[A comparative analysis of diagnostic and therapeutic preferences for Graves' disease among Chinese and international endocrinologists].

Objective: To compare the diagnostic and therapeutic preferences for Graves' disease (GD) between Chinese and international endocrinologists. Methods: A secondary analysis was conducted on the results of a global questionnaire survey on the management preferences for GD from May 1 to August 31, 2023. The questionnaire consisted of 31 items covering the diagnosis and treatment of GD, as well as the management of patients under different clinical scenarios, including those with pregnancy plans or concurrent pregnancy, and those with recurrent GD. Differences in responses between endocrinologists in China and those in other countries were compared. Results: A total of 991 questionnaire responses from interviewed endocrinologists were deemed valid data, including 380 males, 604 females, and 7 physicians who declined to answer. Among them, there were 108 Chinese endocrinologists and 883 foreign endocrinologists. The age of Chinese endocrinologists was mainly concentrated in the 36-45 age group (43.5%, 47/108), while foreign endocrinologists were mostly over 45 years old (56.9%, 502/883). For the diagnosis of GD, both Chinese and foreign endocrinologists selected thyrotropin receptor antibody (TRAb), thyroid peroxidase antibody (TPOAb), free triiodothyronine (FT3), and thyroid-stimulating hormone re-examination as diagnostic indicators. The proportion of Chinese endocrinologists choosing TRAb [98.1% (106/108) vs 75.4% (666/883)], TPOAb [84.3% (91/108) vs 40.8% (360/883)], thyroglobulin antibody (TgAb) [82.4% (89/108) vs 24.7% (218/883)], and FT3 [58.3% (63/108) vs 28.1% (248/883)] was higher than that of foreign endocrinologists (all P<0.001). For GD treatment, antithyroid drugs (ATD) were selected as the preferred treatment method by both Chinese and foreign endocrinologists [95.4% (103/108) vs 94.2% (832/883), P=0.637]. When treating GD patients with pregnancy plans or concurrent pregnancy, Chinese endocrinologists were more likely to choose ATD or radioactive iodine therapy compared to foreign endocrinologists (both P<0.05). For patients with recurrent GD, Chinese endocrinologists had a significantly higher proportion of selecting long-term (≥24 months) ATD treatment compared to foreign endocrinologists (P<0.001). Conclusions: Chinese endocrinologists generally share similar core diagnostic and therapeutic strategy preferences (in terms of diagnostic items and first-choice medications) with their foreign counterparts for GD. However, they exhibit a higher selection rate for certain examination items and demonstrate differences from foreign endocrinologists in terms of treatment approaches and duration preferences for special GD patients.