Tools to Predict Unilateral Primary Aldosteronism and Optimise Patient Selection for Adrenal Vein Sampling: A Systematic Review
Authors' conclusion
Accurate algorithms to inform selection for AVS will ensure that AVS is only performed in patients with a high probability of unilateral PA without clear evidence of the side of lateralisation. This will lower the demand for this invasive procedure, avoid unnecessary procedural complications, and reduce associated health care costs. Further validation of the top-performing algorithms in larger and diverse cohorts will support their use in routine practice.
Study context
- Population
- Patients with primary aldosteronism (PA) evaluated for subtype; algorithms using adrenal vein sampling (AVS) and/or surgical outcomes as gold standard; Medline and EMBASE28 studies
- Comparison
- Published algorithms predicting unilateral PA to select patients for AVS
- Outcome
- Diagnostic accuracy of algorithms predicting unilateral PA
Pooled result
As reported in the abstract
Studies; unique predictive algorithms; tested in multiple cohorts
28; 63; 14
Sensitivity for unilateral PA of top algorithm
78-96%
Hypothetical 1000 people with PA (30% unilateral): appropriately selected for AVS
234-289
Hypothetical 1000 people with PA (30% unilateral): correctly bypass AVS
143-324
Original publication
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