Clinician decision-making in non-functioning pituitary adenomas: an Australian and New Zealand interdisciplinary survey study
Authors' conclusion
This survey identifies clinically important variation in NFPA management, concentrated in domains lacking guideline recommendations.
Study context
- Population
- Endocrinologists, neurosurgeons, ENT surgeons and radiation oncologists involved in pituitary adenoma care in Australia and New Zealand, January–April 2025; 3 non-functioning pituitary adenomas (NFPA) scenarios (incidental microadenoma, incidental asymptomatic macroadenoma, symptomatic macroadenoma with visual compromise)completed survey
- Participants
- 145 participants
- Exposure
- Endocrinologists vs Surgeons vs Radiation oncologists
- Endocrinologistsn = 99
- Surgeonsn = 31
- Radiation oncologistsn = 15
- Outcome
- Concordance (>70% agreement on a single response within any group) in clinical decision-making across NFPA presentations
Methodological detailsanonymous electronic survey, interdisciplinary
- Anonymous electronic survey
- Interdisciplinary
Main finding
As reported in the abstract
Practice conformity vs heterogeneity
- Conformity: broad anterior pituitary hormonal evaluation, conservative management of incidental asymptomatic macroadenomas, active intervention for symptomatic disease with visual loss
- Significant heterogeneity: ophthalmological assessment, repeat imaging intervals, post-operative MRI and visual field timing, multidisciplinary team (MDT) meeting referral rates
Observational data: associations, not effects.
Further findings
Pituitary subspecialty vs general endocrinologists
- Pituitary subspecialty endocrinologists significantly more likely to refer for MDT discussion and to know the referral surgeon's caseload, and less likely to measure serum cortisol immediately post-operatively
Original publication
Clinician decision-making in non-functioning pituitary adenomas: an Australian and New Zealand interdisciplinary survey study. Pituitary. Published 3 July 2026. doi:10.
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