Evidence map›Paper›PMID 34687601›Full record

ReviewThe lancet. Diabetes & endocrinology2021

Consensus on diagnosis and management of Cushing's disease: a guideline update.

Maria Fleseriu, Richard Auchus, Irina Bancos, Anat Ben-Shlomo, Jerome Bertherat, Nienke R Biermasz, Cesar L Boguszewski, Marcello D Bronstein, Michael Buchfelder, John D Carmichael and 43 more

Open access · greenAbstract readConsensus StatementReview
PubMed Full text at PMC Publisher
In one paragraph

Review in The lancet. Diabetes & endocrinology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 470 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
470citing papers in PubMed, 5 pooled it
74.0field-weighted citation impact, top 1% of its field
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

470 citing papers in PubMed, 5 syntheses or guidelines pooled it, 789 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
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  4. Pooled it
  5. Pooled it
  6. Trial
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  8. Prospective Multicenter Evaluation of [Journal of nuclear medicine : official publication, Society of Nuclear Medicine · 2025
    Trial
  9. Article
  10. Review
  11. Observational
  12. Functional pituitary adenoma imaging.Reviews in endocrine & metabolic disorders · 2026
    Review
  13. Review
  14. Review
  15. Article
  16. Article
  17. Distinct plasma protein profiles after long-term remission of Cushing's disease.The Journal of clinical endocrinology and metabolism · 2026
    Article
  18. Article
  19. Article
  20. Review

410 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

53 authors at 20 institutions in 14 countries.

Maria FleseriuOregon Health & Science University, Portland, OR, USA. Electronic address: fleseriu@ohsu.edu.
Richard AuchusUniversity of Michigan, Ann Arbor, MI, USA.
Irina BancosMayo Clinic, Rochester, MN, USA.
Anat Ben-ShlomoCedars-Sinai Medical Center, Los Angeles, CA, USA.
Jerome BertheratUniversité de Paris, Assistance Publique-Hôpitaux de Paris, Centre de Référence Maladies Rares de la Surrénale, Service d'Endocrinologie, Hôpital Cochin, Paris, France.
Nienke R BiermaszLeiden University Medical Center and European Reference Center for Rare Endocrine Conditions (Endo-ERN), Leiden, Netherlands.
Cesar L BoguszewskiFederal University of Parana, Curitiba, Brazil.
Marcello D BronsteinUniversity of Sao Paulo, Sao Paulo, Brazil.
Michael BuchfelderUniversity Hospital Erlangen, Erlangen, Germany.
John D CarmichaelKeck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Felipe F CasanuevaSantiago de Compostela University and Ciber OBN, Santiago de Compostela, Spain.
Frederic CastinettiAix Marseille Université, Marseille Medical Genetics, INSERM, Marseille, France; Assistance Publique Hopitaux de Marseille, Marseille, France; Department of Endocrinology, La Conception Hospital, Marseille, France.
Philippe ChansonUniversité Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.
James FindlingMedical College of Wisconsin, Milwaukee, WI, USA.
Mônica GadelhaUniversidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
Eliza B GeerMemorial Sloan-Kettering Cancer Center, New York, NY, USA.
Andrea GiustinaSan Raffaele Vita-Salute University, Milan, Italy.
Ashley GrossmanUniversity of London, London, UK; University of Oxford, Oxford, UK.
Mark GurnellUniversity of Cambridge, Cambridge, UK; NIHR Cambridge Biomedical Research Center, Cambridge, UK; Addenbrooke's Hospital, Cambridge, UK.
Ken HoThe Garvan Institute of Medical Research, Sydney, NSW, Australia.
Adriana G IoachimescuEmory University School of Medicine, Atlanta, GA, USA.
Ursula B KaiserBrigham & Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
Niki KaravitakiInstitute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK; Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK; Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Laurence KatznelsonStanford University, Stanford, CA, USA.
Daniel F KellyPacific Neuroscience Institute, Santa Monica, CA, USA.
André LacroixCentre Hospitalier de l'Université de Montréal, Montréal, QC, Canada.
Ann McCormackThe Garvan Institute of Medical Research, Sydney, NSW, Australia.
Shlomo MelmedCedars-Sinai Medical Center, Los Angeles, CA, USA.
Mark MolitchNorthwestern University Feinberg School of Medicine, Chicago, IL, USA.
Pietro MortiniSan Raffaele Vita-Salute University, Milan, Italy.
John Newell-PriceUniversity of Sheffield, Sheffield, UK.
Lynnette NiemanNational Institutes of Health, Bethesda, MD, USA.
Alberto M PereiraLeiden University Medical Center and European Reference Center for Rare Endocrine Conditions (Endo-ERN), Leiden, Netherlands.
Stephan PetersennENDOC Center for Endocrine Tumors, Hamburg, Germany and University of Duisburg-Essen, Essen, Germany.
Rosario PivonelloUniversità Federico II di Napoli, Naples, Italy.
Hershel RaffMedical College of Wisconsin, Milwaukee, WI, USA; Advocate Aurora Research Institute, Aurora St. Luke's Medical Center, Milwaukee, WI, USA.
Martin ReinckeDepartment of Medicine IV, University Hospital of LMU, Ludwig-Maximilians-Universität, Munich, Germany.
Roberto SalvatoriJohns Hopkins University, Baltimore, MD, USA.
Carla ScaroniUniversity of Padova, Padova, Italy.
Ilan ShimonRabin Medical Center, Beilinson Hospital, Petah-Tikva, Israel.
Constantine A StratakisNational Institutes of Health, Bethesda, MD, USA.
Brooke SwearingenMassachusetts General Hospital, Boston, MA, USA.
Antoine TabarinCHU de Bordeaux, Hôpital Haut Lévêque, University of Bordeaux, Bordeaux, France.
Yutaka TakahashiNara Medical University, Kashihara, Japan.
Marily TheodoropoulouDepartment of Medicine IV, University Hospital of LMU, Ludwig-Maximilians-Universität, Munich, Germany.
Stylianos TsagarakisEvangelismos Hospital, Athens, Greece.
Elena ValassiEndocrinology Unit, Hospital General de Catalunya, Barcelona, Spain; Research Center for Pituitary Diseases (CIBERER Unit 747), Hospital Sant Pau, Barcelona, Spain.
Elena V VarlamovOregon Health & Science University, Portland, OR, USA.
Greisa VilaMedical University of Vienna, Vienna, Austria.
John WassChurchill Hospital, Oxford, United Kingdom.
Susan M WebbResearch Center for Pituitary Diseases (CIBERER Unit 747), Hospital Sant Pau, Barcelona, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain.
Maria C ZatelliUniversity of Ferrara, Ferrara, Italy.
Beverly M K BillerMassachusetts General Hospital, Boston, MA, USA.
Cedars-Sinai Medical Center · USGarvan Institute of Medical Research · AULeiden University Medical Center · NLLudwig-Maximilians-Universität München · DEMassachusetts General Hospital · USNational Institutes of Health · USVita-Salute San Raffaele University · ITCentre Hospitalier de l’Université de Montréal · CACentre Hospitalier Universitaire de Bordeaux · FRChurchill Hospital · GBEmory University · USEvangelismos Hospital · GRJohns Hopkins University · USMayo Clinic in Arizona · USMedical College of Wisconsin · USMedical University of Vienna · ATMemorial Sloan Kettering Cancer Center · USNara Medical University · JPNorthwestern University · USOregon Health & Science University · US

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI SELWYN M VICKERS · 1985 to 2026
$347.4M
Molecular Genetics of Endocrine Tumors and Related DisordersZIAHD008920 · NICHD · EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT · PI STRATAKIS, CONSTANTINE A. · 2012 to 2021
$25.8M
Training Program in Endocrinology, Diabetes, and MetabolismT32DK007770 · NIDDK · CEDARS-SINAI MEDICAL CENTER · PI MELMED, SHLOMO · 1999 to 2022
$3.4M
The differential diagnosis and treatment of Cushing's syndromeZ01HD008833 · NICHD · EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT · PI NIEMAN, LYNNETTE K · 2007 to 2008
$838k
Body Composition and the Metabolic Syndrome in Cushing's DiseaseK23DK082617 · NIDDK · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI GEER, ELIZA BREVOORT · 2008 to 2012
$751k
TRAINING PROGRAM IN ENDOCRINOLOGY &DIABETEST32DK007682 · NIDDK · CEDARS-SINAI MEDICAL CENTER · PI MELMED, SHLOMO · 1992 to 1996
–
Intramural NIH HHS Z01 HD008833Intramural NIH HHS ZIA HD008920NCI NIH HHS P30 CA008748NIDDK NIH HHS K23 DK082617NIDDK NIH HHS T32 DK007682NIDDK NIH HHS T32 DK007770
6 · The paper itself

Abstract

Cushing's disease requires accurate diagnosis, careful treatment selection, and long-term management to optimise patient outcomes. The Pituitary Society convened a consensus workshop comprising more than 50 academic researchers and clinical experts to discuss the application of recent evidence to clinical practice. In advance of the virtual meeting, data from 2015 to present about screening and diagnosis; surgery, medical, and radiation therapy; and disease-related and treatment-related complications of Cushing's disease summarised in recorded lectures were reviewed by all participants. During the meeting, concise summaries of the recorded lectures were presented, followed by small group breakout discussions. Consensus opinions from each group were collated into a draft document, which was reviewed and approved by all participants. Recommendations regarding use of laboratory tests, imaging, and treatment options are presented, along with algorithms for diagnosis of Cushing's syndrome and management of Cushing's disease. Topics considered most important to address in future research are also identified.

Indexed as

Cushing SyndromePituitary ACTH HypersecretionConsensusHumansPituitary Gland

Identifiers

PMID34687601
PMCPMC8743006
OpenAlexW3204188022

What OpenQuestion holds

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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.