ArticleAACE endocrinology and diabetes
The Reflex Dexamethasone Suppression Test: Development and Assessment of Reflexed Serum Dexamethasone Measurement for the Diagnosis of Cushing Syndrome.
Article in AACE endocrinology and diabetes. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Plasma cortisol cut-off concentrations using the dexamethasone suppression test in patients with adrenal incidentalomas.Frontiers in endocrinology · 2026Observational
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Screening for Cushing syndrome (CS; endogenous overproduction of ACTH or cortisol) is performed by the low-dose overnight serum dexamethasone suppression test (oDST) with the measurement of serum dexamethasone concentration to assure an effective dose. Objective: We evaluated the utility of only measuring serum dexamethasone in samples with nonsuppressed serum cortisol using a conservative serum cortisol cutoff. Methods: This retrospective study included 261 oDSTs completed before Reflex implementation (Pre-Reflex-oDST) and 281 oDSTs completed after (Post-Reflex-oDST). Serum cortisol and serum dexamethasone data were paired to the diagnosis and analyzed with comparative statistical tests and receiver operating characteristic curve (ROC) analysis. Results: Endogenous hypercortisolism was diagnosed in 38 of 261 Pre-Reflex-oDSTs (14%) and 40 of 281 (14%) Post-Reflex-oDSTs. In oDSTs with SerCort >1.8 mcg/dL, there were 9% and 6% false positives in the Pre-vs Post-Reflex-oDST group, respectively. In the Pre-Reflex-oDST group, the median SerCort was 1.1 mcg/dL (95% CI: 0.8-1.5) in patients without CS and 3.9 mcg/dL (95% CI: 2.6-7.9) in those with CS ( Conclusion: Reflex measurement of the serum dexamethasone did not affect oDST test performance while reducing costs.
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