":"2022-02-07T00:00:00Z","timestamp":1644192000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100005847","name":"Health and Medical Research Fund","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005847","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100005407","name":"Food and Health Bureau","doi-asserted-by":"crossref","award":["#17181051"],"award-info":[{"award-number":["#17181051"]}],"id":[{"id":"10.13039\/501100005407","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The aim of this study was to compare long-term mortality, morbidity, and cumulative healthcare costs between antithyroid drugs, radioactive iodine, and surgical treatment for patients with persistent or relapsed Graves\u2019 disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data on patients with persistent or relapsed Graves\u2019 disease between 2006 and 2018 were retrieved from the Hong Kong Hospital Authority. Hazard ratios (HRs) estimated by Cox proportional hazards regression models were used to compare the risks of all-cause mortality, cardiovascular disease, atrial fibrillation, psychological disease, Graves\u2019 ophthalmopathy, and cancer across treatment groups. The 10-year healthcare cost and change in co-morbidity status were also estimated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Over a median follow-up of 79 months (22\u2009636 person-years), a total of 3443 patients (antithyroid drug 2294, radioactive iodine 755, surgery 394) were analysed. Compared with antithyroid drug treatment, surgery was associated with significantly lower risks of all-cause mortality (HR 0.40, 95 per cent c.i. 0.36 to 0.45), cardiovascular disease (HR 0.54, 0.48 to 0.60), atrial fibrillation (HR 0.11, 0.09 to 0.14), psychological disease (HR 0.85, 0.79 to 0.92), Graves\u2019 ophthalmopathy (HR 0.09, 0.08 to 0.10), and cancer (HR 0.56, 0.50 to 0.63). Patients who underwent surgery also had a lower risk of all outcome events than those in the radioactive iodine group. The 10-year direct cumulative healthcare cost was \u20ac14\u2009754 for surgery compared with \u20ac17\u2009390 for antithyroid drugs, and \u20ac17\u2009918 for the radioactive iodine group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients who underwent surgery for persistent or relapsed Graves\u2019 disease had lower risks of all-cause mortality and analysed morbidities. The 10-year cumulative healthcare cost in the surgery group was lowest among the three treatment alternatives.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjs\/znab474","type":"journal-article","created":{"date-parts":[[2021,12,24]],"date-time":"2021-12-24T07:08:00Z","timestamp":1640329680000},"page":"381-389","source":"Crossref","is-referenced-by-count":10,"title":["Long-term outcome of patients treated with antithyroid drugs, radioactive iodine or surgery for persistent or relapsed Graves\u2019 disease"],"prefix":"10.1093","volume":"109","author":[{"given":"Xiaodong","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Surgery, Li Ka Shing Faculty of Medicine, University of Hong Kong , Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6895-6071","authenticated-orcid":false,"given":"Carlos K. 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M.","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, University of Hong Kong , Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu Cho","family":"Woo","sequence":"additional","affiliation":[{"name":"Department of Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong , Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shirley Y. W.","family":"Liu","sequence":"additional","affiliation":[{"name":"Division of Endocrine Surgery, Department of Surgery, Prince of Wales Hospital, Faculty of Medicine, University of Hong Kong , Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cindy L. 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