Quality of Life and Decision Regret Risk in Graves' Disease After Radioactive Iodine Therapy: A Prospective Cohort Study
Authors' conclusion
Non-clinical factors (marital/employment/income status) and psychological states strongly predict post-RAI regret. Hypothyroidism remains unpredictable, but high DR risk can be accurately identified (AUC = 0.81) for targeted intervention. Persistent cognitive impairment requires clinical attention despite biochemical normalisation.
Study context
- Population
- Patients with Graves' disease (GD) receiving radioiodine (RAI) therapy
- Participants
- 500 patients
- Outcome
- Pre-treatment determinants of hypothyroidism and decision regret (DR) after RAI; longitudinal impact on health-related QoL
Methodological detailsmachine learning prediction models
- Machine learning prediction models
Main finding
As reported in the abstract
Determinants of high DR and prediction of DR and hypothyroidism
- Unmarried patients had significantly higher decision regret (DR)
- p < 0.001
- Unemployed patients had significantly higher DR (35.50 ± 23.15 vs. 27.01 ± 6.95)
- p = 0.032
- Higher income (> 5000 CNY/month) patients had significantly higher DR (29.67 ± 6.94 vs. 26.10 ± 7.95)
- p = 0.018
- Longer pre-RAI medication (> 12 months) increased regret (30.31 ± 15.96 vs. 27.48 ± 10.42)
- p = 0.015
- Hypothyroidism models: poor discrimination
- AUC ≤ 0.59
- DR prediction, LR model
- AUC = 0.81
- DR driven by pre-treatment stress
- β = 1.32, p < 0.001
- DR driven by pre-treatment anxiety
- β = 0.98, p = 0.003
Observational data: associations, not effects.
Further findings
Quality of life (QoL) over time · 3 and 6 months
- QoL improved in goitre at 3 months
- P < 0.001
- QoL improved in hypermetabolic symptoms at 3 months
- P < 0.001
- Overall QoL improved by 6 months
- P < 0.001
- Depression improved by 6 months
- P = 0.006
- Cognitive deficits persisted beyond 3 months
- P > 0.05
Original publication
Quality of Life and Decision Regret Risk in Graves' Disease After Radioactive Iodine Therapy: A Prospective Cohort Study. Clin Endocrinol (Oxf). Published 12 January 2026. doi:10.
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