{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T06:34:00Z","timestamp":1787898840476,"version":"build-2784847793"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2022,12,14]],"date-time":"2022-12-14T00:00:00Z","timestamp":1670976000000},"content-version":"vor","delay-in-days":42,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>When applying intraoperative parathyroid hormone monitoring (IOPTH) to patients with primary hyperparathyroidism (PHPT), there are established criteria predicting biochemical cure in patients with basal parathyroid hormone (PTH) levels in the medium range (100\u2013400\u2005pg\/ml); however, there is a challenge concerning patients with low (less than 100\u2005pg\/ml) or high (more than 400\u2005pg\/ml) basal PTH levels. The aim of this study was to investigate the value of the \u2018Vienna criterion\u2019 applied during IOPTH in patients with PHPT and various basal PTH concentrations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive patients between 1999\u20132009 with a biochemical diagnosis of PHPT who underwent surgical parathyroidectomy were included. Based on preoperative PTH levels they were divided into three groups: group 1 (low) (&amp;lt;100 pg\/ml), group 2 (medium) (100\u2013400 pg\/ml) and group 3 (high) (&amp;gt;400 pg\/ml) basal PTH. PTH was measured at the start of the operation, when the gland was excised and then at 5, 10 and 15 min after. Calcium and PTH levels were measured at 7 days and 12 months postoperatively. Sensitivity, specificity, positive and negative predictive value, as well as accuracy of IOPTH were calculated for the different groups postoperatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>675 patients with PHPT were analysed. Sensitivity and specificity were 83.7 per cent and 66.7 per cent in group 1 (n = 187), 90.7 per cent and 69.2 per cent in group 2 (n = 433), and 94.4 per cent and 100 per cent in group 3 (n = 55) to predict cure. Preoperative creatinine (p = 0.002) showed significant statistical difference between the groups but was not related to intraoperative PTH decline. At 12 months follow-up normocalcaemia was documented in 98.9 per cent in group 1, 99.0 per cent group 2, and 98.0 per cent of group 3 patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Normocalcaemia was predicted intraoperatively by applying the \u2018Vienna criterion\u2019 in 98 to 100 per cent and was confirmed after 12 months follow-up in up to 99.0 per cent of patients. Low specificity and a high false-negative rate in patients with low basal PTH show that other criteria might be better suited for this group.<\/jats:p><\/jats:sec>","DOI":"10.1093\/bjsopen\/zrac118","type":"journal-article","created":{"date-parts":[[2022,12,14]],"date-time":"2022-12-14T14:29:25Z","timestamp":1671028165000},"source":"Crossref","is-referenced-by-count":14,"title":["The value of intraoperative parathyroid hormone monitoring in patients with primary hyperparathyroidism and varying baseline parathyroid hormone levels"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9363-8323","authenticated-orcid":false,"given":"Lindsay","family":"Hargitai","sequence":"first","affiliation":[{"name":"Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna , Vienna , Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen Maria","family":"Bereuter","sequence":"additional","affiliation":[{"name":"Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna , Vienna , Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Dunkler","sequence":"additional","affiliation":[{"name":"Section for Clinical Biometrics, Centre for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna , Vienna , Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelika","family":"Geroldinger","sequence":"additional","affiliation":[{"name":"Section for Clinical Biometrics, Centre for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna , Vienna , Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Scheuba","sequence":"additional","affiliation":[{"name":"Division of Visceral Surgery, Department of General Surgery, Medical University of 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