Evidence map›Paper›PMID 38261997›Full record

ArticleThe Journal of clinical endocrinology and metabolism2024

Health Care Challenges in the Management of Primary Aldosteronism in Southeast Asia.

Norlela Sukor, Sarat Sunthornyothin, Thang V Tran, Tri Juli Tarigan, Leilani B Mercado-Asis, Satha Sum, Moe Wint Aung, Alice M L Yong, Tania Tedjo, Michael Villa and 8 more

Abstract read
In one paragraph

Article in The Journal of clinical endocrinology and metabolism, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing 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

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

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Renin-aldosterone testing: The essentials.Clinical medicine (London, England) · 2026
    Review
  6. Is It Time to Retire Aldosterone Suppression Testing?American journal of hypertension · 2026
    Review
  7. Article
  8. Review
  9. Article
  10. Approach to the Patient With Primary Aldosteronism: Role of Molecular Imaging.The Journal of clinical endocrinology and metabolism · 2025
    Review
  11. Article
  12. 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

18 authors.

Norlela SukorDepartment of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia.ORCID 0000-0002-5434-2087
Sarat SunthornyothinDepartment of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.
Thang V TranDepartment of Endocrinology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam.
Tri Juli TariganDivision of Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia.
Leilani B Mercado-AsisFaculty of Medicine and Surgery, University of Santo Tomas, Manila 1008, Philippines.
Satha SumDepartment of Internal Medicine, Calmette Hospital, Phnom Penh 12201, Cambodia.
Moe Wint AungDepartment of Endocrinology, University of Medicine 1, Yangon General Hospital, Yangon 11131, Myanmar.
Alice M L YongDepartment of Internal Medicine, R.I.P.A.S. Hospital, Bandar Seri Begawan BA1712, Brunei Darussalam.
Tania TedjoDepartment of Internal Medicine, Faculty of Medicine, Universitas Diponegoro, Semarang, Jawa Tengah 50275, Indonesia.
Michael VillaPhilippines Center for Diabetes, Thyroid and Endocrine Disorders, St. Luke's Medical Center, Taguig 1634, Philippines.
Nang Ei Ei KhaingHealth Services Research, Changi General Hospital, Singapore 529889, Singapore.
Elena Aisha AzizanDepartment of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia.
Waye Hann KangDepartment of Medicine, Faculty of Medicine and Health Sciences, University Tunku Abdul Rahman, Kuala Lumpur 53300, Malaysia.
Vivien LimGleneagles Medical Centre, Singapore 258500, Singapore.
Ada E D TeoDepartment of Medicine, Division of Endocrinology, National University Health System, Singapore 119228, Singapore.
Meifen ZhangDepartment of Endocrinology, Changi General Hospital, Singapore 529889, Singapore.
Hieu TranDepartment of Endocrinology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam.
Troy H PuarDepartment of Endocrinology, Changi General Hospital, Singapore 529889, Singapore.ORCID 0000-0002-8047-5836

Funding

SingHealth Duke-NUS Medical School
6 · The paper itself

Abstract

contextWhile guidelines have been formulated for the management of primary aldosteronism (PA), following these recommendations may be challenging in developing countries with limited health care access.

objectiveWe aimed to assess the availability and affordability of health care resources for managing PA in the Association of Southeast Asian Nations (ASEAN) region, which includes low-middle-income countries.

methodsWe instituted a questionnaire-based survey to specialists managing PA, assessing the availability and affordability of investigations and treatment. Population and income status data were taken from the national census and registries.

resultsNine ASEAN country members (48 respondents) participated. While screening with aldosterone-renin ratio is performed in all countries, confirmatory testing is routinely performed in only 6 countries due to lack of facilities and local assays, and cost constraint. Assays are locally available in only 4 countries, and some centers have a test turnaround time exceeding 3 weeks. In 7 countries (combined population of 442 million), adrenal vein sampling (AVS) is not routinely performed due to insufficient radiological facilities or trained personnel, and cost constraint. Most patients have access to adrenalectomy and medications. In 6 countries, the cost of AVS and adrenalectomy combined is more than 30% of its annual gross domestic product per capita. While most patients had access to spironolactone, it was not universally affordable.

conclusionLarge populations currently do not have access to the health care resources required for the optimal management of PA. Greater efforts are required to improve health care access and affordability. Future guideline revisions for PA may need to consider these limitations.

Indexed as

Health Services AccessibilityHyperaldosteronismAdrenalectomyAsia, SoutheasternDelivery of Health CareDeveloping CountriesDisease ManagementHumansSurveys and Questionnairesadrenalectomyadrenal vein samplingglobal healthhealth care economicshealth disparitieshyperaldosteronism epidemiology

Identifiers

PMID38261997
PMCPMC11180499

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.