Accuracy of Laboratory Tests for the Diagnosis of Cushing Syndrome.

The Journal of Clinical Endocrinology and Metabolism
Brandon P GalmNicholas A Tritos

Abstract

The diagnosis of Cushing syndrome (CS) can be challenging. It remains to be determined which diagnostic tests are the most accurate. To summarize the accuracy of diagnostic tests for CS using contemporary meta-analytic techniques (hierarchical models). PubMed, Embase, Scopus, Web of Science, and the Cochrane Database of Systemic Reviews (inception until August 3, 2018). Studies performed in adults that determined the accuracy of one or more diagnostic tests: overnight 1-mg dexamethasone suppression test (DST), 2-day low-dose DST (2d DST), 24-hour urinary free cortisol (UFC), late-night salivary cortisol (LNSC), midnight serum cortisol (MSC), and the dexamethasone-suppressed CRH (dex-CRH) and desmopressin (dex-DDAVP) tests. Two authors independently extracted data and performed methodological assessments. One hundred thirty-nine studies (14 140 participants) were included in the analysis. The respective sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio (95% confidence interval [CI]) estimates include the following: DST 98.6% (96.9%-99.4%), 90.6% (86.4%-93.6%), 10.5 (7.2-15.3), and 0.016 (0.007-0.035); 2d DST 95.3% (91.3%-97.5%), 92.8% (85.7%-96.5%), 13.2 (6.47-27.1), and 0.051 (0.027-0.095); UFC ...Continue Reading

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Citations

Aug 21, 2020·The Journal of Clinical Endocrinology and Metabolism·Filippo CeccatoCarla Scaroni
Jan 1, 2021·The Journal of Clinical Endocrinology and Metabolism·Adina F Turcu, Richard Auchus
Jan 22, 2021·Best Practice & Research. Clinical Endocrinology & Metabolism·José Miguel Hinojosa-Amaya, Daniel Cuevas-Ramos
Mar 25, 2021·Best Practice & Research. Clinical Endocrinology & Metabolism·Stephan Petersenn
Feb 18, 2021·The Journal of Clinical Endocrinology and Metabolism·Pauline GendreitzigMarcus Quinkler
Jul 20, 2021·Endocrinology, Diabetes & Metabolism·Tiphaine CartonNatacha Driessens

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