to i) Epidemiological Insights
Although it will be difficult to accurately estimate prevalence and incidence of hypoparathyroidism using a cohort study based on patient self-enrolment and Clinician encouraged enrolment, it will nevertheless provide incidence & prevalence of complications, mortality and HRQoL outcomes within the studied cohort. This in turn can be extrapolated to the wider population, depending upon the end sample size as the UK epidemiological insights remain poorly characterized. This information is crucial for healthcare planning, resource allocation, and identifying regional disparities in diagnosis and care.
ii) Standardizing Care
Variation in clinical practice is a major challenge in managing hypoparathyroidism. For example, treatment strategies for post-surgical hypoparathyroidism differ widely among UK clinicians (11). A cohort study would facilitate the development of UK-standardized protocols by analyzing real-world treatment patterns and outcomes. This could reduce unwarranted variations in care and improve patient outcomes.
iii) Facilitating Research
A UK study would serve as a resource for observational studies and clinical trials. By providing a centralized dataset, it would reduce recruitment barriers for research, enabling studies on novel therapies and interventions. For instance, emerging treatments like recombinant PTH (rhPTH) and PTH analogues could be evaluated in a real-world context, complementing clinical trial data (12).
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iv) Distinguishing the UK Study
The UK NHS HYPOPT should build on the strengths of existing registries, such as PARADIGHM, the Swedish Hypoparathyroidism Registry, and the Danish Nationwide Registry, while addressing their limitations:
- Broader Inclusion Criteria: Unlike PARADIGHM, which focuses predominantly on patients receiving PTH replacement therapy, the UK NHS HYPOPT should capture a more diverse patient population, including those on standard care.
- Comprehensive Data on Comorbidities: The UK NHS HYPOPT will track long-term comorbidities like nephrocalcinosis, cardiovascular disease, and neurological disorders, areas underrepresented in some existing studies.
- Patient-Centred Outcomes: Emphasis will be placed on patient-reported outcomes, (HRQoL questionnaires, Pregnancy questionnaires, Hospital episode questionnaires) ultimately guiding tailored treatments where possible.
vi) Empowering Patients
Patient involvement is central to the success of any study. Engaging patients through advocacy groups such as Parathyroid UK could enhance study participation and ensure that research priorities align with patient needs. Furthermore, studies can empower patients by providing them with information about their condition and fostering a sense of community.
