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Screening for phaeochromocytoma and paraganglioma: impact of using supine reference intervals for plasma metanephrines with samples collected from fasted/seated patients

Overview of attention for article published in Annals of Clinical Biochemistry, September 2016
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Title
Screening for phaeochromocytoma and paraganglioma: impact of using supine reference intervals for plasma metanephrines with samples collected from fasted/seated patients
Published in
Annals of Clinical Biochemistry, September 2016
DOI 10.1177/0004563216646395
Pubmed ID
Authors

R Casey, TP Griffin, D Wall, MC Dennedy, M Bell, PM O’Shea

Abstract

The Endocrine Society Clinical Practice Guideline on Phaeochomocytoma and Paraganglioma (PPGL) recommends phlebotomy for plasma-free metanephrines (PMets) with patients fasted and supine using appropriately defined reference intervals. Studies have shown higher diagnostic sensitivities using these criteria. Further, with seated-sampling protocols, for result interpretation, reference intervals that do not compromise diagnostic sensitivity should be employed. To determine the impact on diagnostic performance and financial cost of using supine reference intervals for result interpretation with our current PMets fasted/seated-sampling protocol. We conducted a retrospective cohort study of patients who underwent screening for PPGL using PMets from 2009-2014 at Galway University Hospitals (GUH). PMets were measured using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Supine thresholds for plasma NMN and MN set at 610pmol/L and 310pmol/L respectively were used. A total of 183 patients were evaluated. Mean age of participants was 53.4 (±16.3) years. Five of 183 (2.7%) patients had histologically confirmed PPGL (males, n=4). Using seated reference intervals for PMets, diagnostic sensitivity and specificity was 100% and 98.9% respectively with two false positive cases. Application of reference intervals established in subjects supine and fasted to this cohort gave diagnostic sensitivity of 100% with specificity of 74.7%. Financial analysis of each pre-testing strategy demonstrated cost-equivalence (€147.27/patient). Our cost analysis, together with the evidence that fasted/supine-sampling for PMets offers more reliable exclusion of PPGL mandates changing our current practice. This study highlights the important advantages of standardised diagnostic protocols for PMets to ensure the highest diagnostic accuracy for investigation of PPGL.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 43 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 43 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 5 12%
Student > Postgraduate 5 12%
Student > Master 5 12%
Student > Bachelor 4 9%
Other 4 9%
Other 8 19%
Unknown 12 28%
Readers by discipline Count As %
Medicine and Dentistry 20 47%
Biochemistry, Genetics and Molecular Biology 2 5%
Nursing and Health Professions 2 5%
Psychology 2 5%
Pharmacology, Toxicology and Pharmaceutical Science 1 2%
Other 1 2%
Unknown 15 35%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 28 January 2017.
All research outputs
#14,278,028
of 25,374,647 outputs
Outputs from Annals of Clinical Biochemistry
#661
of 1,270 outputs
Outputs of similar age
#169,194
of 330,346 outputs
Outputs of similar age from Annals of Clinical Biochemistry
#397
of 492 outputs
Altmetric has tracked 25,374,647 research outputs across all sources so far. This one is in the 43rd percentile – i.e., 43% of other outputs scored the same or lower than it.
So far Altmetric has tracked 1,270 research outputs from this source. They receive a mean Attention Score of 3.7. This one is in the 47th percentile – i.e., 47% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 330,346 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 48th percentile – i.e., 48% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 492 others from the same source and published within six weeks on either side of this one. This one is in the 19th percentile – i.e., 19% of its contemporaries scored the same or lower than it.