Application of multi-disciplinary team clinic in thyroid eye disease_West China Medical Journal

Authors：

DAI Jialing ¹ , HE Qian ¹ ,  HE Weimin ²

1. Rare Diseases Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

HE Weimin, Email: hewm888@hotmail.com

Keywords：

Thyroid eye disease; multi-disciplinary team; clinic

DOI：

10.7507/1002-0179.202308061

Video：

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Objective To analyze the implementation of multi-disciplinary team (MDT) clinic for thyroid eye disease (TED) and explore the significance of TED MDT clinic. Methods A retrospective analysis was conducted on the medical records of patients who visited TED MDT clinic at West China Hospital of Sichuan University between December 1, 2022 and November 30, 2024. Patient condition indicators were collected and MDT outpatient operation indicators were statistically analyzed. Results During the study period, a total of 696 patients were admitted to the TED MDT clinic, with an average age of (51.14±12.00) years. All patients were diagnosed with TED and showed symptoms of extraocular muscle involvement and restricted eye movement. According to the NOSPECS clinical grading system, all patients were classified as grade 4 or above. Among them, 693 patients’ orbital enhanced MRI showed that the extraocular muscles were in an inflammatory active phase, and 690 patients received periarbital injection of triamcinolone acetonide, precise orbital radiation therapy, and thyroid function regulation. During the research period, TED MDT clinic received a total of 90 visits, with an average of 7.73 patients per visit. The patient satisfaction rate was 99.67%, and there were no cases of experts being late, absent, or doctors with insufficient qualifications to participate in discussions. Conclusion The TED MDT clinic has been well developed, and the experts within the team attach great importance to it, making it valuable for continued large-scale promotion.

Citation： DAI Jialing, HE Qian, HE Weimin. Application of multi-disciplinary team clinic in thyroid eye disease. West China Medical Journal, 2025, 40(4): 579-582. doi: 10.7507/1002-0179.202308061 Copy

1.	Wang Y, Smith TJ. Current concepts in the molecular pathogenesis of thyroid-associated ophthalmopathy. Invest Ophthalmol Vis Sci, 2014, 55(3): 1735-1748.
2.	國家衛生健康委員會. 腫瘤多學科診療試點工作方案(2018-2020 年). 北京: 國家衛生健康委員會, 2018.
3.	Alexandersson N, Rosell L, Wihl J, et al. Determinants of variable resource use for multidisciplinary team meetings in cancer care. Acta Oncol, 2018, 57(5): 675-680.
4.	Prabhakar CN, Fong KM, Peake MD, et al. The effectiveness of lung cancer MDT and the role of respiratory physicians. Respirology, 2015, 20(6): 884-888.
5.	代佳靈, 何為民, 何謙. 多學科診療活動期重度甲狀腺相關眼病一例. 華西醫學, 2024, 39(1): 164-166.
6.	Bartley GB, Gorman CA. Diagnostic criteria for Graves’ ophthalmopathy. Am J Ophthalmol, 1995, 119(6): 792-795.
7.	曾鵬, 余韻, 范淑賢, 等. 甲狀腺相關眼病的 EUGOGO 臨床分級特征. 中山大學學報(醫學科學版), 2018, 39(6): 884-890.
8.	Abukar AA, Ramsanahie A, Martin-Lumbard K, et al. Availability and feasibility of structured, routine collection of comorbidity data in a colorectal cancer multi-disciplinary team (MDT) setting. Int J Colorectal Dis, 2018, 33(8): 1057-1061.
9.	Grover S, Chiyapo SP, Puri P, et al. Multidisciplinary gynecologic oncology clinic in botswana: a model for multidisciplinary oncology care in low- and middle-income settings. J Glob Oncol, 2017, 3(5): 666-670.
10.	國家衛生健康委, 國家中醫藥管理局. 改善就醫感受提升患者體驗主題活動方案(2023-2025 年). 北京: 國家衛生健康委, 2023.
11.	陳威, 趙紅, 王娜, 等. 醫療機構推廣多學科診療案例分析. 中華醫院管理雜志, 2019, 35(4): 302-306.
12.	Muralidhar A, Das S, Tiple S. Clinical profile of thyroid eye disease and factors predictive of disease severity. Indian J Ophthalmol, 2020, 68(8): 1629-1634.
13.	Tramunt B, Imbert P, Grunenwald S, et al. Sight-threatening Graves’ orbitopathy: twenty years’ experience of a multidisciplinary thyroid-eye outpatient clinic. Clin Endocrinol (Oxf), 2019, 90(1): 208-213.
14.	Du B, Wang Y, Yang M, et al. Clinical features and clinical course of thyroid-associated ophthalmopathy: a case series of 3620 Chinese cases. Eye (Lond), 2021, 35(8): 2294-2301.
15.	Rivera-Grana E, Lin P, Suhler EB, et al. Methotrexate as a corticosteroid-sparing agent for thyroid eye disease. J Clin Exp Ophthalmol, 2015, 6(2): 422.
16.	Werner SC. Modification of the classification of the eye changes of Graves’ disease. Am J Ophthalmol, 1977, 83(5): 725-727.
17.	李冬梅, 姜雪. 規范甲狀腺相關眼病眶周注射糖皮質激素的治療. 中華眼科雜志, 2022, 58(9): 641-645.
18.	Li YJ, Luo Y, He WM, et al. Clinical outcomes of Graves’ ophthalmopathy treated with intensity modulated radiation therapy. Radiat Oncol, 2017, 12(1): 171.
19.	Miko? H, Miko? M, Obara-Moszyńska M, et al. The role of the immune system and cytokines involved in the pathogenesis of autoimmune thyroid disease (AITD). Endokrynol Pol, 2014, 65(2): 150-155.
20.	樊琳琳, 吳君麗, 盧穎, 等. 激素沖擊治療聯合放射治療對中重度 Graves 眼病臨床療效分析. 現代生物醫學進展, 2016, 16(24): 4734-4736, 4743.

1. Wang Y, Smith TJ. Current concepts in the molecular pathogenesis of thyroid-associated ophthalmopathy. Invest Ophthalmol Vis Sci, 2014, 55(3): 1735-1748.
2. 國家衛生健康委員會. 腫瘤多學科診療試點工作方案(2018-2020 年). 北京: 國家衛生健康委員會, 2018.
3. Alexandersson N, Rosell L, Wihl J, et al. Determinants of variable resource use for multidisciplinary team meetings in cancer care. Acta Oncol, 2018, 57(5): 675-680.
4. Prabhakar CN, Fong KM, Peake MD, et al. The effectiveness of lung cancer MDT and the role of respiratory physicians. Respirology, 2015, 20(6): 884-888.
5. 代佳靈, 何為民, 何謙. 多學科診療活動期重度甲狀腺相關眼病一例. 華西醫學, 2024, 39(1): 164-166.
6. Bartley GB, Gorman CA. Diagnostic criteria for Graves’ ophthalmopathy. Am J Ophthalmol, 1995, 119(6): 792-795.
7. 曾鵬, 余韻, 范淑賢, 等. 甲狀腺相關眼病的 EUGOGO 臨床分級特征. 中山大學學報(醫學科學版), 2018, 39(6): 884-890.
8. Abukar AA, Ramsanahie A, Martin-Lumbard K, et al. Availability and feasibility of structured, routine collection of comorbidity data in a colorectal cancer multi-disciplinary team (MDT) setting. Int J Colorectal Dis, 2018, 33(8): 1057-1061.
9. Grover S, Chiyapo SP, Puri P, et al. Multidisciplinary gynecologic oncology clinic in botswana: a model for multidisciplinary oncology care in low- and middle-income settings. J Glob Oncol, 2017, 3(5): 666-670.
10. 國家衛生健康委, 國家中醫藥管理局. 改善就醫感受提升患者體驗主題活動方案(2023-2025 年). 北京: 國家衛生健康委, 2023.
11. 陳威, 趙紅, 王娜, 等. 醫療機構推廣多學科診療案例分析. 中華醫院管理雜志, 2019, 35(4): 302-306.
12. Muralidhar A, Das S, Tiple S. Clinical profile of thyroid eye disease and factors predictive of disease severity. Indian J Ophthalmol, 2020, 68(8): 1629-1634.
13. Tramunt B, Imbert P, Grunenwald S, et al. Sight-threatening Graves’ orbitopathy: twenty years’ experience of a multidisciplinary thyroid-eye outpatient clinic. Clin Endocrinol (Oxf), 2019, 90(1): 208-213.
14. Du B, Wang Y, Yang M, et al. Clinical features and clinical course of thyroid-associated ophthalmopathy: a case series of 3620 Chinese cases. Eye (Lond), 2021, 35(8): 2294-2301.
15. Rivera-Grana E, Lin P, Suhler EB, et al. Methotrexate as a corticosteroid-sparing agent for thyroid eye disease. J Clin Exp Ophthalmol, 2015, 6(2): 422.
16. Werner SC. Modification of the classification of the eye changes of Graves’ disease. Am J Ophthalmol, 1977, 83(5): 725-727.
17. 李冬梅, 姜雪. 規范甲狀腺相關眼病眶周注射糖皮質激素的治療. 中華眼科雜志, 2022, 58(9): 641-645.
18. Li YJ, Luo Y, He WM, et al. Clinical outcomes of Graves’ ophthalmopathy treated with intensity modulated radiation therapy. Radiat Oncol, 2017, 12(1): 171.
19. Miko? H, Miko? M, Obara-Moszyńska M, et al. The role of the immune system and cytokines involved in the pathogenesis of autoimmune thyroid disease (AITD). Endokrynol Pol, 2014, 65(2): 150-155.
20. 樊琳琳, 吳君麗, 盧穎, 等. 激素沖擊治療聯合放射治療對中重度 Graves 眼病臨床療效分析. 現代生物醫學進展, 2016, 16(24): 4734-4736, 4743.

West China Medical Journal

Application of multi-disciplinary team clinic in thyroid eye disease

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