Real world evidence supports waking salivary cortisone as a screening test for adrenal insufficiency
Authors' conclusion
This service evaluation provides real-world evidence that home waking salivary cortisone is an effective, practical screening test for adrenal insufficiency. It identified key barriers to testing implementation that need to be addressed when introducing the test to a health service.
Study context
- Population
- Patients referred for adrenal insufficiency who had a home waking salivary cortisone
- Participants
- 212 patients
- Outcome
- Waking salivary cortisone result
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Normal test
55%
Adrenal suppression
23%
Equivocal result requiring clinical centre ACTH stimulation test
22%
Further findings
Time of saliva sample
- Median (IQR) time of saliva sample
- 07:40 (07:00-08:40)
Days from collection to delivery to local laboratory
- Median (IQR) days, collection to delivery to local laboratory
- 1 (0.25-2) day
Days from collection to reporting by local laboratory
- Median (IQR) days, collection to reporting by local laboratory
- 13 (11-18) days
Patient feedback (focus groups)
- Patients considered the test "easy to do" and preferred it to the inpatient ACTH stimulation test
Implementation barriers
- Principal challenge: results reporting to clinicians due to delays at the local laboratory
Original publication
Real world evidence supports waking salivary cortisone as a screening test for adrenal insufficiency. Clin Endocrinol (Oxf). Published 11 October 2023. doi:10.
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