Harnessing eConsultations to Improve Practice-Based Learning in Endocrinology

s / Can J Diabetes 39 (2015) 529e547 539 their quality of life. Although management strategies during the immediate post-operative period are well-described, there are limited recommendations regarding long-term management and monitoring of permanent post-surgical hypoparathyroidism beyond the first post-operative year. Purpose: To review published peer-reviewed articles to support development of a clinical algorithm to guide the long-term management of hypoparathyroidism after thyroid surgery. Methods: A literature search of MEDLINE and PubMed databases along with a guidelines search were performed. Articles reviewed were limited to English language. Results: Forty-one articles that met the search criteria were reviewed. No graded evidence-based guidelines were identified for the long-term management of postsurgical hypoparathyroidism. There is no consensus on the type and frequency of biochemistry monitoring for patients on pharmacological treatment for hypoparathyroidism. The ideal method to measure calcium levels (i.e. serum versus ionized) and the clinical utility of 24-hour urine calcium collections are unclear. There is a paucity of information on long-term outcomes such as nephrocalcinosis or renal failure. The results were synthesized to propose a best practice guide to managing long-term hypoparathyroidism. Conclusion: There is a significant knowledge gap regarding the ideal long-term treatment and monitoring of permanent hypoparathyroidism after thyroid surgery. This calls for an urgent need for research into the long-term consequences of postoperative hypoparathyroidism and formalized guidelines that can address potential concerns related to new options for treatment such as recombinant parathyroid hormone. 037-2015. CLINICAL CARE Harnessing eConsultations to Improve Practice-Based Learning in Endocrinology CHRISTOPHER TRAN*, DORA M. LIU, AMIR AFKHAM, CLARE E. LIDDY,