Evidence map›Paper›PMID 39096742›Full record

ArticleThe Journal of surgical research2024

Adrenal Referral Pattern: Management of Patients With an Adrenal Incidentaloma.

Ashba Allahwasaya, Ramsha Akhund, Sanjana Balachandra, Chandler McLeod, Brenessa Lindeman, Jessica Fazendin, Andrea Gillis, Polina Zmijewski, Herbert Chen

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Article in The Journal of surgical research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–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

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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

4 citing papers in PubMed.

  1. Article
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4 · The record

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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

9 authors.

Ashba AllahwasayaDepartment of Surgery, University of Alabama at Birmingham, Birmingham Alabama.
Ramsha AkhundDepartment of Surgery, University of Alabama at Birmingham, Birmingham Alabama.
Sanjana BalachandraDepartment of Surgery, University of Alabama at Birmingham, Birmingham Alabama.
Chandler McLeodDepartment of Surgery, University of Alabama at Birmingham, Birmingham Alabama.
Brenessa LindemanDepartment of Surgery, University of Alabama at Birmingham, Birmingham Alabama.
Jessica FazendinDepartment of Surgery, University of Alabama at Birmingham, Birmingham Alabama.
Andrea GillisDepartment of Surgery, University of Alabama at Birmingham, Birmingham Alabama.
Polina ZmijewskiDepartment of Surgery, University of Alabama at Birmingham, Birmingham Alabama.
Herbert ChenDepartment of Surgery, University of Alabama at Birmingham, Birmingham Alabama. Electronic address: herbchen@uab.edu.

Funding

TRAINING AND CAREER DEVELOPMENTU54CA118948 · NCI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI UPENDER MANNE · 2005 to 2026
$26.6M
Surgical Oncology Research Training ProgramT32CA229102 · NCI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI HERBERT CHEN · 2018 to 2026
$3.2M
NCI NIH HHS T32 CA229102NCI NIH HHS U54 CA118948
6 · The paper itself

Abstract

introductionAdrenal incidentalomas (AIs) are found in 3%-4% of abdominal computed tomography scans. Timely evaluation of their functional status and malignant potential is necessary to guide nonoperative surveillance or surgery. This study aims to evaluate the adherence of referring service patterns to the American Association of Endocrine Surgeons and American Association of Clinical Endocrinologists guidelines for the biochemical workup of AIs at a tertiary surgical clinic.

methodsWe conducted a retrospective study of 125 patients evaluated for AIs at the endocrine surgery clinic between 2017 and 2022. Information on patient demographics, referral source, and reasons for referral was collected. The appropriateness of the biochemical workup for AIs by referring physicians was assessed. Statistical analyses included chi-square and Kruskal-Wallis tests.

resultsReferrals came from endocrinologists (44.8%), other subspecialists (31.2%), and primary care physicians (PCPs) (19.2%). Among 125 patients, diagnoses included benign adrenal masses (52.8%), aldosteronomas (10.4%), cortisol-secreting tumors (15.2%), pheochromocytomas (12.8%), and metastatic masses (4.0%). Endocrinologists were more likely to conduct a complete biochemical workup compared to other subspecialties and PCPs (P < 0.001). Eighty-three (66.4%) patients underwent adrenalectomy, with those referred by endocrinologists more likely to undergo surgery than those referred by other subspecialties and PCPs (P < 0.001). There was no significant difference in the time from the initial clinic visit to surgery by referral source (P > 0.05).

conclusionsOver half of AIs referrals to the endocrine surgery clinic came from subspecialists and PCPs rather than endocrinologists. Familiarizing all referring physicians with American Association of Endocrine Surgeons/Association of Clinical Endocrinologists guidelines may reduce undiagnosed functional AI cases and facilitate timely surgical management.

Indexed as

Adrenal Gland NeoplasmsGuideline AdherenceReferral and ConsultationAdrenalectomyAdultAgedFemaleHumansMaleMiddle AgedPractice Guidelines as TopicPractice Patterns, Physicians'Retrospective StudiesAdrenal incidentalomaClinical guidelinesClinical managementHormonal evaluationReferral pathways

Identifiers

PMID39096742
PMCPMC11490361

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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.