Development and validation of clinical screening systems for Cushing disease in the United States
Authors' conclusion
In US patient populations, the RAPID Community Cushing CSS demonstrated superior discriminative ability for CD compared to the Italian and Spanish CSSs, and the RAPID CD CSS achieved the highest sensitivity for CD among all CSSs evaluated.
Study context
- Population
- United States (US) patients: RAPID registry (615 patients resected for CD at 11 US pituitary centers), 2019 National Health Interview Survey (NHIS) (31,997 US respondents), single-institution CD-NFA cohort (468 patients; CD n = 385, NFA n = 83)
- Comparison
- RAPID CSSs vs Spanish and Italian CSSs
- Outcome
- External validation in US-based cohorts
Methodological detailsdevelopment and external validation, multicentre registry (11 US pituitary centers)
- Development and external validation
- Multicentre registry (11 US pituitary centers)
Performance
As reported in the abstract
| Test or model | AUC | Sensitivity (threshold = 0.5) | Sensitivity (threshold = 4) | Sensitivity (threshold = 6) |
|---|---|---|---|---|
| RAPID Community CSS | 0.707 | — not stated in the abstract | — not stated in the abstract | — not stated in the abstract |
| RAPID CD CSS | — not stated in the abstract | 0.836 | — not stated in the abstract | — not stated in the abstract |
| Spanish | 0.691 | — not stated in the abstract | 0.605 | — not stated in the abstract |
| Italian | 0.685 | — not stated in the abstract | — not stated in the abstract | 0.735 |
AUC
RAPID Community CSS0.707
RAPID CD CSS— not stated in the abstract
Spanish0.691
Italian0.685
Sensitivity (threshold = 0.5)
RAPID Community CSS— not stated in the abstract
RAPID CD CSS0.836
Spanish— not stated in the abstract
Italian— not stated in the abstract
Sensitivity (threshold = 4)
RAPID Community CSS— not stated in the abstract
RAPID CD CSS— not stated in the abstract
Spanish0.605
Italian— not stated in the abstract
Sensitivity (threshold = 6)
RAPID Community CSS— not stated in the abstract
RAPID CD CSS— not stated in the abstract
Spanish— not stated in the abstract
Italian0.735
— not stated in the abstract
Original publication
Development and validation of clinical screening systems for Cushing disease in the United States. Pituitary. Published 10 October 2025. doi:10.
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