Audit Of Outcomes Research Articles

Do charitable auditors deliver better audit quality? Evidence from Chinese CPAs

ABSTRACT This paper investigates the relationship between auditors’ participation in charity and audit outcomes. Using charitable activity records of Chinese CPAs, we find that auditors who engage in charitable activities are associated with significantly better audit quality. Specifically, we examine engagement auditors and review auditors separately and find that engagement auditors with records of charitable activities demonstrate lower discretionary accruals and are more conservative in issuing modified audit opinions. However, firms with review auditors who engage in charitable activities are associated with fewer restatements. Taken together, our results suggest that an individual auditor’s charity activity is associated with audit quality.

Female directors, audit effort and financial reporting quality

ABSTRACT This paper analyses the influence of female directors on the demand for audit effort and on financial reporting quality for a sample of Australian non-financial listed firms over the period 2004–2018. Our results suggest that gender diversity at the Board and the audit committee have a beneficial impact both on the demand of audit effort and on the outcomes of the audit process. This beneficial effect of female directors is attributable to non-executive directors. Long tenured and busy female directors and women chairing the board or the audit committee are revealed as especially influential at improving audit efforts and outcomes. We obtain further indication that audit effort and reporting quality improve from the first women added to the board not being necessary to attain a certain critical mass to generate these effects. Also, gender diversity improves the external auditor independence though the presence of lower of non-audit fees. The results are robust to endogeneity corrections. Evidence from the Australian market provides a positive argument for small and mid-cap Australian listed firms to follow the path of large Australian listed firms towards gender diversity.

The learning curve to attain surgical competency in robotic colorectal surgery.

The aim of the study was to assess the robotic colorectal surgery (RCS) learning curve of an experienced surgeon. A retrospective review of 117 consecutive patients who underwent total RCS at a single institution between October 2018 and July 2021 was performed. Patient demographics, surgery indications, operation type, intraoperative data, histopathology, morbidity and mortality, and length of stay were analysed. Cumulative summation technique (CUSUM) was used to construct a learning curve of surgeon console and total operation times (SCT and TOT). There was no open conversion, positive resection margin and mortality in the study population. There were four Clavien-DIndo grade III complications and one local recurrence. The range for SCT was 18-855 min (mean 214, median 211) and TOT was 68-937 min (mean 302, median 291). The SCT CUSUM graph identified change in slope at cases 44 and 88, which divided the learning curve into three distinct phases. Patient demographics were similar through the three phases. There was proportionally more cancer cases performed in the first phase (P= 0.001). The mean SCT was significantly higher in Phase 2 when compared with Phases 1 and 3 (P= 0.03). The failure rate was similar through the three phases. There was a non-significant steady decline in LOS over the three phases, from 6.9 to 6.1 days. Experienced colorectal surgeons can perform robotic surgery safely, even on patients with high complexity early in the learning curve. Audit of patient outcome should be an important component of learning curve assessment.

Time Out: Auditor Perceptions and Audit Outcomes When an Audit Firm Decides Not to Require Its Auditors to Report Billable Time

Time Out: Auditor Perceptions and Audit Outcomes When an Audit Firm Decides Not to Require Its Auditors to Report Billable Time

Paediatric cataracts in a tertiary eye centre in South-South Nigeria: An initial audit of surgical outcome

Background: Paediatric cataracts is a leading cause of treatable blindness and a major cause of blindness in developing nations. Aim: To present an audit of paediatric cataract and paediatric cataract surgery in a Tertiary Eye Care facility in the South-South Geopolitical Zone of Nigeria during the Seeing is Believing Project intervention. Materials and Methods: A retrospective study of case notes of children who received surgical and adjunctive treatment for cataracts in the Calabar Children's Eye Centre during the 24-month study period from November 1, 2017, to October 31, 2019, was undertaken. Results: Of the 128 children who met the inclusion criteria, 73 (57.0%) were males and 55 (43.0%) were females, giving a male: female ratio of 1.3:1.0. The mean age of patients in years was 5.9 ± 4.1 years, median/interquartile range was 5.0/5. The most frequent diagnosis was bilateral cataracts affecting 80 (62.5%) children. Systemic comorbidities were found in 13/128 (10.2%), of which 7/13 (53.8%) were congenital rubella syndrome. Ocular comorbidities (40.6%) were more common than systemic comorbidities, and sensory esotropia presented most frequently (16.4%). More patients with congenital cataracts had ocular comorbidities, and this association was statistically significant, P < 0.001. The proportion of patients with good visual outcomes was highest among those with bilateral cataracts (64.8%), and ocular comorbidities were a significant negative predictor of best corrected postoperative visual acuity. A total of 94/128 (73.4%) patients received intraocular lens implants, and the most common postoperative complications were visual axis opacification (VAO) 37/69 (53.6%) and fibrinous uveitis 26/69 (37.7). Conclusion: Paediatric cataracts were often bilateral and congenital. Postoperative complications like VAO are common and can be detected early and treated to improve visual outcomes with good follow-up strategies.

Research priorities for vascular services: results of the UK Vascular James Lind Alliance Priority Setting Process

Introduction: The configuration of vascular services is a challenging process where treatment options, access and delivery of services is variable. There is a significant financial burden to the NHS due to rising demand for vascular services; however, guidelines for treatment options and delivery are frequently based on low levels of clinical and cost effectiveness evidence. Therefore, further research is required but capacity is limited and funding is highly competitive. To address this issue, the Vascular Society of Great Britain and Ireland (VSGBI) in association with the James Lind Alliance (JLA) undertook a national Priority Setting Process (PSP) for vascular conditions. This paper presents the results of this process, with a focus on the topic of ‘vascular services’. Methods: A modified JLA Priority Setting Partnership was implemented in three overarching phases: (1) a clinician-led survey to gather clinician research priorities; (2) a patient and carer-led survey to gather patient and carer research priorities; (3) a consensus workshop to discuss clinician and patient priorities and agree a list of joint research priorities. Consensus was achieved using the nominal group technique and a ranked ‘top 10’ list of research priorities for vascular services was established. Results: In the first phase (clinician-led survey), 481 clinicians submitted 1,231 research priorities related to vascular conditions in general. Of these, 338 service-related research priorities were reduced to 16 overarching summary priorities recirculated for interim scoring. In the second phase (patient and carer-led survey), 373 patients and carers submitted 582 research priorities. Of these, 25 service-related priorities were developed and recirculated for interim scoring. In the third phase (consensus workshop), clinician and patient priorities were amalgamated into 18 priorities for discussion. The final ‘top 10’ list of vascular service research priorities relate to: service configuration (organisation, access and delivery), patient experience, education and training (staff and patients), lifestyle and prevention, audit and evaluation and outcomes, diagnostics screening and risk assessment and communication. Conclusion: The ‘top 10’ vascular service-related priorities demonstrate the research areas considered to be most important from the perspective of patients, carers and healthcare professionals. Researchers can now focus their efforts on addressing these important questions and funders should increase their investment to support new research in these areas of greatest importance.

The influence of corporate governance practices on public sector sustainable development: A developing economy study

The study examines the relationship between corporate governance practices (CGPs) on the public sector’s investment in water management (IWM). The critical question addressed in the paper was how good CGPs can provide a vehicle for increasing IWM in the context of local government. The need for addressing an underinvestment gap in local government is necessitated by the surge in poor CGPs that continue to constrain efforts to attract and manage water sector investments (WSIs) (Jacobs, 2019). The study employed secondary data (2009–2019) concerning a sample of eight South African metropolitan municipalities (SAMMs) collected from the annual reports. The multivariate regression analysis is employed using the pooled ordinary least squares (POLS) and feasible generalised least squares (FGLS) models. The results revealed that gender equity and external audit outcomes had a positive and significant relationship with IWM except for human resources which shows an insignificant effect. The results have important implications for water service authorities (WSAs), the public sector, and policymakers to incorporate good CGPs for improved management of water investments to eliminate water provisioning challenges. The research findings acknowledge the degree of adherence to good CGPs requires endless attention. Future studies should focus on ensuring local municipalities comply with the existing water provisioning governance framework to eliminate shortfalls in IWM.

Admissions to a Low-Resource Neonatal Unit in Malawi Using a Mobile App and Dashboard: A 1-Year Digital Perinatal Outcome Audit.

Introduction: Understanding the extent and cause of high neonatal deaths rates in Sub-Saharan Africa is a challenge, especially in the presence of poor-quality and inaccurate data. The NeoTree digital data capture and quality improvement system has been live at Kamuzu Central Hospital, Neonatal Unit, Malawi, since April 2019.Objective: To describe patterns of admissions and outcomes in babies admitted to a Malawian neonatal unit over a 1-year period via a prototype data dashboard.Methods: Data were collected prospectively at the point of care, using the NeoTree app, which includes digital admission and outcome forms containing embedded clinical decision and management support and education in newborn care according to evidence-based guidelines. Data were exported and visualised using Microsoft Power BI. Descriptive and inferential analysis statistics were executed using R.Results: Data collected via NeoTree were 100% for all mandatory fields and, on average, 96% complete across all fields. Coverage of admissions, discharges, and deaths was 97, 99, and 91%, respectively, when compared with the ward logbook. A total of 2,732 neonates were admitted and 2,413 (88.3%) had an electronic outcome recorded: 1,899 (78.7%) were discharged alive, 12 (0.5%) were referred to another hospital, 10 (0.4%) absconded, and 492 (20%) babies died. The overall case fatality rate (CFR) was 204/1,000 admissions. Babies who were premature, low birth weight, out born, or hypothermic on admission, and had significantly higher CFR. Lead causes of death were prematurity with respiratory distress (n = 252, 51%), neonatal sepsis (n = 116, 23%), and neonatal encephalopathy (n = 80, 16%). The most common perceived modifiable factors in death were inadequate monitoring of vital signs and suboptimal management of sepsis. Two hundred and two (8.1%) neonates were HIV exposed, of whom a third [59 (29.2%)] did not receive prophylactic nevirapine, hence vulnerable to vertical infection.Conclusion: A digital data capture and quality improvement system was successfully deployed in a low resource neonatal unit with high (1 in 5) mortality rates providing and visualising reliable, timely, and complete data describing patterns, risk factors, and modifiable causes of newborn mortality. Key targets for quality improvement were identified. Future research will explore the impact of the NeoTree on quality of care and newborn survival.

O-B06 The Impact of Covid-19 on Bariatric surgery in England during 2020

BackgroundThe Covid-19 pandemic had a significant impact on NHS services across England. Due to the significant rise in demand for beds in both ward and ITU environments, trusts were forced to reduce the number of operations carried out to help reduced the burden on secondary care services. Whilst efforts were made to preserve operations where possible, the Covid-19 burden has had a significant impact on bariatric surgery throughout 2020. The following research looks at the true impact of Covid-19 on bariatric surgery in England and analyses this in relation to the Covid-19 burden.MethodsData relating to operation numbers was taken from The Surgical Workload Outcomes Audit (SWORD) database. The SWORD database was interrogated for the years 2017 – 2020. A mean number of operations was calculated using the 2017-2019 data and compared to data from 2020 for gastric bypass, sleeve gastrectomy, gastric banding and biliopancreatic diversion. Operations performed and other demographic data was analysed regionally and compared to Covid-19 deaths throughout England. Covid-19 data was obtained from the national government dashboards.ResultsThe results of the study show that Nationally there was a significant decline in bariatric surgery operations carried out throughout 2020 due to the Covid-19 pandemic. Overall there was a 53.5% reduction in bariatric surgery operations carried out in 2020. Looking at the individual operation types, there was a 50.7% reduction in gastric bypass surgery, a 50% reduction in biliopancreatic diversion and a 51.9% reduction in sleeve gastrectomy. There was a greater reduction in gastric bands, with a 78.1 % reduction in procedures which may also reflect changes in current practice with regards to the use of gastric bands. On reviewing data at a local level, all trusts were significantly impacted by the pandemic with the reduction in services ranging from 50% to 100% reduction in operations performed.ConclusionsOverall, despite national efforts to preserve as many operations as possible, there was a significant reduction in the delivery of bariatric surgery services throughout England during the Covid-19 pandemic. Due to this reduction in service provision, it is likely that there are now much larger waiting lists which will need to be addressed as we recover from the Covid-19 pandemic. Whilst there was a similar reduction in services across most trusts due to the elective nature of the operations, variation should be further analysed to allow for better planning and resource allocation for futor future waves or future pandemics.

P-OGC83 The Impact of Covid-19 on Malignant Upper GI Operations in England During 2020

BackgroundDue to the Covid-19 pandemic and the overwhelming number of patients requiring ITU due to serious Covid-19 infections, trusts throughout England reduced their operation numbers to reduce the burden on secondary care services. Whilst efforts were made to preserve cancer services in England, the Covid-19 burden still significantly impacted the provision of oesophagectomies and gastrectomies. The following research aims to look at the true impact of Covid-19 on operation numbers in England and compare these to the Covid-19 burden. MethodsData relating to operation numbers was taken from The Surgical Workload Outcomes Audit (SWORD) database. The SWORD database was interrogated for the years 2017 – 2020. A mean number of operations was calculated using the 2017-2019 data and compared to data from 2020. Operations performed and other demographic data was analysed regionally and compared to Covid-19 deaths throughout England. Covid-19 data was obtained from the national government dashboards. ResultsResults showed that there was a significant reduction in the number of operations performed in 2020 due to the Covid-19 pandemic. This was closely correlated with Covid deaths throughout England. Variations between centres were present throughout the UK, however the overall trend reflected more than a 40% reduction in gastrectomies and more than a 30% reduction in oesophagectomies, which equated to 1018 less gastrectomies and 490 less oesophagectomies performed in 2020. There was significant variation between centres, the impact on individual centres and oesophagectomy rates ranged from -0.8% reduction to a 100% reduction in operations carried out in 2020. Gastrectomies was similarly affected, varying between a 2.7% and 89.5% reduction in operations carried out in 2020. ConclusionsOverall, despite efforts to preserve procedures, particularly for malignant disease, there was significant fall in operations performed throughout 2020. As a consequence of this, it is likely that patients requiring life saving or life extending operations did not receive their treatment. The data suggests that overall gastrectomies were worse hit than oesophagectomies across England. Variances in performance across the UK should be further analysed to allow better planning and resource allocation for future waves or future pandemics.

P-BN45 The Impact of Covid-19 on Benign Upper GI Operations in England During 2020

BackgroundSince the cancellation of elective surgery in early 2020 due to the threat of Covid-19, surgical provisions in England have continued to be affected by the Covid-19 pandemic. Elective surgery makes up the majority of surgical procedures performed in England and therefore cancelled operation lists and increased demand for ITU beds has had a significant impact upon the surgical services delivered to patients through out 2020. The following research looks at the impact of Covid-19 on benign upper GI surgery in England and reviews the relationship between Covid-19 deaths and operations performed throughout England and analyses the data at a regional level. MethodsData relating to operation numbers was taken from The Surgical Workload Outcomes Audit (SWORD) database. The SWORD database was interrogated for the years 2017 – 2020. A mean number of operations was calculated using the 2017-2019 data and compared to data from 2020. Operations performed and other demographic data was analysed regionally and compared to Covid-19 deaths throughout England. Covid-19 data was obtained from the national government dashboards. ResultsThe results show that there is a correlation with increasing Covid deaths and lower rates of elective surgery. Furthermore, elective surgery was worse hit than emergency surgery with a slower recovery overall. Cholecystectomies were reduced by a total of 20817 (31.4%) for the year 2020 with a greater reduction seen in elective operations (35.6%). However, similar reductions were seen in both laparoscopic (31.4%) and open (37.5%) Similarly, bile duct explorations and elective splenectomy were reduced by 34.4% and 23.4% respectively. Comparatively, both paraumbilical and inguinal hernias also saw reductions of greater than 40% in 2020 when compared to the mean of the previous 3 years. Regional variances were seen between operation numbers performed and Covid-19 rates, however the overall trend remained the same for national level data. ConclusionsOverall, the Covid-19 pandemic has had a significant impact on operations, particularly on those deemed as benign and ‘less urgent’. Whilst a global impact across all benign operations was seen, greater reductions were seen in elective operations compared to emergency operations. Hernia operations and bile duct exploration saw greater overall reductions compared to cholecystectomies and splenectomies, which suggests that whilst operation numbers were reduced, efforts were made to prioritise operations with greater clinical need throughout the pandemic. On analysis of the data in relation to Covid-19 rates and deaths, variation was seen across the regions in the UK, however overall the trend remained the same. Centres and regions worse hit by Covid-19 performed less operations during 2020. However, further qualitative research to investigate why certain centres maintained higher levels of performance during the pandemic would be beneficial for planning for future waves and future pandemics.

Bayesian inference of local government audit outcomes.

The scandals in publicly listed companies have highlighted the large losses that can result from financial statement fraud and weak corporate governance. Machine learning techniques have been applied to automatically detect financial statement fraud with great success. This work presents the first application of a Bayesian inference approach to the problem of predicting the audit outcomes of financial statements of local government entities using financial ratios. Bayesian logistic regression (BLR) with automatic relevance determination (BLR-ARD) is applied to predict audit outcomes. The benefit of using BLR-ARD, instead of BLR without ARD, is that it allows one to automatically determine which input features are the most relevant for the task at hand, which is a critical aspect to consider when designing decision support systems. This work presents the first implementation of BLR-ARD trained with Separable Shadow Hamiltonian Hybrid Monte Carlo, No-U-Turn sampler, Metropolis Adjusted Langevin Algorithm and Metropolis-Hasting algorithms. Unlike the Gibbs sampling procedure that is typically employed in sampling from ARD models, in this work we jointly sample the parameters and the hyperparameters by putting a log normal prior on the hyperparameters. The analysis also shows that the repairs and maintenance as a percentage of total assets ratio, current ratio, debt to total operating revenue, net operating surplus margin and capital cost to total operating expenditure ratio are the important features when predicting local government audit outcomes using financial ratios. These results could be of use for auditors as focusing on these ratios could potentially speed up the detection of fraudulent behaviour in municipal entities, and improve the speed and quality of the overall audit.

You can't get there from here: The influence of an audit partner's prior non-public accounting experience on audit outcomes

We examine the importance of audit partners' prior non-public accounting experience (hereafter, “industry experience”) to audit outcomes. We conducted 20 (nine) semi-structured interviews of audit partners with (without) industry experience. These interviews shed light on industry-experienced partners’ career path choices, perceptions of the challenges and benefits stemming from industry experience, and perceptions of how this experience influences their current audit work. Grounded in theory and the results of these interviews, we empirically examine using a unique hand-collected dataset whether audit partners with industry experience conduct higher quality and more efficient audits. Our evidence implies that industry experience is associated with both higher audit quality and greater efficiency. In additional analyses, we examine the influence of potential mechanisms for these observed associations and find some evidence that the nature and timing of this experience matters. Specifically, actual first-hand experience in major oversight positions among boomerang auditors plays an integral role in the quality of the audits that these partners deliver, while experience in a major oversight position or specialized industry in which the partner audits translates into greater efficiencies.

Confirmation Bias and Auditor Risk Assessments: Archival Evidence

SUMMARY Judgment and decision-making research suggests that auditors' judgments are negatively affected by the use of heuristics. However, there is little research investigating whether such biases survive the quality control processes that regulators and audit firms implement to mitigate them. We investigate this by identifying a setting where one such bias—confirmation bias—is likely to manifest. Consistent with confirmation bias influencing observable audit outcomes, we find that auditors with previous experience auditing a client with a history of low risk followed by an increase in risk do not adequately respond to the higher level of risk. This effect is mitigated when the risk increase is likely large enough to violate auditors' reasonableness constraint and when the client is highly visible or has strong external monitors. Our study complements prior experimental research by providing archival evidence that auditors' use of heuristics has a significant effect on auditor judgments. JEL Classifications: M40; M42.

SIOG2021-0119 - Oncological management of organ-confined muscle invasive bladder cancer – a retrospective audit of outcomes at a single institution

SIOG2021-0119 - Oncological management of organ-confined muscle invasive bladder cancer – a retrospective audit of outcomes at a single institution

Does shared tenure between audit committee chair and engagement partner affect audit outcomes? Evidence from the UK

Social psychology literature suggests that shared working experience between individuals affects the way in which they communicate, interact and exchange information. Given that the relationship between audit committee (AC) and engagement partner (EP) involves extensive interactions and information sharing with the aim to protect the integrity of financial statements, this study examines whether the co-tenure relationship between the person who leads the AC (audit committee chair (ACC)) and EP affects audit outcomes. Using 234 UK non-financial companies, we find that longer co-tenure between ACC and EP improves accruals quality and reduces the propensity to meet or beat the earnings benchmark. Moreover, we do not find a significant relationship between ACC–EP shared tenure and audit fees, alleviating the concern that ACC–EP shared tenure could lead to collusion or inappropriate favoritism towards the EP regarding audit fees. Our findings offer a valuable contribution to the literature, practice, and regulators.

Principles-based accounting standards and audit outcomes: empirical evidence

Principles-based accounting standards and audit outcomes: empirical evidence

Short Term Outcomes of Early Term Neonates in a Tertiary Care Centre: A Descriptive Study

Introduction: The number of babies delivered between 37 weeks to 38 weeks and 6 days has been on the rise with increase in lower segment caesarian section (LSCS). These early term neonates have increased risk of developing respiratory distress syndrome, neonatal hyperbilirubinemia, transient tachypnoea, prolonged hospital stays, hypothermia, and feeding difficulty, when compared to a term neonate. An audit of early term neonatal short-term outcomes was undertaken at our institute.&#x0D; Methodology: A retrospective descriptive cross- sectional study was carried out between July 2020 and December 2020 at a private medical college Neonatal Intensive Care Unit. Neonates with a gestation age of 37 weeks and 0 days to 38 weeks and 6 days born were included.&#x0D; Results: A total of 137 early term delivery data were obtained. Hypothyroidism (23%) and gestational diabetes (23%) were found to be the most common associated antenatal problems. The most common morbidity out of 137 early term neonates was neonatal jaundice 91(66.4%) followed by respiratory distress which affected 38 (28%) neonates.&#x0D; Conclusion: This study establishes the high incidence of neonatal jaundice and respiratory morbidities in early term neonates. Hence it is better to avoid elective LSCS before 39 weeks of gestation provided there are no medical indications for the same.

Assessing records management in municipalities with adverse audit opinions in Limpopo Province, South Africa

This article assesses records management in municipalities with adverse audit opinions in the Limpopo province, South Africa. Audit reports issued by the Auditor-General of South Africa (AGSA) yearly indicate that poor recordkeeping is one of the factors contributing to adverse audit opinions in the public sector. The high level of corruption and maladministration, and lack of accountability and transparency in municipalities have become endemic and are a cause for concern in South Africa. Access to relevant and comprehensive information from records is essential for municipalities to perform their constitutional duties effectively. For this study, a quantitative research approach was employed using the survey design. Six municipalities in Limpopo that had adverse audit outcomes in the auditor-general’s report of 2015/2016 were targeted. A total of 92 questionnaires were distributed to registry staff employed in the municipalities and 86 of these were completed and returned. Findings revealed that the selected municipalities in the province face numerous challenges relating to records management practices, including staff shortages, lack of training and poor storage facilities. The study recommends that municipalities’ management and political office-bearers take all the necessary steps to prioritise records management by employing more people. The study further recommends that more universities in South Africa should provide formal qualifications in records management, and government officials should make funding available for records management practices.

Audit of Demographics, Treatment Patterns and Outcomes of Differentiated Thyroid Cancers Treated with Tyrosine Kinase Inhibitors.

The real-world patterns of TKI use in differentiated thyroid cancer (DTC) are largely governed by the accessibility and financial feasibility of the patient with more sorafenib use compared to lenvatinib. There are limited data available on the toxicity profile, safety and tolerance of sorafenib and lenvatinib in DTC. Hence, we audited our practice on DTC. This is a retrospective single-centre analysis of patients with DTC who were referred to the Department of Medical Oncology for systemic therapy. Baseline demographics (age, sex, ECOG PS, comorbidities, substance use), tumour details (site of metastasis), previous treatment details, clinical features at metastasis (symptoms), the pattern of treatment, adverse events and outcomes including progression and death were extracted. There were 67 patients with DTC referred for systemic therapy; the median age was 56 (33-81) with a male preponderance (55.6%). The most common reason to start TKI therapy was radioactive iodine (RAI) cumulative dose > 600 milliCurie, followed by low iodine uptake in the RAI low-dose scan done at progression. The most common TKI used in the first line was sorafenib in 56 (83.6%) patients followed by lenvatinib in 9 (13.4%) patients. Papillary thyroid carcinoma was the most common histology (51, 76.1%), and the rest were follicular carcinoma (16, 23.9%). With a median follow-up of 36months, the median PFS was 13.2months (95% CI 10.4-16.0). The median OS was 18.8months (95% CI 10.0-27.6). Among variables tested, no factors had a significant impact on the PFS or OS. The most common adverse events were hand-foot syndrome (54, 80.5%), diarrhoea (23, 33.3%) and transaminitis (24, 34.4%). The pattern of care of patients with RAI-refractory DTC is TKI therapy, especially sorafenib and lenvatinib in the real-world settings with comparable efficacy and safety profile compared to international literature.