Alore EA, Suliburk JW, Ramsey DJ, et al. - Researchers sought to determine the appropriateness of diagnostic evaluation and treatment of primary hyperparathyroidism across the Veterans Affairs (VA) healthcare system. In this retrospective cohort study of 371,370 veterans with hypercalcemia, they identified 86,887 (23.4%) veterans who were assessed for primary hyperparathyroidism with serum parathyroid hormone level. Hormonal evidence of primary hyperparathyroidism was present for 47,158 patients; of these, 6,049 (12.8%) were reported to have undergone definitive treatment with parathyroidectomy. Findings thereby suggest underdiagnosis of primary hyperparathyroidism despite the presence of chronic hypercalcemia, and its undertreatment with parathyroidectomy despite surgical indications.