David C. Aron, MD; Nathan S. Ross, MD
To the Editors: In their recent review, Molitch and Russell (1) recommend routine biochemical screening for hormonal hypersecretion in patients with a pituitary "incidentaloma" even in the absence of suggestive clinical evidence. In making this recommendation for cases of microadenomas in particular, they fail to take into account the low prevalence of the conditions (including prolactinoma, Cushing disease, acromegaly) for which the tests screen. Given a specificity of less than 100%, screening tests will have a low positive predictive value for disorders with low prevalence, particularly in asymptomatic persons. For example, the prevalence of prolactinoma, the most common hormone-secreting pituitary
David C. Aron, Nathan S. Ross. Pituitary "Incidentalomas". Ann Intern Med. 1990;113:558–559. doi: 10.7326/0003-4819-113-7-558
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Published: Ann Intern Med. 1990;113(7):558-559.
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