Academic Journal
Assessment, External Verification and Modification of Models in Diagnosing Primary Aldosteronism Subtypes.
| Τίτλος: | Assessment, External Verification and Modification of Models in Diagnosing Primary Aldosteronism Subtypes. |
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| Συγγραφείς: | Jing Y; Department of Endocrinology, Xi'an No.3 Hospital, The Affiliated Hospital of Northwest University, Xi'an, China.; Department of Endocrinology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China., Zhang Y; Department of Endocrinology and Second Department of Geriatrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China., Guo H; Department of Endocrinology and Second Department of Geriatrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China., Hou R; Department of Endocrinology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China., Xu J; Department of Endocrinology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China., Wang J; Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, China., Pan X; Xi'an Jiaotong University, Xi'an, China., Niu X; Xi'an Jiaotong University, Xi'an, China., Song L; Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, China., Huang L; Department of Medical Ultrasound, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China., Zhang J; Xi'an Jiaotong University, Xi'an, China., Jia F; Department of Endocrinology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China., Sun B; Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, China.; Postdoctoral Research Station, School of Nursing, Health Science Center, Xi'an Jiaotong University, Xi'an, China., Wang N; Department of Endocrinology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.; Postdoctoral Research Station, School of Nursing, Health Science Center, Xi'an Jiaotong University, Xi'an, China. |
| Πηγή: | Journal of clinical hypertension (Greenwich, Conn.) [J Clin Hypertens (Greenwich)] 2026 Sep; Vol. 28 (9), pp. e70340. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Wiley Periodicals Inc Country of Publication: United States NLM ID: 100888554 Publication Model: Print Cited Medium: Internet ISSN: 1751-7176 (Electronic) Linking ISSN: 15246175 NLM ISO Abbreviation: J Clin Hypertens (Greenwich) Subsets: MEDLINE |
| Imprint Name(s): | Publication: Original Publication: Greenwich, CT : Le Jacq Communication, Inc., c1999- |
| Ιατρικοί όροι (MeSH): | Hyperaldosteronism*/diagnosis , Hyperaldosteronism*/classification , Hyperaldosteronism*/blood , Aldosterone*/blood, Humans ; Sensitivity and Specificity ; Reproducibility of Results |
| Περίληψη: | Diagnostic models are used to identify primary aldosteronism (PA) subtypes, including unilateral primary aldosteronism (UPA) and bilateral primary aldosteronism (BPA), only UPA could be treated through surgery. PA diagnostic models were screened from the NCBI, Embase, and Web of Science databases and assessed using the Prediction Model Risk of Bias Assessment Tool (PROBAST). External validation of these models was conducted using our Cohort. Models with high specificity were selected as the foundation for further modification. Based on the data from Cohort A and Cohort B, a new diagnostic model was developed by incorporating plasma aldosterone concentration (PAC) changes during postural stimulation testing (PST) as a variable. Eleven UPA diagnostic models were selected, with the concordance index (C index) varying from 0.745 to 0.938. Among these, three models conducted external validation, and one conducted internal validation. All models were identified as having a high risk of bias by using PROBAST. During external validations, the value of the C-index ranged from 0.600 to 0.708. In the modified diagnostic model, the PAC change was set at ≤ -23.0% during PST. This adjustment increased specificity from 94.5% to 98.7% in cohort A, while specificity from cohort B increased to 96.3%. The performance of all included models needs improvement. Adding a PAC change of ≤ -23.0% during PST as an additional variable to the published UPA diagnostic models improved their specificity and may broaden the models' applicability across different populations. (© 2026 The Author(s). The Journal of Clinical Hypertension published by Wiley Periodicals LLC.) |
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| Grant Information: | 2023-JC-QN-0946 The Natural Science Foundation of Shaanxi Province; YXJLRH2022029 The Basic and Clinical Research Project of Xi'an jiaotong University; M075 The IIT Clinical Research Fund of the second Hosptial of Xi'an jiaotong University; Y(QN)202307 The Research Fund of Second Affiliated Hosptial of Xi'an jiaotong University; 2020SF-248 The Key Research Project of Shaanxi Province; 2024JC-YBQN-0906 The Basic Research Projrct of Natural Science of Shaanxi Province; The National Natural Science Foundation of China |
| Contributed Indexing: | Keywords: aldosterone; cohort; external validation; external validity; hyperaldosteronism; internal medicine; internal validation; medicine; primary aldosteronism; validation cohort |
| Substance Nomenclature: | 4964P6T9RB (Aldosterone) |
| Entry Date(s): | Date Created: 20260925 Date Completed: 20260925 Latest Revision: 20260928 |
| Update Code: | 20260928 |
| PubMed Central ID: | PMC13614488 |
| DOI: | 10.1111/jch.70340 |
| PMID: | 42789381 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1751-7176 |
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| DOI: | 10.1111/jch.70340 |