Henry Völzke1, Iris Erlund2, Alicja Hubalewska-Dydejczyk3, Till Ittermann1, Robin P Peeters4, Margaret Rayman5, Monika Buchberger6, Uwe Siebert6, Betina H Thuesen7, Michael B Zimmermann8, Stefan Grünert9, John H Lazarus10. 1. Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany. 2. Department of Public Health Solutions, National Institute for Health and Welfare (THL), Helsinki, Finland. 3. Department of Endocrinology, Jagiellonian University Medical College, Krakow, Poland. 4. Department of Internal Medicine, Rotterdam Thyroid Centre, Erasmus Medical Centre, Rotterdam, the Netherlands. 5. University of Surrey, Surrey, United Kingdom. 6. Department of Public Health and Health Technology Assessment, UMIT, University for Health Science, Medical Informatics and Technology, Hall, Austria. 7. Research Centre for Prevention and Health, Glostrup, Denmark. 8. Swiss Federal Institute of Technology, Zürich Department of Health Sciences and Technology, Zürich, Switzerland. 9. Biolution GmbH, Vienna, Austria. 10. Institute of Molecular Medicine, Cardiff University, Cardiff, United Kingdom.
Abstract
BACKGROUND: Iodine deficiency disorders (IDD) represent a global health threat to individuals and societies. IDD prevention programmes have been introduced in many parts of the world. However, challenges remain, particularly in Europe due to fragmentation and diversity of approaches that are not harmonized. OBJECTIVES: This review is dedicated to the public-health impact of IDD prevention programmes. It sums up experiences collected by the EUthyroid consortium so far and provides information on stakeholders that should be involved in actions directed to improve the impact of IDD prevention. METHODS: A joint European database for combining registry-based outcome and monitoring data as well as tools for harmonizing study methods were established. Methods for analyzing thyroglobulin from a dried blood spot are available for assessing the iodine status in the general population and at-risk groups. Mother-child cohorts are used for in-depth analysis of the potential impact of mild-to-moderate iodine deficiency on the neurocognitive development of the offspring. A decision-analytic model has been developed to evaluate the long-term effectiveness and cost effectiveness of IDD prevention programmes. RESULTS: EUthyroid has produced tools and infrastructure to improve the quality of IDD monitoring and follows a dissemination strategy targeting policymakers and the general public. There are tight connections to major stakeholders in the field of IDD monitoring and prevention. CONCLUSIONS: EUthyroid has taken steps towards achieving a euthyroid Europe. Our challenge is to inspire a greater sense of urgency in both policymakers and the wider public to address this remediable deficit caused by IDD.
BACKGROUND: Iodine deficiency disorders (IDD) represent a global health threat to individuals and societies. IDD prevention programmes have been introduced in many parts of the world. However, challenges remain, particularly in Europe due to fragmentation and diversity of approaches that are not harmonized. OBJECTIVES: This review is dedicated to the public-health impact of IDD prevention programmes. It sums up experiences collected by the EUthyroid consortium so far and provides information on stakeholders that should be involved in actions directed to improve the impact of IDD prevention. METHODS: A joint European database for combining registry-based outcome and monitoring data as well as tools for harmonizing study methods were established. Methods for analyzing thyroglobulin from a dried blood spot are available for assessing the iodine status in the general population and at-risk groups. Mother-child cohorts are used for in-depth analysis of the potential impact of mild-to-moderate iodine deficiency on the neurocognitive development of the offspring. A decision-analytic model has been developed to evaluate the long-term effectiveness and cost effectiveness of IDD prevention programmes. RESULTS: EUthyroid has produced tools and infrastructure to improve the quality of IDD monitoring and follows a dissemination strategy targeting policymakers and the general public. There are tight connections to major stakeholders in the field of IDD monitoring and prevention. CONCLUSIONS: EUthyroid has taken steps towards achieving a euthyroid Europe. Our challenge is to inspire a greater sense of urgency in both policymakers and the wider public to address this remediable deficit caused by IDD.
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