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Letters |15 June 1995

The Cushing Syndrome

Peter C. Avgerinos; Gordon B. Cutler Jr.

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TO THE EDITOR:
In his editorial, Orth [1] raises several concerns about our paper [2]. He criticizes our use of cut-off criteria that maintain 100% test specificity. From a clinical standpoint, the rationale for achieving a specificity of nearly 100% is to avoid misclassifying cases of ectopic adrenocorticortropic hormone (ACTH) syndrome as Cushing disease, an error that would lead to inappropriate pituitary surgery.
Second, Dr. Orth suggests that restricting the study to patients whose 24-hour urine collections varied no more than 10% might have yielded different cut-off criteria and different study results. We have reanalyzed the study using coefficients...
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Avgerinos PC, Cutler Jr. GB. The Cushing Syndrome. Ann Intern Med. 1995;122:959–960. doi: 10.7326/0003-4819-122-12-199506150-00013

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Published: Ann Intern Med. 1995;122(12):959-960.

DOI: 10.7326/0003-4819-122-12-199506150-00013

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Print ISSN: 0003-4819 | Online ISSN: 1539-3704

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