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<div class="main-content lit-style"><div class="body-content whole_rhythm"><div id="ch3.tab3" class="table"><h3><span class="label">Table 3</span><span class="title">Summary of NRSs included in the evidence review</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577892/table/ch3.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch3.tab3_lrgtbl__"><table><thead><tr><th id="hd_h_ch3.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Study</th><th id="hd_h_ch3.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Intervention and comparison</th><th id="hd_h_ch3.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Population</th><th id="hd_h_ch3.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_ch3.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Comments</th></tr></thead><tbody><tr><td headers="hd_h_ch3.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Clifton-Bligh 2015<a class="bk_pop" href="/books/NBK577892/#ch3.ref27" data-bk-pop-rid="/books/NBK577892/def-item/ch3.ref27/" data-bk-pop-others=""><sup>27</sup></a></td><td headers="hd_h_ch3.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Parathyroidectomy vs Conservative management</p>
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<p>Follow-up: Not reported</p>
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</td><td headers="hd_h_ch3.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>n=561</p>
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<p>Diagnosed with PHPT either because surgery restored eucalcaemia, full investigation failed to find another cause of hypercalcaemia or serum calcium and PTH were above the upper limits of the reference range</p>
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<p>No details of severity of PHPT</p>
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<p>Protocol subgroups:
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<ol id="ch3.l14"><li id="ch3.lt61" class="half_rhythm"><div>Adjusted serum calcium: not stated</div></li><li id="ch3.lt62" class="half_rhythm"><div>Age: not stated</div></li><li id="ch3.lt63" class="half_rhythm"><div>Creatinine clearance: not stated</div></li><li id="ch3.lt64" class="half_rhythm"><div>End-organ effects: not stated</div></li></ol></p>
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</td><td headers="hd_h_ch3.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul id="ch3.l15"><li id="ch3.lt65" class="half_rhythm"><div>Mortality</div></li></ul></td><td headers="hd_h_ch3.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Adjusted for age, sex and time of diagnosis.</p>
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<p>Confounders in our protocol not adjusted for: serum calcium and end-organ effects.</p>
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<p>Retrospective cohort study</p>
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</td></tr><tr><td headers="hd_h_ch3.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Vanderwalde 2006<a class="bk_pop" href="/books/NBK577892/#ch3.ref87" data-bk-pop-rid="/books/NBK577892/def-item/ch3.ref87/" data-bk-pop-others=""><sup>87</sup></a> (Vanderwalde 2009<a class="bk_pop" href="/books/NBK577892/#ch3.ref88" data-bk-pop-rid="/books/NBK577892/def-item/ch3.ref88/" data-bk-pop-others=""><sup>88</sup></a>)</p>
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<p>(Results from second paper used: same study but second paper adjusted for BMD)</p>
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</td><td headers="hd_h_ch3.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Parathyroidectomy vs Conservative management</p>
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<p>Follow-up: 7.4 years (range: 13 days to 10 years)</p>
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</td><td headers="hd_h_ch3.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>n=533 (n=1569 in original study but BMD data not available for all people for adjusted analysis)</p>
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<p>People on the database defined as having PHPT if they had an intact parathyroid hormone (PTH) level greater than 65 pg/mL, a calcium level greater than 10.5 mg/dL (>2.6 mmol/L), and a creatinine level less than 2.5 mg/dL (<221.0 µmol/L).</p>
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<p>No details of severity of PHPT</p>
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<p>Protocol subgroups:
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<ol id="ch3.l16"><li id="ch3.lt66" class="half_rhythm"><div>Adjusted serum calcium: not stated</div></li><li id="ch3.lt67" class="half_rhythm"><div>Age: ≥50 years old (89% ≥ 50 years old)</div></li><li id="ch3.lt68" class="half_rhythm"><div>Creatinine clearance: not stated</div></li><li id="ch3.lt69" class="half_rhythm"><div>End-organ effects: not stated (22% had osteoporosis at baseline; kidney stones or history of fragility fractures not reported)</div></li></ol></p>
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</td><td headers="hd_h_ch3.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul id="ch3.l17"><li id="ch3.lt70" class="half_rhythm"><div>Fractures (hospitalised fractures)</div></li></ul></td><td headers="hd_h_ch3.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Adjusted for age, sex, Charlson comorbidity index (CCI); levels of calcium, PTH, and creatinine; BMD (T score femur)</p>
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<p>Confounders in our protocol not adjusted for: end-organ effects.</p>
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<p>Retrospective cohort study</p>
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<p>Outcome of fracture taken from records of hospitalised fractures (so would not pick up all vertebral fractures on radiograph or outpatient fractures of the extremities).</p>
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</td></tr><tr><td headers="hd_h_ch3.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Vestergaard 2003<a class="bk_pop" href="/books/NBK577892/#ch3.ref90" data-bk-pop-rid="/books/NBK577892/def-item/ch3.ref90/" data-bk-pop-others=""><sup>90</sup></a></td><td headers="hd_h_ch3.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Parathyroidectomy vs Conservative management</p>
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<p>Follow-up: 6.1 years</p>
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</td><td headers="hd_h_ch3.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>n=3213</p>
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<p>First time diagnosis from national hospital discharge database</p>
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<p>No details of severity of PHPT</p>
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<p>Protocol subgroups:
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<ol id="ch3.l18"><li id="ch3.lt71" class="half_rhythm"><div>Adjusted serum calcium: not stated</div></li><li id="ch3.lt72" class="half_rhythm"><div>Age: not stated</div></li><li id="ch3.lt73" class="half_rhythm"><div>Creatinine clearance: not stated</div></li><li id="ch3.lt74" class="half_rhythm"><div>End-organ effects: not stated</div></li></ol></p>
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</td><td headers="hd_h_ch3.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul id="ch3.l19"><li id="ch3.lt75" class="half_rhythm"><div>Mortality</div></li><li id="ch3.lt76" class="half_rhythm"><div>Fracture</div></li><li id="ch3.lt77" class="half_rhythm"><div>Kidney stones</div></li><li id="ch3.lt78" class="half_rhythm"><div>Cancer</div></li></ul></td><td headers="hd_h_ch3.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Adjusted for age, sex and presence of the endpoint in question at baseline.</p>
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<p>Confounders in our protocol not adjusted for: serum calcium and end-organ effects.</p>
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<p>Retrospective cohort study</p>
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<p>Outcomes are based on whether the person had a hospital contact for that outcome in the records.</p>
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</td></tr></tbody></table></div></div></div></div>
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<div class="post-content"><div><p>From: <a href="/books/NBK577892/" target="mainwindow">Evidence review for indications for surgery</a></p><div class="iconblock clearfix ten_col"><a class="img_link icnblk_img" title="Table of Contents Page" href="/books/n/niceng132er3/" target="mainwindow"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-niceng132er3-lrg.png" alt="Cover of Evidence review for indications for surgery" height="100px" width="80px" /></a><div class="icnblk_cntnt"><div><div>Evidence review for indications for surgery: Hyperparathyroidism (primary): diagnosis, assessment and initial management: Evidence review C.</div><div class="series-statement">NICE Guideline, No. 132.</div><div>National Guideline Centre (UK).</div><div>London: <a href="https://www.nice.org.uk" target="mainwindow" ref="pagearea=content-footer&targetsite=external&targetcat=link&targettype=publisher">National Institute for Health and Care Excellence (NICE)</a>; 2019 May.</div></div></div></div><div class="half_rhythm"><a href="/books/about/copyright/" target="mainwindow">Copyright</a> © NICE 2019.</div><p>NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p></div></div>
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