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<meta name="citation_keywords" content="Adrenal Hyperplasia, Congenital">
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id="_NBK609103_"><span itemprop="name">When to suspect adrenal insufficiency</span></h1><div class="subtitle">Adrenal insufficiency: identification and management</div><p><b>Evidence review B</b></p><p><i>NICE Guideline, No. 243</i></p><div class="half_rhythm">London: <a href="https://www.nice.org.uk" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=publisher"><span itemprop="publisher">National Institute for Health and Care Excellence (NICE)</span></a>; <span itemprop="datePublished">2024 Aug</span>.<div class="small">ISBN-13: <span itemprop="isbn">978-1-4731-6464-2</span></div></div><div><a href="/books/about/copyright/">Copyright</a> © NICE 2024.</div></div><div class="bkr_clear"></div></div><div id="niceng243er2.s1"><h2 id="_niceng243er2_s1_">1. When to suspect adrenal insufficiency</h2><div id="niceng243er2.s1.1"><h3>1.1. Review question</h3><p>When should adrenal insufficiency be suspected (for example, based on risk factors or symptoms)?</p><div id="niceng243er2.s1.1.1"><h4>1.1.1. Introduction</h4><p>Whilst adrenal insufficiency is rare, not diagnosing it has fatal consequences, indeed some patients present with adrenal crisis, hence healthcare professionals should be aware of the risks factors and signs and symptoms associated with this condition.</p><p>Primary adrenal Insufficiency: Addis</p><p>on’s disease is the most common cause in adults, and congenital adrenal hyperplasia is the most common cause in children.</p><p>Secondary adrenal insufficiency: caused by inadequate adrenocorticotropic hormone production by the pituitary gland, often because of treatment for pituitary disease, or from pituitary tumours and their treatment)</p><p>Tertiary adrenal insufficiency: caused by inadequate corticotrophin-releasing hormone production by the hypothalamus. This can be because of treatment for tumours in the hypothalamus or adjoining structures, or more commonly because of administration of glucocorticoids for more than 4 weeks causing hypothalamic-pituitary-adrenal axis [HPA-axis] suppression). Stopping glucocorticoids abruptly may also cause adrenal insufficiency.</p><p>Some medicines may cause adrenal insufficiency, such as opioids, checkpoint inhibitors (used increasingly for treating cancer), and medicines inhibiting cortisol clearance such as antifungals and antiretrovirals.</p><p>There are number of signs and symptoms for AI and factors that can cause AI (risk factors); however, their ability to discriminate AI accurately enough to make a differential diagnosis and begin treatment is uncertain. The aim of this review is to determine whether these signs, symptoms and risk factors can be as prompts for health care professionals to consider a diagnosis of adrenal insufficiency to initiate treatment in a timely way to prevent death or significant morbidity.</p></div><div id="niceng243er2.s1.1.2"><h4>1.1.2. Summary of the protocol</h4><p>For full details see the review protocol in <a href="#niceng243er2.appa">Appendix A</a>.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng243er2tab1"><a href="/books/NBK609103/table/niceng243er2.tab1/?report=objectonly" target="object" title="Table 1" class="img_link icnblk_img" rid-ob="figobniceng243er2tab1"><img class="small-thumb" src="/corehtml/pmc/css/bookshelf/2.26/img/table-icon.gif" alt="Table Icon" /></a><div class="icnblk_cntnt"><h4 id="niceng243er2.tab1"><a href="/books/NBK609103/table/niceng243er2.tab1/?report=objectonly" target="object" rid-ob="figobniceng243er2tab1">Table 1</a></h4><p class="float-caption no_bottom_margin">PICO characteristics of review question. </p></div></div></div><div id="niceng243er2.s1.1.3"><h4>1.1.3. Methods and process</h4><p>This evidence review was developed using the methods and process described in <a href="https://www.nice.org.uk/process/pmg20/chapter/introduction-and-overview" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>. Methods specific to this review question are described in the review protocol in <a href="#niceng243er2.appa">Appendix A</a> and the <a href="/books/NBK609103/bin/NG243-Methods.pdf">methods</a> document.</p><p>Declarations of interest were recorded according to <a href="https://www.nice.org.uk/about/who-we-are/policies-and-procedures" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NICE’s conflicts of interest policy</a>.</p></div><div id="niceng243er2.s1.1.4"><h4>1.1.4. Diagnostic evidence</h4><div id="niceng243er2.s1.1.4.1"><h5>1.1.4.1. Included studies</h5><div id="niceng243er2.s1.1.4.1.1"><h5>Signs and symptoms</h5><p>A search was conducted for cross-sectional (single gate) studies reporting the diagnostic accuracy of signs and symptoms to identify whether adrenal insufficiency is present as indicated by the reference standard (clinical diagnosis of adrenal insufficiency by a specialist, short Synacthen test (standard and low dose), or insulin tolerance test).</p><p>Six studies were included in the review;<a class="bibr" href="#niceng243er2.ref1" rid="niceng243er2.ref1"><sup>1</sup></a><sup>–</sup><a class="bibr" href="#niceng243er2.ref5" rid="niceng243er2.ref5"><sup>5</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng243er2.ref7" rid="niceng243er2.ref7"><sup>7</sup></a> these are summarised in <a href="/books/NBK609103/table/niceng243er2.tab2/?report=objectonly" target="object" rid-ob="figobniceng243er2tab2">Table 2</a> below. Evidence from these studies is summarised in the clinical evidence summary below in <a href="/books/NBK609103/table/niceng243er2.tab3/?report=objectonly" target="object" rid-ob="figobniceng243er2tab3">Table 3</a>–<a href="/books/NBK609103/table/niceng243er2.tab13/?report=objectonly" target="object" rid-ob="figobniceng243er2tab13">13</a> and the references are detailed in the References section. Evidence was identified for low blood pressure, hyperpigmentation, lethargy, salt craving, weight loss, hyponatraemia, hyperkalaemia, nausea, vomiting and diarrhoea. A variety of reference standard tests and cut-offs were used to identify adrenal insufficiency and one study used more than one reference standard. Three studies were based on people with HIV/AIDS, one study was based on people with dermatological conditions using topical corticosteroids, one study was based on people with suspected tuberculosis and one study was based on people with liver cirrhosis. No studies were identified in children.</p><p>The assessment of the evidence quality was conducted with emphasis on test sensitivity and specificity as this was identified by the committee as the primary measure in guiding decision-making. The committee set clinical decision thresholds as sensitivity/specificity 90% and 70% above which a test would be recommended and 60% and 50% below which a test is of no clinical use.</p></div><div id="niceng243er2.s1.1.4.1.2"><h5>Risk factors</h5><p>A search was conducted for prospective cohort studies with multivariable analysis reporting the predictive value of risk factors for adrenal insufficiency. No evidence was identified.</p><p>See also the study selection flow chart in <a href="#niceng243er2.appc">Appendix C</a>, sensitivity and specificity forest plots in <a href="#niceng243er2.appe">Appendix E</a>, and study evidence tables in <a href="#niceng243er2.appd">Appendix D</a>.</p></div></div><div id="niceng243er2.s1.1.4.2"><h5>1.1.4.2. Excluded studies</h5><p>See the excluded studies list in <a href="#niceng243er2.appi">Appendix I</a>.</p></div></div><div id="niceng243er2.s1.1.5"><h4>1.1.5. Summary of studies included in the diagnostic evidence</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng243er2tab2"><a href="/books/NBK609103/table/niceng243er2.tab2/?report=objectonly" target="object" title="Table 2" class="img_link icnblk_img" rid-ob="figobniceng243er2tab2"><img class="small-thumb" src="/corehtml/pmc/css/bookshelf/2.26/img/table-icon.gif" alt="Table Icon" /></a><div class="icnblk_cntnt"><h4 id="niceng243er2.tab2"><a href="/books/NBK609103/table/niceng243er2.tab2/?report=objectonly" target="object" rid-ob="figobniceng243er2tab2">Table 2</a></h4><p class="float-caption no_bottom_margin">Summary of studies included in the evidence review of signs and symptoms. </p></div></div><p>See <a href="#niceng243er2.appd">Appendix D</a> for full evidence tables.</p></div><div id="niceng243er2.s1.1.6"><h4>1.1.6. Summary of the diagnostic evidence</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng243er2tab3"><a href="/books/NBK609103/table/niceng243er2.tab3/?report=objectonly" target="object" title="Table 3" class="img_link icnblk_img" rid-ob="figobniceng243er2tab3"><img class="small-thumb" src="/corehtml/pmc/css/bookshelf/2.26/img/table-icon.gif" alt="Table Icon" /></a><div class="icnblk_cntnt"><h4 id="niceng243er2.tab3"><a href="/books/NBK609103/table/niceng243er2.tab3/?report=objectonly" target="object" rid-ob="figobniceng243er2tab3">Table 3</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: low blood pressure (hypotension inclusion postural hypotension). </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng243er2tab4"><a href="/books/NBK609103/table/niceng243er2.tab4/?report=objectonly" target="object" title="Table 4" class="img_link icnblk_img" rid-ob="figobniceng243er2tab4"><img class="small-thumb" src="/corehtml/pmc/css/bookshelf/2.26/img/table-icon.gif" alt="Table Icon" /></a><div class="icnblk_cntnt"><h4 id="niceng243er2.tab4"><a href="/books/NBK609103/table/niceng243er2.tab4/?report=objectonly" target="object" rid-ob="figobniceng243er2tab4">Table 4</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: hyperpigmentation. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng243er2tab5"><a href="/books/NBK609103/table/niceng243er2.tab5/?report=objectonly" target="object" title="Table 5" class="img_link icnblk_img" rid-ob="figobniceng243er2tab5"><img class="small-thumb" src="/corehtml/pmc/css/bookshelf/2.26/img/table-icon.gif" alt="Table Icon" /></a><div class="icnblk_cntnt"><h4 id="niceng243er2.tab5"><a href="/books/NBK609103/table/niceng243er2.tab5/?report=objectonly" target="object" rid-ob="figobniceng243er2tab5">Table 5</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: lethargy. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng243er2tab6"><a href="/books/NBK609103/table/niceng243er2.tab6/?report=objectonly" target="object" title="Table 6" class="img_link icnblk_img" rid-ob="figobniceng243er2tab6"><img class="small-thumb" src="/corehtml/pmc/css/bookshelf/2.26/img/table-icon.gif" alt="Table Icon" /></a><div class="icnblk_cntnt"><h4 id="niceng243er2.tab6"><a href="/books/NBK609103/table/niceng243er2.tab6/?report=objectonly" target="object" rid-ob="figobniceng243er2tab6">Table 6</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: salt craving. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng243er2tab7"><a href="/books/NBK609103/table/niceng243er2.tab7/?report=objectonly" target="object" title="Table 7" class="img_link icnblk_img" rid-ob="figobniceng243er2tab7"><img class="small-thumb" src="/corehtml/pmc/css/bookshelf/2.26/img/table-icon.gif" alt="Table Icon" /></a><div class="icnblk_cntnt"><h4 id="niceng243er2.tab7"><a href="/books/NBK609103/table/niceng243er2.tab7/?report=objectonly" target="object" rid-ob="figobniceng243er2tab7">Table 7</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: weight loss. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng243er2tab8"><a href="/books/NBK609103/table/niceng243er2.tab8/?report=objectonly" target="object" title="Table 8" class="img_link icnblk_img" rid-ob="figobniceng243er2tab8"><img class="small-thumb" src="/corehtml/pmc/css/bookshelf/2.26/img/table-icon.gif" alt="Table Icon" /></a><div class="icnblk_cntnt"><h4 id="niceng243er2.tab8"><a href="/books/NBK609103/table/niceng243er2.tab8/?report=objectonly" target="object" rid-ob="figobniceng243er2tab8">Table 8</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: Hyponatraemia (serum sodium <135 mEq/L) for diagnosing adrenal insufficiency. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng243er2tab9"><a href="/books/NBK609103/table/niceng243er2.tab9/?report=objectonly" target="object" title="Table 9" class="img_link icnblk_img" rid-ob="figobniceng243er2tab9"><img class="small-thumb" src="/corehtml/pmc/css/bookshelf/2.26/img/table-icon.gif" alt="Table Icon" /></a><div class="icnblk_cntnt"><h4 id="niceng243er2.tab9"><a href="/books/NBK609103/table/niceng243er2.tab9/?report=objectonly" target="object" rid-ob="figobniceng243er2tab9">Table 9</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: Hyperkalaemia (serum Potassium >5 mEq/L) for diagnosing adrenal insufficiency. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng243er2tab10"><a href="/books/NBK609103/table/niceng243er2.tab10/?report=objectonly" target="object" title="Table 10" class="img_link icnblk_img" rid-ob="figobniceng243er2tab10"><img class="small-thumb" src="/corehtml/pmc/css/bookshelf/2.26/img/table-icon.gif" alt="Table Icon" /></a><div class="icnblk_cntnt"><h4 id="niceng243er2.tab10"><a href="/books/NBK609103/table/niceng243er2.tab10/?report=objectonly" target="object" rid-ob="figobniceng243er2tab10">Table 10</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: nausea and vomiting for diagnosing adrenal insufficiency. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng243er2tab11"><a href="/books/NBK609103/table/niceng243er2.tab11/?report=objectonly" target="object" title="Table 11" class="img_link icnblk_img" rid-ob="figobniceng243er2tab11"><img class="small-thumb" src="/corehtml/pmc/css/bookshelf/2.26/img/table-icon.gif" alt="Table Icon" /></a><div class="icnblk_cntnt"><h4 id="niceng243er2.tab11"><a href="/books/NBK609103/table/niceng243er2.tab11/?report=objectonly" target="object" rid-ob="figobniceng243er2tab11">Table 11</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: nausea for diagnosing adrenal insufficiency. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng243er2tab12"><a href="/books/NBK609103/table/niceng243er2.tab12/?report=objectonly" target="object" title="Table 12" class="img_link icnblk_img" rid-ob="figobniceng243er2tab12"><img class="small-thumb" src="/corehtml/pmc/css/bookshelf/2.26/img/table-icon.gif" alt="Table Icon" /></a><div class="icnblk_cntnt"><h4 id="niceng243er2.tab12"><a href="/books/NBK609103/table/niceng243er2.tab12/?report=objectonly" target="object" rid-ob="figobniceng243er2tab12">Table 12</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: vomiting for diagnosing adrenal insufficiency. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng243er2tab13"><a href="/books/NBK609103/table/niceng243er2.tab13/?report=objectonly" target="object" title="Table 13" class="img_link icnblk_img" rid-ob="figobniceng243er2tab13"><img class="small-thumb" src="/corehtml/pmc/css/bookshelf/2.26/img/table-icon.gif" alt="Table Icon" /></a><div class="icnblk_cntnt"><h4 id="niceng243er2.tab13"><a href="/books/NBK609103/table/niceng243er2.tab13/?report=objectonly" target="object" rid-ob="figobniceng243er2tab13">Table 13</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: Diarrhoea for diagnosing adrenal insufficiency. </p></div></div><p>See <a href="#niceng243er2.appf">appendix F</a> for full details of Diagnostic evidence.</p></div><div id="niceng243er2.s1.1.7"><h4>1.1.7. Economic evidence</h4><div id="niceng243er2.s1.1.7.1"><h5>1.1.7.1. Included studies</h5><p>No health economic studies were included.</p></div><div id="niceng243er2.s1.1.7.2"><h5>1.1.7.2. Excluded studies</h5><p>No relevant health economic studies were excluded due to assessment of limited applicability or methodological limitations.</p><p>See also the health economic study selection flow chart in <a href="#niceng243er2.appf">Appendix F</a>.</p></div></div><div id="niceng243er2.s1.1.8"><h4>1.1.8. Economic model</h4><p>This area was not prioritised for new cost-effectiveness analysis.</p></div></div><div id="niceng243er2.s1.2"><h3>1.2. The committee's discussion and interpretation of the evidence</h3><p>There was limited evidence for this review question, so the committee also used their clinical knowledge and experience to make the recommendations.</p><div id="niceng243er2.s1.2.1"><h4>1.2.1. The outcomes that matter most</h4><div id="niceng243er2.s1.2.1.1"><h5>Signs and symptoms review</h5><p>The committee considered the diagnostic measures of sensitivity and specificity for the signs and symptoms that are associated with adrenal insufficiency, or that predict its occurrence. Clinical decision thresholds were set by the committee as sensitivity/specificity=0.9 and 0.7 above which a test would be recommended and 0.6 and 0.5 below which a test is of no clinical use. The committee prioritised sensitivity over specificity because the signs and symptoms would be used to help select those suspected of having adrenal insufficiency, in whom further investigation and timely treatment may be required. As there was sufficient sensitivity and specificity data available, no association data was included in the review.</p></div><div id="niceng243er2.s1.2.1.2"><h5>Risk factors review</h5><p>The committee considered association data (such as adjusted hazard ratios, risk ratios or odds ratios) along with diagnostic accuracy data of any risk prediction tools to identify the association and predictive accuracy of specific factors or patient characteristics that may lead to developing adrenal insufficiency. No relevant evidence was identified.</p></div></div><div id="niceng243er2.s1.2.2"><h4>1.2.2. The quality of the evidence</h4><div id="niceng243er2.s1.2.2.1"><h5>Signs and symptoms review</h5><p>A search was conducted for cross-sectional (single gate) studies reporting the diagnostic accuracy of signs and symptoms to identify whether adrenal insufficiency is present. Evidence was very limited, and six studies were included in the review. Evidence was identified for the following signs and symptoms: low blood pressure, hyperpigmentation, lethargy, salt craving, weight loss, hyponatraemia, hyperkalaemia, nausea, vomiting and diarrhoea. No evidence was identified for hypoglycaemia or failure to respond to initial treatments.</p><p>Evidence was from a mix of populations. Three studies were based on people with HIV/AIDS, one study was based on people with dermatological conditions using topical corticosteroids, one study was based on people with suspected tuberculosis and one study was based on people with liver cirrhosis. All studies were conducted in adults and no studies were identified for children.</p><p>A variety of reference standard tests and cut-offs were used to identify adrenal insufficiency and one study used more than one reference standard for diagnosis. The majority of studies used the Short Synacthen Test (either the standard or low dose).</p><p>All evidence was rated very low quality due to the risk of bias and imprecision around the effect estimate. Risk of bias was rated very high due to unclear recruitment strategies (whether random/consecutive), uncertainty around whether the sign/symptom was recorded without knowledge of the diagnosis and vice versa and unclear timing between the recording of the sign/symptom and the diagnosis. Many outcomes were downgraded for imprecision due to small study sizes and the confidence intervals crossing the decision thresholds, indicating conflicting interpretations of the result.</p><p>Meta-analysis of the data was not possible due to the differences in populations, reference standards and the cortisol cut-offs used, meaning that all results were based on small individual studies.</p></div><div id="niceng243er2.s1.2.2.2"><h5>Risk factors review</h5><p>A search was conducted for prospective cohort studies with multivariable analysis reporting the predictive value of risk factors for adrenal insufficiency. However, no evidence was identified so the committee used their clinical knowledge and experience to make the recommendations.</p></div></div><div id="niceng243er2.s1.2.3"><h4>1.2.3. Benefits and harms</h4><p>The committee discussed the evidence base available for the signs and symptoms review. Evidence was identified for the following signs and symptoms: low blood pressure (3 studies), hyperpigmentation (2 studies), lethargy (5 studies), salt craving (2 studies), weight loss (4 studies), hyponatraemia (2 studies), hyperkalaemia (1 study), nausea (2 studies, vomiting (2 studies), nausea and vomiting combined (1 study) and diarrhoea (2 studies). Overall, the evidence was reported in six studies. However, one study reported each sign/symptom at four different definitions of adrenal insufficiency and cut-offs so there are many more outcomes included.</p><p>The committee noted that the populations in the included studies were very specific (HIV, TB and liver cirrhosis) and were unsure how relevant the evidence was to make recommendations for a general adrenal insufficiency population.</p><p>The assessment of the evidence quality was conducted with emphasis on test sensitivity and specificity as this was identified by the committee as the primary measure in guiding decision-making. The committee set clinical decision thresholds as sensitivity/specificity 90% and 70% above which a test would be recommended and 60% and 50% below which a test is of no clinical use. Using these thresholds none of the signs and symptoms met the agreed threshold of 90% for sensitivity to base recommendations. Several outcomes reached the specificity threshold of 70% however, when looking at the paired values together, none of these reached the sensitivity threshold which was considered of higher priority in clinical decision making. The committee noted the high specificity for hyperpigmentation and discussed it is common in people with primary AI and the clearest indicator for suspecting the condition. They noted this feature may not be easily recognised in people with black or brown skin and that clinicians should inspect buccal mucosa, surgical scars and ask the person if they have noticed any change to their skin.</p><p>Other symptoms also had a high specificity, such as hyperkalaemia but the committee noted these are very uncommon. Due to the limitations of the available evidence the committee decided to use their consensus opinion to formulate recommendations and agreed on a weaker ‘consider’ recommendation for the specific signs and symptoms indicative of adrenal insufficiency.</p><p>The committee agreed that the symptoms and signs associated with adrenal insufficiency were common to a range of conditions and this is partly why a diagnosis of adrenal insufficiency can be missed. Nevertheless, the committee agreed that when one or more of the symptoms, signs or features are present without an alternative explanation, it should raise suspicion of adrenal insufficiency amongst clinicians. They discussed that non-specific symptoms such as lethargy or diarrhoea are too general and might lead to over-testing, therefore these symptoms would also need to be persistent and other potential causes ruled out before warranting further investigation. The committee discussed the needs of young children and people not able to communicate how they are feeling, noting that clinicians and carers need to be vigilant in monitoring for signs of adrenal insufficiency as these can be subtle and easily missed.</p><p>The committee noted that hyponatraemia, whilst common, can be indicative of adrenal insufficiency if it occurs in conjunction with other symptoms listed. Hyponatraemia can be profound in primary adrenal insufficiency and associated with significant postural symptoms due to both glucocorticoid (GC) and mineralocorticoid deficiencies.</p><p>The committee also agreed through consensus opinion that features such as hypoglycaemia, faltering growth, hypotensive crisis, and differences in sex and development in children should also prompt consideration of adrenal insufficiency, especially when these are not in isolation. For example, hypoglycaemia by itself wouldn’t necessarily indicate adrenal insufficiency but if other causes have been excluded such as not being small for gestational age and other investigations as part of a hypoglycaemia screen have not shown other causes then adrenal insufficiency should be suspected, and the cortisol levels should be checked.</p><p>The committee decided to make consensus recommendations drawing on their experience of symptoms and signs seen in clinical practice, and their knowledge of the risk factors associated with medications and people with other co-existing conditions and comorbidities. The most common coexisting conditions include primary hypothyroidism and type 1 diabetes. However, clinicians should be aware that there are some rare co-exiting conditions such as Adrenoleukodystrophy and Adrenomyeloneuropathy where adrenal insufficiency should not be overlooked as investigations are often focussed on the conditions themselves and adrenal insufficiency is missed.</p></div><div id="niceng243er2.s1.2.4"><h4>1.2.4. Cost-effectiveness and resource use</h4><p>No economic evaluations were identified for this review question. Due to a lack of clinical evidence that was generalisable to all people with adrenal insufficiency, the committee made consensus recommendations that were reflective of current practice. These recommendations are therefore not expected to result in a significant resource impact.</p></div><div id="niceng243er2.s1.2.5"><h4>1.2.5. Recommendations supported by this evidence review</h4><p>This evidence review supports recommendations 1.2.1 to 1.2.4 and 1.9.6 to 1.9.7.</p></div></div></div><div id="niceng243er2.s1.1.rl.r1"><h2 id="_niceng243er2_s1_1_rl_r1_">References</h2><dl class="temp-labeled-list"><dl class="bkr_refwrap"><dt>1.</dt><dd><div class="bk_ref" id="niceng243er2.ref1">Abbott
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[<a href="/pmc/articles/PMC8594898/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8594898</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/34803396" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34803396</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>4.</dt><dd><div class="bk_ref" id="niceng243er2.ref4">Mabuza
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LH, Sarpong
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DF. Indicators of adrenal insufficiency in TB-suspect patients presenting with signs and symptoms of adrenal insufficiency at three South African Hospitals in Pretoria. Open Public Health Journal. 2020; 13(1):178–187</div></dd></dl><dl class="bkr_refwrap"><dt>5.</dt><dd><div class="bk_ref" id="niceng243er2.ref5">Naguib
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R, Fayed
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A, Abouelnaga
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S, Naguib
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H. Evaluation of adrenal function in hemodynamically stable patients with liver cirrhosis. Clinical and experimental hepatology. 2022; 8(1):78–83
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[<a href="/pmc/articles/PMC8984798/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8984798</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/35415258" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35415258</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>6.</dt><dd><div class="bk_ref" id="niceng243er2.ref6">National Institute for Health and Care Excellence. Developing NICE guidelines: the manual. London. National Institute for Health and Care Excellence, 2014. Available from: <a href="https://www.nice.org.uk/process/pmg20/chapter/introduction" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.nice.org<wbr style="display:inline-block"></wbr>​.uk/process/pmg20/chapter/introduction</a> [<a href="https://pubmed.ncbi.nlm.nih.gov/26677490" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26677490</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>7.</dt><dd><div class="bk_ref" id="niceng243er2.ref7">Wolff
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FH, Nhuch
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C, Cadore
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LP, Glitz
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CL, Lhullier
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F, Furlanetto
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TW. Low-dose adrenocorticotropin test in patients with the acquired immunodeficiency syndrome. The Brazilian journal of infectious diseases: an official publication of the Brazilian
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Society of Infectious Diseases. 2001; 5(2):53–59 [<a href="https://pubmed.ncbi.nlm.nih.gov/11493409" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11493409</span></a>]</div></dd></dl></dl></div><div id="appendixesappgroup1"><h2 id="_appendixesappgroup1_">Appendices</h2><div id="niceng243er2.appa"><h3>Appendix A. Review protocols</h3><p id="niceng243er2.appa.et1"><a href="/books/NBK609103/bin/niceng243er2-appa-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">A.1. Review protocol for when to suspect adrenal crisis</a><span class="small"> (PDF, 183K)</span></p><p id="niceng243er2.appa.et2"><a href="/books/NBK609103/bin/niceng243er2-appa-et2.pdf" class="bk_dwnld_icn bk_dwnld_pdf">A.2. Health economic review protocol</a><span class="small"> (PDF, 143K)</span></p></div><div id="niceng243er2.appb"><h3>Appendix B. Literature search strategies</h3><p>The literature searches for this review are detailed below and complied with the methodology outlined in Developing NICE guidelines: the manual.<a class="bibr" href="#niceng243er2.ref6" rid="niceng243er2.ref6"><sup>6</sup></a></p><p>For more information, please see the Methodology review published as part of the accompanying documents for this guideline.</p><div id="niceng243er2.appb.s1"><h4>B.1. Clinical search literature search strategy</h4><p>Searches were constructed using a PICO framework where population (P) terms were combined with Intervention (I) and in some cases Comparison (C) terms. Outcomes (O) are rarely used in search strategies as these concepts may not be indexed or described in the title or abstract and are therefore difficult to retrieve. Search filters were applied to the search where appropriate.</p><p id="niceng243er2.appb.et1"><a href="/books/NBK609103/bin/niceng243er2-appb-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (282K)</span></p></div><div id="niceng243er2.appb.s2"><h4>B.2. Health Economics literature search strategy</h4><p>Health economic evidence was identified by conducting searches using terms for a broad Adrenal Insufficiency population. The following databases were searched: NHS Economic Evaluation Database (NHS EED - this ceased to be updated after 31st March 2015), Health Technology Assessment database (HTA - this ceased to be updated from 31st March 2018) and The International Network of Agencies for Health Technology Assessment (INAHTA). Searches for recent evidence were run on Medline and Embase from 2014 onwards.</p><p id="niceng243er2.appb.et2"><a href="/books/NBK609103/bin/niceng243er2-appb-et2.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (158K)</span></p></div></div><div id="niceng243er2.appc"><h3>Appendix C. Diagnostic evidence study selection</h3><p id="niceng243er2.appc.et1"><a href="/books/NBK609103/bin/niceng243er2-appc-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (111K)</span></p></div><div id="niceng243er2.appd"><h3>Appendix D. Diagnostic evidence</h3><p id="niceng243er2.appd.et1"><a href="/books/NBK609103/bin/niceng243er2-appd-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (407K)</span></p></div><div id="niceng243er2.appe"><h3>Appendix E. Forest plots</h3><div id="niceng243er2.appe.s1"><h4>E.1. Coupled sensitivity and specificity forest plots</h4><p id="niceng243er2.appe.et1"><a href="/books/NBK609103/bin/niceng243er2-appe-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">E.1.1. Hypotension for diagnosing adrenal insufficiency</a><span class="small"> (PDF, 142K)</span></p><p id="niceng243er2.appe.et2"><a href="/books/NBK609103/bin/niceng243er2-appe-et2.pdf" class="bk_dwnld_icn bk_dwnld_pdf">E.1.2. Hyperpigmentation for diagnosing adrenal insufficiency</a><span class="small"> (PDF, 165K)</span></p><p id="niceng243er2.appe.et3"><a href="/books/NBK609103/bin/niceng243er2-appe-et3.pdf" class="bk_dwnld_icn bk_dwnld_pdf">E.1.3. Mucoses hyperpigmentation for diagnosing adrenal insufficiency</a><span class="small"> (PDF, 135K)</span></p><p id="niceng243er2.appe.et4"><a href="/books/NBK609103/bin/niceng243er2-appe-et4.pdf" class="bk_dwnld_icn bk_dwnld_pdf">E.1.4. Lethargy for diagnosing adrenal insufficiency</a><span class="small"> (PDF, 165K)</span></p><p id="niceng243er2.appe.et5"><a href="/books/NBK609103/bin/niceng243er2-appe-et5.pdf" class="bk_dwnld_icn bk_dwnld_pdf">E.1.5. Salt craving for diagnosing adrenal insufficiency</a><span class="small"> (PDF, 111K)</span></p><p id="niceng243er2.appe.et6"><a href="/books/NBK609103/bin/niceng243er2-appe-et6.pdf" class="bk_dwnld_icn bk_dwnld_pdf">E.1.6. Weight loss for diagnosing adrenal insufficiency</a><span class="small"> (PDF, 151K)</span></p><p id="niceng243er2.appe.et7"><a href="/books/NBK609103/bin/niceng243er2-appe-et7.pdf" class="bk_dwnld_icn bk_dwnld_pdf">E.1.7. Hyponatraemia (serum sodium (<135mEq/l) for diagnosing adrenal insufficiency</a><span class="small"> (PDF, 140K)</span></p><p id="niceng243er2.appe.et8"><a href="/books/NBK609103/bin/niceng243er2-appe-et8.pdf" class="bk_dwnld_icn bk_dwnld_pdf">E.1.8. Hyperkalaemia (serum Potassium > 5 mEq/L) for diagnosing adrenal insufficiency</a><span class="small"> (PDF, 139K)</span></p><p id="niceng243er2.appe.et9"><a href="/books/NBK609103/bin/niceng243er2-appe-et9.pdf" class="bk_dwnld_icn bk_dwnld_pdf">E.1.9. Nausea and vomiting for diagnosing adrenal insufficiency</a><span class="small"> (PDF, 143K)</span></p><p id="niceng243er2.appe.et10"><a href="/books/NBK609103/bin/niceng243er2-appe-et10.pdf" class="bk_dwnld_icn bk_dwnld_pdf">E.1.10. Nausea for diagnosing adrenal insufficiency</a><span class="small"> (PDF, 99K)</span></p><p id="niceng243er2.appe.et11"><a href="/books/NBK609103/bin/niceng243er2-appe-et11.pdf" class="bk_dwnld_icn bk_dwnld_pdf">E. 1.11. Vomiting for diagnosing adrenal insufficiency</a><span class="small"> (PDF, 132K)</span></p><p id="niceng243er2.appe.et12"><a href="/books/NBK609103/bin/niceng243er2-appe-et12.pdf" class="bk_dwnld_icn bk_dwnld_pdf">E.1.12. Diarrhoea for diagnosing adrenal insufficiency</a><span class="small"> (PDF, 117K)</span></p></div></div><div id="niceng243er2.appf"><h3>Appendix F. Economic evidence study selection</h3><p id="niceng243er2.appf.et1"><a href="/books/NBK609103/bin/niceng243er2-appf-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (176K)</span></p></div><div id="niceng243er2.appg"><h3>Appendix G. Economic evidence tables</h3><p>None.</p></div><div id="niceng243er2.apph"><h3>Appendix H. Health economic model</h3><p>No original economic modelling was undertaken for this review question.</p></div><div id="niceng243er2.appi"><h3>Appendix I. Excluded studies</h3><div id="niceng243er2.appi.s1"><h4>I.1. Clinical studies</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng243er2appitab1"><a href="/books/NBK609103/table/niceng243er2.appi.tab1/?report=objectonly" target="object" title="Table 16" class="img_link icnblk_img" rid-ob="figobniceng243er2appitab1"><img class="small-thumb" src="/corehtml/pmc/css/bookshelf/2.26/img/table-icon.gif" alt="Table Icon" /></a><div class="icnblk_cntnt"><h4 id="niceng243er2.appi.tab1"><a href="/books/NBK609103/table/niceng243er2.appi.tab1/?report=objectonly" target="object" rid-ob="figobniceng243er2appitab1">Table 16</a></h4><p class="float-caption no_bottom_margin">Studies excluded from the clinical review. </p></div></div></div><div id="niceng243er2.appi.s2"><h4>I.2. Health Economic studies</h4><p>None.</p></div></div></div></div><div class="fm-sec"><div><p>Final</p></div><div><p>Evidence reviews underpinning recommendations 1.2.1 to 1.2.4 and 1.9.6 to 1.9.7 in the NICE guideline</p><p>This evidence review was developed by NICE</p></div><div><p><b>Disclaimer</b>: The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.</p><p>Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.</p><p>NICE guidelines cover health and care in England. Decisions on how they apply in other UK countries are made by ministers in the <a href="https://www.gov.wales/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Welsh Government</a>, <a href="http://www.scotland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Scottish Government</a>, and <a href="http://www.northernireland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Northern Ireland Executive</a>. All NICE guidance is subject to regular review and may be updated or withdrawn.</p></div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright</a> © NICE 2024.</div><div class="small"><span class="label">Bookshelf ID: NBK609103</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/39541489" title="PubMed record of this title" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">39541489</a></span></div></div><div class="small-screen-prev"></div><div class="small-screen-next"></div></article><article data-type="table-wrap" id="figobniceng243er2tab1"><div id="niceng243er2.tab1" class="table"><h3><span class="label">Table 1</span><span class="title">PICO characteristics of review question</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK609103/table/niceng243er2.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng243er2.tab1_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Population</b>
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</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Adults and children without a diagnosis of adrenal insufficiency</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Target condition</b>
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</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Adrenal insufficiency</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Index tests</b>
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</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Signs/symptoms:<ul><li class="half_rhythm"><div>Low blood pressure (hypotension including postural hypotension)</div></li><li class="half_rhythm"><div>Hyperpigmentation</div></li><li class="half_rhythm"><div>Lethargy</div></li><li class="half_rhythm"><div>Salt craving</div></li><li class="half_rhythm"><div>Weight loss</div></li><li class="half_rhythm"><div>Hyponatraemia</div></li><li class="half_rhythm"><div>Hyperkalaemia</div></li><li class="half_rhythm"><div>Hypoglycaemia</div></li><li class="half_rhythm"><div>Nausea</div></li><li class="half_rhythm"><div>Vomiting</div></li><li class="half_rhythm"><div>Diarrhoea</div></li><li class="half_rhythm"><div>Failure to respond to initial treatments.</div></li></ul></td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Exposure</b>
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</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<b>Risk factors:</b>
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</p>
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<p><u>Drugs</u>:<ul><li class="half_rhythm"><div>checkpoint inhibitors e.g., atezolizumab, avelumab, durvalumab</div></li><li class="half_rhythm"><div>opioids</div></li><li class="half_rhythm"><div>glucocorticoid therapy (any route)</div></li><li class="half_rhythm"><div>adrenal enzyme inhibitors: e.g., mitotane ketoconazole, itraconazole, voriconazole, metyrapone, etomidate, aminoglutethimidie, phenobarbital, phenytoin, rifampicin</div></li><li class="half_rhythm"><div>mifepristone</div></li><li class="half_rhythm"><div>chlorpromazine</div></li><li class="half_rhythm"><div>imipramine</div></li></ul></p>
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<p><u>Co-existing conditions or co-morbidities</u>:<ul><li class="half_rhythm"><div>Primary hypothyroidism</div></li><li class="half_rhythm"><div>Type 1 diabetes</div></li><li class="half_rhythm"><div>Premature ovarian insufficiency</div></li><li class="half_rhythm"><div>Autoimmune Polyendocrinopathy Syndrome type 1</div></li><li class="half_rhythm"><div>Pituitary tumours</div></li><li class="half_rhythm"><div>Hypothalamic tumours or disease</div></li><li class="half_rhythm"><div>Traumatic brain injury (particularly base of skull fracture)</div></li><li class="half_rhythm"><div>Infections: TB, HIV/AIDS, CMV, fungal infections, syphilis, Lymphocytic hypophysitis, sarcoidosis, histiocytosis X, haemochromatosis</div></li></ul></p>
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<p>
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<u>Specific to children and neonates:</u>
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<ul><li class="half_rhythm"><div>Prolonged jaundice</div></li><li class="half_rhythm"><div>Hypoglycaemia</div></li><li class="half_rhythm"><div>Ambiguous genitalia (in females)</div></li><li class="half_rhythm"><div>Hypotensive crisis</div></li></ul>
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</p>
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<p>Any of the above, alone or in combination.</p>
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</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Reference standards</b>
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</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Reference standard for signs and symptoms review:<ul><li class="half_rhythm"><div>Clinical diagnosis of adrenal insufficiency by a specialist</div></li><li class="half_rhythm"><div>Short Synacthen Test (standard and low dose)</div></li><li class="half_rhythm"><div>Insulin tolerance test (insulin hypoglycaemia test)</div></li></ul></td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Confounding factors</b>
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</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Confounding factors for risk factors review:<ul><li class="half_rhythm"><div>Any exposure/risk factors listed above.</div></li><li class="half_rhythm"><div>Age and sex as a minimum.</div></li></ul></td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Statistical measures [or] Outcomes</b>
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</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<b>For signs and symptoms review:</b>
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<ul><li class="half_rhythm"><div>Diagnostic accuracy data<ul class="circle"><li class="half_rhythm"><div>Sensitivity (prioritised)</div></li><li class="half_rhythm"><div>Specificity</div></li></ul></div></li></ul>
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</p>
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<p>If no sensitivity or specificity, LR− and LR+ if raw data unavailable and unable to calculate from 2 × 2 table.</p>
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<p>Diagnostic association of signs and symptoms with a confirmed diagnosis of adrenal insufficiency. Measured by:<ul><li class="half_rhythm"><div>Association data<ul class="circle"><li class="half_rhythm"><div>Adjusted hazard ratios, odds ratios or risk ratios.</div></li></ul></div></li><li class="half_rhythm"><div>Discrimination<ul class="circle"><li class="half_rhythm"><div>For example C statistic, area under ROC curve</div></li></ul></div></li><li class="half_rhythm"><div>Calibration<ul class="circle"><li class="half_rhythm"><div>for example calibration slope</div></li></ul></div></li></ul></p>
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<p>
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<b>For risk factors review:</b>
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<ul><li class="half_rhythm"><div>Diagnosis of adrenal insufficiency as defined by authors and reported as adjusted hazard ratios, odds ratios or risk ratios.</div></li><li class="half_rhythm"><div>For risk prediction tools: sensitivity, specificity and statistical measures of discrimination and calibration including Area Under the Curve (AUC) for risk tools.</div></li></ul>
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</p>
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</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Study design</b>
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</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<b>For signs and symptoms review:</b>
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<ul><li class="half_rhythm"><div>Cross sectional (single gate) diagnostic studies</div></li><li class="half_rhythm"><div>If no or insufficient diagnostic accuracy studies are identified, prospective cohort studies looking at the association between individual or combinations of signs and symptoms (multivariable models/algorithms) and a confirmed diagnosis of adrenal insufficiency.</div></li><li class="half_rhythm"><div>Systematic reviews of the above</div></li></ul>
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</p>
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<p>
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<b>For risk factor review:</b>
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<ul><li class="half_rhythm"><div>Prospective cohort studies with multivariate analysis.</div></li><li class="half_rhythm"><div>Systematic reviews of the above.</div></li></ul>
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</p>
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<p>Studies will only be included if key confounders have been accounted for in a multivariate analysis. Key confounders will vary based on each risk factor but should at least include age and sex.</p>
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<p>Published NMAs and IPDs will be considered for inclusion.</p>
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</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng243er2tab2"><div id="niceng243er2.tab2" class="table"><h3><span class="label">Table 2</span><span class="title">Summary of studies included in the evidence review of signs and symptoms</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK609103/table/niceng243er2.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng243er2.tab2_lrgtbl__"><table><thead><tr><th id="hd_h_niceng243er2.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Study</th><th id="hd_h_niceng243er2.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Population</th><th id="hd_h_niceng243er2.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Target condition</th><th id="hd_h_niceng243er2.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Index test</th><th id="hd_h_niceng243er2.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Reference standard</th><th id="hd_h_niceng243er2.tab2_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Comments</th></tr></thead><tbody><tr><td headers="hd_h_niceng243er2.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Abbott 1995<a class="bibr" href="#niceng243er2.ref1" rid="niceng243er2.ref1"><sup>1</sup></a></td><td headers="hd_h_niceng243er2.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Adults with HIV (n=49)</td><td headers="hd_h_niceng243er2.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cortisol deficiency</td><td headers="hd_h_niceng243er2.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Fatigue (lethargy)</p>
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<p>Sodium (<135 mmol/1)</p>
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<p>Potassium (>5 mmol/l)</p>
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</td><td headers="hd_h_niceng243er2.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Rapid ACTH stimulation test (short-duration 250 μg synthetic corticotrophin test): normal response defined as 30 min post stimulation cortisol level ≥450 nmol/L, abnormal response defined as post stimulation cortisol <350 nmol/L and impaired response was any intermediate result</td><td headers="hd_h_niceng243er2.tab2_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Conducted in UK</p>
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<p>Study also reports systolic postural drop (≥10 mmHg), measured by erect and supine blood pressures, but insufficient data to calculate sensitivity/specificity (data missing)</p>
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<p>Serious indirectness: population</p>
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</td></tr><tr><td headers="hd_h_niceng243er2.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Casanova-Cardiel 2003<a class="bibr" href="#niceng243er2.ref2" rid="niceng243er2.ref2"><sup>2</sup></a></td><td headers="hd_h_niceng243er2.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Adults with HIV (n=106)</td><td headers="hd_h_niceng243er2.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Adrenal insufficiency</td><td headers="hd_h_niceng243er2.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>Fatigue (lethargy)</p>
|
|
<p>Weight loss</p>
|
|
<p>Salt intake (salt craving)</p>
|
|
<p>Diarrhoea</p>
|
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<p>Skin hyperpigmentation</p>
|
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<p>Mucoses hyperpigmentation</p>
|
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<p>Orthostatic hypotension</p>
|
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<p>Hyponatraemia (serum Na < 135 mEq/L)</p>
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<p>Hyperkalaemia (serum Potassium > 5 mEq/L)</p>
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</td><td headers="hd_h_niceng243er2.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Low dose short corticotropin stimulation test. Abnormal response cortisol peak response at 60 min <11 μg with respect to basal, also analyse the data with three different criteria to define subnormal response to ACTH-stimulation test: 1) twofold value of basal cortisol; 2) any cortisol value above 18 μg/dL; and 3) any cortisol value above 20 μg/dL.</td><td headers="hd_h_niceng243er2.tab2_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>Conducted in Mexico</p>
|
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<p>Very serious indirectness: population and reference standard</p>
|
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</td></tr><tr><td headers="hd_h_niceng243er2.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Hintong 2021<a class="bibr" href="#niceng243er2.ref3" rid="niceng243er2.ref3"><sup>3</sup></a></td><td headers="hd_h_niceng243er2.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Adults with dermatological conditions using topical corticosteroids (n=42)</td><td headers="hd_h_niceng243er2.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Adrenal insufficiency</td><td headers="hd_h_niceng243er2.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>Lethargy</p>
|
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<p>Nausea</p>
|
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<p>Hypotension</p>
|
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<p>Weight loss</p>
|
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</td><td headers="hd_h_niceng243er2.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8am cortisol level of <3 μg/dL or peak serum cortisol level <0.6 nmol/L at 20 or 40 minutes after a 18 μg/dl ACTH stimulation test defined as AI</td><td headers="hd_h_niceng243er2.tab2_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Conducted in Thailand</p>
|
|
<p>Very serious indirectness: population and reference standard</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mabuza 2020<a class="bibr" href="#niceng243er2.ref4" rid="niceng243er2.ref4"><sup>4</sup></a></td><td headers="hd_h_niceng243er2.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Tuberculosis-suspect patients (n=75)</td><td headers="hd_h_niceng243er2.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Adrenal insufficiency</td><td headers="hd_h_niceng243er2.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Hypotension</p>
|
|
<p>Hyperpigmentation</p>
|
|
<p>Salt craving</p>
|
|
<p>Weight loss</p>
|
|
<p>Nausea</p>
|
|
<p>Vomiting</p>
|
|
<p>Tiredness (lethargy)</p>
|
|
</td><td headers="hd_h_niceng243er2.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Low-dose ((1μg/ml intravenously) short corticotropin (Synacthen<sup>®</sup>) stimulation test: morning serum cortisol of<500 mmol/L</td><td headers="hd_h_niceng243er2.tab2_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Conducted in South Africa</p>
|
|
<p>Very serious indirectness: population and reference standard</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Naguib 2022<a class="bibr" href="#niceng243er2.ref5" rid="niceng243er2.ref5"><sup>5</sup></a></td><td headers="hd_h_niceng243er2.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Adults with liver cirrhosis (n=132)</td><td headers="hd_h_niceng243er2.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Adrenal insufficiency</td><td headers="hd_h_niceng243er2.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Hyponatraemia</td><td headers="hd_h_niceng243er2.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Basal and peak cortisol after 60 minutes following the short 250 μg Synacthen test: basal cortisol of <9μg/dl and/or peak cortisol <18 μg/dl</td><td headers="hd_h_niceng243er2.tab2_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Conducted in Egypt</p>
|
|
<p>Serious indirectness: population</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Wolff 2001<a class="bibr" href="#niceng243er2.ref7" rid="niceng243er2.ref7"><sup>7</sup></a></td><td headers="hd_h_niceng243er2.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Critically ill AIDs patients (n=72)</td><td headers="hd_h_niceng243er2.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Abnormal cortisol response to ACTH</td><td headers="hd_h_niceng243er2.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Fatigue (lethargy)</p>
|
|
<p>Weakness (lethargy)</p>
|
|
<p>Nausea</p>
|
|
<p>Vomiting</p>
|
|
<p>Diarrhoea</p>
|
|
<p>Weight loss</p>
|
|
</td><td headers="hd_h_niceng243er2.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Low-dose ACTH test (1 μg/mL); cortisol <18 mg/dl 30 and 40 minutes after</td><td headers="hd_h_niceng243er2.tab2_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Conducted in Brazil</p>
|
|
<p>Study also reports concomitant drug use, but cross-sectional data collection and no multivariable analysis (not extracted)</p>
|
|
<p>Very serious indirectness: population and reference standard</p>
|
|
</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng243er2tab3"><div id="niceng243er2.tab3" class="table"><h3><span class="label">Table 3</span><span class="title">Clinical evidence summary: low blood pressure (hypotension inclusion postural hypotension)</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK609103/table/niceng243er2.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng243er2.tab3_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng243er2.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Studies</th><th id="hd_h_niceng243er2.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">N</th><th id="hd_h_niceng243er2.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Risk of bias</th><th id="hd_h_niceng243er2.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Inconsistency</th><th id="hd_h_niceng243er2.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Indirectness</th><th id="hd_h_niceng243er2.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Imprecision</th><th id="hd_h_niceng243er2.tab3_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Effect size (95%CI)</th><th id="hd_h_niceng243er2.tab3_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality</th></tr></thead><tbody><tr><td headers="hd_h_niceng243er2.tab3_1_1_1_1 hd_h_niceng243er2.tab3_1_1_1_2 hd_h_niceng243er2.tab3_1_1_1_3 hd_h_niceng243er2.tab3_1_1_1_4 hd_h_niceng243er2.tab3_1_1_1_5 hd_h_niceng243er2.tab3_1_1_1_6 hd_h_niceng243er2.tab3_1_1_1_7 hd_h_niceng243er2.tab3_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Orthostatic hypotension for diagnosing adrenal insufficiency (cortisol peak response < 11 μg after low dose 10 μg short corticotropin stimulation test) in people with HIV infection</td></tr><tr><td headers="hd_h_niceng243er2.tab3_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study (index test and reference standard data collected cross-sectionally)</td><td headers="hd_h_niceng243er2.tab3_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">106</td><td headers="hd_h_niceng243er2.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not Serious</td><td headers="hd_h_niceng243er2.tab3_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.34 (0.21–0.49)</td><td headers="hd_h_niceng243er2.tab3_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>c</sup></td><td headers="hd_h_niceng243er2.tab3_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.66 (0.53–0.78)</td><td headers="hd_h_niceng243er2.tab3_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab3_1_1_1_1 hd_h_niceng243er2.tab3_1_1_1_2 hd_h_niceng243er2.tab3_1_1_1_3 hd_h_niceng243er2.tab3_1_1_1_4 hd_h_niceng243er2.tab3_1_1_1_5 hd_h_niceng243er2.tab3_1_1_1_6 hd_h_niceng243er2.tab3_1_1_1_7 hd_h_niceng243er2.tab3_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Orthostatic hypotension for diagnosing adrenal insufficiency (twofold value of basal cortisol after low dose 10 μg short corticotropin stimulation test) in people with HIV infection</td></tr><tr><td headers="hd_h_niceng243er2.tab3_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study (index test and reference standard data collected cross-sectionally)</td><td headers="hd_h_niceng243er2.tab3_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">106</td><td headers="hd_h_niceng243er2.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not Serious</td><td headers="hd_h_niceng243er2.tab3_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.31 (0.21–0.42)</td><td headers="hd_h_niceng243er2.tab3_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>d</sup></td><td headers="hd_h_niceng243er2.tab3_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.57 (0.37–0.76)</td><td headers="hd_h_niceng243er2.tab3_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab3_1_1_1_1 hd_h_niceng243er2.tab3_1_1_1_2 hd_h_niceng243er2.tab3_1_1_1_3 hd_h_niceng243er2.tab3_1_1_1_4 hd_h_niceng243er2.tab3_1_1_1_5 hd_h_niceng243er2.tab3_1_1_1_6 hd_h_niceng243er2.tab3_1_1_1_7 hd_h_niceng243er2.tab3_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Orthostatic hypotension for diagnosing adrenal insufficiency (any cortisol value > 18 μg/dL after low dose 10 μg short corticotropin stimulation test) in people with HIV infection</td></tr><tr><td headers="hd_h_niceng243er2.tab3_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study (index test and reference standard data collected cross-sectionally)</td><td headers="hd_h_niceng243er2.tab3_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">106</td><td headers="hd_h_niceng243er2.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>e</sup></td><td headers="hd_h_niceng243er2.tab3_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.40 (0.05–0.85)</td><td headers="hd_h_niceng243er2.tab3_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>c</sup></td><td headers="hd_h_niceng243er2.tab3_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.66 (0.56–0.75)</td><td headers="hd_h_niceng243er2.tab3_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab3_1_1_1_1 hd_h_niceng243er2.tab3_1_1_1_2 hd_h_niceng243er2.tab3_1_1_1_3 hd_h_niceng243er2.tab3_1_1_1_4 hd_h_niceng243er2.tab3_1_1_1_5 hd_h_niceng243er2.tab3_1_1_1_6 hd_h_niceng243er2.tab3_1_1_1_7 hd_h_niceng243er2.tab3_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Orthostatic hypotension for diagnosing adrenal insufficiency (any cortisol value > 20 μg/dL after low dose 10 μg short corticotropin stimulation test) in people with HIV infection</td></tr><tr><td headers="hd_h_niceng243er2.tab3_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study (index test and reference standard data collected cross-sectionally)</td><td headers="hd_h_niceng243er2.tab3_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">106</td><td headers="hd_h_niceng243er2.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>e</sup></td><td headers="hd_h_niceng243er2.tab3_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.33 (0.04–0.78)</td><td headers="hd_h_niceng243er2.tab3_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>c</sup></td><td headers="hd_h_niceng243er2.tab3_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.66 (0.56–0.75)</td><td headers="hd_h_niceng243er2.tab3_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab3_1_1_1_1 hd_h_niceng243er2.tab3_1_1_1_2 hd_h_niceng243er2.tab3_1_1_1_3 hd_h_niceng243er2.tab3_1_1_1_4 hd_h_niceng243er2.tab3_1_1_1_5 hd_h_niceng243er2.tab3_1_1_1_6 hd_h_niceng243er2.tab3_1_1_1_7 hd_h_niceng243er2.tab3_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Orthostatic hypotension for diagnosing adrenal insufficiency (8am cortisol level of <3 μg/dL or a peak serum cortisol level of <18 μg/dL after a 5 μg ACTH stimulation test) in adults with dermatological conditions using topical corticosteroids</td></tr><tr><td headers="hd_h_niceng243er2.tab3_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 cross-sectional study</td><td headers="hd_h_niceng243er2.tab3_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">42</td><td headers="hd_h_niceng243er2.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>f</sup></td><td headers="hd_h_niceng243er2.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab3_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.00 (0.00–0.20)</td><td headers="hd_h_niceng243er2.tab3_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>f</sup></td><td headers="hd_h_niceng243er2.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab3_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=1.00 (0.86–1.00)</td><td headers="hd_h_niceng243er2.tab3_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab3_1_1_1_1 hd_h_niceng243er2.tab3_1_1_1_2 hd_h_niceng243er2.tab3_1_1_1_3 hd_h_niceng243er2.tab3_1_1_1_4 hd_h_niceng243er2.tab3_1_1_1_5 hd_h_niceng243er2.tab3_1_1_1_6 hd_h_niceng243er2.tab3_1_1_1_7 hd_h_niceng243er2.tab3_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Systolic hypotension for diagnosing adrenal insufficiency (serum cortisol < 500nmol/L after low dose (1 μg/ml) short corticotropin (Synacthen<sup>®</sup>) stimulation test in people with suspected tuberculosis</td></tr><tr><td headers="hd_h_niceng243er2.tab3_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 cross-sectional study</td><td headers="hd_h_niceng243er2.tab3_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">75</td><td headers="hd_h_niceng243er2.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>g</sup></td><td headers="hd_h_niceng243er2.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>h</sup></td><td headers="hd_h_niceng243er2.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>i</sup></td><td headers="hd_h_niceng243er2.tab3_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.86 (0.67–0.96)</td><td headers="hd_h_niceng243er2.tab3_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>g</sup></td><td headers="hd_h_niceng243er2.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>h</sup></td><td headers="hd_h_niceng243er2.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab3_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.11 (0.04–0.23)</td><td headers="hd_h_niceng243er2.tab3_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">LOW</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng243er2.tab3_1"><p class="no_margin">Risk of bias was assessed using the QUADAS-2 checklist. The evidence was downgraded by 2 increments due to very high risk of bias (unclear reporting on patient selection; unclear application of the index test; unclear application of the reference standard (unclear if blinded); or timing between index test and reference standard).</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng243er2.tab3_2"><p class="no_margin">The evidence was downgraded by 2 increments due to very serious indirectness (serious population indirectness due to concerns over applicability of evidence from HIV infection population to general population; serious indirectness of the reference standard due to concerns over applicability of evidence on low dose 10 μg ACTH test).</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng243er2.tab3_3"><p class="no_margin">Confidence interval crossed the decision threshold corresponding to ‘high specificity’ (70%).</p></div></dd></dl><dl class="bkr_refwrap"><dt>d</dt><dd><div id="niceng243er2.tab3_4"><p class="no_margin">Confidence interval crossed the decision thresholds corresponding to ‘high specificity’ (70%) and ‘low specificity’ (50%).</p></div></dd></dl><dl class="bkr_refwrap"><dt>e</dt><dd><div id="niceng243er2.tab3_5"><p class="no_margin">Confidence interval crossed the decision threshold corresponding to ‘low sensitivity’ (60%).</p></div></dd></dl><dl class="bkr_refwrap"><dt>f</dt><dd><div id="niceng243er2.tab3_6"><p class="no_margin">The evidence was downgraded by 2 increments due to very serious indirectness (serious population indirectness due to concerns over applicability of evidence from people taking long term topical steroids to general population; serious indirectness of the reference standard due to concerns over applicability of evidence on low dose 5 μg ACTH test).</p></div></dd></dl><dl class="bkr_refwrap"><dt>g</dt><dd><div id="niceng243er2.tab3_7"><p class="no_margin">Risk of bias was assessed using the QUADAS-2 checklist. The evidence was downgraded by 2 increments due to very high risk of bias (unclear reporting on patient selection; unclear application of the index test; unclear application of the reference standard (unclear if blinded); unclear timing between index test and reference standard and high risk of bias arising from the patient flow (missing data)).</p></div></dd></dl><dl class="bkr_refwrap"><dt>h</dt><dd><div id="niceng243er2.tab3_8"><p class="no_margin">The evidence was downgraded by 2 increments due to very serious indirectness (serious population indirectness due to concerns over applicability of evidence from tuberculosis population to general population; serious indirectness of the reference standard due to concerns over applicability of evidence on low dose 1 μg/ml Synacthen test).</p></div></dd></dl><dl class="bkr_refwrap"><dt>i</dt><dd><div id="niceng243er2.tab3_9"><p class="no_margin">Confidence interval crossed the decision threshold corresponding to ‘high sensitivity’ (90%).</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng243er2tab4"><div id="niceng243er2.tab4" class="table"><h3><span class="label">Table 4</span><span class="title">Clinical evidence summary: hyperpigmentation</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK609103/table/niceng243er2.tab4/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng243er2.tab4_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng243er2.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Studies</th><th id="hd_h_niceng243er2.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">N</th><th id="hd_h_niceng243er2.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Risk of bias</th><th id="hd_h_niceng243er2.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Inconsistency</th><th id="hd_h_niceng243er2.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Indirectness</th><th id="hd_h_niceng243er2.tab4_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Imprecision</th><th id="hd_h_niceng243er2.tab4_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Effect size (95%CI)</th><th id="hd_h_niceng243er2.tab4_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality</th></tr></thead><tbody><tr><td headers="hd_h_niceng243er2.tab4_1_1_1_1 hd_h_niceng243er2.tab4_1_1_1_2 hd_h_niceng243er2.tab4_1_1_1_3 hd_h_niceng243er2.tab4_1_1_1_4 hd_h_niceng243er2.tab4_1_1_1_5 hd_h_niceng243er2.tab4_1_1_1_6 hd_h_niceng243er2.tab4_1_1_1_7 hd_h_niceng243er2.tab4_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Skin hyperpigmentation for diagnosing adrenal insufficiency (cortisol peak response < 11 μg after low dose 10 μg short corticotropin stimulation test) in people with HIV infection</td></tr><tr><td headers="hd_h_niceng243er2.tab4_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study (index test and reference standard data collected cross-sectionally)</td><td headers="hd_h_niceng243er2.tab4_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">160</td><td headers="hd_h_niceng243er2.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not Serious</td><td headers="hd_h_niceng243er2.tab4_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.40 (0.26–0.56)</td><td headers="hd_h_niceng243er2.tab4_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>c</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.63 (0.49–0.75)</td><td headers="hd_h_niceng243er2.tab4_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab4_1_1_1_1 hd_h_niceng243er2.tab4_1_1_1_2 hd_h_niceng243er2.tab4_1_1_1_3 hd_h_niceng243er2.tab4_1_1_1_4 hd_h_niceng243er2.tab4_1_1_1_5 hd_h_niceng243er2.tab4_1_1_1_6 hd_h_niceng243er2.tab4_1_1_1_7 hd_h_niceng243er2.tab4_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Mucoses hyperpigmentation for diagnosing adrenal insufficiency (cortisol peak response < 11 μg after low dose 10 μg short corticotropin stimulation test) in people with HIV infection</td></tr><tr><td headers="hd_h_niceng243er2.tab4_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study (index test and reference standard data collected cross-sectionally)</td><td headers="hd_h_niceng243er2.tab4_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">106</td><td headers="hd_h_niceng243er2.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not Serious</td><td headers="hd_h_niceng243er2.tab4_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.06 (0.11–0.18)</td><td headers="hd_h_niceng243er2.tab4_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab4_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.93 (0.84–0.98)</td><td headers="hd_h_niceng243er2.tab4_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab4_1_1_1_1 hd_h_niceng243er2.tab4_1_1_1_2 hd_h_niceng243er2.tab4_1_1_1_3 hd_h_niceng243er2.tab4_1_1_1_4 hd_h_niceng243er2.tab4_1_1_1_5 hd_h_niceng243er2.tab4_1_1_1_6 hd_h_niceng243er2.tab4_1_1_1_7 hd_h_niceng243er2.tab4_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Skin hyperpigmentation for diagnosing adrenal insufficiency (twofold value of basal cortisol after low dose 10 μg short corticotropin stimulation test) in people with HIV infection</td></tr><tr><td headers="hd_h_niceng243er2.tab4_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study (index test and reference standard data collected cross-sectionally)</td><td headers="hd_h_niceng243er2.tab4_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">106</td><td headers="hd_h_niceng243er2.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not Serious</td><td headers="hd_h_niceng243er2.tab4_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.40 (0.29–0.51)</td><td headers="hd_h_niceng243er2.tab4_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>c</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.64 (0.44–0.81)</td><td headers="hd_h_niceng243er2.tab4_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab4_1_1_1_1 hd_h_niceng243er2.tab4_1_1_1_2 hd_h_niceng243er2.tab4_1_1_1_3 hd_h_niceng243er2.tab4_1_1_1_4 hd_h_niceng243er2.tab4_1_1_1_5 hd_h_niceng243er2.tab4_1_1_1_6 hd_h_niceng243er2.tab4_1_1_1_7 hd_h_niceng243er2.tab4_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Mucoses hyperpigmentation for diagnosing adrenal insufficiency (twofold value of basal cortisol after low dose 10 μg short corticotropin stimulation test) in people with HIV infection</td></tr><tr><td headers="hd_h_niceng243er2.tab4_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study (index test and reference standard data collected cross-sectionally)</td><td headers="hd_h_niceng243er2.tab4_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">106</td><td headers="hd_h_niceng243er2.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not Serious</td><td headers="hd_h_niceng243er2.tab4_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.04 (0.01–0.11)</td><td headers="hd_h_niceng243er2.tab4_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>d</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.86 (0.67–0.96)</td><td headers="hd_h_niceng243er2.tab4_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab4_1_1_1_1 hd_h_niceng243er2.tab4_1_1_1_2 hd_h_niceng243er2.tab4_1_1_1_3 hd_h_niceng243er2.tab4_1_1_1_4 hd_h_niceng243er2.tab4_1_1_1_5 hd_h_niceng243er2.tab4_1_1_1_6 hd_h_niceng243er2.tab4_1_1_1_7 hd_h_niceng243er2.tab4_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Skin hyperpigmentation for diagnosing adrenal insufficiency (any cortisol value > 18 μg/dL after low dose 10 μg short corticotropin stimulation test) in people with HIV infection</td></tr><tr><td headers="hd_h_niceng243er2.tab4_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study (index test and reference standard data collected cross-sectionally)</td><td headers="hd_h_niceng243er2.tab4_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">106</td><td headers="hd_h_niceng243er2.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>e</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.20 (0.01–0.72)</td><td headers="hd_h_niceng243er2.tab4_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab4_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.60 (0.50–0.70)</td><td headers="hd_h_niceng243er2.tab4_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab4_1_1_1_1 hd_h_niceng243er2.tab4_1_1_1_2 hd_h_niceng243er2.tab4_1_1_1_3 hd_h_niceng243er2.tab4_1_1_1_4 hd_h_niceng243er2.tab4_1_1_1_5 hd_h_niceng243er2.tab4_1_1_1_6 hd_h_niceng243er2.tab4_1_1_1_7 hd_h_niceng243er2.tab4_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Mucoses hyperpigmentation for diagnosing adrenal insufficiency (any cortisol value > 18 μg/dL after low dose 10 μg short corticotropin stimulation test) in people with HIV infection</td></tr><tr><td headers="hd_h_niceng243er2.tab4_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study (index test and reference standard data collected cross-sectionally)</td><td headers="hd_h_niceng243er2.tab4_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">106</td><td headers="hd_h_niceng243er2.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>e</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.20 (0.01–0.72)</td><td headers="hd_h_niceng243er2.tab4_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab4_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.94 (0.88–0.98)</td><td headers="hd_h_niceng243er2.tab4_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab4_1_1_1_1 hd_h_niceng243er2.tab4_1_1_1_2 hd_h_niceng243er2.tab4_1_1_1_3 hd_h_niceng243er2.tab4_1_1_1_4 hd_h_niceng243er2.tab4_1_1_1_5 hd_h_niceng243er2.tab4_1_1_1_6 hd_h_niceng243er2.tab4_1_1_1_7 hd_h_niceng243er2.tab4_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Skin hyperpigmentation for diagnosing adrenal insufficiency (any cortisol value > 20 μg/dL after low dose 10 μg short corticotropin stimulation test) in people with HIV infection</td></tr><tr><td headers="hd_h_niceng243er2.tab4_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study (index test and reference standard data collected cross-sectionally)</td><td headers="hd_h_niceng243er2.tab4_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">106</td><td headers="hd_h_niceng243er2.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>e</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.33 (0.04–0.78)</td><td headers="hd_h_niceng243er2.tab4_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>d</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.61 (0.51–0.71)</td><td headers="hd_h_niceng243er2.tab4_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab4_1_1_1_1 hd_h_niceng243er2.tab4_1_1_1_2 hd_h_niceng243er2.tab4_1_1_1_3 hd_h_niceng243er2.tab4_1_1_1_4 hd_h_niceng243er2.tab4_1_1_1_5 hd_h_niceng243er2.tab4_1_1_1_6 hd_h_niceng243er2.tab4_1_1_1_7 hd_h_niceng243er2.tab4_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Mucoses hyperpigmentation for diagnosing adrenal insufficiency (any cortisol value > 20 μg/dL after low dose 10 μg short corticotropin stimulation test) in people with HIV infection</td></tr><tr><td headers="hd_h_niceng243er2.tab4_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study (index test and reference standard data collected cross-sectionally)</td><td headers="hd_h_niceng243er2.tab4_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">106</td><td headers="hd_h_niceng243er2.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>e</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.17 (0.00–0.64)</td><td headers="hd_h_niceng243er2.tab4_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab4_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.94 (0.87–0.98)</td><td headers="hd_h_niceng243er2.tab4_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab4_1_1_1_1 hd_h_niceng243er2.tab4_1_1_1_2 hd_h_niceng243er2.tab4_1_1_1_3 hd_h_niceng243er2.tab4_1_1_1_4 hd_h_niceng243er2.tab4_1_1_1_5 hd_h_niceng243er2.tab4_1_1_1_6 hd_h_niceng243er2.tab4_1_1_1_7 hd_h_niceng243er2.tab4_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Skin hyperpigmentation for diagnosing adrenal insufficiency (serum cortisol < 500nmol/L after low dose (1 μg/ml) short corticotropin (Synacthen<sup>®</sup>) stimulation test in people with suspected tuberculosis</td></tr><tr><td headers="hd_h_niceng243er2.tab4_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 cross-sectional study</td><td headers="hd_h_niceng243er2.tab4_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">75</td><td headers="hd_h_niceng243er2.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>f</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>g</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>h</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.79 (0.59–0.92)</td><td headers="hd_h_niceng243er2.tab4_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>f</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>g</sup></td><td headers="hd_h_niceng243er2.tab4_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab4_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.26 (0.14–0.40)</td><td headers="hd_h_niceng243er2.tab4_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng243er2.tab4_1"><p class="no_margin">Risk of bias was assessed using the QUADAS-2 checklist. The evidence was downgraded by 2 increments due to very high risk of bias (unclear reporting on patient selection; unclear application of the index test; unclear application of the reference standard (unclear if blinded); or timing between index test and reference standard).</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng243er2.tab4_2"><p class="no_margin">The evidence was downgraded by 2 increments due to very serious indirectness (serious population indirectness due to concerns over applicability of evidence from HIV infection population to general population; serious indirectness of the reference standard due to concerns over applicability of evidence on low dose 10 μg ACTH test).</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng243er2.tab4_3"><p class="no_margin">Confidence interval crossed the decision thresholds corresponding to ‘high specificity’ (70%) and ‘low specificity’ (50%).</p></div></dd></dl><dl class="bkr_refwrap"><dt>d</dt><dd><div id="niceng243er2.tab4_4"><p class="no_margin">Confidence interval crossed the decision threshold corresponding to ‘high specificity’ (70%).</p></div></dd></dl><dl class="bkr_refwrap"><dt>e</dt><dd><div id="niceng243er2.tab4_5"><p class="no_margin">Confidence interval crossed the decision threshold corresponding to ‘low sensitivity’ (60%).</p></div></dd></dl><dl class="bkr_refwrap"><dt>f</dt><dd><div id="niceng243er2.tab4_6"><p class="no_margin">Risk of bias was assessed using the QUADAS-2 checklist. The evidence was downgraded by 2 increments due to very high risk of bias (unclear reporting on patient selection; unclear application of the index test; unclear application of the reference standard (unclear if blinded); unclear timing between index test and reference standard and high risk of bias arising from the patient flow (missing data)).</p></div></dd></dl><dl class="bkr_refwrap"><dt>g</dt><dd><div id="niceng243er2.tab4_7"><p class="no_margin">The evidence was downgraded by 2 increments due to very serious indirectness (serious population indirectness due to concerns over applicability of evidence from tuberculosis population to general population; serious indirectness of the reference standard due to concerns over applicability of evidence on low dose 1 μg/ml Synacthen test).</p></div></dd></dl><dl class="bkr_refwrap"><dt>h</dt><dd><div id="niceng243er2.tab4_8"><p class="no_margin">Confidence interval crossed the decision thresholds corresponding to ‘high sensitivity’ (90%) and ‘low sensitivity’ (60%).</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng243er2tab5"><div id="niceng243er2.tab5" class="table"><h3><span class="label">Table 5</span><span class="title">Clinical evidence summary: lethargy</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK609103/table/niceng243er2.tab5/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng243er2.tab5_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng243er2.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Studies</th><th id="hd_h_niceng243er2.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">N</th><th id="hd_h_niceng243er2.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk of bias</th><th id="hd_h_niceng243er2.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Inconsistency</th><th id="hd_h_niceng243er2.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Indirectness</th><th id="hd_h_niceng243er2.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Imprecision</th><th id="hd_h_niceng243er2.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Effect size (95%CI)</th><th id="hd_h_niceng243er2.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Quality</th></tr></thead><tbody><tr><td headers="hd_h_niceng243er2.tab5_1_1_1_1 hd_h_niceng243er2.tab5_1_1_1_2 hd_h_niceng243er2.tab5_1_1_1_3 hd_h_niceng243er2.tab5_1_1_1_4 hd_h_niceng243er2.tab5_1_1_1_5 hd_h_niceng243er2.tab5_1_1_1_6 hd_h_niceng243er2.tab5_1_1_1_7 hd_h_niceng243er2.tab5_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Lethargy (fatigue ≥2) for diagnosing cortisol deficiency (cortisol <350 nmol/L or indeterminate result after 250μg Synacthen) in people with HIV infection</td></tr><tr><td headers="hd_h_niceng243er2.tab5_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 cross-sectional study</td><td headers="hd_h_niceng243er2.tab5_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">49</td><td headers="hd_h_niceng243er2.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>c</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.86 (0.57–0.98)</td><td headers="hd_h_niceng243er2.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.26 (0.12–0.43)</td><td headers="hd_h_niceng243er2.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab5_1_1_1_1 hd_h_niceng243er2.tab5_1_1_1_2 hd_h_niceng243er2.tab5_1_1_1_3 hd_h_niceng243er2.tab5_1_1_1_4 hd_h_niceng243er2.tab5_1_1_1_5 hd_h_niceng243er2.tab5_1_1_1_6 hd_h_niceng243er2.tab5_1_1_1_7 hd_h_niceng243er2.tab5_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Lethargy (fatigue ≥3) for diagnosing cortisol deficiency (cortisol <350 nmol/L or indeterminate result after 250μg Synacthen) in people with HIV infection</td></tr><tr><td headers="hd_h_niceng243er2.tab5_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 cross-sectional study</td><td headers="hd_h_niceng243er2.tab5_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">49</td><td headers="hd_h_niceng243er2.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not Serious</td><td headers="hd_h_niceng243er2.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.29 (0.08–0.58)</td><td headers="hd_h_niceng243er2.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>d</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.74 (0.57–0.88)</td><td headers="hd_h_niceng243er2.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab5_1_1_1_1 hd_h_niceng243er2.tab5_1_1_1_2 hd_h_niceng243er2.tab5_1_1_1_3 hd_h_niceng243er2.tab5_1_1_1_4 hd_h_niceng243er2.tab5_1_1_1_5 hd_h_niceng243er2.tab5_1_1_1_6 hd_h_niceng243er2.tab5_1_1_1_7 hd_h_niceng243er2.tab5_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Lethargy (fatigue) for diagnosing adrenal insufficiency (cortisol peak response < 11 μg after low dose 10 μg short corticotropin stimulation test) in people with HIV infection</td></tr><tr><td headers="hd_h_niceng243er2.tab5_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study (index test and reference standard data collected cross-sectionally)</td><td headers="hd_h_niceng243er2.tab5_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">106</td><td headers="hd_h_niceng243er2.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>e</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>f</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.72 (0.57–0.84)</td><td headers="hd_h_niceng243er2.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>e</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.32 (0.21–0.46)</td><td headers="hd_h_niceng243er2.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab5_1_1_1_1 hd_h_niceng243er2.tab5_1_1_1_2 hd_h_niceng243er2.tab5_1_1_1_3 hd_h_niceng243er2.tab5_1_1_1_4 hd_h_niceng243er2.tab5_1_1_1_5 hd_h_niceng243er2.tab5_1_1_1_6 hd_h_niceng243er2.tab5_1_1_1_7 hd_h_niceng243er2.tab5_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Lethargy (fatigue) for diagnosing adrenal insufficiency (twofold value of basal cortisol after low dose 10 μg short corticotropin stimulation test) in people with HIV infection</td></tr><tr><td headers="hd_h_niceng243er2.tab5_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study (index test and reference standard data collected cross-sectionally)</td><td headers="hd_h_niceng243er2.tab5_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">106</td><td headers="hd_h_niceng243er2.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>e</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not Serious</td><td headers="hd_h_niceng243er2.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.74 (0.63–0.84)</td><td headers="hd_h_niceng243er2.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>e</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>g</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.43 (0.24–0.63)</td><td headers="hd_h_niceng243er2.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab5_1_1_1_1 hd_h_niceng243er2.tab5_1_1_1_2 hd_h_niceng243er2.tab5_1_1_1_3 hd_h_niceng243er2.tab5_1_1_1_4 hd_h_niceng243er2.tab5_1_1_1_5 hd_h_niceng243er2.tab5_1_1_1_6 hd_h_niceng243er2.tab5_1_1_1_7 hd_h_niceng243er2.tab5_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Lethargy (fatigue) for diagnosing adrenal insufficiency (any cortisol value > 18 μg/dL after low dose 10 μg short corticotropin stimulation test) in people with HIV infection</td></tr><tr><td headers="hd_h_niceng243er2.tab5_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study (index test and reference standard data collected cross-sectionally)</td><td headers="hd_h_niceng243er2.tab5_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">106</td><td headers="hd_h_niceng243er2.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>e</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>f</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.40 (0.05–0.85)</td><td headers="hd_h_niceng243er2.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>e</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.29 (0.20–0.39)</td><td headers="hd_h_niceng243er2.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab5_1_1_1_1 hd_h_niceng243er2.tab5_1_1_1_2 hd_h_niceng243er2.tab5_1_1_1_3 hd_h_niceng243er2.tab5_1_1_1_4 hd_h_niceng243er2.tab5_1_1_1_5 hd_h_niceng243er2.tab5_1_1_1_6 hd_h_niceng243er2.tab5_1_1_1_7 hd_h_niceng243er2.tab5_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Lethargy (fatigue) for diagnosing adrenal insufficiency (any cortisol value > 20 μg/dL after low dose 10 μg short corticotropin stimulation test) in people with HIV infection</td></tr><tr><td headers="hd_h_niceng243er2.tab5_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study (index test and reference standard data collected cross-sectionally)</td><td headers="hd_h_niceng243er2.tab5_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">106</td><td headers="hd_h_niceng243er2.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>e</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>f</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.33 (0.04–0.78)</td><td headers="hd_h_niceng243er2.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>e</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.28 (0.19–0.38)</td><td headers="hd_h_niceng243er2.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab5_1_1_1_1 hd_h_niceng243er2.tab5_1_1_1_2 hd_h_niceng243er2.tab5_1_1_1_3 hd_h_niceng243er2.tab5_1_1_1_4 hd_h_niceng243er2.tab5_1_1_1_5 hd_h_niceng243er2.tab5_1_1_1_6 hd_h_niceng243er2.tab5_1_1_1_7 hd_h_niceng243er2.tab5_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Lethargy for diagnosing adrenal insufficiency (8am cortisol level of <3 μg/dL or a peak serum cortisol level of <18 μg/dL after a 5 μg ACTH stimulation test) in adults with dermatological conditions using topical corticosteroids</td></tr><tr><td headers="hd_h_niceng243er2.tab5_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 cross-sectional study</td><td headers="hd_h_niceng243er2.tab5_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">42</td><td headers="hd_h_niceng243er2.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>h</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.00 (0.00–0.20)</td><td headers="hd_h_niceng243er2.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>h</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.96 (0.80–1.00)</td><td headers="hd_h_niceng243er2.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab5_1_1_1_1 hd_h_niceng243er2.tab5_1_1_1_2 hd_h_niceng243er2.tab5_1_1_1_3 hd_h_niceng243er2.tab5_1_1_1_4 hd_h_niceng243er2.tab5_1_1_1_5 hd_h_niceng243er2.tab5_1_1_1_6 hd_h_niceng243er2.tab5_1_1_1_7 hd_h_niceng243er2.tab5_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Lethargy (tiredness) for diagnosing adrenal insufficiency (serum cortisol < 500nmol/L after low dose (1 μg/ml) short corticotropin (Synacthen<sup>®</sup>) stimulation test in people with suspected tuberculosis</td></tr><tr><td headers="hd_h_niceng243er2.tab5_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 cross-sectional study</td><td headers="hd_h_niceng243er2.tab5_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">75</td><td headers="hd_h_niceng243er2.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>i</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>j</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.25 (0.11–0.45)</td><td headers="hd_h_niceng243er2.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>i</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>j</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.85 (0.72–0.94)</td><td headers="hd_h_niceng243er2.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab5_1_1_1_1 hd_h_niceng243er2.tab5_1_1_1_2 hd_h_niceng243er2.tab5_1_1_1_3 hd_h_niceng243er2.tab5_1_1_1_4 hd_h_niceng243er2.tab5_1_1_1_5 hd_h_niceng243er2.tab5_1_1_1_6 hd_h_niceng243er2.tab5_1_1_1_7 hd_h_niceng243er2.tab5_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Lethargy (fatigue) for diagnosing adrenal hypofunction (all cortisol measurements <18 μg/dL including 1 μg/mL ACTH test) in people with AIDS</td></tr><tr><td headers="hd_h_niceng243er2.tab5_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study (index test and reference standard data collected cross-sectionally)</td><td headers="hd_h_niceng243er2.tab5_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">63</td><td headers="hd_h_niceng243er2.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>k</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>l</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>c</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.75 (0.43–0.95)</td><td headers="hd_h_niceng243er2.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>k</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>l</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>g</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.47 (0.33–0.62)</td><td headers="hd_h_niceng243er2.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab5_1_1_1_1 hd_h_niceng243er2.tab5_1_1_1_2 hd_h_niceng243er2.tab5_1_1_1_3 hd_h_niceng243er2.tab5_1_1_1_4 hd_h_niceng243er2.tab5_1_1_1_5 hd_h_niceng243er2.tab5_1_1_1_6 hd_h_niceng243er2.tab5_1_1_1_7 hd_h_niceng243er2.tab5_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Lethargy (weakness) for diagnosing adrenal hypofunction (all cortisol measurements <18 μg/dL including 1 μg/mL ACTH test) in people with AIDS</td></tr><tr><td headers="hd_h_niceng243er2.tab5_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study (index test and reference standard data collected cross-sectionally)</td><td headers="hd_h_niceng243er2.tab5_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">63</td><td headers="hd_h_niceng243er2.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>k</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>l</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>f</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.42 (0.15–0.72)</td><td headers="hd_h_niceng243er2.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>k</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>l</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>g</sup></td><td headers="hd_h_niceng243er2.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.49 (0.35–0.63)</td><td headers="hd_h_niceng243er2.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng243er2.tab5_1"><p class="no_margin">Risk of bias was assessed using the QUADAS-2 checklist. The evidence was downgraded by 2 increments due to very high risk of bias (unclear reporting on patient selection; unclear application of the index test; unclear application of the reference standard (unclear if blinded); or timing between index test and reference standard).</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng243er2.tab5_2"><p class="no_margin">The evidence was downgraded by 1 increment due to serious indirectness (serious population indirectness due to concerns over applicability of evidence from HIV infection population to general population).</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng243er2.tab5_3"><p class="no_margin">Confidence interval crossed the decision thresholds corresponding to ‘high sensitivity’ (90%) and ‘low sensitivity’ (60%).</p></div></dd></dl><dl class="bkr_refwrap"><dt>d</dt><dd><div id="niceng243er2.tab5_4"><p class="no_margin">Confidence interval crossed the decision threshold corresponding to ‘high specificity’ (70%).</p></div></dd></dl><dl class="bkr_refwrap"><dt>e</dt><dd><div id="niceng243er2.tab5_5"><p class="no_margin">The evidence was downgraded by 2 increments due to very serious indirectness (serious population indirectness due to concerns over applicability of evidence from HIV infection population to general population; serious indirectness of the reference standard due to concerns over applicability of evidence on low dose 10 μg ACTH test).</p></div></dd></dl><dl class="bkr_refwrap"><dt>f</dt><dd><div id="niceng243er2.tab5_6"><p class="no_margin">Confidence interval crossed the decision threshold corresponding to ‘low sensitivity’ (60%).</p></div></dd></dl><dl class="bkr_refwrap"><dt>g</dt><dd><div id="niceng243er2.tab5_7"><p class="no_margin">Confidence interval crossed the decision threshold corresponding to ‘low specificity’ (50%).</p></div></dd></dl><dl class="bkr_refwrap"><dt>h</dt><dd><div id="niceng243er2.tab5_8"><p class="no_margin">The evidence was downgraded by 2 increments due to very serious indirectness (serious population indirectness due to concerns over applicability of evidence from people taking long term topical steroids to general population; serious indirectness of the reference standard due to concerns over applicability of evidence on low dose 5 μg ACTH test).</p></div></dd></dl><dl class="bkr_refwrap"><dt>i</dt><dd><div id="niceng243er2.tab5_9"><p class="no_margin">The evidence was downgraded by 2 increments due to very high risk of bias (unclear reporting on patient selection; unclear application of the index test; unclear application of the reference standard (unclear if blinded); unclear timing between index test and reference standard and high risk of bias arising from the patient flow (missing data)).</p></div></dd></dl><dl class="bkr_refwrap"><dt>j</dt><dd><div id="niceng243er2.tab5_10"><p class="no_margin">The evidence was downgraded by 2 increments due to very serious indirectness (serious population indirectness due to concerns over applicability of evidence from tuberculosis population to general population; serious indirectness of the reference standard due to concerns over applicability of evidence on low dose 1 μg/ml Synacthen test).</p></div></dd></dl><dl class="bkr_refwrap"><dt>k</dt><dd><div id="niceng243er2.tab5_11"><p class="no_margin">The evidence was downgraded by 2 increments due to very high risk of bias (unclear reporting on patient selection; whether reference standard was conducted without knowledge of index test results; or timing between index test and reference standard).</p></div></dd></dl><dl class="bkr_refwrap"><dt>l</dt><dd><div id="niceng243er2.tab5_12"><p class="no_margin">The evidence was downgraded by 2 increments due to very serious indirectness (serious population indirectness due to concerns over applicability of evidence from AIDS population to general population; serious indirectness of the reference standard due to concerns over applicability of evidence on low dose 1 μg/ml ACTH test).</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng243er2tab6"><div id="niceng243er2.tab6" class="table"><h3><span class="label">Table 6</span><span class="title">Clinical evidence summary: salt craving</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK609103/table/niceng243er2.tab6/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng243er2.tab6_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng243er2.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Studies</th><th id="hd_h_niceng243er2.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">N</th><th id="hd_h_niceng243er2.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Risk of bias</th><th id="hd_h_niceng243er2.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Inconsistency</th><th id="hd_h_niceng243er2.tab6_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Indirectness</th><th id="hd_h_niceng243er2.tab6_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Imprecision</th><th id="hd_h_niceng243er2.tab6_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Effect size (95%CI)</th><th id="hd_h_niceng243er2.tab6_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality</th></tr></thead><tbody><tr><td headers="hd_h_niceng243er2.tab6_1_1_1_1 hd_h_niceng243er2.tab6_1_1_1_2 hd_h_niceng243er2.tab6_1_1_1_3 hd_h_niceng243er2.tab6_1_1_1_4 hd_h_niceng243er2.tab6_1_1_1_5 hd_h_niceng243er2.tab6_1_1_1_6 hd_h_niceng243er2.tab6_1_1_1_7 hd_h_niceng243er2.tab6_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Salt intake for diagnosing adrenal insufficiency (cortisol peak response < 11 μg after low dose 10 μg short corticotropin stimulation test) in people with HIV infection</td></tr><tr><td headers="hd_h_niceng243er2.tab6_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study (index test and reference standard data collected cross-sectionally)</td><td headers="hd_h_niceng243er2.tab6_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">106</td><td headers="hd_h_niceng243er2.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab6_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab6_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not Serious</td><td headers="hd_h_niceng243er2.tab6_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.15 (0.06–0.28)</td><td headers="hd_h_niceng243er2.tab6_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab6_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab6_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>c</sup></td><td headers="hd_h_niceng243er2.tab6_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.76 (0.63–0.86)</td><td headers="hd_h_niceng243er2.tab6_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab6_1_1_1_1 hd_h_niceng243er2.tab6_1_1_1_2 hd_h_niceng243er2.tab6_1_1_1_3 hd_h_niceng243er2.tab6_1_1_1_4 hd_h_niceng243er2.tab6_1_1_1_5 hd_h_niceng243er2.tab6_1_1_1_6 hd_h_niceng243er2.tab6_1_1_1_7 hd_h_niceng243er2.tab6_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Salt intake for diagnosing adrenal insufficiency (twofold value of basal cortisol after low dose 10 μg short corticotropin stimulation test) in people with HIV infection</td></tr><tr><td headers="hd_h_niceng243er2.tab6_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study (index test and reference standard data collected cross-sectionally)</td><td headers="hd_h_niceng243er2.tab6_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">106</td><td headers="hd_h_niceng243er2.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab6_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab6_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not Serious</td><td headers="hd_h_niceng243er2.tab6_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.19 (0.11–0.30)</td><td headers="hd_h_niceng243er2.tab6_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab6_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab6_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>c</sup></td><td headers="hd_h_niceng243er2.tab6_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.79 (0.59–0.92)</td><td headers="hd_h_niceng243er2.tab6_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab6_1_1_1_1 hd_h_niceng243er2.tab6_1_1_1_2 hd_h_niceng243er2.tab6_1_1_1_3 hd_h_niceng243er2.tab6_1_1_1_4 hd_h_niceng243er2.tab6_1_1_1_5 hd_h_niceng243er2.tab6_1_1_1_6 hd_h_niceng243er2.tab6_1_1_1_7 hd_h_niceng243er2.tab6_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Salt intake for diagnosing adrenal insufficiency (any cortisol value > 18 μg/dL after low dose 10 μg short corticotropin stimulation test) in people with HIV infection</td></tr><tr><td headers="hd_h_niceng243er2.tab6_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study (index test and reference standard data collected cross-sectionally)</td><td headers="hd_h_niceng243er2.tab6_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">106</td><td headers="hd_h_niceng243er2.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab6_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab6_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>d</sup></td><td headers="hd_h_niceng243er2.tab6_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.20 (0.01–0.72)</td><td headers="hd_h_niceng243er2.tab6_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab6_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab6_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab6_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.80 (0.71–0.87)</td><td headers="hd_h_niceng243er2.tab6_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab6_1_1_1_1 hd_h_niceng243er2.tab6_1_1_1_2 hd_h_niceng243er2.tab6_1_1_1_3 hd_h_niceng243er2.tab6_1_1_1_4 hd_h_niceng243er2.tab6_1_1_1_5 hd_h_niceng243er2.tab6_1_1_1_6 hd_h_niceng243er2.tab6_1_1_1_7 hd_h_niceng243er2.tab6_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Salt intake for diagnosing adrenal insufficiency (any cortisol value > 20 μg/dL after low dose 10 μg short corticotropin stimulation test) in people with HIV infection</td></tr><tr><td headers="hd_h_niceng243er2.tab6_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study (index test and reference standard data collected cross-sectionally)</td><td headers="hd_h_niceng243er2.tab6_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">106</td><td headers="hd_h_niceng243er2.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious</td><td headers="hd_h_niceng243er2.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab6_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab6_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>d</sup></td><td headers="hd_h_niceng243er2.tab6_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.17 (0.00–0.64)</td><td headers="hd_h_niceng243er2.tab6_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab6_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab6_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab6_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.80 (0.71–0.87)</td><td headers="hd_h_niceng243er2.tab6_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab6_1_1_1_1 hd_h_niceng243er2.tab6_1_1_1_2 hd_h_niceng243er2.tab6_1_1_1_3 hd_h_niceng243er2.tab6_1_1_1_4 hd_h_niceng243er2.tab6_1_1_1_5 hd_h_niceng243er2.tab6_1_1_1_6 hd_h_niceng243er2.tab6_1_1_1_7 hd_h_niceng243er2.tab6_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Salt craving for diagnosing adrenal insufficiency (serum cortisol < 500nmol/L after low dose (1 μg/ml) short corticotropin (Synacthen<sup>®</sup>) stimulation test in people with suspected tuberculosis</td></tr><tr><td headers="hd_h_niceng243er2.tab6_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 cross-sectional study</td><td headers="hd_h_niceng243er2.tab6_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">75</td><td headers="hd_h_niceng243er2.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>e</sup></td><td headers="hd_h_niceng243er2.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab6_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>f</sup></td><td headers="hd_h_niceng243er2.tab6_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>c</sup></td><td headers="hd_h_niceng243er2.tab6_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.82 (0.63–0.94)</td><td headers="hd_h_niceng243er2.tab6_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>e</sup></td><td headers="hd_h_niceng243er2.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab6_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>f</sup></td><td headers="hd_h_niceng243er2.tab6_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab6_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.19 (0.09–0.33)</td><td headers="hd_h_niceng243er2.tab6_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng243er2.tab6_1"><p class="no_margin">Risk of bias was assessed using the QUADAS-2 checklist. The evidence was downgraded by 2 increments due to very high risk of bias (unclear reporting on patient selection; unclear application of the index test; unclear application of the reference standard (unclear if blinded); or timing between index test and reference standard).</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng243er2.tab6_2"><p class="no_margin">The evidence was downgraded by 2 increments due to very serious indirectness (serious population indirectness due to concerns over applicability of evidence from HIV infection population to general population; serious indirectness of the reference standard due to concerns over applicability of evidence on low dose 10 μg ACTH test).</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng243er2.tab6_3"><p class="no_margin">Confidence interval crossed the decision threshold corresponding to ‘high specificity’ (70%).</p></div></dd></dl><dl class="bkr_refwrap"><dt>d</dt><dd><div id="niceng243er2.tab6_4"><p class="no_margin">Confidence interval crossed the decision threshold corresponding to ‘low sensitivity’ (60%).</p></div></dd></dl><dl class="bkr_refwrap"><dt>e</dt><dd><div id="niceng243er2.tab6_5"><p class="no_margin">Risk of bias was assessed using the QUADAS-2 checklist. The evidence was downgraded by 2 increments due to very high risk of bias (unclear reporting on patient selection; unclear application of the index test; unclear application of the reference standard (unclear if blinded); unclear timing between index test and reference standard and high risk of bias arising from the patient flow (missing data)).</p></div></dd></dl><dl class="bkr_refwrap"><dt>f</dt><dd><div id="niceng243er2.tab6_6"><p class="no_margin">The evidence was downgraded by 2 increments due to very serious indirectness (serious population indirectness due to concerns over applicability of evidence from tuberculosis population to general population; serious indirectness of the reference standard due to concerns over applicability of evidence on low dose 1 μg/ml Synacthen test).</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng243er2tab7"><div id="niceng243er2.tab7" class="table"><h3><span class="label">Table 7</span><span class="title">Clinical evidence summary: weight loss</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK609103/table/niceng243er2.tab7/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng243er2.tab7_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng243er2.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Studies</th><th id="hd_h_niceng243er2.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">N</th><th id="hd_h_niceng243er2.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Risk of bias</th><th id="hd_h_niceng243er2.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Inconsistency</th><th id="hd_h_niceng243er2.tab7_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Indirectness</th><th id="hd_h_niceng243er2.tab7_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Imprecision</th><th id="hd_h_niceng243er2.tab7_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Effect size (95%CI)</th><th id="hd_h_niceng243er2.tab7_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality</th></tr></thead><tbody><tr><td headers="hd_h_niceng243er2.tab7_1_1_1_1 hd_h_niceng243er2.tab7_1_1_1_2 hd_h_niceng243er2.tab7_1_1_1_3 hd_h_niceng243er2.tab7_1_1_1_4 hd_h_niceng243er2.tab7_1_1_1_5 hd_h_niceng243er2.tab7_1_1_1_6 hd_h_niceng243er2.tab7_1_1_1_7 hd_h_niceng243er2.tab7_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Weight loss for diagnosing adrenal insufficiency (cortisol peak response < 11 μg after low dose 10 μg short corticotropin stimulation test) in people with HIV infection</td></tr><tr><td headers="hd_h_niceng243er2.tab7_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study (index test and reference standard data collected cross-sectionally)</td><td headers="hd_h_niceng243er2.tab7_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">106</td><td headers="hd_h_niceng243er2.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab7_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab7_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>c</sup></td><td headers="hd_h_niceng243er2.tab7_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.68 (0.53–0.81)</td><td headers="hd_h_niceng243er2.tab7_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab7_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab7_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab7_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.34 (0.22–0.47)</td><td headers="hd_h_niceng243er2.tab7_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab7_1_1_1_1 hd_h_niceng243er2.tab7_1_1_1_2 hd_h_niceng243er2.tab7_1_1_1_3 hd_h_niceng243er2.tab7_1_1_1_4 hd_h_niceng243er2.tab7_1_1_1_5 hd_h_niceng243er2.tab7_1_1_1_6 hd_h_niceng243er2.tab7_1_1_1_7 hd_h_niceng243er2.tab7_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Weight loss for diagnosing adrenal insufficiency (twofold value of basal cortisol after low dose 10 μg short corticotropin stimulation test) in people with HIV infection</td></tr><tr><td headers="hd_h_niceng243er2.tab7_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study (index test and reference standard data collected cross-sectionally)</td><td headers="hd_h_niceng243er2.tab7_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">106</td><td headers="hd_h_niceng243er2.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab7_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab7_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not Serious</td><td headers="hd_h_niceng243er2.tab7_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.72 (0.60–0.81)</td><td headers="hd_h_niceng243er2.tab7_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab7_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab7_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>d</sup></td><td headers="hd_h_niceng243er2.tab7_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.46 (0.28–0.66)</td><td headers="hd_h_niceng243er2.tab7_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab7_1_1_1_1 hd_h_niceng243er2.tab7_1_1_1_2 hd_h_niceng243er2.tab7_1_1_1_3 hd_h_niceng243er2.tab7_1_1_1_4 hd_h_niceng243er2.tab7_1_1_1_5 hd_h_niceng243er2.tab7_1_1_1_6 hd_h_niceng243er2.tab7_1_1_1_7 hd_h_niceng243er2.tab7_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Weight loss for diagnosing adrenal insufficiency (any cortisol value > 18 μg/dL after low dose 10 μg short corticotropin stimulation test) in people with HIV infection</td></tr><tr><td headers="hd_h_niceng243er2.tab7_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study (index test and reference standard data collected cross-sectionally)</td><td headers="hd_h_niceng243er2.tab7_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">106</td><td headers="hd_h_niceng243er2.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab7_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab7_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>e</sup></td><td headers="hd_h_niceng243er2.tab7_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.80 (0.28–0.99)</td><td headers="hd_h_niceng243er2.tab7_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab7_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab7_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab7_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.34 (0.25–0.44)</td><td headers="hd_h_niceng243er2.tab7_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab7_1_1_1_1 hd_h_niceng243er2.tab7_1_1_1_2 hd_h_niceng243er2.tab7_1_1_1_3 hd_h_niceng243er2.tab7_1_1_1_4 hd_h_niceng243er2.tab7_1_1_1_5 hd_h_niceng243er2.tab7_1_1_1_6 hd_h_niceng243er2.tab7_1_1_1_7 hd_h_niceng243er2.tab7_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Weight loss for diagnosing adrenal insufficiency (any cortisol value > 20 μg/dL after low dose 10 μg short corticotropin stimulation test) in people with HIV infection</td></tr><tr><td headers="hd_h_niceng243er2.tab7_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study (index test and reference standard data collected cross-sectionally)</td><td headers="hd_h_niceng243er2.tab7_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">106</td><td headers="hd_h_niceng243er2.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab7_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab7_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>e</sup></td><td headers="hd_h_niceng243er2.tab7_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.83 (0.36–1.00)</td><td headers="hd_h_niceng243er2.tab7_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab7_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab7_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab7_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.34 (0.25–0.44)</td><td headers="hd_h_niceng243er2.tab7_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab7_1_1_1_1 hd_h_niceng243er2.tab7_1_1_1_2 hd_h_niceng243er2.tab7_1_1_1_3 hd_h_niceng243er2.tab7_1_1_1_4 hd_h_niceng243er2.tab7_1_1_1_5 hd_h_niceng243er2.tab7_1_1_1_6 hd_h_niceng243er2.tab7_1_1_1_7 hd_h_niceng243er2.tab7_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Weight loss for diagnosing adrenal insufficiency (8am cortisol level of <3 μg/dL or a peak serum cortisol level of <18 μg/dL after a 5 μg ACTH stimulation test) in adults with dermatological conditions using topical corticosteroids</td></tr><tr><td headers="hd_h_niceng243er2.tab7_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 cross-sectional study</td><td headers="hd_h_niceng243er2.tab7_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">42</td><td headers="hd_h_niceng243er2.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab7_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>f</sup></td><td headers="hd_h_niceng243er2.tab7_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab7_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.06 (0.00–0.29)</td><td headers="hd_h_niceng243er2.tab7_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab7_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>f</sup></td><td headers="hd_h_niceng243er2.tab7_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab7_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=1.00 (0.86–1.00)</td><td headers="hd_h_niceng243er2.tab7_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab7_1_1_1_1 hd_h_niceng243er2.tab7_1_1_1_2 hd_h_niceng243er2.tab7_1_1_1_3 hd_h_niceng243er2.tab7_1_1_1_4 hd_h_niceng243er2.tab7_1_1_1_5 hd_h_niceng243er2.tab7_1_1_1_6 hd_h_niceng243er2.tab7_1_1_1_7 hd_h_niceng243er2.tab7_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Weight loss for diagnosing adrenal insufficiency (serum cortisol < 500nmol/L after low dose (1 μg/ml) short corticotropin (Synacthen<sup>®</sup>) stimulation test in people with suspected tuberculosis</td></tr><tr><td headers="hd_h_niceng243er2.tab7_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 cross-sectional study</td><td headers="hd_h_niceng243er2.tab7_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">75</td><td headers="hd_h_niceng243er2.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>g</sup></td><td headers="hd_h_niceng243er2.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab7_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>h</sup></td><td headers="hd_h_niceng243er2.tab7_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab7_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.21 (0.08–0.41)</td><td headers="hd_h_niceng243er2.tab7_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>g</sup></td><td headers="hd_h_niceng243er2.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab7_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>h</sup></td><td headers="hd_h_niceng243er2.tab7_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab7_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.94 (0.82–0.99)</td><td headers="hd_h_niceng243er2.tab7_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab7_1_1_1_1 hd_h_niceng243er2.tab7_1_1_1_2 hd_h_niceng243er2.tab7_1_1_1_3 hd_h_niceng243er2.tab7_1_1_1_4 hd_h_niceng243er2.tab7_1_1_1_5 hd_h_niceng243er2.tab7_1_1_1_6 hd_h_niceng243er2.tab7_1_1_1_7 hd_h_niceng243er2.tab7_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Weight loss for diagnosing adrenal hypofunction (all cortisol measurements <18 μg/dL including 1 μg/mL ACTH test) in people with AIDS (Wolff 2021)</td></tr><tr><td headers="hd_h_niceng243er2.tab7_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study (index test and reference standard data collected cross-sectionally)</td><td headers="hd_h_niceng243er2.tab7_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">63</td><td headers="hd_h_niceng243er2.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>i</sup></td><td headers="hd_h_niceng243er2.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab7_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>j</sup></td><td headers="hd_h_niceng243er2.tab7_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>e</sup></td><td headers="hd_h_niceng243er2.tab7_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.83 (0.52–0.98)</td><td headers="hd_h_niceng243er2.tab7_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>i</sup></td><td headers="hd_h_niceng243er2.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab7_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>j</sup></td><td headers="hd_h_niceng243er2.tab7_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab7_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.29 (0.17–0.44)</td><td headers="hd_h_niceng243er2.tab7_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng243er2.tab7_1"><p class="no_margin">Risk of bias was assessed using the QUADAS-2 checklist. The evidence was downgraded by 2 increments due to very high risk of bias (unclear reporting on patient selection; unclear application of the index test; unclear application of the reference standard (unclear if blinded); or timing between index test and reference standard).</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng243er2.tab7_2"><p class="no_margin">The evidence was downgraded by 2 increments due to very serious indirectness (serious population indirectness due to concerns over applicability of evidence from HIV infection population to general population; serious indirectness of the reference standard due to concerns over applicability of evidence on low dose 10 μg ACTH test).</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng243er2.tab7_3"><p class="no_margin">Confidence interval crossed the decision threshold corresponding to ‘low sensitivity’ (60%).</p></div></dd></dl><dl class="bkr_refwrap"><dt>d</dt><dd><div id="niceng243er2.tab7_4"><p class="no_margin">Confidence interval crossed the decision threshold corresponding to ‘low specificity’ (50%).</p></div></dd></dl><dl class="bkr_refwrap"><dt>e</dt><dd><div id="niceng243er2.tab7_5"><p class="no_margin">Confidence interval crossed the decision thresholds corresponding to ‘high sensitivity’ (90%) and ‘low sensitivity’ (60%).</p></div></dd></dl><dl class="bkr_refwrap"><dt>f</dt><dd><div id="niceng243er2.tab7_6"><p class="no_margin">The evidence was downgraded by 2 increments due to very serious indirectness (serious population indirectness due to concerns over applicability of evidence from people taking long term topical steroids to general population; serious indirectness of the reference standard due to concerns over applicability of evidence on low dose 5 μg ACTH test).</p></div></dd></dl><dl class="bkr_refwrap"><dt>g</dt><dd><div id="niceng243er2.tab7_7"><p class="no_margin">Risk of bias was assessed using the QUADAS-2 checklist. The evidence was downgraded by 2 increments due to very high risk of bias (unclear reporting on patient selection; unclear application of the index test; unclear application of the reference standard (unclear if blinded); unclear timing between index test and reference standard and high risk of bias arising from the patient flow (missing data)).</p></div></dd></dl><dl class="bkr_refwrap"><dt>h</dt><dd><div id="niceng243er2.tab7_8"><p class="no_margin">The evidence was downgraded by 2 increments due to very serious indirectness (serious population indirectness due to concerns over applicability of evidence from tuberculosis population to general population; serious indirectness of the reference standard due to concerns over applicability of evidence on low dose 1 μg/ml Synacthen test).</p></div></dd></dl><dl class="bkr_refwrap"><dt>i</dt><dd><div id="niceng243er2.tab7_9"><p class="no_margin">The evidence was downgraded by 2 increments due to very high risk of bias (unclear reporting on patient selection; whether reference standard was conducted without knowledge of index test results; or timing between index test and reference standard).</p></div></dd></dl><dl class="bkr_refwrap"><dt>j</dt><dd><div id="niceng243er2.tab7_10"><p class="no_margin">The evidence was downgraded by 2 increments due to very serious indirectness (serious population indirectness due to concerns over applicability of evidence from AIDS population to general population; serious indirectness of the reference standard due to concerns over applicability of evidence on low dose 1 μg/ml ACTH test).</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng243er2tab8"><div id="niceng243er2.tab8" class="table"><h3><span class="label">Table 8</span><span class="title">Clinical evidence summary: Hyponatraemia (serum sodium <135 mEq/L) for diagnosing adrenal insufficiency</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK609103/table/niceng243er2.tab8/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng243er2.tab8_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng243er2.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Studies</th><th id="hd_h_niceng243er2.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">N</th><th id="hd_h_niceng243er2.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Risk of bias</th><th id="hd_h_niceng243er2.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Inconsistency</th><th id="hd_h_niceng243er2.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Indirectness</th><th id="hd_h_niceng243er2.tab8_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Imprecision</th><th id="hd_h_niceng243er2.tab8_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Effect size (95%CI)</th><th id="hd_h_niceng243er2.tab8_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality</th></tr></thead><tbody><tr><td headers="hd_h_niceng243er2.tab8_1_1_1_1 hd_h_niceng243er2.tab8_1_1_1_2 hd_h_niceng243er2.tab8_1_1_1_3 hd_h_niceng243er2.tab8_1_1_1_4 hd_h_niceng243er2.tab8_1_1_1_5 hd_h_niceng243er2.tab8_1_1_1_6 hd_h_niceng243er2.tab8_1_1_1_7 hd_h_niceng243er2.tab8_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Hyponatraemia (<135mEq/l) for diagnosing adrenal insufficiency (basal cortisol < 9 μg/dl and/or peak cortisol < 18 μg/dl after short 250 μg Synacthen test) in people with stable liver cirrhosis</td></tr><tr><td headers="hd_h_niceng243er2.tab8_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 cross sectional study</td><td headers="hd_h_niceng243er2.tab8_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">132</td><td headers="hd_h_niceng243er2.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab8_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not Serious</td><td headers="hd_h_niceng243er2.tab8_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.37 (0.27–0.48)</td><td headers="hd_h_niceng243er2.tab8_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab8_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab8_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.91 (0.79–0.98)</td><td headers="hd_h_niceng243er2.tab8_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab8_1_1_1_1 hd_h_niceng243er2.tab8_1_1_1_2 hd_h_niceng243er2.tab8_1_1_1_3 hd_h_niceng243er2.tab8_1_1_1_4 hd_h_niceng243er2.tab8_1_1_1_5 hd_h_niceng243er2.tab8_1_1_1_6 hd_h_niceng243er2.tab8_1_1_1_7 hd_h_niceng243er2.tab8_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Hyponatraemia (serum Na < 135 mEq/L) for diagnosing adrenal insufficiency (cortisol peak response < 11 μg after low dose 10 μg short corticotropin stimulation test) in adults with HIV-infection</td></tr><tr><td headers="hd_h_niceng243er2.tab8_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study</td><td headers="hd_h_niceng243er2.tab8_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">106</td><td headers="hd_h_niceng243er2.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very Serious<sup>c</sup></td><td headers="hd_h_niceng243er2.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>d</sup></td><td headers="hd_h_niceng243er2.tab8_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>e</sup></td><td headers="hd_h_niceng243er2.tab8_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.51 (0.36–0.66)</td><td headers="hd_h_niceng243er2.tab8_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very Serious<sup>c</sup></td><td headers="hd_h_niceng243er2.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>d</sup></td><td headers="hd_h_niceng243er2.tab8_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>f</sup></td><td headers="hd_h_niceng243er2.tab8_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.64 (0.51–0.76)</td><td headers="hd_h_niceng243er2.tab8_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab8_1_1_1_1 hd_h_niceng243er2.tab8_1_1_1_2 hd_h_niceng243er2.tab8_1_1_1_3 hd_h_niceng243er2.tab8_1_1_1_4 hd_h_niceng243er2.tab8_1_1_1_5 hd_h_niceng243er2.tab8_1_1_1_6 hd_h_niceng243er2.tab8_1_1_1_7 hd_h_niceng243er2.tab8_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Hyponatraemia (serum Na < 135 mEq/L) for diagnosing adrenal insufficiency (twofold value of basal cortisol after low dose 10 μg short corticotropin stimulation test) in adults with HIV-infection</td></tr><tr><td headers="hd_h_niceng243er2.tab8_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study</td><td headers="hd_h_niceng243er2.tab8_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">106</td><td headers="hd_h_niceng243er2.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very Serious<sup>c</sup></td><td headers="hd_h_niceng243er2.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>d</sup></td><td headers="hd_h_niceng243er2.tab8_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab8_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.46 (0.35–0.58)</td><td headers="hd_h_niceng243er2.tab8_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very Serious<sup>c</sup></td><td headers="hd_h_niceng243er2.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>d</sup></td><td headers="hd_h_niceng243er2.tab8_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>g</sup></td><td headers="hd_h_niceng243er2.tab8_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.68 (0.48–0.84)</td><td headers="hd_h_niceng243er2.tab8_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab8_1_1_1_1 hd_h_niceng243er2.tab8_1_1_1_2 hd_h_niceng243er2.tab8_1_1_1_3 hd_h_niceng243er2.tab8_1_1_1_4 hd_h_niceng243er2.tab8_1_1_1_5 hd_h_niceng243er2.tab8_1_1_1_6 hd_h_niceng243er2.tab8_1_1_1_7 hd_h_niceng243er2.tab8_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Hyponatraemia (serum Na <135mEq/L) for diagnosing adrenal insufficiency (any cortisol value > 18 μg/dL after low dose 10 μg short corticotropin stimulation test) in adults with HIV-infection</td></tr><tr><td headers="hd_h_niceng243er2.tab8_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study</td><td headers="hd_h_niceng243er2.tab8_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">106</td><td headers="hd_h_niceng243er2.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very Serious<sup>c</sup></td><td headers="hd_h_niceng243er2.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>d</sup></td><td headers="hd_h_niceng243er2.tab8_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>e</sup></td><td headers="hd_h_niceng243er2.tab8_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.40 (0.05–0.85)</td><td headers="hd_h_niceng243er2.tab8_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very Serious<sup>c</sup></td><td headers="hd_h_niceng243er2.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>d</sup></td><td headers="hd_h_niceng243er2.tab8_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>h</sup></td><td headers="hd_h_niceng243er2.tab8_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.57 (0.47–0.67)</td><td headers="hd_h_niceng243er2.tab8_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab8_1_1_1_1 hd_h_niceng243er2.tab8_1_1_1_2 hd_h_niceng243er2.tab8_1_1_1_3 hd_h_niceng243er2.tab8_1_1_1_4 hd_h_niceng243er2.tab8_1_1_1_5 hd_h_niceng243er2.tab8_1_1_1_6 hd_h_niceng243er2.tab8_1_1_1_7 hd_h_niceng243er2.tab8_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Hyponatraemia (serum Na <135 mEq/L) for diagnosing adrenal insufficiency (any cortisol value > 20 μg/dL after low dose 10 μg short corticotropin stimulation test) in adults with HIV-infection</td></tr><tr><td headers="hd_h_niceng243er2.tab8_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study</td><td headers="hd_h_niceng243er2.tab8_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">106</td><td headers="hd_h_niceng243er2.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very Serious<sup>c</sup></td><td headers="hd_h_niceng243er2.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>d</sup></td><td headers="hd_h_niceng243er2.tab8_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>e</sup></td><td headers="hd_h_niceng243er2.tab8_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.33 (0.04–0.78)</td><td headers="hd_h_niceng243er2.tab8_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very Serious<sup>c</sup></td><td headers="hd_h_niceng243er2.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>d</sup></td><td headers="hd_h_niceng243er2.tab8_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>h</sup></td><td headers="hd_h_niceng243er2.tab8_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.57 (0.47–0.67)</td><td headers="hd_h_niceng243er2.tab8_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng243er2.tab8_1"><p class="no_margin">Risk of bias was assessed using the QUADAS-2 checklist. The evidence was downgraded by 1 increment due to high risk of bias (unclear patient selection, unclear application of the reference standard (unclear if blinded) and unclear timing between index test and reference standard).</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng243er2.tab8_2"><p class="no_margin">The evidence was downgraded by 1 increment due to serious indirectness (population indirectness due to concerns over applicability of evidence from stable liver cirrhosis population to general population).</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng243er2.tab8_3"><p class="no_margin">Risk of bias was assessed using the QUADAS-2 checklist. The evidence was downgraded by 2 increments due to very high risk of bias (unclear patient selection; unclear application of the index test; unclear application of the reference standard and the timing between index test and reference standard).</p></div></dd></dl><dl class="bkr_refwrap"><dt>d</dt><dd><div id="niceng243er2.tab8_4"><p class="no_margin">The evidence was downgraded by 2 increments due to very serious indirectness (serious population indirectness due to concerns over applicability of evidence from HIV infection population to general population; serious indirectness of the reference standard due to concerns over applicability of evidence on low dose 10 μg ACTH test).</p></div></dd></dl><dl class="bkr_refwrap"><dt>e</dt><dd><div id="niceng243er2.tab8_5"><p class="no_margin">Confidence interval crossed the decision threshold corresponding to ‘low sensitivity’ (60%).</p></div></dd></dl><dl class="bkr_refwrap"><dt>f</dt><dd><div id="niceng243er2.tab8_6"><p class="no_margin">Confidence interval crossed the decision threshold corresponding to ‘high specificity’ (70%).</p></div></dd></dl><dl class="bkr_refwrap"><dt>g</dt><dd><div id="niceng243er2.tab8_7"><p class="no_margin">Confidence interval crossed the decision thresholds corresponding to ‘high specificity’ (70%) and ‘low specificity’ (50%).</p></div></dd></dl><dl class="bkr_refwrap"><dt>h</dt><dd><div id="niceng243er2.tab8_8"><p class="no_margin">Confidence interval crossed the decision threshold corresponding to ‘low specificity’ (50%).</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng243er2tab9"><div id="niceng243er2.tab9" class="table"><h3><span class="label">Table 9</span><span class="title">Clinical evidence summary: Hyperkalaemia (serum Potassium >5 mEq/L) for diagnosing adrenal insufficiency</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK609103/table/niceng243er2.tab9/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng243er2.tab9_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng243er2.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Studies</th><th id="hd_h_niceng243er2.tab9_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">N</th><th id="hd_h_niceng243er2.tab9_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Risk of bias</th><th id="hd_h_niceng243er2.tab9_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Inconsistency</th><th id="hd_h_niceng243er2.tab9_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Indirectness</th><th id="hd_h_niceng243er2.tab9_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Imprecision</th><th id="hd_h_niceng243er2.tab9_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Effect size (95%CI)</th><th id="hd_h_niceng243er2.tab9_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality</th></tr></thead><tbody><tr><td headers="hd_h_niceng243er2.tab9_1_1_1_1 hd_h_niceng243er2.tab9_1_1_1_2 hd_h_niceng243er2.tab9_1_1_1_3 hd_h_niceng243er2.tab9_1_1_1_4 hd_h_niceng243er2.tab9_1_1_1_5 hd_h_niceng243er2.tab9_1_1_1_6 hd_h_niceng243er2.tab9_1_1_1_7 hd_h_niceng243er2.tab9_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Hyperkalaemia (serum Potassium > 5 mEq/L) for diagnosing adrenal insufficiency (cortisol peak response < 11 μg after low dose 10 μg short corticotropin stimulation test) in people with HIV-infection</td></tr><tr><td headers="hd_h_niceng243er2.tab9_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study</td><td headers="hd_h_niceng243er2.tab9_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">106</td><td headers="hd_h_niceng243er2.tab9_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very Serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab9_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab9_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab9_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab9_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.11 (0.04–0.23)</td><td headers="hd_h_niceng243er2.tab9_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab9_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very Serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab9_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab9_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab9_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab9_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.88 (0.77–0.95)</td><td headers="hd_h_niceng243er2.tab9_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab9_1_1_1_1 hd_h_niceng243er2.tab9_1_1_1_2 hd_h_niceng243er2.tab9_1_1_1_3 hd_h_niceng243er2.tab9_1_1_1_4 hd_h_niceng243er2.tab9_1_1_1_5 hd_h_niceng243er2.tab9_1_1_1_6 hd_h_niceng243er2.tab9_1_1_1_7 hd_h_niceng243er2.tab9_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Hyperkalaemia (serum Potassium > 5 mEq/L) for diagnosing adrenal insufficiency (twofold value of basal cortisol after low dose 10 μg short corticotropin stimulation test) in people with HIV-infection</td></tr><tr><td headers="hd_h_niceng243er2.tab9_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study</td><td headers="hd_h_niceng243er2.tab9_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">106</td><td headers="hd_h_niceng243er2.tab9_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very Serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab9_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab9_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab9_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab9_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.13 (0.06–0.22)</td><td headers="hd_h_niceng243er2.tab9_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab9_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very Serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab9_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab9_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab9_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab9_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.93 (0.76–0.99)</td><td headers="hd_h_niceng243er2.tab9_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab9_1_1_1_1 hd_h_niceng243er2.tab9_1_1_1_2 hd_h_niceng243er2.tab9_1_1_1_3 hd_h_niceng243er2.tab9_1_1_1_4 hd_h_niceng243er2.tab9_1_1_1_5 hd_h_niceng243er2.tab9_1_1_1_6 hd_h_niceng243er2.tab9_1_1_1_7 hd_h_niceng243er2.tab9_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Hyperkalaemia (serum potassium <5mEq/L) for diagnosing adrenal insufficiency (any cortisol value > 18 μg/dL after low dose 10 μg short corticotropin stimulation test) in people with HIV-infection</td></tr><tr><td headers="hd_h_niceng243er2.tab9_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study</td><td headers="hd_h_niceng243er2.tab9_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">106</td><td headers="hd_h_niceng243er2.tab9_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very Serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab9_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab9_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab9_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>c</sup></td><td headers="hd_h_niceng243er2.tab9_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.60 (0.15–0.95)</td><td headers="hd_h_niceng243er2.tab9_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab9_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very Serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab9_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab9_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab9_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab9_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.91 (0.84–0.96)</td><td headers="hd_h_niceng243er2.tab9_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab9_1_1_1_1 hd_h_niceng243er2.tab9_1_1_1_2 hd_h_niceng243er2.tab9_1_1_1_3 hd_h_niceng243er2.tab9_1_1_1_4 hd_h_niceng243er2.tab9_1_1_1_5 hd_h_niceng243er2.tab9_1_1_1_6 hd_h_niceng243er2.tab9_1_1_1_7 hd_h_niceng243er2.tab9_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Hyperkalaemia (serum potassium >5 mEq/L) for diagnosing adrenal insufficiency (any cortisol value > 20 μg/dL after low dose 10 μg short corticotropin stimulation test) in people with HIV-infection</td></tr><tr><td headers="hd_h_niceng243er2.tab9_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study</td><td headers="hd_h_niceng243er2.tab9_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">106</td><td headers="hd_h_niceng243er2.tab9_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very Serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab9_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab9_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab9_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>d</sup></td><td headers="hd_h_niceng243er2.tab9_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.50 (0.12–0.88)</td><td headers="hd_h_niceng243er2.tab9_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab9_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very Serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab9_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab9_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab9_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab9_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.91 (0.84–0.96)</td><td headers="hd_h_niceng243er2.tab9_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng243er2.tab9_1"><p class="no_margin">Risk of bias was assessed using the QUADAS-2 checklist. The evidence was downgraded by 2 increments due to very high risk of bias (unclear patient selection; unclear application of the index test; unclear application of the reference standard and the timing between index test and reference standard).</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng243er2.tab9_2"><p class="no_margin">The evidence was downgraded by 2 increments due to very serious indirectness (serious population indirectness due to concerns over applicability of evidence from HIV infection population to general population; serious indirectness of the reference standard due to concerns over applicability of evidence on low dose 10 μg ACTH test).</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng243er2.tab9_3"><p class="no_margin">Confidence interval crossed the decision thresholds corresponding to ‘high sensitivity’ (90%) and ‘low sensitivity’ (60%).</p></div></dd></dl><dl class="bkr_refwrap"><dt>d</dt><dd><div id="niceng243er2.tab9_4"><p class="no_margin">Confidence interval crossed the decision threshold corresponding to ‘low sensitivity’ (60%).</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng243er2tab10"><div id="niceng243er2.tab10" class="table"><h3><span class="label">Table 10</span><span class="title">Clinical evidence summary: nausea and vomiting for diagnosing adrenal insufficiency</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK609103/table/niceng243er2.tab10/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng243er2.tab10_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng243er2.tab10_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Studies</th><th id="hd_h_niceng243er2.tab10_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">N</th><th id="hd_h_niceng243er2.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Risk of bias</th><th id="hd_h_niceng243er2.tab10_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Inconsistency</th><th id="hd_h_niceng243er2.tab10_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Indirectness</th><th id="hd_h_niceng243er2.tab10_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Imprecision</th><th id="hd_h_niceng243er2.tab10_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Effect size (95%CI)</th><th id="hd_h_niceng243er2.tab10_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality</th></tr></thead><tbody><tr><td headers="hd_h_niceng243er2.tab10_1_1_1_1 hd_h_niceng243er2.tab10_1_1_1_2 hd_h_niceng243er2.tab10_1_1_1_3 hd_h_niceng243er2.tab10_1_1_1_4 hd_h_niceng243er2.tab10_1_1_1_5 hd_h_niceng243er2.tab10_1_1_1_6 hd_h_niceng243er2.tab10_1_1_1_7 hd_h_niceng243er2.tab10_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Nausea and vomiting for diagnosing adrenal insufficiency (8am cortisol level of <3 μg/dL or a peak serum cortisol level of <18 μg/dL after a 5 μg ACTH stimulation test) in people using topical corticosteroids for at least 12 months</td></tr><tr><td headers="hd_h_niceng243er2.tab10_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 cross sectional study</td><td headers="hd_h_niceng243er2.tab10_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">42</td><td headers="hd_h_niceng243er2.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very Serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab10_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab10_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab10_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab10_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.00 (0.00–0.20)</td><td headers="hd_h_niceng243er2.tab10_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very Serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab10_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab10_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab10_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab10_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=1.00 (0.86–1.00)</td><td headers="hd_h_niceng243er2.tab10_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng243er2.tab10_1"><p class="no_margin">Risk of bias was assessed using the QUADAS-2 checklist. The evidence was downgraded by 2 increments due to very high risk of bias (unclear patient selection, unclear application of the reference standard (unclear if blinded) and unclear timing between index test and reference standard).</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng243er2.tab10_2"><p class="no_margin">The evidence was downgraded by 2 increments due to very serious indirectness (serious population indirectness due to concerns over applicability of evidence from topical steroid use population to general population; serious indirectness of the reference standard due to concerns over applicability of evidence on low dose ACTH test).</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng243er2tab11"><div id="niceng243er2.tab11" class="table"><h3><span class="label">Table 11</span><span class="title">Clinical evidence summary: nausea for diagnosing adrenal insufficiency</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK609103/table/niceng243er2.tab11/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng243er2.tab11_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng243er2.tab11_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Studies</th><th id="hd_h_niceng243er2.tab11_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">N</th><th id="hd_h_niceng243er2.tab11_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Risk of bias</th><th id="hd_h_niceng243er2.tab11_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Inconsistency</th><th id="hd_h_niceng243er2.tab11_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Indirectness</th><th id="hd_h_niceng243er2.tab11_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Imprecision</th><th id="hd_h_niceng243er2.tab11_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Effect size (95%CI)</th><th id="hd_h_niceng243er2.tab11_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality</th></tr></thead><tbody><tr><td headers="hd_h_niceng243er2.tab11_1_1_1_1 hd_h_niceng243er2.tab11_1_1_1_2 hd_h_niceng243er2.tab11_1_1_1_3 hd_h_niceng243er2.tab11_1_1_1_4 hd_h_niceng243er2.tab11_1_1_1_5 hd_h_niceng243er2.tab11_1_1_1_6 hd_h_niceng243er2.tab11_1_1_1_7 hd_h_niceng243er2.tab11_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Nausea for diagnosing adrenal insufficiency (serum cortisol < 500nmol/L after low dose (1 μg/ml) short corticotropin (Synacthen<sup>®</sup>) stimulation test in people with suspected TB</td></tr><tr><td headers="hd_h_niceng243er2.tab11_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 cross sectional study</td><td headers="hd_h_niceng243er2.tab11_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">92 (75 analysed)</td><td headers="hd_h_niceng243er2.tab11_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab11_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab11_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab11_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not Serious</td><td headers="hd_h_niceng243er2.tab11_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.57 (0.37–0.76)</td><td headers="hd_h_niceng243er2.tab11_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab11_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab11_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab11_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab11_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab11_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.55 (0.40–0.70)</td><td headers="hd_h_niceng243er2.tab11_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab11_1_1_1_1 hd_h_niceng243er2.tab11_1_1_1_2 hd_h_niceng243er2.tab11_1_1_1_3 hd_h_niceng243er2.tab11_1_1_1_4 hd_h_niceng243er2.tab11_1_1_1_5 hd_h_niceng243er2.tab11_1_1_1_6 hd_h_niceng243er2.tab11_1_1_1_7 hd_h_niceng243er2.tab11_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Nausea for diagnosing adrenal hypofunction (all cortisol measurements <18 μg/dL including 1 μg/mL ACTH test) in people with AIDS</td></tr><tr><td headers="hd_h_niceng243er2.tab11_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study</td><td headers="hd_h_niceng243er2.tab11_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">72 (63 analysed)</td><td headers="hd_h_niceng243er2.tab11_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very Serious<sup>c</sup></td><td headers="hd_h_niceng243er2.tab11_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab11_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>d</sup></td><td headers="hd_h_niceng243er2.tab11_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>e</sup></td><td headers="hd_h_niceng243er2.tab11_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.50 (0.21–0.79)</td><td headers="hd_h_niceng243er2.tab11_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab11_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very Serious<sup>c</sup></td><td headers="hd_h_niceng243er2.tab11_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab11_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>d</sup></td><td headers="hd_h_niceng243er2.tab11_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>f</sup></td><td headers="hd_h_niceng243er2.tab11_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.61 (0.46–0.74)</td><td headers="hd_h_niceng243er2.tab11_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng243er2.tab11_1"><p class="no_margin">Risk of bias was assessed using the QUADAS-2 checklist. The evidence was downgraded by 2 increments due to very high risk of bias (unclear patient selection; unclear application of the index test; unclear application of the reference standard, the timing between index test and reference standard and patient flow (17 of 92 missing data sheets).</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng243er2.tab11_2"><p class="no_margin">Indirectness was assessed using the QUADAS-2 checklist. The evidence was downgraded by 2 increments due to very serious indirectness (serious population indirectness due to concerns over applicability of evidence from suspected TB population to general population; serious indirectness of the reference standard due to concerns over applicability of evidence on low dose ACTH test).</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng243er2.tab11_3"><p class="no_margin">Risk of bias was assessed using the QUADAS-2 checklist. The evidence was downgraded by 2 increments due to very high risk of bias (unclear patient selection, unclear application of the reference standard (unclear if blinded) and unclear timing between index test and reference standard).</p></div></dd></dl><dl class="bkr_refwrap"><dt>d</dt><dd><div id="niceng243er2.tab11_4"><p class="no_margin">The evidence was downgraded by 2 increments due to very serious indirectness (serious population indirectness due to concerns over applicability of evidence from AIDS population to general population; serious indirectness of the reference standard due to concerns over applicability of evidence on low dose 1 μg/mL ACTH test).</p></div></dd></dl><dl class="bkr_refwrap"><dt>e</dt><dd><div id="niceng243er2.tab11_5"><p class="no_margin">Confidence interval crossed the decision threshold corresponding to ‘low sensitivity’ (60%).</p></div></dd></dl><dl class="bkr_refwrap"><dt>f</dt><dd><div id="niceng243er2.tab11_6"><p class="no_margin">Confidence interval crossed the decision thresholds corresponding to ‘high specificity’ (70%) and ‘low specificity’ (50%).</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng243er2tab12"><div id="niceng243er2.tab12" class="table"><h3><span class="label">Table 12</span><span class="title">Clinical evidence summary: vomiting for diagnosing adrenal insufficiency</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK609103/table/niceng243er2.tab12/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng243er2.tab12_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng243er2.tab12_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Studies</th><th id="hd_h_niceng243er2.tab12_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">N</th><th id="hd_h_niceng243er2.tab12_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Risk of bias</th><th id="hd_h_niceng243er2.tab12_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Inconsistency</th><th id="hd_h_niceng243er2.tab12_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Indirectness</th><th id="hd_h_niceng243er2.tab12_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Imprecision</th><th id="hd_h_niceng243er2.tab12_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Effect size (95%CI)</th><th id="hd_h_niceng243er2.tab12_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality</th></tr></thead><tbody><tr><td headers="hd_h_niceng243er2.tab12_1_1_1_1 hd_h_niceng243er2.tab12_1_1_1_2 hd_h_niceng243er2.tab12_1_1_1_3 hd_h_niceng243er2.tab12_1_1_1_4 hd_h_niceng243er2.tab12_1_1_1_5 hd_h_niceng243er2.tab12_1_1_1_6 hd_h_niceng243er2.tab12_1_1_1_7 hd_h_niceng243er2.tab12_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Vomiting for diagnosing adrenal insufficiency (serum cortisol < 500nmol/L after low dose (1 μg/ml) short corticotropin (Synacthen<sup>®</sup>) stimulation test in people with suspected TB</td></tr><tr><td headers="hd_h_niceng243er2.tab12_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 cross sectional study</td><td headers="hd_h_niceng243er2.tab12_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">92 (75 analysed)</td><td headers="hd_h_niceng243er2.tab12_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab12_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab12_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab12_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>c</sup></td><td headers="hd_h_niceng243er2.tab12_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.68 (0.48–0.84)</td><td headers="hd_h_niceng243er2.tab12_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab12_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab12_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab12_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab12_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab12_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.26 (0.14–0.40)</td><td headers="hd_h_niceng243er2.tab12_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab12_1_1_1_1 hd_h_niceng243er2.tab12_1_1_1_2 hd_h_niceng243er2.tab12_1_1_1_3 hd_h_niceng243er2.tab12_1_1_1_4 hd_h_niceng243er2.tab12_1_1_1_5 hd_h_niceng243er2.tab12_1_1_1_6 hd_h_niceng243er2.tab12_1_1_1_7 hd_h_niceng243er2.tab12_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Vomiting for diagnosing adrenal hypofunction (all cortisol measurements <18 μg/dL including 1 μg/mL ACTH test) in people with AIDS</td></tr><tr><td headers="hd_h_niceng243er2.tab12_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study</td><td headers="hd_h_niceng243er2.tab12_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">72 (63 analysed)</td><td headers="hd_h_niceng243er2.tab12_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very Serious<sup>d</sup></td><td headers="hd_h_niceng243er2.tab12_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab12_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>e</sup></td><td headers="hd_h_niceng243er2.tab12_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>c</sup></td><td headers="hd_h_niceng243er2.tab12_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.42 (0.15–0.72)</td><td headers="hd_h_niceng243er2.tab12_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab12_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very Serious<sup>d</sup></td><td headers="hd_h_niceng243er2.tab12_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab12_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>e</sup></td><td headers="hd_h_niceng243er2.tab12_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>f</sup></td><td headers="hd_h_niceng243er2.tab12_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.69 (0.54–0.81)</td><td headers="hd_h_niceng243er2.tab12_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng243er2.tab12_1"><p class="no_margin">Risk of bias was assessed using the QUADAS-2 checklist. The evidence was downgraded by 2 increments due to very high risk of bias (unclear patient selection; unclear application of the index test; unclear application of the reference standard, the timing between index test and reference standard and patient flow (17 of 92 missing data sheets).</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng243er2.tab12_2"><p class="no_margin">Indirectness was assessed using the QUADAS-2 checklist. The evidence was downgraded by 2 increments due to very serious indirectness (serious population indirectness due to concerns over applicability of evidence from suspected TB population to general population; serious indirectness of the reference standard due to concerns over applicability of evidence on low dose ACTH test).</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng243er2.tab12_3"><p class="no_margin">Confidence interval crossed the decision threshold corresponding to ‘low sensitivity’ (60%).</p></div></dd></dl><dl class="bkr_refwrap"><dt>d</dt><dd><div id="niceng243er2.tab12_4"><p class="no_margin">Risk of bias was assessed using the QUADAS-2 checklist. The evidence was downgraded by 2 increments due to very high risk of bias (unclear patient selection, unclear application of the reference standard (unclear if blinded) and unclear timing between index test and reference standard).</p></div></dd></dl><dl class="bkr_refwrap"><dt>e</dt><dd><div id="niceng243er2.tab12_5"><p class="no_margin">The evidence was downgraded by 2 increments due to very serious indirectness (serious population indirectness due to concerns over applicability of evidence from AIDS population to general population; serious indirectness of the reference standard due to concerns over applicability of evidence on low dose 1 μg/mL ACTH test).</p></div></dd></dl><dl class="bkr_refwrap"><dt>f</dt><dd><div id="niceng243er2.tab12_6"><p class="no_margin">Confidence interval crossed the decision threshold corresponding to ‘high specificity’ (70%).</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng243er2tab13"><div id="niceng243er2.tab13" class="table"><h3><span class="label">Table 13</span><span class="title">Clinical evidence summary: Diarrhoea for diagnosing adrenal insufficiency</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK609103/table/niceng243er2.tab13/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng243er2.tab13_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng243er2.tab13_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Studies</th><th id="hd_h_niceng243er2.tab13_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">N</th><th id="hd_h_niceng243er2.tab13_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Risk of bias</th><th id="hd_h_niceng243er2.tab13_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Inconsistency</th><th id="hd_h_niceng243er2.tab13_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Indirectness</th><th id="hd_h_niceng243er2.tab13_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Imprecision</th><th id="hd_h_niceng243er2.tab13_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Effect size (95%CI)</th><th id="hd_h_niceng243er2.tab13_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality</th></tr></thead><tbody><tr><td headers="hd_h_niceng243er2.tab13_1_1_1_1 hd_h_niceng243er2.tab13_1_1_1_2 hd_h_niceng243er2.tab13_1_1_1_3 hd_h_niceng243er2.tab13_1_1_1_4 hd_h_niceng243er2.tab13_1_1_1_5 hd_h_niceng243er2.tab13_1_1_1_6 hd_h_niceng243er2.tab13_1_1_1_7 hd_h_niceng243er2.tab13_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Diarrhoea for diagnosing adrenal hypofunction (all cortisol measurements <18 μg/dL including 1 μg/mL ACTH test) in people with AIDS</td></tr><tr><td headers="hd_h_niceng243er2.tab13_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study</td><td headers="hd_h_niceng243er2.tab13_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">72 (63 analysed)</td><td headers="hd_h_niceng243er2.tab13_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab13_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab13_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab13_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not Serious</td><td headers="hd_h_niceng243er2.tab13_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.25 (0.05–0.57)</td><td headers="hd_h_niceng243er2.tab13_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab13_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab13_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab13_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>b</sup></td><td headers="hd_h_niceng243er2.tab13_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>c</sup></td><td headers="hd_h_niceng243er2.tab13_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.69 (0.54–0.81)</td><td headers="hd_h_niceng243er2.tab13_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab13_1_1_1_1 hd_h_niceng243er2.tab13_1_1_1_2 hd_h_niceng243er2.tab13_1_1_1_3 hd_h_niceng243er2.tab13_1_1_1_4 hd_h_niceng243er2.tab13_1_1_1_5 hd_h_niceng243er2.tab13_1_1_1_6 hd_h_niceng243er2.tab13_1_1_1_7 hd_h_niceng243er2.tab13_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Diarrhoea for diagnosing adrenal insufficiency (cortisol peak response < 11 μg after low dose 10 μg short corticotropin stimulation test) in people with HIV-infection</td></tr><tr><td headers="hd_h_niceng243er2.tab13_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study</td><td headers="hd_h_niceng243er2.tab13_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">106</td><td headers="hd_h_niceng243er2.tab13_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very Serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab13_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab13_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>d</sup></td><td headers="hd_h_niceng243er2.tab13_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab13_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.17 (0.08–0.31)</td><td headers="hd_h_niceng243er2.tab13_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab13_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very Serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab13_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab13_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>d</sup></td><td headers="hd_h_niceng243er2.tab13_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>e</sup></td><td headers="hd_h_niceng243er2.tab13_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.78 (0.65–0.88)</td><td headers="hd_h_niceng243er2.tab13_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab13_1_1_1_1 hd_h_niceng243er2.tab13_1_1_1_2 hd_h_niceng243er2.tab13_1_1_1_3 hd_h_niceng243er2.tab13_1_1_1_4 hd_h_niceng243er2.tab13_1_1_1_5 hd_h_niceng243er2.tab13_1_1_1_6 hd_h_niceng243er2.tab13_1_1_1_7 hd_h_niceng243er2.tab13_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Diarrhoea for diagnosing adrenal insufficiency (twofold value of basal cortisol after low dose 10 μg short corticotropin stimulation test) in people with HIV-infection</td></tr><tr><td headers="hd_h_niceng243er2.tab13_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study</td><td headers="hd_h_niceng243er2.tab13_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">106</td><td headers="hd_h_niceng243er2.tab13_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very Serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab13_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab13_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>d</sup></td><td headers="hd_h_niceng243er2.tab13_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab13_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.22 (0.13–0.33)</td><td headers="hd_h_niceng243er2.tab13_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab13_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very Serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab13_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab13_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>d</sup></td><td headers="hd_h_niceng243er2.tab13_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>e</sup></td><td headers="hd_h_niceng243er2.tab13_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.86 (0.67–0.96)</td><td headers="hd_h_niceng243er2.tab13_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab13_1_1_1_1 hd_h_niceng243er2.tab13_1_1_1_2 hd_h_niceng243er2.tab13_1_1_1_3 hd_h_niceng243er2.tab13_1_1_1_4 hd_h_niceng243er2.tab13_1_1_1_5 hd_h_niceng243er2.tab13_1_1_1_6 hd_h_niceng243er2.tab13_1_1_1_7 hd_h_niceng243er2.tab13_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Diarrhoea for diagnosing adrenal insufficiency (any cortisol value > 18 μg/dL after low dose 10 μg short corticotropin stimulation test) in people with HIV-infection</td></tr><tr><td headers="hd_h_niceng243er2.tab13_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study</td><td headers="hd_h_niceng243er2.tab13_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">106</td><td headers="hd_h_niceng243er2.tab13_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very Serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab13_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab13_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>d</sup></td><td headers="hd_h_niceng243er2.tab13_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab13_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.00 (0.00–0.52)</td><td headers="hd_h_niceng243er2.tab13_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab13_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very Serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab13_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab13_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>d</sup></td><td headers="hd_h_niceng243er2.tab13_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab13_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.79 (0.70–0.87)</td><td headers="hd_h_niceng243er2.tab13_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab13_1_1_1_1 hd_h_niceng243er2.tab13_1_1_1_2 hd_h_niceng243er2.tab13_1_1_1_3 hd_h_niceng243er2.tab13_1_1_1_4 hd_h_niceng243er2.tab13_1_1_1_5 hd_h_niceng243er2.tab13_1_1_1_6 hd_h_niceng243er2.tab13_1_1_1_7 hd_h_niceng243er2.tab13_1_1_1_8" colspan="8" rowspan="1" style="text-align:left;vertical-align:top;">Diarrhoea for diagnosing adrenal insufficiency (any cortisol value > 20 μg/dL after low dose 10 μg short corticotropin stimulation test) in people with HIV-infection</td></tr><tr><td headers="hd_h_niceng243er2.tab13_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">1 prospective cohort study</td><td headers="hd_h_niceng243er2.tab13_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">106</td><td headers="hd_h_niceng243er2.tab13_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very Serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab13_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab13_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>d</sup></td><td headers="hd_h_niceng243er2.tab13_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab13_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sensitivity=0.00 (0.00–0.46)</td><td headers="hd_h_niceng243er2.tab13_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng243er2.tab13_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very Serious<sup>a</sup></td><td headers="hd_h_niceng243er2.tab13_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab13_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>d</sup></td><td headers="hd_h_niceng243er2.tab13_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_niceng243er2.tab13_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specificity=0.79 (0.70–0.87)</td><td headers="hd_h_niceng243er2.tab13_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng243er2.tab13_1"><p class="no_margin">Risk of bias was assessed using the QUADAS-2 checklist. The evidence was downgraded by 2 increments due to very high risk of bias (unclear patient selection, unclear application of the reference standard (unclear if blinded) and unclear timing between index test and reference standard).</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng243er2.tab13_2"><p class="no_margin">The evidence was downgraded by 2 increments due to very serious indirectness (serious population indirectness due to concerns over applicability of evidence from AIDS population to general population; serious indirectness of the reference standard due to concerns over applicability of evidence on low dose 1 μg/mL ACTH test).</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng243er2.tab13_3"><p class="no_margin">Confidence interval crossed the decision threshold corresponding to ‘high specificity’ (70%).</p></div></dd></dl><dl class="bkr_refwrap"><dt>d</dt><dd><div id="niceng243er2.tab13_4"><p class="no_margin">The evidence was downgraded by 2 increments due to very serious indirectness (serious population indirectness due to concerns over applicability of evidence from HIV infection population to general population; serious indirectness of the reference standard due to concerns over applicability of evidence on low dose 10 μg ACTH test).</p></div></dd></dl><dl class="bkr_refwrap"><dt>e</dt><dd><div id="niceng243er2.tab13_5"><p class="no_margin">Confidence interval crossed the decision threshold corresponding to ‘high specificity’ (70%).</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng243er2appitab1"><div id="niceng243er2.appi.tab1" class="table"><h3><span class="label">Table 16</span><span class="title">Studies excluded from the clinical review</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK609103/table/niceng243er2.appi.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng243er2.appi.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Reason for exclusion</th></tr></thead><tbody><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Abdel-Rahman, Omar; ElHalawani, Hesham; Fouad, Mona (2016) Risk of endocrine complications in cancer patients treated with immune check point inhibitors: a meta-analysis. Future oncology (London, England)
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12(3): 413–25
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[<a href="https://pubmed.ncbi.nlm.nih.gov/26775673" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26775673</span></a>]
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</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>- Systematic review used as source of primary studies</p>
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<p>
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<i>Systematic review of RCTs reporting endocrine complications due to checkpoint inhibitor use e.g., hyper or hypo thyroidism and AI. 3 out of 10 studies included report AI.</i>
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</p>
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</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Abosmaha, E.A., Almsahli, S.E., Alsabri, S.G.
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et al (2014) Coexistence of autoimmune disease with type I diabetes mellitus in Libyan patients. International Journal of Pharmacy and Pharmaceutical Sciences
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6(2): 120–124
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</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report multivariable analysis of assessed risk factor(s)</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Abu Bakar, K., Khalil, K., Lim, Y.N.
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et al (2020) Adrenal Insufficiency in Children with Nephrotic Syndrome on Corticosteroid Treatment. Frontiers in Pediatrics
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8: 164
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[<a href="/pmc/articles/PMC7174641/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7174641</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32351921" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32351921</span></a>]
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</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Comparator in study does not match that specified in this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Afreen, Bahjat; Khan, Khurshid Ahmed; Riaz, Amna (2017) Adrenal Insufficiency In Pakistani Hiv Infected Patients. Journal of Ayub Medical College, Abbottabad: JAMC
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29(3): 428–431
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[<a href="https://pubmed.ncbi.nlm.nih.gov/29076676" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29076676</span></a>]
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</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report adrenal insufficiency diagnosis or association data</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Ahmet, Alexandra, Benchimol, Eric I, Goldbloom, Ellen B
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et al (2016) Adrenal suppression in children treated with swallowed fluticasone and oral viscous budesonide for eosinophilic esophagitis. Allergy, asthma, and clinical immunology: official journal of the Canadian Society of Allergy and Clinical Immunology
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12: 49
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[<a href="/pmc/articles/PMC5057375/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5057375</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/27766109" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27766109</span></a>]
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</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report multivariable analysis of assessed risk factor(s)</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Ahmet, Alexandra, Brienza, Vincent, Tran, Audrey
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et al (2017) Frequency and Duration of Adrenal Suppression Following Glucocorticoid Therapy in Children With Rheumatic Diseases. Arthritis care & research
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69(8): 1224–1230
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[<a href="https://pubmed.ncbi.nlm.nih.gov/27723273" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27723273</span></a>]
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</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report multivariable analysis of assessed risk factor(s)</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Al
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Argan, Reem, Ramadhan, Abdulaziz, Agnihotram, Ramanakumar
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V
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et al (2021) Baseline MRI findings as predictors of hypopituitarism in patients with non-functioning pituitary adenomas. Endocrine connections
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10(11): 1445–1454
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[<a href="/pmc/articles/PMC8630757/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8630757</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/34636742" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34636742</span></a>]
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</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not contain a risk factor relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Al-Aridi, Ribal; Abdelmannan, Dima; Arafah, Baha M (2011) Biochemical diagnosis of adrenal insufficiency: the added value of dehydroepiandrosterone sulfate measurements. Endocrine practice: official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
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17(2): 261–70
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[<a href="https://pubmed.ncbi.nlm.nih.gov/21134877" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21134877</span></a>]
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</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Review article but not a systematic review</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Albert, L., Profitos, J., Sanchez-Delgado, J.
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et al (2019) Salivary cortisol determination in ACTH stimulation test to diagnose adrenal insufficiency in patients with liver cirrhosis. International Journal of Endocrinology
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2019: 7251010
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[<a href="/pmc/articles/PMC6609341/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6609341</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/31320899" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31320899</span></a>]
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</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not contain any signs or symptoms relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Albert, Stewart G; Ariyan, Srividya; Rather, Ayesha (2011) The effect of etomidate on adrenal function in critical illness: a systematic review. Intensive care medicine
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37(6): 901–10
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[<a href="https://pubmed.ncbi.nlm.nih.gov/21373823" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21373823</span></a>]
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</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Ali, S.R., Bryce, J., Krone, N.P.
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et al (2022) Management of Acute Adrenal Insufficiency-Related Adverse Events in Children with Congenital Adrenal Hyperplasia: Results of an International Survey of Specialist Centres. Hormone Research in Paediatrics
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95(4): 363–373
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[<a href="https://pubmed.ncbi.nlm.nih.gov/35569445" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35569445</span></a>]
|
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</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report adrenal insufficiency diagnosis or association data</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Archambault, Patrick, Dionne, Clermont E, Lortie, Gilles
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et al (2012) Adrenal inhibition following a single dose of etomidate in intubated traumatic brain injury victims. CJEM
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14(5): 270–82
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[<a href="https://pubmed.ncbi.nlm.nih.gov/22967694" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22967694</span></a>]
|
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</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report adrenal insufficiency diagnosis or association data</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Arrington-Sanders, Renata; Hutton, Nancy; Siberry, George K (2006) Ritonavir-fluticasone interaction causing Cushing syndrome in HIV-infected children and adolescents. The Pediatric infectious disease journal
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25(11): 1044–8
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[<a href="https://pubmed.ncbi.nlm.nih.gov/17072128" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17072128</span></a>]
|
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</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report multivariable analysis of assessed risk factor(s)</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Aydin, Banu Kucukemre, Saka, Nurcin, Bas, Firdevs
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et al (2019) Frequency of Ambiguous Genitalia in 14,177 Newborns in Turkey. Journal of the Endocrine Society
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3(6): 1185–1195
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[<a href="/pmc/articles/PMC6532673/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6532673</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/31139765" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31139765</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report adrenal insufficiency diagnosis or association data</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Azeez, Taoreed Adegoke, Irojah, Olakunle Ayorinde, Lakoh, Sulaiman
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et al (2021) A systematic review of adrenal insufficiency among patients with pulmonary tuberculosis in Sub-Saharan Africa. International journal of mycobacteriology
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10(1): 1–7
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/33707364" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33707364</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study does not report adrenal insufficiency diagnosis or association data</p>
|
|
<p>- Systematic review used as source of primary studies</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Bachelot, Anne, Golmard, Jean Louis, Dulon, Jerome
|
|
et al (2015) Determining clinical and biological indicators for health outcomes in adult patients with childhood onset of congenital adrenal hyperplasia. European journal of endocrinology
|
|
173(2): 175–84
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/25947139" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25947139</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Comparator in study does not match that specified in this review protocol</p>
|
|
<p>- Study does not contain a risk factor relevant to this review protocol</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Bai, Xuefeng, Lin, Xiahong, Zheng, Kainan
|
|
et al (2020) Mapping endocrine toxicity spectrum of immune checkpoint inhibitors: a disproportionality analysis using the WHO adverse drug reaction database, VigiBase. Endocrine
|
|
69(3): 670–681
|
|
[<a href="/pmc/articles/PMC7447663/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7447663</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32507965" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32507965</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design not relevant to this review protocol</p>
|
|
<p>
|
|
<i>retrospective cohort study</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Balibegloo, Maryam, Nejadghaderi, Seyed Aria, Sadeghalvad, Mona
|
|
et al (2021) Adverse events associated with immune checkpoint inhibitors in patients with breast cancer: A systematic review and meta-analysis. International immunopharmacology
|
|
96: 107796
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/34162158" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34162158</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Bangsgaard, Regitze, Main, Katharina M, Boberg-Ans, Goril
|
|
et al (2018) Adrenal Suppression in Infants Treated with Topical Ocular Glucocorticoids. Ophthalmology
|
|
125(10): 1638–1643
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/29934270" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29934270</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report multivariable analysis of assessed risk factor(s)</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Barroso-Sousa, Romualdo, Barry, William T, Garrido-Castro, Ana C
|
|
et al (2018) Incidence of Endocrine Dysfunction Following the Use of Different Immune Checkpoint Inhibitor Regimens: A Systematic Review and Metaanalysis. JAMA oncology
|
|
4(2): 173–182
|
|
[<a href="/pmc/articles/PMC5838579/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5838579</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/28973656" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28973656</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study does not report adrenal insufficiency diagnosis or association data</p>
|
|
<p>
|
|
<i>Incidence only</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ben-Shlomo, Anat, Mirocha, James, Gwin, Stephanie M
|
|
et al (2014) Clinical factors associated with biochemical adrenal-cortisol insufficiency in hospitalized patients. The American journal of medicine
|
|
127(8): 754–762
|
|
[<a href="/pmc/articles/PMC4127354/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4127354</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/24632056" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24632056</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design not relevant to this review protocol</p>
|
|
<p>
|
|
<i>retrospective</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Bensalah, M., Donaldson, M., Labassen, M.
|
|
et al (2020) Prevalence of hypopituitarism and quality of life in survivors of post-traumatic brain injury. Endocrinology, Diabetes and Metabolism
|
|
3(3): e00146 [<a href="/pmc/articles/PMC7375098/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7375098</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32704567" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32704567</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Comparator in study does not match that specified in this review protocol</p>
|
|
<p>- Study does not report multivariable analysis of assessed risk factor(s)</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Bensalah, Meriem, Donaldson, Malcolm, Aribi, Yamina
|
|
et al (2018) Cortisol evaluation during the acute phase of traumatic brain injury-A prospective study. Clinical endocrinology
|
|
88(5): 627–636
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/29405355" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29405355</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Reference standard or method of diagnosis does not match the review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Bergthorsdottir, Ragnhildur, Ragnarsson, Oskar, Skrtic, Stanko
|
|
et al (2017) Visceral Fat and Novel Biomarkers of Cardiovascular Disease in Patients With Addison's Disease: A Case-Control Study. The Journal of clinical endocrinology and metabolism
|
|
102(11): 4264–4272
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/28945861" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28945861</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Population not relevant to this review protocol</p>
|
|
<p>
|
|
<i>population have been diagnosed with Addison’s diesase.</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Betterle, C., Rossi, A., Dalla Pria, S.
|
|
et al (1993) Premature ovarian failure: Autoimmunity and natural history. Clinical Endocrinology
|
|
39(1): 35–43
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/8348706" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8348706</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report adrenal insufficiency diagnosis or association data</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Betterle, C, Volpato, M, Rees Smith, B
|
|
et al (1997) I. Adrenal cortex and steroid 21-hydroxylase autoantibodies in adult patients with organ-specific autoimmune diseases: markers of low progression to clinical Addison's disease. The Journal of clinical endocrinology and metabolism
|
|
82(3): 932–8
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/9062509" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9062509</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study does not contain a risk factor relevant to this review protocol</p>
|
|
<p>- Study does not report multivariable analysis of assessed risk factor(s)</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Betterle, C, Volpato, M, Rees Smith, B
|
|
et al (1997) II. Adrenal cortex and steroid 21-hydroxylase autoantibodies in children with organ-specific autoimmune diseases: markers of high progression to clinical Addison's disease. The Journal of clinical endocrinology and metabolism
|
|
82(3): 939–42
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/9062510" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9062510</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study does not contain a risk factor relevant to this review protocol</p>
|
|
<p>- Study does not report multivariable analysis of assessed risk factor(s)</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Betterle, C, Zanette, F, Pedini, B
|
|
et al (1984) Clinical and subclinical organ-specific autoimmune manifestations in type 1 (insulin-dependent) diabetic patients and their first-degree relatives. Diabetologia
|
|
26(6): 431–6
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/6381190" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 6381190</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design not relevant to this review protocol</p>
|
|
<p>
|
|
<i>Case-control</i>
|
|
</p>
|
|
<p>- Data not reported in an extractable format or a format that can be analysed</p>
|
|
<p>
|
|
<i>Prevalence data only</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Bilavsky, Efraim, Dagan, Adi, Yarden-Bilavsky, Havatzelet
|
|
et al (2011) Adrenal insufficiency during physiological stress in children after kidney or liver transplantation. Pediatric transplantation
|
|
15(3): 314–20
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/21443548" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21443548</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report adrenal insufficiency diagnosis or association data</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Boots, Johannes M M, van den Ham, E C H, Christiaans, M H L
|
|
et al (2002) Risk of adrenal insufficiency with steroid maintenance therapy in renal transplantation. Transplantation proceedings
|
|
34(5): 1696–7
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/12176541" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12176541</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Comparator in study does not match that specified in this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Borresen, Stina W, Thorgrimsen, Toke B, Jensen, Bente
|
|
et al (2020) Adrenal insufficiency in prednisolone-treated patients with polymyalgia rheumatica or giant cell arteritis-prevalence and clinical approach. Rheumatology (Oxford, England)
|
|
59(10): 2764–2773
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/32031663" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32031663</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study does not report multivariable analysis of assessed risk factor(s)</p>
|
|
<p>- Study does not contain a risk factor relevant to this review protocol</p>
|
|
<p>
|
|
<i>Corticosteroid dose</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Bouca, Bruno, Nogueira, Andreia, Caetano, Joana
|
|
et al (2022) Clinical characteristics of polyglandular autoimmune syndromes in pediatric age: an observational study. Journal of pediatric endocrinology & metabolism: JPEM
|
|
35(4): 477–480
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/35170268" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35170268</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Reference standard or method of diagnosis does not match the review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Brennan, Vincent, Martin-Grace, Julie, Greene, Garrett
|
|
et al (2022) The Contribution of Oral and Inhaled Glucocorticoids to Adrenal Insufficiency in Asthma. The journal of allergy and clinical immunology. In practice 10(10): 2614–2623
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/35697207" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35697207</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Reference standard or method of diagnosis does not match the review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Broersen, Leonie H A, Pereira, Alberto M, Jorgensen, Jens Otto L
|
|
et al (2015) Adrenal Insufficiency in Corticosteroids Use: Systematic Review and Meta-Analysis. The Journal of clinical endocrinology and metabolism
|
|
100(6): 2171–80
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/25844620" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25844620</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Brossaud, Julie, Barat, Pascal, Georges, Agnes
|
|
et al (2012) Impact of the reference values on the clinically relevant cut-offs. The example of cortisol testing in children. Clinical chemistry and laboratory medicine
|
|
50(5): 901–3
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/22628335" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22628335</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not contain any signs or symptoms relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Brown, P H, Blundell, G, Greening, A P
|
|
et al (1991) Hypothalamo-pituitary-adrenal axis suppression in asthmatics inhaling high dose corticosteroids. Respiratory medicine
|
|
85(6): 501–10
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/1775677" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 1775677</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study design not relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Cagliani, Joaquin A, Ruhemann, Andres, Molmenti, Ernesto
|
|
et al (2021) Association between Etomidate Use for Rapid Sequence Intubation and Adrenal Insufficiency in Sepsis. Cureus
|
|
13(2): e13445
|
|
[<a href="/pmc/articles/PMC7982295/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7982295</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/33767929" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33767929</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study does not report multivariable analysis of assessed risk factor(s)</p>
|
|
<p>- Study design not relevant to this review protocol</p>
|
|
<p>
|
|
<i>Retrospective</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Cavkaytar, Ozlem, Vuralli, Dogus, Arik Yilmaz, Ebru
|
|
et al (2015) Evidence of hypothalamic-pituitary-adrenal axis suppression during moderate-to-high-dose inhaled corticosteroid use. European journal of pediatrics
|
|
174(11): 1421–31
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/26255048" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26255048</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study design not relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Cerina, Vatroslav, Kruljac, Ivan, Radosevic, Jelena Marinkovic
|
|
et al (2016) Diagnostic Accuracy of Perioperative Measurement of Basal Anterior Pituitary and Target Gland Hormones in Predicting Adrenal Insufficiency After Pituitary Surgery. Medicine
|
|
95(9): e2898
|
|
[<a href="/pmc/articles/PMC4782865/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4782865</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26945381" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26945381</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not contain a risk factor relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Chacko, Shireen R, Abraham, Ananth P, Asha, Hesarghatta Shyamasunder
|
|
et al (2020) Selective perioperative steroid supplementation protocol in patients undergoing endoscopic transsphenoidal surgery for pituitary adenomas. Acta neurochirurgica
|
|
162(10): 2381–2388
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/32772164" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32772164</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study design not relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Chan, C.; Mitchell, A.; Shorr, A. (2011) The effect of etomidate on adrenal insufficiency and mortality: A meta-analysis. Chest
|
|
140(4meetingabstract)
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Conference abstract</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Chan, Chee Man; Mitchell, Anthony L; Shorr, Andrew F (2012) Etomidate is associated with mortality and adrenal insufficiency in sepsis: a meta-analysis*. Critical care medicine
|
|
40(11): 2945–53
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/22971586" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22971586</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Chantzichristos, Dimitrios, Persson, Anders, Miftaraj, Mervete
|
|
et al (2019) Early Clinical Indicators of Addison Disease in Adults with Type 1 Diabetes: A Nationwide, Observational, Cohort Study. The Journal of clinical endocrinology and metabolism
|
|
104(4): 1148–1157
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/30476180" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30476180</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design not relevant to this review protocol</p>
|
|
<p>
|
|
<i>Case-control</i>
|
|
</p>
|
|
<p>- Study does not report multivariable analysis of assessed risk factor(s)</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Chen, Xin, Chai, Yan, Wang, Shao-Bo
|
|
et al (2020) Risk factors for corticosteroid insufficiency during the sub-acute phase of acute traumatic brain injury. Neural regeneration research
|
|
15(7): 1259–1265
|
|
[<a href="/pmc/articles/PMC7047797/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7047797</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/31960811" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31960811</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Reference standard or method of diagnosis does not match the review protocol</p>
|
|
<p>
|
|
<i>Dexamethasone supression</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Christensson, Camilla; Thoren, Anders; Lindberg, Bengt (2008) Safety of inhaled budesonide: clinical manifestations of systemic corticosteroid-related adverse effects. Drug safety
|
|
31(11): 965–88
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/18840017" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18840017</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Clark, D J, Grove, A, Cargill, R I
|
|
et al (1996) Comparative adrenal suppression with inhaled budesonide and fluticasone propionate in adult asthmatic patients. Thorax
|
|
51(3): 262–6
|
|
[<a href="/pmc/articles/PMC1090636/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC1090636</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/8779128" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8779128</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Reference standard or method of diagnosis does not match the review protocol</p>
|
|
<p>- Study design not relevant to this review protocol</p>
|
|
<p>
|
|
<i>RCT</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Cohan, Pejman, Wang, Christina, McArthur, David L
|
|
et al (2005) Acute secondary adrenal insufficiency after traumatic brain injury: a prospective study. Critical care medicine
|
|
33(10): 2358–66
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/16215393" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16215393</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Reference standard or method of diagnosis does not match the review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Conrad, Nathalie, Misra, Shivani, Verbakel, Jan Y
|
|
et al (2023) Incidence, prevalence, and co-occurrence of autoimmune disorders over time and by age, sex, and socioeconomic status: a population-based cohort study of 22 million individuals in the UK. Lancet (London, England) [<a href="https://pubmed.ncbi.nlm.nih.gov/37156255" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 37156255</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report adrenal insufficiency diagnosis or association data</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Cook, M., Pratt, G., Powell, R.
|
|
et al (2019) Therapy with Steroid-Containing Regimens in Myeloma Patients Can Result in Significantly Low Serum Cortisol Levels. Clinical Lymphoma, Myeloma and Leukemia
|
|
19(10supplement): e252
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Conference abstract</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Cotton, Bryan A, Guillamondegui, Oscar D, Fleming, Sloan B
|
|
et al (2008) Increased risk of adrenal insufficiency following etomidate exposure in critically injured patients. Archives of surgery (Chicago, Ill.: 1960)
|
|
143(1): 62–67
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/18209154" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18209154</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design not relevant to this review protocol</p>
|
|
<p>
|
|
<i>Retrospective registry study</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Cui, Kai, Wang, Ziqi, Zhang, Qianqian
|
|
et al (2022) Immune checkpoint inhibitors and adrenal insufficiency: a large-sample case series study. Annals of translational medicine
|
|
10(5): 251
|
|
[<a href="/pmc/articles/PMC8987884/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8987884</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/35402601" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35402601</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study does not report adrenal insufficiency diagnosis or association data</p>
|
|
<p>
|
|
<i>prevalence only</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Dar, Sheeraz A, Nazir, Mudasir, Lone, Roumissa
|
|
et al (2018) Clinical Spectrum of Disorders of Sex Development: A Cross-sectional Observational Study. Indian journal of endocrinology and metabolism
|
|
22(6): 774–779
|
|
[<a href="/pmc/articles/PMC6330871/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6330871</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30766817" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30766817</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report adrenal insufficiency diagnosis or association data</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Davallow Ghajar, Ladan, Wood Heickman, Lauren K, Conaway, Mark
|
|
et al (2019) Low Risk of Adrenal Insufficiency After Use of Low- to Moderate-Potency Topical Corticosteroids for Children With Atopic Dermatitis. Clinical pediatrics
|
|
58(4): 406–412
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/30694073" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30694073</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
de Filette, Jeroen, Andreescu, Corina Emilia, Cools, Filip
|
|
et al (2019) A Systematic Review and Meta-Analysis of Endocrine-Related Adverse Events Associated with Immune Checkpoint Inhibitors. Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme
|
|
51(3): 145–156
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/30861560" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30861560</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report adrenal insufficiency diagnosis or association data</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Dellon, E.S., Falk, G.W., Lucendo, A.
|
|
et al (2021) Low Rates of Glucocorticoid-Related Adverse Effects With Long-Term Treatment Of Eosinophilic Esophagitis With Fluticasone Propionate Orally Disintegrating Tablet (Apt-1011): Results From 52 Weeks Of Exposure In A Phase 2b Trial. Gastroenterology
|
|
160(6supplement): 249
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Conference abstract</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Edvardsen, Kine, Hellesen, Alexander, Husebye, Eystein S
|
|
et al (2016) Analysis of cellular and humoral immune responses against cytomegalovirus in patients with autoimmune Addison's disease. Journal of translational medicine
|
|
14: 68
|
|
[<a href="/pmc/articles/PMC4784442/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4784442</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26956521" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26956521</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study design not relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Edwin, Stephanie B and Walker, Pamela L (2010) Controversies surrounding the use of etomidate for rapid sequence intubation in patients with suspected sepsis. The Annals of pharmacotherapy
|
|
44(78): 1307–13
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/20530707" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20530707</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Review article but not a systematic review</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Einarsdottir, Margret J, Bankvall, Maria, Robledo-Sierra, Jairo
|
|
et al (2023) Topical clobetasol treatment for oral lichen planus can cause adrenal insufficiency. Oral diseases [<a href="https://pubmed.ncbi.nlm.nih.gov/37103329" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 37103329</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Data not reported in an extractable format or a format that can be analysed</p>
|
|
<p>
|
|
<i>Only reports prevalence data</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
El-Maouche, Diala, Hannah-Shmouni, Fady, Mallappa, Ashwini
|
|
et al (2019) Adrenal morphology and associated comorbidities in congenital adrenal hyperplasia. Clinical endocrinology
|
|
91(2): 247–255
|
|
[<a href="/pmc/articles/PMC6635023/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6635023</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/31001843" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31001843</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report adrenal insufficiency diagnosis or association data</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Elamin, Mohamed B, Murad, M Hassan, Mullan, Rebecca
|
|
et al (2008) Accuracy of diagnostic tests for Cushing's syndrome: a systematic review and metaanalyses. The Journal of clinical endocrinology and metabolism
|
|
93(5): 1553–62
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/18334594" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18334594</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Emelifeonwu, J.A., Flower, H., Loan, J.
|
|
et al (2019) Prevalence of Anterior Pituitary Dysfunction 12 months or more following Traumatic Brain Injury in Adults - A Systematic review and Meta-analysis. Journal of neurotrauma [<a href="https://pubmed.ncbi.nlm.nih.gov/31111791" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31111791</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Erichsen, Martina M, Lovas, Kristian, Skinningsrud, Beate
|
|
et al (2009) Clinical, immunological, and genetic features of autoimmune primary adrenal insufficiency: observations from a Norwegian registry. The Journal of clinical endocrinology and metabolism
|
|
94(12): 4882–90 [<a href="https://pubmed.ncbi.nlm.nih.gov/19858318" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19858318</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study design not relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ersoy, G.Z.; Erguven, M.; Yildiz, M. (2023) Factors Associated with the Development of Adrenal Insufficiency in Patients with Juvenile Idiopathic Arthritis Who Received Systemic Corticosteroids. Journal of Pediatric Research
|
|
10(1): 26–33
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study design not relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Falorni, A. and Laureti, S. (2000) Adrenal autoimmunity and correlation with adrenal dysfunction. Endocrinologist
|
|
10(3): 145–154
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Review article but not a systematic review</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Farahid, O.H., Khawaja, N., Shennak, M.M.
|
|
et al (2013) Prevalence of coeliac disease among adult patients with autoimmune hypothyroidism in Jordan. Eastern Mediterranean Health Journal
|
|
20(1): 51–55 [<a href="https://pubmed.ncbi.nlm.nih.gov/24932934" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24932934</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study design not relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Fassnacht, Martin, Arlt, Wiebke, Bancos, Irina
|
|
et al (2016) Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline in collaboration with the European Network for the Study of Adrenal Tumors. European journal of endocrinology
|
|
175(2): g1–g34
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/27390021" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27390021</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study design not relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Feng, Gui-Long, Zheng, Miao-Miao, Yao, Shi-Hong
|
|
et al (2021) Risk factors and predictive model of adrenocortical insufficiency in patients with traumatic brain injury. World journal of emergency medicine
|
|
12(3): 179–184
|
|
[<a href="/pmc/articles/PMC8188278/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8188278</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/34141031" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34141031</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Reference standard or method of diagnosis does not match the review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ferguson, A, Campieri, M, Doe, W
|
|
et al (1998) Oral budesonide as maintenance therapy in Crohn's disease--results of a 12-month study. Global Budesonide Study Group. Alimentary pharmacology & therapeutics
|
|
12(2): 175–83 [<a href="https://pubmed.ncbi.nlm.nih.gov/9692692" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9692692</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design not relevant to this review protocol</p>
|
|
<p>
|
|
<i>RCT</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Findling, J W, Buggy, B P, Gilson, I H
|
|
et al (1994) Longitudinal evaluation of adrenocortical function in patients infected with the human immunodeficiency virus. The Journal of clinical endocrinology and metabolism
|
|
79(4): 1091–6
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/7962279" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7962279</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Data not reported in an extractable format or a format that can be analysed</p>
|
|
<p>- Study does not report multivariable analysis of assessed risk factor(s)</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Foisy, M M, Yakiwchuk, E M K, Chiu, I
|
|
et al (2008) Adrenal suppression and Cushing's syndrome secondary to an interaction between ritonavir and fluticasone: a review of the literature. HIV medicine
|
|
9(6): 389–96
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/18459946" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18459946</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Review article but not a systematic review</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Friedly, J.L., Comstock, B.A., Standaert, C.J.
|
|
et al (2016) Patient and procedural risk factors for cortisol suppression following epidural steroid injections for spinal stenosis. PM and R
|
|
8(9supplement): 159–s160 [<a href="https://pubmed.ncbi.nlm.nih.gov/27672767" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27672767</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Conference abstract</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Gao, J., Jiao, X., Dang, Y.
|
|
et al (2017) Identification of patients with primary ovarian insufficiency caused by autoimmunity. Reproductive BioMedicine Online
|
|
35(4): 475–479
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/28689853" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28689853</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report multivariable analysis of assessed risk factor(s)</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Gleicher, Norbert, Kushnir, Vitaly A, Weghofer, Andrea
|
|
et al (2016) The importance of adrenal hypoandrogenism in infertile women with low functional ovarian reserve: a case study of associated adrenal insufficiency. Reproductive biology and endocrinology: RB&E
|
|
14: 23
|
|
[<a href="/pmc/articles/PMC4845439/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4845439</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/27112552" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27112552</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study design not relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Gray, T.F., Borstelmann, N., Rosenberg, S.
|
|
et al (2021) Relative risk of variousendocrinopathies associated with the use of chemoimmunotherapy for triple-negative breast cancer: Asystematic review and metaanalysis. Cancer Research
|
|
81(4suppl)
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Conference abstract</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Grouthier, V., Lebrun-Vignes, B., Moey, M.
|
|
et al (2020) Immune Checkpoint Inhibitors Associated Primary Adrenal Insufficiency: WHO VigiBase Report Analysis. The oncologist [<a href="/pmc/articles/PMC7418341/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7418341</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32390168" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32390168</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study design not relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Grouthier, Virginie, Lebrun-Vignes, Benedicte, Moey, Melissa
|
|
et al (2020) Immune Checkpoint Inhibitor-Associated Primary Adrenal Insufficiency: WHO VigiBase Report Analysis. The oncologist
|
|
25(8): 696–701
|
|
[<a href="/pmc/articles/PMC7418341/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7418341</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32390168" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32390168</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report adrenal insufficiency diagnosis or association data</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Guven, Ayla (2020) Different Potent Glucocorticoids, Different Routes of Exposure but the Same Result: Iatrogenic Cushing's Syndrome and Adrenal Insufficiency. Journal of clinical research in pediatric endocrinology
|
|
12(4): 383–392
|
|
[<a href="/pmc/articles/PMC7711638/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7711638</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32431136" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32431136</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design not relevant to this review protocol</p>
|
|
<p>
|
|
<i>Retrospective case series</i>
|
|
</p>
|
|
<p>- Study does not report adrenal insufficiency diagnosis or association data</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Haddad, Amir, Ashkenazi, Ron Ilan, Bitterman, Haim
|
|
et al (2017) Endocrine Comorbidities in Patients with Psoriatic Arthritis: A Population-based Case-controlled Study. The Journal of rheumatology
|
|
44(6): 786–790
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/28412706" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28412706</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not contain a risk factor relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Han, Hye Sook, Park, Ji Chan, Park, Suk Young
|
|
et al (2015) A Prospective Multicenter Study Evaluating Secondary Adrenal Suppression After Antiemetic Dexamethasone Therapy in Cancer Patients Receiving Chemotherapy: A Korean Southwest Oncology Group Study. The oncologist
|
|
20(12): 1432–9
|
|
[<a href="/pmc/articles/PMC4679085/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4679085</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26463869" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26463869</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not contain a risk factor relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Harel, Shira, Hursh, Brenden E, Chan, Edmond S
|
|
et al (2015) Adrenal Suppression in Children Treated with Oral Viscous Budesonide for Eosinophilic Esophagitis. Journal of pediatric gastroenterology and nutrition
|
|
61(2): 190–3
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/25950088" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25950088</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design not relevant to this review protocol</p>
|
|
<p>- Study does not report multivariable analysis of assessed risk factor(s)</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Hasegawa, Shiori, Ikesue, Hiroaki, Nakao, Satoshi
|
|
et al (2020) Analysis of immune-related adverse events caused by immune checkpoint inhibitors using the Japanese Adverse Drug Event Report database. Pharmacoepidemiology and drug safety
|
|
29(10): 1279–1294
|
|
[<a href="/pmc/articles/PMC7692939/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7692939</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32869941" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32869941</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report adrenal insufficiency diagnosis or association data</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Heckmann, M, Wudy, S A, Haack, D
|
|
et al (2000) Serum cortisol concentrations in ill preterm infants less than 30 weeks gestational age. Acta paediatrica (Oslo, Norway: 1992)
|
|
89(9): 1098–103
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/11071092" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11071092</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Reference standard or method of diagnosis does not match the review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Hildreth, Amy N, Mejia, Vicente A, Maxwell, Robert A
|
|
et al (2008) Adrenal suppression following a single dose of etomidate for rapid sequence induction: a prospective randomized study. The Journal of trauma
|
|
65(3): 573–9
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/18784570" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18784570</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report adrenal insufficiency diagnosis or association data</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Holme, J, Tomlinson, J W, Stockley, R A
|
|
et al (2008) Adrenal suppression in bronchiectasis and the impact of inhaled corticosteroids. The European respiratory journal
|
|
32(4): 1047–52
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/18508829" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18508829</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report multivariable analysis of assessed risk factor(s)</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Hou, X., Xu, X., Chen, X.
|
|
et al (2019) Analysis of clinical manifestations and gene mutations in infants with 21-hydroxylase deficiencies. International Journal of Clinical and Experimental Medicine
|
|
12(5): 5373–5380
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Comparator in study does not match that specified in this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Hoyos-Martinez, Alfonso, Horne, Vincent E, Wood, Alexis C
|
|
et al (2021) Prevalence of Adrenal Insufficiency and Glucocorticoid Use in Pediatric Pseudotumor Cerebri Syndrome. Journal of neuro-ophthalmology: the official journal of the North American Neuro-Ophthalmology Society
|
|
41(4): e451–e457
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/33110007" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33110007</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study design not relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Huber, Benedikt M, Bolt, Isabel B, Sauvain, Marie-Josephe
|
|
et al (2010) Adrenal insufficiency after glucocorticoid withdrawal in children with rheumatic diseases. Acta paediatrica (Oslo, Norway: 1992)
|
|
99(12): 1889–93
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/20649769" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20649769</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report adrenal insufficiency diagnosis or association data</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Iglesias, Pedro; Sanchez, Juan Cristobal; Diez, Juan Jose (2021) Isolated ACTH deficiency induced by cancer immunotherapy: a systematic review. Pituitary
|
|
24(4): 630–643
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/33761049" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33761049</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Imrich, R, Vlcek, M, Kerlik, J
|
|
et al (2014) Determinants of adrenal androgen hypofunction in premenopausal females with rheumatoid arthritis. Physiological research
|
|
63(3): 321–9
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/24564598" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24564598</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report multivariable analysis of assessed risk factor(s)</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Iribarren, Jose L, Jimenez, Juan J, Hernandez, Domingo
|
|
et al (2010) Relative adrenal insufficiency and hemodynamic status in cardiopulmonary bypass surgery patients. A prospective cohort study. Journal of cardiothoracic surgery
|
|
5: 26
|
|
[<a href="/pmc/articles/PMC2867788/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2867788</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/20403156" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20403156</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Reference standard or method of diagnosis does not match the review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Iwanaga, K., Yamamoto, A., Matsukura, T.
|
|
et al (2017) Corticotrophin-releasing hormone stimulation tests for the infants with relative adrenal insufficiency. Clinical Endocrinology
|
|
87(6): 660–664
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/28802067" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28802067</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report adrenal insufficiency diagnosis or association data</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Izzy, Saef, Chen, Patrick M, Tahir, Zabreen
|
|
et al (2022) Association of Traumatic Brain Injury with the Risk of Developing Chronic Cardiovascular, Endocrine, Neurological, and Psychiatric Disorders. JAMA network open
|
|
5(4): e229478
|
|
[<a href="/pmc/articles/PMC9051987/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9051987</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/35482306" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35482306</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Reference standard or method of diagnosis does not match the review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Jahan, N.; Rehman, S.; Tijani, L. (2022) The relative risk of various endocrinopathies associated with neoadjuvant chemoimmunotherapy use in early-stage triple-negative breast cancer: A systematic review and meta-analysis. Cancer Research
|
|
82(4suppl)
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Conference abstract</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Joseph, Rebecca M, Hunter, Ann Louise, Ray, David W
|
|
et al (2016) Systemic glucocorticoid therapy and adrenal insufficiency in adults: A systematic review. Seminars in arthritis and rheumatism
|
|
46(1): 133–41
|
|
[<a href="/pmc/articles/PMC4987145/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4987145</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/27105755" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27105755</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Kachroo, P., Stewart, I.D., Kelly, R.S.
|
|
et al (2022) Metabolomic profiling reveals extensive adrenal suppression due to inhaled corticosteroid therapy in asthma. Nature Medicine
|
|
28(4): 814–822 [<a href="/pmc/articles/PMC9350737/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9350737</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/35314841" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35314841</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report adrenal insufficiency diagnosis or association data</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Kakarla, V., Balagopal, M., Shaik, N.R.
|
|
et al (2022) A Study Of Prevalence Of Thyroid Dysfunction In Type 1 Diabetic Children In A Tertiary Care Hospital From A Sub-Urban Population. Journal of Pharmaceutical Negative Results
|
|
13: 2244–2246
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Reference standard or method of diagnosis does not match the review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Kanji, S., Morin, S., Agtarap, K.
|
|
et al (2022) Adverse Events Associated with Immune Checkpoint Inhibitors: Overview of Systematic Reviews. Drugs
|
|
82(7): 793–809
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/35416592" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35416592</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Kaplan, S.A. (1979) Disorders of the adrenal cortex. I. Pediatric Clinics of North America
|
|
26(1): 65–76
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/460988" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 460988</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Review article but not a systematic review</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Karaguzel, Gulay, Atay, Suleyman, Deger, Orhan
|
|
et al (2012) The effects of three specific conditions related to critical care on adrenal function in children. Intensive care medicine
|
|
38(10): 1689–96
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/22878348" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22878348</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report adrenal insufficiency diagnosis or association data</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Killeen, A.A., Hanson, N.Q., Eklund, R.
|
|
et al (1992) Prevalence of nonclassical congenital adrenal hyperplasia among women self-referred for electrolytic treatment of hirsutism. American Journal of Medical Genetics
|
|
42(2): 197–200
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/1733169" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 1733169</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report adrenal insufficiency diagnosis or association data</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Kim, Tae Yun, Rhee, Joong Eui, Kim, Kyu Seok
|
|
et al (2008) Etomidate should be used carefully for emergent endotracheal intubation in patients with septic shock. Journal of Korean medical science
|
|
23(6): 988–91
|
|
[<a href="/pmc/articles/PMC2610664/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2610664</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/19119441" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19119441</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study design not relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Kopacek, Cristiane, Prado, Mayara J, da Silva, Claudia M D
|
|
et al (2019) Clinical and molecular profile of newborns with confirmed or suspicious congenital adrenal hyperplasia detected after a public screening program implementation. Jornal de pediatria
|
|
95(3): 282–290
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/29715434" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29715434</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report adrenal insufficiency diagnosis or association data</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Kromah, Fatuma, Tyroch, Alan, McLean, Susan
|
|
et al (2011) Relative adrenal insufficiency in the critical care setting: debunking the classic myth. World journal of surgery
|
|
35(8): 1818–23
|
|
[<a href="/pmc/articles/PMC7101698/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7101698</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/21533963" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21533963</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Reference standard or method of diagnosis does not match the review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Kronvall, Erik, Sonesson, Bengt, Valdemarsson, Stig
|
|
et al (2016) Reduced Quality of Life in Patients with Pituitary Dysfunction After Aneurysmal Subarachnoid Hemorrhage: A Prospective Longitudinal Study. World neurosurgery
|
|
88: 83–91
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/26724609" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26724609</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report adrenal insufficiency diagnosis or association data</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Kuenzig, M Ellen, Rezaie, Ali, Seow, Cynthia H
|
|
et al (2014) Budesonide for maintenance of remission in Crohn's disease. The Cochrane database of systematic reviews: cd002913
|
|
[<a href="/pmc/articles/PMC7133546/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7133546</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/25141071" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25141071</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Kurokawa, Kana, Mitsuishi, Yoichiro, Shimada, Naoko
|
|
et al (2023) Clinical characteristics of adrenal insufficiency induced by pembrolizumab in non-small-cell lung cancer. Thoracic cancer
|
|
14(5): 442–449
|
|
[<a href="/pmc/articles/PMC9925336/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9925336</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/36523162" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 36523162</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study does not report adrenal insufficiency diagnosis or association data</p>
|
|
<p>- Study design not relevant to this review protocol</p>
|
|
<p>
|
|
<i>Retrospective</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Kwda, Anuradha, Gldc, Prematilake, Baui, Batuwita
|
|
et al (2019) Effect of long-term inhaled corticosteroid therapy on adrenal suppression, growth and bone health in children with asthma. BMC pediatrics
|
|
19(1): 411
|
|
[<a href="/pmc/articles/PMC6829958/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6829958</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/31684902" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31684902</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study does not report multivariable analysis of assessed risk factor(s)</p>
|
|
<p>- Study does not contain any signs or symptoms relevant to this review protocol</p>
|
|
<p>- Study does not contain a risk factor relevant to this review protocol</p>
|
|
<p>
|
|
<i>Dose and duration of corticosteroid use analysed as diagnostic factors.</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Kwon, Min Kwan, Kim, Junhwan, Ahn, Jonghwa
|
|
et al (2022) Clinical Features and Risk Factors of Adrenal Insufficiency in Patients with Cancer Admitted to the Hospitalist-Managed Medical Unit. Journal of Korean medical science
|
|
37(28): e222
|
|
[<a href="/pmc/articles/PMC9294500/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9294500</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/35851863" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35851863</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design not relevant to this review protocol</p>
|
|
<p>
|
|
<i>retrospective</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Kwon, Yong Soo, Kang, Eunhae, Suh, Gee Young
|
|
et al (2009) A prospective study on the incidence and predictive factors of relative adrenal insufficiency in Korean critically ill patients. Journal of Korean medical science
|
|
24(4): 668–73
|
|
[<a href="/pmc/articles/PMC2719193/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2719193</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/19654950" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19654950</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not contain a risk factor relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Lapi, Francesco, Kezouh, Abbas, Suissa, Samy
|
|
et al (2013) The use of inhaled corticosteroids and the risk of adrenal insufficiency. The European respiratory journal
|
|
42(1): 79–86
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/23060630" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23060630</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Reference standard or method of diagnosis does not match the review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Lee, Keum Hwa, Lee, HyunJeong, Lee, Cheol-Hun
|
|
et al (2019) Adrenal insufficiency in systematic lupus erythematosus (SLE) and antiphospholipid syndrome (APS): A systematic review. Autoimmunity reviews
|
|
18(1): 1–8
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/30408580" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30408580</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Comparator in study does not match that specified in this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Lichtenstein, G R, Bengtsson, B, Hapten-White, L
|
|
et al (2009) Oral budesonide for maintenance of remission of Crohn's disease: a pooled safety analysis. Alimentary pharmacology & therapeutics
|
|
29(6): 643–53
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/19035972" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19035972</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study design not relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Lipworth, B J (1999) Systemic adverse effects of inhaled corticosteroid therapy: A systematic review and meta-analysis. Archives of internal medicine
|
|
159(9): 941–55
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/10326936" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10326936</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Comparator in study does not match that specified in this review protocol</p>
|
|
<p>
|
|
<i>Compares different corticosteroids with each other.</i>
|
|
</p>
|
|
<p>- Reference standard or method of diagnosis does not match the review protocol</p>
|
|
<p>
|
|
<i>Association with cortisol levels as a continuous variable (no diagnostic threshold used)</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Lobatto, D.J., de Vries, F., Zamanipoor Najafabadi, A.H.
|
|
et al (2018) Preoperative risk factors for postoperative complications in endoscopic pituitary surgery: a systematic review. Pituitary
|
|
21(1): 84–97
|
|
[<a href="/pmc/articles/PMC5767215/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5767215</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/28916976" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28916976</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Lomenick, Jefferson P, Reifschneider, Kent L, Lucky, Anne W
|
|
et al (2009) Prevalence of adrenal insufficiency following systemic glucocorticoid therapy in infants with hemangiomas. Archives of dermatology
|
|
145(3): 262–6
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/19289754" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19289754</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report multivariable analysis of assessed risk factor(s)</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Lugogo, Njira, Chipps, Bradley E, Panettieri, Reynold A
|
|
Jr
|
|
et al (2022) Long-Term Use of Maintenance Systemic Corticosteroids is Associated with Multiple Adverse Conditions in a Large, Real-World Cohort of US Adults with Severe Asthma. Journal of asthma and allergy
|
|
15: 1753–1761
|
|
[<a href="/pmc/articles/PMC9741834/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9741834</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/36514709" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 36514709</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design not relevant to this review protocol</p>
|
|
<p>
|
|
<i>retrospective: definition of AI not stated and derived from medical records.</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Makimattila, S., Harjutsalo, V., Forsblom, C.
|
|
et al (2020) Every fifth individual with type 1 diabetes suffers from an additional autoimmune disease: A Finnish nationwide study. Diabetes Care
|
|
43(5): 1041–1047
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/32139386" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32139386</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study design not relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Malerba, Gabriel, Romano-Girard, Florence, Cravoisy, Aurelie
|
|
et al (2005) Risk factors of relative adrenocortical deficiency in intensive care patients needing mechanical ventilation. Intensive care medicine
|
|
31(3): 388–92
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/15703896" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15703896</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study does not report adrenal insufficiency diagnosis or association data</p>
|
|
<p>
|
|
<i>Reports on relative adrenocortical deficiency based on high dose corticotropin test.</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Manglik, Savita, Flores, Eugene, Lubarsky, Laura
|
|
et al (2003) Glucocorticoid insufficiency in patients who present to the hospital with severe sepsis: a prospective clinical trial. Critical care medicine
|
|
31(6): 1668–75
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/12794402" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12794402</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Data not reported in an extractable format or a format that can be analysed</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Manosroi, Worapaka, Phimphilai, Mattabhorn, Khorana, Jiraporn
|
|
et al (2020) Predictive Factors of Adrenal Insufficiency in Outpatients with Indeterminate Serum Cortisol Levels: A Retrospective Study. Medicina (Kaunas, Lithuania)
|
|
56(1) [<a href="/pmc/articles/PMC7022503/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7022503</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/31936335" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31936335</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design not relevant to this review protocol</p>
|
|
<p>
|
|
<i>Retrospective cohort</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Manosroi, Worapaka, Pipanmekaporn, Tanyong, Khorana, Jiraporn
|
|
et al (2021) A Predictive Risk Score to Diagnose Adrenal Insufficiency in Outpatients: A 7 Year Retrospective Cohort Study. Medicines (Basel, Switzerland)
|
|
8(3) [<a href="/pmc/articles/PMC7998205/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7998205</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/33801854" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33801854</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design not relevant to this review protocol</p>
|
|
<p>
|
|
<i>retrospective cohort study</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Mansoor, S., Baloch, M.H., Khan, Z.
|
|
et al (2023) A clinical account of Pakistani children suffering from congenital adrenal hyperplasia. Journal of the Pakistan Medical Association
|
|
73(2): 366–369
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/36800727" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 36800727</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study design not relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Mantan, M, Grover, R, Kaushik, S
|
|
et al (2018) Adrenocortical Suppression in Children with Nephrotic Syndrome Treated with Low-Dose Alternate Day Corticosteroids. Indian journal of nephrology
|
|
28(3): 203–208
|
|
[<a href="/pmc/articles/PMC5998710/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5998710</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29962670" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29962670</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study does not report adrenal insufficiency diagnosis or association data</p>
|
|
<p>
|
|
<i>Correlation data only</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Mantilla, E.C., Abramowitz, J., Dan, T.
|
|
et al (2020) Prolonged steroid dependence in adult patients with glioma.
|
|
Anticancer Research
|
|
40(4): 2059–2064
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/32234897" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32234897</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study design not relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Matsubayashi, Sunao; Nakatake, Nobuhiro; Hara, Takeshi (2020) Possible adrenal insufficiency among fatigue patients in a psychosomatic medical clinic. Endocrine journal
|
|
67(1): 53–57
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/31597820" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31597820</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report multivariable analysis of assessed risk factor(s)</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Mattour, A.H., Janakiraman, N., Farhan, S.
|
|
et al (2015) Incidence of adrenal insufficiency in patients with multiple myeloma during high dose chemotherapy and autologous stem cell transplant. Biology of Blood and Marrow Transplantation
|
|
21(2suppl1): 142
|
|
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Conference abstract</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
McKenna, D S, Wittber, G M, Nagaraja, H N
|
|
et al (2000) The effects of repeat doses of antenatal corticosteroids on maternal adrenal function. American journal of obstetrics and gynecology
|
|
183(3): 669–73
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/10992191" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10992191</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Data not reported in an extractable format or a format that can be analysed</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Mebrahtu, Teumzghi F, Morgan, Ann W, Keeley, Adam
|
|
et al (2019) Dose Dependency of Iatrogenic Glucocorticoid Excess and Adrenal Insufficiency and Mortality: A Cohort Study in England. The Journal of clinical endocrinology and metabolism
|
|
104(9): 3757–3767
|
|
[<a href="/pmc/articles/PMC6656418/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6656418</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/31009052" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31009052</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study does not contain a risk factor relevant to this review protocol</p>
|
|
<p>
|
|
<i>GC dose</i>
|
|
</p>
|
|
<p>- Study design not relevant to this review protocol</p>
|
|
<p>
|
|
<i>retrospective</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Menon, Kusum, Ward, Roxanne E, Lawson, Margaret L
|
|
et al (2010) A prospective multicenter study of adrenal function in critically ill children. American journal of respiratory and critical care medicine
|
|
182(2): 246–51
|
|
[<a href="/pmc/articles/PMC5003603/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5003603</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/20299532" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20299532</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not contain a risk factor relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Methiniti, D., Hamilton, J., Saravanan, V.
|
|
et al (2009) Consider hypoadrenalism in patients with fatigue and rheumatic disease. Rheumatology
|
|
48(suppl1): i113
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Conference abstract</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Meya, David B, Katabira, Elly, Otim, Marcel
|
|
et al (2007) Functional adrenal insufficiency among critically ill patients with human immunodeficiency virus in a resource-limited setting. African health sciences
|
|
7(2): 101–7
|
|
[<a href="/pmc/articles/PMC1925266/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC1925266</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/17594287" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17594287</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Reference standard or method of diagnosis does not match the review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Mourinho Bala, Nadia, Goncalves, Raquel S, Serra Caetano, Joana
|
|
et al (2022) Autoimmune Primary Adrenal Insufficiency in Children. Journal of clinical research in pediatric endocrinology
|
|
14(3): 308–312
|
|
[<a href="/pmc/articles/PMC9422918/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9422918</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/35633647" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35633647</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Population not relevant to this review protocol</p>
|
|
<p>
|
|
<i>All had adrenal insufficiency.</i>
|
|
</p>
|
|
<p>- Study does not report multivariable analysis of assessed risk factor(s)</p>
|
|
<p>- Study does not report adrenal insufficiency diagnosis or association data</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Muller, M, Beiglbock, H, Fellinger, P
|
|
et al (2021) Micro- and macrovascular function in patients suffering from primary adrenal insufficiency: a cross-sectional case-control study. Journal of endocrinological investigation
|
|
44(2): 339–345
|
|
[<a href="/pmc/articles/PMC7817592/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7817592</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32488723" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32488723</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design not relevant to this review protocol</p>
|
|
<p>
|
|
<i>case-control</i>
|
|
</p>
|
|
<p>- Study does not contain a risk factor relevant to this review protocol</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Mytareli, Chrysoula, Ziogas, Dimitrios C, Karampela, Athina
|
|
et al (2023) The Uncharted Landscape of Rare Endocrine Immune-Related Adverse Events. Cancers
|
|
15(7) [<a href="/pmc/articles/PMC10093286/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC10093286</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/37046677" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 37046677</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Naggirinya, Agnes Bwanika, Mujugira, Andrew, Meya, David B
|
|
et al (2020) Functional adrenal insufficiency among tuberculosis-human immunodeficiency virus co-infected patients: a cross-sectional study in Uganda. BMC research notes
|
|
13(1): 224
|
|
[<a href="/pmc/articles/PMC7169013/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7169013</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32307006" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32307006</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not contain a risk factor relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nederstigt, C, Uitbeijerse, B S, Janssen, L G M
|
|
et al (2019) Associated auto-immune disease in type 1 diabetes patients: a systematic review and meta-analysis. European journal of endocrinology
|
|
180(2): 135–144
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/30508413" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30508413</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Neogi, Subhasis, Mukhopadhyay, Pradip, Sarkar, Niladri
|
|
et al (2021) Overt and Subclinical Adrenal Insufficiency in Pulmonary Tuberculosis. Endocrine practice: official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
|
|
27(6): 601–606
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/33645514" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33645514</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Data not reported in an extractable format or a format that can be analysed</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ng, P C, Fok, T F, Wong, G W
|
|
et al (1998) Pituitary-adrenal suppression in preterm, very low birth weight infants after inhaled fluticasone propionate treatment. The Journal of clinical endocrinology and metabolism
|
|
83(7): 2390–3
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/9661616" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9661616</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study design not relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ng, P C, Lee, C H, Lam, C W K
|
|
et al (2004) Transient adrenocortical insufficiency of prematurity and systemic hypotension in very low birthweight infants. Archives of disease in childhood. Fetal and neonatal edition
|
|
89(2): f119–26
|
|
[<a href="/pmc/articles/PMC1756043/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC1756043</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/14977894" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 14977894</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Reference standard or method of diagnosis does not match the review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nie, Ding, Fang, Qiuyue, Wong, Wakam
|
|
et al (2023) The effect of endoscopic transsphenoidal somatotroph tumors resection on pituitary hormones: systematic review and metaanalysis. World journal of surgical oncology
|
|
21(1): 71
|
|
[<a href="/pmc/articles/PMC9976528/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9976528</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/36859291" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 36859291</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Oboni, Jean-Baptiste, Marques-Vidal, Pedro, Pralong, Francois
|
|
et al (2013) Predictive factors of adrenal insufficiency in patients admitted to acute medical wards: a case control study. BMC endocrine disorders
|
|
13: 3
|
|
[<a href="/pmc/articles/PMC3574842/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3574842</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/23351185" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23351185</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design not relevant to this review protocol</p>
|
|
<p>
|
|
<i>retrospective design</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Odeniyi, I A, Fasanmade, O A, Ajala, M O
|
|
et al (2013) Adrenocortical function in Nigerians with human immunodeficiency virus infection. Ghana medical journal
|
|
47(4): 171–7
|
|
[<a href="/pmc/articles/PMC3961856/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3961856</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/24669022" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24669022</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study design not relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Oyama, T and Takiguchi, M (1972) Prediction of adrenal hypofunction in anaesthesia. Canadian Anaesthetists' Society journal
|
|
19(3): 239–50
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/4337665" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 4337665</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Data not reported in an extractable format or a format that can be analysed</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Park, JungHyun, Kwak, Jueun, Chung, Sukyung
|
|
et al (2020) Incidence of Adrenal Insufficiency and Cushing's Syndrome After Long-Term Epidural Steroid Injections Over Six Months or Longer: A Preliminary Study. Journal of pain research
|
|
13: 1505–1514
|
|
[<a href="/pmc/articles/PMC7321692/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7321692</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32606916" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32606916</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study does not report multivariable analysis of assessed risk factor(s)</p>
|
|
<p>- Study does not contain a risk factor relevant to this review protocol</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Park, Sang Hoon, Joo, Min Sun, Kim, Byoung Hoon
|
|
et al (2018) Clinical characteristics and prevalence of adrenal insufficiency in hemodynamically stable patients with cirrhosis. Medicine
|
|
97(26): e11046
|
|
[<a href="/pmc/articles/PMC6039635/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6039635</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29952944" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29952944</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study does not contain a risk factor relevant to this review protocol</p>
|
|
<p>- Study does not report multivariable analysis of assessed risk factor(s)</p>
|
|
<p>
|
|
<i>undertaken but not reported.</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Pei, Wen-Guang, Chen, Wen-Zheng, Wu, Yu-Kang
|
|
et al (2023) Immune-related adverse events associated with immune checkpoint inhibitors for advanced gastric and gastroesophageal junction cancer: A metaanalysis. World journal of gastrointestinal oncology
|
|
15(2): 352–367
|
|
[<a href="/pmc/articles/PMC9994050/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9994050</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/36908315" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 36908315</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Philla, Katherine Q, Min, Steve B, Hefner, Jody N
|
|
et al (2015) Swallowed glucocorticoid therapy for eosinophilic esophagitis in children does not suppress adrenal function. Journal of pediatric endocrinology & metabolism: JPEM
|
|
28(910): 1101–6
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/26024243" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26024243</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report adrenal insufficiency diagnosis or association data</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Philpott, H., Reed, C.C., Dougherty, M.
|
|
et al (2017) Adrenal insufficiency is rare with topical corticosteroid treatment for eosinophilic esophagitis: A systematic review. American Journal of Gastroenterology
|
|
112(supplement1): 193–s194
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Piedrola, G, Casado, J L, Lopez, E
|
|
et al (1996) Clinical features of adrenal insufficiency in patients with acquired immunodeficiency syndrome. Clinical endocrinology
|
|
45(1): 97–101
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/8796145" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8796145</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study design not relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Preville-Ratelle, Sebastien, Coriati, Adele, Menard, Aurelie
|
|
et al (2018) Adrenal Insufficiency in Cystic Fibrosis: A Rare Phenomenon?. Canadian respiratory journal
|
|
2018: 3629031
|
|
[<a href="/pmc/articles/PMC5872627/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5872627</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29731953" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29731953</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design not relevant to this review protocol</p>
|
|
<p>
|
|
<i>retrospective</i>
|
|
</p>
|
|
<p>- Study does not report multivariable analysis of assessed risk factor(s)</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Raschi, Emanuel, Mazzarella, Alessandra, Antonazzo, Ippazio Cosimo
|
|
et al (2019) Toxicities with Immune Checkpoint Inhibitors: Emerging Priorities From Disproportionality Analysis of the FDA Adverse Event Reporting System. Targeted oncology
|
|
14(2): 205–221
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/30927173" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30927173</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study design not relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Reddy, Pramod (2021) Diagnosis and Management of Adrenal Insufficiency in Hospitalized Patients. American journal of therapeutics
|
|
28(2): e238–e244
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/31567142" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31567142</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Review article but not a systematic review</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Rensen, Niki, Gemke, Reinoud Jbj, van Dalen, Elvira C
|
|
et al (2017) Hypothalamic-pituitary-adrenal (HPA) axis suppression after treatment with glucocorticoid therapy for childhood acute lymphoblastic leukaemia. The Cochrane database of systematic reviews
|
|
11: cd008727
|
|
[<a href="/pmc/articles/PMC6486149/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6486149</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29106702" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29106702</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Rezaie, Ali, Kuenzig, M Ellen, Benchimol, Eric I
|
|
et al (2015) Budesonide for induction of remission in Crohn's disease. The Cochrane database of systematic reviews: cd000296
|
|
[<a href="/pmc/articles/PMC10613338/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC10613338</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26039678" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26039678</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Rodriguez-Gutierrez, Rene, Gonzalez-Velazquez, Camilo, Gonzalez-Saldivar, Gerardo
|
|
et al (2014) Glucocorticoid functional reserve in full-spectrum intensity of primary hypothyroidism. International journal of endocrinology
|
|
2014: 313519
|
|
[<a href="/pmc/articles/PMC4142294/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4142294</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/25180035" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25180035</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report multivariable analysis of assessed risk factor(s)</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ross, Ian Louis and Levitt, Naomi S (2013) Addison's disease symptoms--a cross sectional study in urban South Africa. PloS one
|
|
8(1): e53526
|
|
[<a href="/pmc/articles/PMC3538548/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3538548</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/23308244" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23308244</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study design not relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Saari, Viivi, Holopainen, Elina, Makitie, Outi
|
|
et al (2020) Pubertal development and premature ovarian insufficiency in patients with APECED. European journal of endocrinology
|
|
183(5): 513–520
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/33107435" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33107435</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report taraet condition</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Sadeghi, P., Aghighi, Y., Ziaee, V.
|
|
et al (2019) Adrenal insufficiency in children with juvenile idiopathic arthritis (JIA) treated with prednisolone. Journal of Comprehensive Pediatrics
|
|
10(2): e64681
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Data not reported in an extractable format or a format that can be analysed</p>
|
|
<p>- Study does not report multivariable analysis of assessed risk factor(s)</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Sahlander, F, Patrova, J, Mannheimer, B
|
|
et al (2023) Congenital adrenal hyperplasia in patients with adrenal tumors: a population-based case-control study. Journal of endocrinological investigation
|
|
46(3): 559–565
|
|
[<a href="/pmc/articles/PMC9938068/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9938068</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/36269558" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 36269558</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design not relevant to this review protocol</p>
|
|
<p>
|
|
<i>retrospective cohort study and no MV analysis</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Sakao, Yukitoshi, Sugiura, Takeshi, Tsuji, Takayuki
|
|
et al (2014) Clinical manifestation of hypercalcemia caused by adrenal insufficiency in hemodialysis patients: a case-series study. Internal medicine (Tokyo, Japan)
|
|
53(14): 1485–90
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/25030558" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25030558</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study design not relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Sakar, M., Ozdogan, S., Ucar, A.
|
|
et al (2019) The prevalence of hypothalamic-pituitary-adrenal axis suppression in children with persistent asthma. Iranian Journal of Pediatrics
|
|
29(5): e90891
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not contain any signs or symptoms relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Saleem, Mohammed D and Feldman, Steven R (2018) Desoximetasone 0.25% spray, adrenal suppression and efficacy in extensive plaque psoriasis. The Journal of dermatological treatment
|
|
29(1): 36–38
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/28494626" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28494626</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Comparator in study does not match that specified in this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Salgado, D R; Rocco, J R; Rosso Verdeal, J C (2008) Adrenal function in different subgroups of septic shock patients. Acta anaesthesiologica Scandinavica
|
|
52(1): 36–44
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/17999714" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17999714</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report target condition</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Sampieri, Gianluca, Namavarian, Amirpouyan, Lee, John J W
|
|
et al (2022) Hypothalamic-pituitary-adrenal axis suppression and intranasal corticosteroid use: A systematic review and meta-analysis. International forum of allergy & rhinology
|
|
12(1): 11–27
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/34260153" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34260153</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study does not report adrenal insufficiency diagnosis or association data</p>
|
|
<p>
|
|
<i>Prevalence data only</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Sarna, S, Hoppu, K, Neuvonen, P J et al (1997) Methylprednisolone exposure, rather than dose, predicts adrenal suppression and growth inhibition in children with liver and renal transplants. The Journal of clinical endocrinology and metabolism
|
|
82(1): 75–7
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/8989236" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8989236</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Reference standard or method of diagnosis does not match the review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Schmidt, Diana C, Kessel, Line, Bach-Holm, Daniella
|
|
et al (2023) Prevalence and risk factors for hypothalamus-pituitary-adrenal axis suppression in infants receiving glucocorticoid eye drops after ocular surgery. Acta ophthalmologica
|
|
101(2): 229–235
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/36165330" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 36165330</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study does not report multivariable analysis of assessed risk factor(s)</p>
|
|
<p>- Study does not contain a risk factor relevant to this review protocol</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Schonfeld, Sara J, Tucker, Margaret A, Engels, Eric A
|
|
et al (2022) Immune-Related Adverse Events After Immune Checkpoint Inhibitors for Melanoma Among Older Adults. JAMA network open
|
|
5(3): e223461
|
|
[<a href="/pmc/articles/PMC8941351/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8941351</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/35315916" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35315916</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design not relevant to this review protocol</p>
|
|
<p>
|
|
<i>retrospective and diagnosis based on medical claims database terms.</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Shah, Koral, Boyd, Jennifer W, Broussard, Julia R
|
|
et al (2022) Adrenocortical Function in Children With Brain Tumors and Pediatric Hematopoietic Cell Transplantation Recipients. Journal of pediatric hematology/oncology
|
|
44(2): e469–e473
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/34054040" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34054040</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report multivariable analysis of assessed risk factor(s)</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Sharma, Neera, Sharma, Lokesh Kumar, Anand, Atul
|
|
et al (2018) Presence, patterns & predictors of hypocortisolism in patients with HIV infection in India. The Indian journal of medical research
|
|
147(2): 142–150
|
|
[<a href="/pmc/articles/PMC5991125/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5991125</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29806602" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29806602</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report multivariable analysis of assessed risk factor(s)</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Sherlock, Mary E, MacDonald, John K, Griffiths, Anne Marie
|
|
et al (2015) Oral budesonide for induction of remission in ulcerative colitis. The Cochrane database of systematic reviews: cd007698
|
|
[<a href="/pmc/articles/PMC9239584/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9239584</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26497719" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26497719</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Shi, Yun, Shen, Min, Zheng, Xuqin
|
|
et al (2021) Immune Checkpoint Inhibitor-Induced Adrenalitis and Primary Adrenal Insufficiency: Systematic Review and Optimal Management. Endocrine practice: official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
|
|
27(2): 165–169
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/33554872" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33554872</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design not relevant to this review protocol</p>
|
|
<p>
|
|
<i>Systematic review of case reports</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Shin, Won Shik, Ahn, Dong Ki, Kim, Myung Jin
|
|
et al (2019) Influence of Epidural Steroid Injection on Adrenal Function. Clinics in orthopedic surgery
|
|
11(2): 183–186
|
|
[<a href="/pmc/articles/PMC6526135/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6526135</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/31156770" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31156770</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design not relevant to this review protocol</p>
|
|
<p>
|
|
<i>retrospective</i>
|
|
</p>
|
|
<p>- Study does not contain a risk factor relevant to this review protocol</p>
|
|
<p>
|
|
<i>spinal surgery</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Simon, Albane, Warszawski, Josiane, Kariyawasam, Dulanjalee
|
|
et al (2011) Association of prenatal and postnatal exposure to lopinavir-ritonavir and adrenal dysfunction among uninfected infants of HIV-infected mothers. JAMA
|
|
306(1): 70–8
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/21730243" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21730243</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Reference standard or method of diagnosis does not match the review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Singhal, Mukul, Sharma, Shrikant, Tom, Nikhil Basil
|
|
et al (2022) A Study of Adrenal Insufficiency in Hemodynamically Stable Patients with Cirrhosis. The Journal of the Association of Physicians of India
|
|
70(4): 11–12 [<a href="https://pubmed.ncbi.nlm.nih.gov/35443330" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35443330</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Conference abstract</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Skoll, Amanda, Boutin, Amelie, Bujold, Emmanuel
|
|
et al (2018) No. 364-Antenatal Corticosteroid Therapy for Improving Neonatal Outcomes. Journal of obstetrics and gynaecology Canada: JOGC = Journal d'obstetrique et gynecologie du Canada: JOGC
|
|
40(9): 1219–1239 [<a href="https://pubmed.ncbi.nlm.nih.gov/30268316" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30268316</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study design not relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Skov, Inge Raadal, Madsen, Hanne, Henriksen, Daniel Pilsgaard
|
|
et al (2022) Low-dose oral corticosteroids in asthma associates with increased morbidity and mortality. The European respiratory journal
|
|
60(3) [<a href="https://pubmed.ncbi.nlm.nih.gov/35144997" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35144997</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Reference standard or method of diagnosis does not match the review protocol</p>
|
|
<p>
|
|
<i>hospital given diagnosis, no further information.</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Skov, M, Main, K M, Sillesen, I B
|
|
et al (2002) Iatrogenic adrenal insufficiency as a side-effect of combined treatment of itraconazole and budesonide. The European respiratory journal
|
|
20(1): 127–33
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/12166560" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12166560</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study does not report multivariable analysis of assessed risk factor(s)</p>
|
|
<p>
|
|
<i>No association data reported.</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Smith, Ryan W, Downey, Kim, Gordon, Michelle
|
|
et al (2012) Prevalence of hypothalamic-pituitary-adrenal axis suppression in children treated for asthma with inhaled corticosteroid. Paediatrics & child health
|
|
17(5): e34–9
|
|
[<a href="/pmc/articles/PMC3381924/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3381924</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/23633903" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23633903</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not contain a risk factor relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Sridhar, Subbiah, Balachandran, Karthik, Nazirudeen, Roshan
|
|
et al (2022) Clinical Profile of Addison's Disease in a Tertiary Care Institute, Southern India - The Changing Landscape. Indian journal of endocrinology and metabolism
|
|
26(1): 50–54
|
|
[<a href="/pmc/articles/PMC9162256/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9162256</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/35662761" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35662761</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study does not report adrenal insufficiency diagnosis or association data</p>
|
|
<p>
|
|
<i>prevalence data only</i>
|
|
</p>
|
|
<p>- Study design not relevant to this review protocol</p>
|
|
<p>
|
|
<i>Retrospective</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Staby, Ida, Krogh, Jesper, Klose, Marianne
|
|
et al (2021) Pituitary function after transsphenoidal surgery including measurement of basal morning cortisol as predictor of adrenal insufficiency. Endocrine connections
|
|
10(7): 750–757
|
|
[<a href="/pmc/articles/PMC8346196/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8346196</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/34137733" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34137733</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study does not contain a risk factor relevant to this review protocol</p>
|
|
<p>- Study does not contain any signs or symptoms relevant to this review protocol</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Tallis, Philippa H, Rushworth, R Louise, Torpy, David J
|
|
et al (2019) Adrenal insufficiency due to bilateral adrenal metastases - A systematic review and meta-analysis. Heliyon
|
|
5(5): e01783
|
|
[<a href="/pmc/articles/PMC6541881/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6541881</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/31193734" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31193734</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Systematic review used as source of primary studies</p>
|
|
<p>
|
|
<i>Included case reports and case series as well as comparative studies.</i>
|
|
</p>
|
|
<p>- Study does not report adrenal insufficiency diagnosis or association data</p>
|
|
<p>
|
|
<i>Prevalence and correlation data only</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Thorp, J A, Jones, A M, Hunt, C
|
|
et al (2001) The effect of multidose antenatal betamethasone on maternal and infant outcomes. American journal of obstetrics and gynecology
|
|
184(2): 196–202 [<a href="https://pubmed.ncbi.nlm.nih.gov/11174502" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11174502</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Reference standard or method of diagnosis does not match the review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Toniutto, Pierluigi, Fabris, Carlo, Fumolo, Elisa
|
|
et al (2008) Prevalence and risk factors for delayed adrenal insufficiency after liver transplantation. Liver transplantation: official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
|
|
14(7): 1014–9
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/18581463" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18581463</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report target condition</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Turmel-Roy, Justine, Bedard, Marc-Antoine, Millette, Maude
|
|
et al (2020) Risk of adrenal insufficiency following intra-articular or periarticular corticosteroid injections among children with chronic arthritis. Journal of pediatric endocrinology & metabolism: JPEM
|
|
33(10): 1257–1263
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/32845867" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32845867</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study design not relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Valentin, Amalie, Borresen, Stina Willemoes, Rix, Marianne
|
|
et al (2020) Adrenal insufficiency in kidney transplant patients during low-dose prednisolone therapy: a cross-sectional case-control study. Nephrology, dialysis, transplantation: official publication of the European Dialysis and Transplant Association European Renal Association
|
|
35(12): 2191–2197
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/31539081" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31539081</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study does not report multivariable analysis of assessed risk factor(s)</p>
|
|
<p>- Study design not relevant to this review protocol</p>
|
|
<p>- Study does not contain a risk factor relevant to this review protocol</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Vassiliadi, Dimitra Argyro, Dimopoulou, Ioanna, Tzanela, Marinella
|
|
et al (2014) Longitudinal assessment of adrenal function in the early and prolonged phases of critical illness in septic patients: relations to cytokine levels and outcome. The Journal of clinical endocrinology and metabolism
|
|
99(12): 4471–80
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/25148237" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25148237</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not contain a risk factor relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Voss, Martin, Batarfi, AbdulAziz, Steidl, Eike
|
|
et al (2019) Adrenal Insufficiency in Patients with Corticosteroid-Refractory Cerebral Radiation Necrosis Treated with Bevacizumab. Journal of clinical medicine
|
|
8(10) [<a href="/pmc/articles/PMC6832264/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6832264</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/31623403" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31623403</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design not relevant to this review protocol</p>
|
|
<p>
|
|
<i>retrospective cohort study</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Wang, Peng-Fei, Chen, Yang, Song, Si-Ying
|
|
et al (2017) Immune-Related Adverse Events Associated with Anti-PD-1/PD-L1 Treatment for Malignancies: A Meta-Analysis. Frontiers in pharmacology
|
|
8: 730
|
|
[<a href="/pmc/articles/PMC5651530/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5651530</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29093678" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29093678</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study does not report adrenal insufficiency diagnosis or association data</p>
|
|
<p>
|
|
<i>Incidence only</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Wang, Wen-Bo, She, Fei, Xie, Li-Fang
|
|
et al (2016) Evaluation of Basal Serum Adrenocorticotropic Hormone and Cortisol Levels and Their Relationship with Nonalcoholic Fatty Liver Disease in Male Patients with Idiopathic Hypogonadotropic Hypogonadism. Chinese medical journal
|
|
129(10): 1147–53
|
|
[<a href="/pmc/articles/PMC4878158/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4878158</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/27174321" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27174321</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Reference standard or method of diagnosis does not match the review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Wang, Xiao, Heinrich, Daniel A, Kunz, Sonja L
|
|
et al (2021) Characteristics of preoperative steroid profiles and glucose metabolism in patients with primary aldosteronism developing adrenal insufficiency after adrenalectomy. Scientific reports
|
|
11(1): 11181
|
|
[<a href="/pmc/articles/PMC8160266/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8160266</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/34045650" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34045650</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not contain a risk factor relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Whelan, Gareth, Sim, Julius, Smith, Benjamin
|
|
et al (2022) Are Corticosteroid Injections Associated With Secondary Adrenal Insufficiency in Adults With Musculoskeletal Pain? A Systematic Review and Meta-analysis of Prospective Studies. Clinical orthopaedics and related research
|
|
480(6): 1061–1074
|
|
[<a href="/pmc/articles/PMC9263464/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9263464</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/35302533" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35302533</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report adrenal insufficiency diagnosis or association data</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Winchester Behr, T, Sonnenblick, M, Nesher, G
|
|
et al (2012) Hyponatraemia in older people as a sign of adrenal insufficiency: a case-control study. Internal medicine journal
|
|
42(3): 306–10
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/20646095" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20646095</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not report adrenal insufficiency diagnosis or association data</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Xu, Hang, Tan, Ping, Zheng, Xiaonan
|
|
et al (2019) Immune-related adverse events following administration of anti-cytotoxic T-lymphocyte-associated protein-4 drugs: a comprehensive systematic review and meta-analysis. Drug design, development, and therapy
|
|
13: 2215–2234
|
|
[<a href="/pmc/articles/PMC6613615/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6613615</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/31308633" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31308633</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Yang, Yaxian, Liu, Jingfang, Yang, Kaili
|
|
et al (2021) Endocrine Adverse Events Caused by Different Types and Different Doses of Immune Checkpoint Inhibitors in the Treatment of Solid Tumors: A Meta-Analysis and Systematic Review. Journal of clinical pharmacology
|
|
61(3): 282–297
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/33345342" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33345342</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Yu, Sherry H, Drucker, Aaron M, Lebwohl, Mark
|
|
et al (2018) A systematic review of the safety and efficacy of systemic corticosteroids in atopic dermatitis. Journal of the American Academy of Dermatology
|
|
78(4): 733–740e11
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/29032119" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29032119</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Yuan, Hang, Mao, Jiaxi, Liu, Cong
|
|
et al (2020) Risk of adverse events in advanced hepatocellular carcinoma with immune checkpoint therapy: A systematic review and meta-analysis. Clinics and research in hepatology and gastroenterology
|
|
44(6): 845–854
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/32307332" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32307332</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Yuen, K.C.J.; Moraitis, A.; Nguyen, D. (2017) Evaluation of evidence of adrenal insufficiency in trials of normocortisolemic patients treated with mifepristone. Journal of the Endocrine Society
|
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1(4): 237–246
|
|
[<a href="/pmc/articles/PMC5686650/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5686650</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29264481" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29264481</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Reference standard or method of diagnosis does not match the review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Zargar, A H, Laway, B A, Masoodi, S R
|
|
et al (2001) A critical evaluation of signs and symptoms in the diagnosis of Addison's diseases. The Journal of the Association of Physicians of India
|
|
49: 523–6
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/11361265" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11361265</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design not relevant to this review protocol</p>
|
|
<p>
|
|
<i>retrospective</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Zhai, Yinghong, Ye, Xiaofei, Hu, Fangyuan
|
|
et al (2019) Endocrine toxicity of immune checkpoint inhibitors: a real-world study leveraging US Food and Drug Administration adverse events reporting system. Journal for immunotherapy of cancer
|
|
7(1): 286
|
|
[<a href="/pmc/articles/PMC6836403/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6836403</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/31694698" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31694698</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study does not report adrenal insufficiency diagnosis or association data</p>
|
|
<p>- Study design not relevant to this review protocol</p>
|
|
<p>
|
|
<i>retrospective</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Zhang, Yixi, Wang, Jingyuan, Hu, Taobo
|
|
et al (2022) Adverse Events of PD-1 or PD-L1 Inhibitors in Triple-Negative Breast Cancer: A Systematic Review and Meta-Analysis. Life (Basel, Switzerland)
|
|
12(12) [<a href="/pmc/articles/PMC9787874/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9787874</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/36556355" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 36556355</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Zhou, Q.; Patel, S.; Hamidi, V. (2019) Clinical features of immune checkpoint inhibitor-related adrenal insufficiency: A retrospective analysis. Journal for ImmunoTherapy of Cancer
|
|
7(supplement1)
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Conference abstract</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Zollner, Ekkehard W, Lombard, Carl, Galal, Ushma
|
|
et al (2011) Hypothalamic-pituitary-adrenal axis suppression in asthmatic children on inhaled and nasal corticosteroids: is the early-morning serum adrenocorticotropic hormone (ACTH) a useful screening test?. Pediatric allergy and immunology: official publication of the European Society of Pediatric Allergy and Immunology
|
|
22(6): 614–20
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/21797928" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21797928</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study does not address this clinical question</p>
|
|
<p>
|
|
<i>Assessment of various diagnostic tests</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Zollner, Ekkehard Werner (2007) Hypothalamic-pituitary-adrenal axis suppression in asthmatic children on inhaled corticosteroids (Part 2)--the risk as determined by gold standard adrenal function tests: a systematic review. Pediatric
|
|
allergy and immunology: official publication of the European Society of Pediatric Allergy and Immunology
|
|
18(6): 469–74 [<a href="https://pubmed.ncbi.nlm.nih.gov/17680905" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17680905</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Zollner, Ekkehard Werner, Lombard, Carl J, Galal, Ushma
|
|
et al (2012) Hypothalamic-pituitary-adrenal axis suppression in asthmatic school children. Pediatrics
|
|
130(6): e1512–9
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/23147980" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23147980</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Reference standard or method of diagnosis does not match the review protocol</td></tr><tr><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Zueger, Thomas, Jordi, Marlen, Laimer, Markus
|
|
et al (2014) Utility of 30- and 60-minute cortisol samples after high-dose synthetic ACTH-1–24 injection in the diagnosis of adrenal insufficiency. Swiss medical weekly
|
|
144: w13987
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/25068461" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25068461</span></a>]
|
|
</td><td headers="hd_h_niceng243er2.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not contain any signs or symptoms relevant to this review protocol</td></tr></tbody></table></div></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
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