{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T20:41:43Z","timestamp":1775508103472,"version":"3.50.1"},"reference-count":34,"publisher":"The Endocrine Society","issue":"2","license":[{"start":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T00:00:00Z","timestamp":1738022400000},"content-version":"vor","delay-in-days":22,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100018942","name":"Biomedical Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100018942","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100031198","name":"Department of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100031198","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Purpose<\/jats:title>\n                  <jats:p>To describe diagnostic approaches and management strategies for patients with primary hyperparathyroidism (PHPT) and recent fracture in England.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We developed a survey based on a patient at high fracture risk and a new diagnosis of probable PHPT. The survey was circulated among 50 secondary care professionals identified by the Society for Endocrinology Calcium and Bone special interest group. Descriptive statistics, combinatorial, and thematic analyses were employed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In the patient with hyperparathyroidism and a recent fracture, 54% of respondents favoured a 24-hour urinary calcium: creatinine clearance ratio, with 85% opting to do so after correcting vitamin D levels. Thirty-two percent (16\/50) preferred the spot urinary calcium:creatinine clearance ratio, as a random test (56%, n = 9\/16). Ninety-six percent of the respondents agreed they would include a fracture risk assessment in their management plan. Eighty-five percent of the respondents selected dual-energy X-ray absorptiometry scans of the lumbar spine, total hip, and femoral neck as the most popular choice. Before initiating antiosteoporotic medications (AOMs), 94% of the respondents preferred correcting vitamin D levels with diverse regimens. IV zoledronate acid was the preferred AOM, and 58% (n = 29\/50) supported cinacalcet usage if the patient was ineligible for parathyroid surgery, while 26% (n = 13\/50) opposed cinacalcet use entirely. No significant correlation was found between status as an endocrinology consultant or working in a tertiary care hospital and these management preferences.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main Conclusion<\/jats:title>\n                  <jats:p>This study of National Health Service medical staff identified highly-varied clinical practices in managing PHPT in the setting of high fracture risk, highlighting the need for pragmatic guidelines and wider education.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/jendso\/bvae225","type":"journal-article","created":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T06:50:42Z","timestamp":1738047042000},"source":"Crossref","is-referenced-by-count":3,"title":["Assessing and Managing Primary Hyperparathyroidism and Fracture Risk in England: A Survey of Medical Professionals"],"prefix":"10.1210","volume":"9","author":[{"given":"Kaiyang","family":"Song","sequence":"first","affiliation":[{"name":"Medical Sciences Division, University of Oxford , Oxford OX3 9DU ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rohit","family":"Vijjhalwar","sequence":"additional","affiliation":[{"name":"Medical Sciences Division, University of Oxford , Oxford OX3 9DU ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mo","family":"Aye","sequence":"additional","affiliation":[{"name":"Centre for Metabolic Bone Diseases, Hull Royal Infirmary , Hull HU3 2JZ ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7104-2297","authenticated-orcid":false,"given":"Alexander N","family":"Comninos","sequence":"additional","affiliation":[{"name":"Endocrine Bone Unit, Imperial College Healthcare NHS Trust , London W2 1NY ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2204-2095","authenticated-orcid":false,"given":"Marian","family":"Schini","sequence":"additional","affiliation":[{"name":"Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield , Sheffield S10 2TN ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2497-6887","authenticated-orcid":false,"given":"Afroze","family":"Abbas","sequence":"additional","affiliation":[{"name":"Leeds Centre of Endocrinology and Diabetes, Leeds Teaching Hospitals NHS Trust , Leeds LS9 7TF ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neil","family":"Gittoes","sequence":"additional","affiliation":[{"name":"Centre for Endocrinology, Diabetes and Metabolism, Queen Elizabeth Hospital and University of Birmingham , Birmingham B15 2GW ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7985-0048","authenticated-orcid":false,"given":"Muhammad Kassim","family":"Javaid","sequence":"additional","affiliation":[{"name":"Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford , Oxford OX3 7LD ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","published-online":{"date-parts":[[2025,1,28]]},"reference":[{"issue":"2","key":"2025020307455334600_bvae225-B1","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1038\/nrendo.2017.104","article-title":"Primary hyperparathyroidism","volume":"14","author":"Walker","year":"2018","journal-title":"Nat Rev Endocrinol"},{"issue":"3","key":"2025020307455334600_bvae225-B2","doi-asserted-by":"crossref","first-page":"1122","DOI":"10.1210\/jc.2012-4022","article-title":"Incidence and prevalence of primary hyperparathyroidism in a racially mixed 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