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Endocrine Abstracts (2012) 28 P342

1Endocrinology, Royal Vicoria Infirmary, Newcastle upon Tyne, United Kingdom; 2BTF, British Thyroid Foundation, Harrogate, United Kingdom; 3Centre for Endocrine and Diabetes Sciences, Cardiff Unversity, Cardiff, United Kingdom; 4Ophthalmology, Royal Victoria Infirmary, Newcastle, United Kingdom; 5Ophthalmology, Ninewells Hospital, Dundee, United Kingdom; 6TEDct, Thyroid Eye Disease Charitable Trust, Bristol, United Kingdom; 7Ophthalmology, Moorfields Eye Hospital, London, United Kingdom; 8Endocrinology, Devon and Exeter Hospital, Exeter, United Kingdom.


Graves’ orbitopathy affects approximately 0.25 million people in the UK and is associated with a significant psychological and socioeconomic burden. Surveys have illustrated that Graves’ orbitopathy is often treated inadequately. The Amsterdam Declaration is a recent incentive supported by many national and international professional and patient-led organizations including the SfE, aiming to improve the outcomes of patients with Graves’ orbitopathy. This report was produced by TEAMeD UK (Thyroid Eye disease Amsterdam Declaration Implementation Group UK), a recently established multidisciplinary group whose remit is to implement the objectives of the Amsterdam Declaration in the UK. Data on orbital decompression in England over a two year period between 2007–2009 were derived from CHKS Ltd and analysed by hospital and Primary Care Trust. 502 procedures were registered during the study period. 281/502 procedures (56%), were carried out in 8 hospital Trusts that performed more than 10 procedures per annum; 104/502 (21%) in 8 hospital Trusts that performed 5–8 procedures per year and the remaining 117 (23%) procedures were carried out in hospitals logging fewer than 5 procedures per annum. Analysis of the same data by Primary Care Trust showed that the median number of operations per 100,000 population/yr was 3.7, the range being 0.4 to 11.3, indicative of an almost thirty-fold variance in the rates of decompression performed per unit population. Populations of patients residing within 20 miles of the top 5 Trusts with the highest decompression activities were more likely to undergo orbital decompression than those living further affield (decompression rates 4.35 /100,000 vs 2.93/100,000, P<0.001). Expertise available to patients with Graves’ orbitopathy and access to specialist care in England appears to vary significantly by geographic location.

Declaration of interest: There is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

Funding: No specific grant from any funding agency in the public, commercial or not-for-profit sector.

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