| Late-Night Salivary Cortisol for the Diagnosis of Cushing's Syndrome: A Meta-Analysis. | |
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MedLine Citation:
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PMID: 19454388 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Objective: The current epidemic of obesity has made the diagnosis of Cushing's syndrome more compelling and requires a practical diagnostic test with high specificity and sensitivity to detect true Cushing's syndrome while avoiding false positive results. Here we report a meta-analysis of latenight salivary cortisol for the diagnosis of Cushing's syndrome.Methods: MEDLINE and EMBASE computer databases were searched to identify relevant articles. The titles and abstracts of all articles, as well as full text of relevant articles, were reviewed. After review by multiple authors, seven articles were identified that contain information sufficient to include in the analysis. Variables of interest were extracted by two of the authors. Discrepancies were resolved by mediation by a third author.Results: A total of 947 patients - 339 with Cushing's syndrome - were identified. Pooled data from the seven studies revealed a sensitivity of 92% (95% CI 88-94%), specificity of 96% (95% CI 94- 97%), and a diagnostic odds ratio of 312 (95% CI 92-1059). The likelihood ratio positive was 21 (95% CI 10-43) with a likelihood ratio negative of 0.08 (95% CI 0.02-0.32). The inconsistencies for each of these results measured by the I2 statistic ranged from moderate to high.Conclusion: This analysis demonstrates that late-night salivary cortisol has excellent diagnostic characteristics, and as such, is a robust, convenient diagnostic test for screening and diagnosis of Cushing's syndrome. |
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Authors:
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Ty Carroll; Hershel Raff; James W Findling |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2009-5-6 |
Journal Detail:
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Title: Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists Volume: - ISSN: 1934-2403 ISO Abbreviation: Endocr Pract Publication Date: 2009 May |
Date Detail:
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Created Date: 2009-5-20 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9607439 Medline TA: Endocr Pract Country: - |
Other Details:
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Languages: ENG Pagination: 1-17 Citation Subset: - |
Affiliation:
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Endocrinology Center, Medical College of Wisconsin, Milwaukee, Wisconsin 53226. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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