{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T00:38:28Z","timestamp":1793320708440,"version":"4.5.0"},"reference-count":17,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Thyroid\u00ae"],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Graves\u2019 disease is the leading cause of hyperthyroidism in children and adolescents, with recent studies indicating a rising incidence. Epidemiological data on trends and determinants influencing this rise remain limited. This study aims to assess the trends in incidence of pediatric Graves\u2019 disease in the United States and stratify incidence patterns based on patient sex, age, geographic region, urban vs. rural setting, and insurance plan type.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This retrospective cohort study utilized the Merative\u2122 Marketscan\u00ae outpatient insurance claims database from 2007 to 2022. Pediatric patients diagnosed with Graves\u2019 disease were identified using International Classification of Diseases (ICD)-9 and ICD-10 codes. Annual incidence rates were analyzed over the study period to detect temporal trends. Incidence rates were further stratified by demographic variables including sex, age, geographic region, community setting (urban vs. rural), and insurance plan. Statistical methods included chi-square, ANOVA, and linear regression models to identify significant trends and differences across subgroups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      3377 total new diagnoses of pediatric Graves\u2019 disease were identified during the 16-year study period. The average annual incidence rate was 3.33 per 100,000 (SD = 0.33), with an annual increase of 0.042 per 100,000 (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.39). Marked differences in average annual incidence rates were observed across sex and age group; female patients exhibited greater average annual incidence rate (5.04 per 100,000) compared with male patients (1.67 per 100,000). Adolescents, patients 13\u201317 years of age, had the highest average annual incidence rate (5.72 per 100,000) compared with other age groups. On multivariable regression analysis, female patients had a significant increase in annual incidence by 1.69 cases per 100,000 compared with male patients [CI: 0.82\u20132.56]. Adolescents also saw a significant increase in adjusted annual incidence by 4.92 cases per 100,000 compared with the other age groups [CI: 3.80\u20136.04]. No significant change in annual incidence rate was observed across insurance plan, geographic region, or rural status.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This study quantifies and delineates trends in pediatric Graves\u2019 disease incidence in the United States. The greatest average incidence rate was observed among female and adolescent patients. This study underscores the importance of monitoring Graves\u2019 disease trends to facilitate early disease detection and management. Further research is needed to elucidate the genetic and environmental factors underlying these epidemiological trends.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10507256251382559","type":"journal-article","created":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T15:27:56Z","timestamp":1758554876000},"page":"1345-1349","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Incidence of Pediatric Graves\u2019 Disease in the United States: An Epidemiological Analysis of 2007\u20132022 Outpatient Insurance Claims"],"prefix":"10.1177","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1066-8381","authenticated-orcid":false,"given":"Srinidhi","family":"Polkampally","sequence":"first","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akash S.","family":"Halagur","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA."},{"name":"Geisel School of Medicine at Dartmouth, Hanover, NH, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allen","family":"Green","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Qian","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Rady Children\u2019s Hospital, UC San Diego School of Medicine, La Jolla, CA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Donner","sequence":"additional","affiliation":[{"name":"Division of Pediatric Endocrinology and Diabetes, Stanford University School of Medicine, Stanford, CA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilary","family":"Seeley","sequence":"additional","affiliation":[{"name":"Division of Pediatric Endocrinology and Diabetes, Stanford University School of Medicine, Stanford, CA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4983-3068","authenticated-orcid":false,"given":"Kara D.","family":"Meister","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,12,24]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2013.12.047"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/11795514221150615"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2021.2715"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2265.2001.01252.x"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1530\/eje.0.1300565"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.993733"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2018-00273"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2009.03717.x"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1159\/000500265"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eprac.2023.01.011"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/0026-0495(72)90041-8"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","unstructured":"Stanford Center for Population Health Sciences. 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