Exclusion Tests in Unilateral Primary Aldosteronism (ExcluPA) Study
Authors' conclusion
The apparently high diagnostic accuracy of the CCT and the SIT was due to the selection of patients with an elevated ARR and thus a high pretest probability of unilateral PA; however, neither test furnished a diagnostic gain over the ARR. Therefore, the systematic use of these exclusion tests in clinical practice is not justified by available evidence.
Study context
- Population
- Patients tested for primary aldosteronism (PA) in studies meeting tight quality criteria, published 1970–2021 (PubMed, EMBASE, Web of Science, Cochrane Library)31 datasets
- Participants
- 4,242 patients
- Comparison
- Exclusion tests vs aldosterone to renin ratio (ARR) for PA, with unilateral PA diagnosis as reference
- Outcome
- Pooled accuracy (summary AUROC) of exclusion tests vs unilateral PA diagnosis as reference
Methodological detailstwo-stage meta-analysis (exploratory and validation phase), PRISMA methodology
- Two-stage meta-analysis (exploratory and validation phase)
- PRISMA methodology
Pooled result
As reported in the abstract
Pooled accuracy (sAUROC)
| Group | Value | Summary area under the ROC curve (sAUROC) |
|---|---|---|
| ARR | 0.95 (95% CI 0.92–0.98) | 0.95 |
| Captopril challenge test (CCT) | 0.92 (95% CI 0.88–0.97) | 0.92 |
| Saline infusion test (SIT) | 0.96 (95% CI 0.94–0.99) | 0.96 |
Value
ARR0.95 (95% CI 0.92–0.98)
Captopril challenge test (CCT)0.92 (95% CI 0.88–0.97)
Saline infusion test (SIT)0.96 (95% CI 0.94–0.99)
Summary area under the ROC curve (sAUROC)
ARR0.95
Captopril challenge test (CCT)0.92
Saline infusion test (SIT)0.96
Original publication
Exclusion Tests in Unilateral Primary Aldosteronism (ExcluPA) Study. J Clin Endocrinol Metab. Published 14 November 2022. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →