Evidence map›Paper›PMID 28275992›Full record

ArticlePituitary2017

Follow-up intervals in patients with Cushing's disease: recommendations from a panel of experienced pituitary clinicians.

Eliza B Geer, Alejandro Ayala, Vivien Bonert, John D Carmichael, Murray B Gordon, Laurence Katznelson, Ekaterina Manuylova, Ismat Shafiq, Vijaya Surampudi, Ronald S Swerdloff and 7 more

Abstract read
PubMed Publisher
In one paragraph

Article in Pituitary, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Eliza B GeerMemorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, USA. geere@mskcc.org.
Alejandro AyalaUniversity of Miami and Jackson Memorial Hospital, 1500 NW 10th Avenue, Miami, FL, USA.
Vivien BonertCedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA, USA.
John D CarmichaelKeck School of Medicine of University of Southern California, 1520 San Pablo Street, Los Angeles, CA, USA.
Murray B GordonAllegheny Neuroendocrinology Center, Allegheny General Hospital, 420 East North Avenue, Pittsburgh, PA, USA.
Laurence KatznelsonStanford University School of Medicine, 875 Blake Wilbur Drive, Stanford, CA, USA.
Ekaterina ManuylovaUniversity of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, NY, USA.
Ismat ShafiqUniversity of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, NY, USA.
Vijaya SurampudiHarbor-UCLA Medical Center, 1124 W. Carson St., Torrance, CA, USA.
Ronald S SwerdloffHarbor-UCLA Medical Center, 1124 W. Carson St., Torrance, CA, USA.
Michael S BroderPartnership for Health Analytic Research, LLC, 280 S. Beverly Drive, Beverly Hills, CA, USA.
Dasha CherepanovPartnership for Health Analytic Research, LLC, 280 S. Beverly Drive, Beverly Hills, CA, USA.
Marianne EaganPartnership for Health Analytic Research, LLC, 280 S. Beverly Drive, Beverly Hills, CA, USA.
Jackie LeePartnership for Health Analytic Research, LLC, 280 S. Beverly Drive, Beverly Hills, CA, USA.
Qayyim SaidNovartis Pharmaceuticals Corporation, One Health Plaza, East Hanover, NJ, USA.
Maureen P NearyNovartis Pharmaceuticals Corporation, One Health Plaza, East Hanover, NJ, USA.
Beverly M K BillerMassachusetts General Hospital, 55 Fruit Street, Boston, MA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeFollow-up guidelines are needed to assess quality of care and to ensure best long-term outcomes for patients with Cushing's disease (CD). The purpose of this study was to assess agreement by experts on recommended follow-up intervals for CD patients at different phases in their treatment course.

methodsThe RAND/UCLA modified Delphi process was used to assess expert consensus. Eleven clinicians who regularly manage CD patients rated 79 hypothetical patient scenarios before and after ("second round") an in-person panel discussion to clarify definitions. Scenarios described CD patients at various time points after treatment. For each scenario, panelists recommended follow-up intervals in weeks. Panel consensus was assigned as follows: "agreement" if no more than two responses were outside a 2 week window around the median response; "disagreement" if more than two responses were outside a 2 week window around the median response. Recommendations were developed based on second round results.

resultsPanel agreement was 65.9% before and 88.6% after the in-person discussion. The panel recommended follow-up within 8 weeks for patients in remission on glucocorticoid replacement and within 1 year of surgery; within 4 weeks for patients with uncontrolled persistent or recurrent disease; within 8-24 weeks in post-radiotherapy patients controlled on medical therapy; and within 24 weeks in asymptomatic patients with stable plasma ACTH concentrations after bilateral adrenalectomy.

conclusionsWith a high level of consensus using the Delphi process, panelists recommended regular follow-up in most patient scenarios for this chronic condition. These recommendations may be useful for assessment of CD care both in research and clinical practice.

Indexed as

AdrenalectomyAdrenocorticotropic HormoneGlucocorticoidsHumansPituitary ACTH HypersecretionPituitary GlandAdrenocorticotropic HormoneGlucocorticoidsBiochemical statusConsensus statementsCushing’s diseaseExpert panelFollow-upTreatment

Identifiers

PMID28275992

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.