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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Clinical judgment to estimate pretest probability in the diagnosis of Cushing's syndrome under a Bayesian perspective

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Author(s):
Cipoli, Daniel E. [1] ; Martinez, Edson Z. [2] ; de Castro, Margaret [3] ; Moreira, Ayrton C. [4]
Total Authors: 4
Affiliation:
[1] Univ Sao Paulo. Dept Med
[2] Univ Sao Paulo. Dept Social Med
[3] Univ Sao Paulo. Dept Med
[4] Univ Sao Paulo. Dept Med
Total Affiliations: 4
Document type: Journal article
Source: Arquivos Brasileiros de Endocrinologia e Metabologia; v. 56, n. 9, p. 633-637, DEC 2012.
Web of Science Citations: 6
Abstract

OBJECTIVE: To estimate the pretest probability of Cushing's syndrome (CS) diagnosis by a Bayesian approach using intuitive clinical judgment. MATERIALS AND METHODS: Physicians were requested, in seven endocrinology meetings, to answer three questions: "Based on your personal expertise, after obtaining clinical history and physical examination, without using laboratorial tests, what is your probability of diagnosing Cushing's Syndrome?"; "For how long have you been practicing Endocrinology?"; and "Where do you work?". A Bayesian beta regression, using the WinBugs software was employed. RESULTS: We obtained 294 questionnaires. The mean pretest probability of CS diagnosis was 51.6% (95%CI: 48.7-54.3). The probability was directly related to experience in endocrinology, but not with the place of work. CONCLUSION: Pretest probability of CS diagnosis was estimated using a Bayesian methodology. Although pretest likelihood can be context-dependent, experience based on years of practice may help the practitioner to diagnosis CS. Arq Bras Endocrinol Metab. 2012;56(9):633-7 (AU)