Author response: Quality of life in patients with permanent hypoparathyroidism after thyroidectomy for benign thyroid disease: population-based study with long-term follow-up

Correspondence to: Matilda Annebäck (email: matilda.anneback@uu.se)

Department of Surgical Sciences

Uppsala University

Uppsala

Sweden

BJS Open, https://doi.org/10.1093/bjsopen/zraf032, published 07 May 2025

We thank Drs. Peng, Chen, and Meng for their thoughtful and constructive comments on our study.1

A key strength of our work is the use of a strict definition of permanent hypoparathyroidism and a long-term follow-up period, which enabled us to evaluate the lasting impact of the condition in a real-world setting. As noted, parathyroid hormone (PTH) replacement therapy was not widely available in Sweden during the study period, and our results therefore reflect outcomes under standard care conditions.

We agree that coping mechanisms may influence patients perceived quality of life, potentially modified by age or duration of disease. Regarding socioeconomic factors, we acknowledge that including such data would have strengthened the analysis. However, in a publicly financed healthcare system such as Sweden’s, major socioeconomic disparities between the groups are less likely to have influenced access to care or long-term outcomes.

Although not raised in the letter, we would also like to highlight the potential value of disease-specific quality-of-life instruments, such as the HPQ-28, in capturing the unique symptom burden associated with hypoparathyroidism. At the time our study was conducted, no validated Swedish version of the HPQ-28 was available. However, ongoing work in this area will hopefully make such tools accessible in the near future. While our study used a generic HRQoL measure, future investigations should consider incorporating disease-specific tools to more accurately reflect patient experience.

We are encouraged that our findings can contribute to a more nuanced understanding of permanent hypoparathyroidism and help support individualized, patient-centred management.

Sincerely,

Matilda Annebäck, MD, PhD

On behalf of the authors