Asban A, et al. – Researchers conducted this study involving 3,200 patients with hypercalcemia to identify reasons for underdiagnosis and undertreatment of hyperparathyroidism that could be addressed by targeted interventions. Study participants had parathyroid hormone levels assessed at the investigators’ instruction from 2011 to 2016. The investigators randomly sampled 60 patients and divided them into three groups based on parathyroid hormone levels. Half of patients had ≥ 1 elevated calcium that was missed by their primary care provider. The diagnosis was missed or delayed in 40% of cases even when calcium and parathyroid hormone were both high. They found no benefit of surgery in 7% of candidates and 8% refused to visit a surgeon; 22% of participants were offered medical treatment or observation. Improvement in systems to identify hypercalcemia and better education to patients and providers about the outcomes of untreated disease was recommended to approach common causes for delayed diagnosis and treatment of hyperparathyroidism.