Should We Use Prolactin Adjustment in Bilateral Inferior Petrosal Sinus Sampling to Diagnose Cushing Disease? A Joint Meta-Analysis of Head-to-Head Diagnostic Tests Accuracy Studies
Authors' conclusion
This meta-analysis indicated that prolactin adjustment in BIPSS might help to recognize Cushing disease among patient with ACTH-dependent CS. However, prolactin adjustment may not help identify ectopic ACTH syndrome in BIPSS.
Study context
- Population
- Patients with adrenocorticotropic hormone (ACTH)-dependent Cushing syndrome (CS) undergoing bilateral inferior petrosal sinus sampling (BIPSS) for differential diagnosis; PubMed, Embase, Web of Science, Cochrane library and WanFang searched to March 2022
- Participants
- 300 patients10 studies
- Comparison
- BIPSS with prolactin adjustment vs without prolactin adjustment
- Outcome
- Diagnostic accuracy (sensitivity and specificity) of BIPSS for diagnosing Cushing disease
Methodological detailsBayesian joint bivariate model
- Bayesian joint bivariate model
Pooled result
As reported in the abstract
Prolactin adjustment
- Sensitivity
- 99.97% (95% CI, 99.03%-100.00%)
- Specificity
- 80.69% (95% CI, 50.27%-97.82%)
No adjustment
- Sensitivity
- 94.47% (95% CI, 88.67%-98.44%)
- Specificity
- 91.14% (95% CI, 57.17%-99.80%)
Sensitivity
Prolactin adjustment99.97% (95% CI, 99.03%-100.00%)
No adjustment94.47% (95% CI, 88.67%-98.44%)
Specificity
Prolactin adjustment80.69% (95% CI, 50.27%-97.82%)
No adjustment91.14% (95% CI, 57.17%-99.80%)
Prolactin adjustment vs No adjustmentEstimate (95% CI)
Statistically significant improvement
difference in sensitivity 5.39 %(1.37%–11.26%)
Decrease not statistically significant
difference in specificity −9.20 %(−42.02% to 26.61%)
Original publication
Should We Use Prolactin Adjustment in Bilateral Inferior Petrosal Sinus Sampling to Diagnose Cushing Disease? A Joint Meta-Analysis of Head-to-Head Diagnostic Tests Accuracy Studies. Endocr Pract. Published 14 January 2023. doi:10.
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