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Giorgio Grani, Livia Lamartina, Vito Cantisani, Marianna Maranghi, Piernatale Lucia and Cosimo Durante

interobserver agreement. For each nodule, the ratings of each reader (together with those recorded during the original examination for nodule size and shape) were elaborated automatically using an in-house algorithm to classify the nodule according to the

Open access

Benjamin Paul Green, Javier Thomas Gonzalez, Kevin Thomas, Emma Stevenson and Penny Louise Sheena Rumbold

measurement error (10, 11) . Quantification of agreement and reproducibility between methods would facilitate appropriate comparisons between studies using venous and capillary blood sampling. This is particularly important given that blood obtained from

Open access

Magaly Zappa, Olivia Hentic, Marie-Pierre Vullierme, Matthieu Lagadec, Maxime Ronot, Philippe Ruszniewski and Valérie Vilgrain

percentage. To our knowledge, there are no published data on the interobserver agreement for this assessment. CT scan, because it enables the exploration of the most common metastatic sites, is the reference technique for initial evaluation and follow-up of

Open access

Federica Saponaro, Alessandro Saba, Sabina Frascarelli, Concetta Prontera, Aldo Clerico, Marco Scalese, Maria Rita Sessa, Filomena Cetani, Simona Borsari, Elena Pardi, Antonella Marvelli, Claudio Marcocci, Claudio Passino and Riccardo Zucchi

interquartile range (IQR – 25° and 75° quartiles) as appropriate. Difference between groups was tested by chi-square test or paired t -test as appropriate. Agreement between LIAISON and HPLC-MS-MS method was measured by concordance correlation coefficient and

Open access

Fabian Eichelmann, Cornelia Weikert, Romina di Giuseppe, Ronald Biemann, Berend Isermann, Matthias B Schulze, Heiner Boeing and Krasimira Aleksandrova

, reliability was also evaluated by inspection of Bland–Altman plots as a recommended complementing procedure to assess the agreement of two measurements for each participant ( 20 ). To evaluate interdependence with the individual characteristics, the ICCs were

Open access

M P Schuijt, C G J Sweep, R van der Steen, A J Olthaar, N M M L Stikkelbroeck, H A Ross and A E van Herwaarden

total testosterone was between 2.2 and 30.5 nmol/L, consistent with our laboratory reference values (10.5–37.0 nmol/L (25)) and free testosterone was measured between 67 and 454 pmol/L ( Fig. 2 ) in agreement with other reports ( 4 , 27 , 28 , 29

Open access

Catarina I Gonçalves, José M Aragüés, Margarida Bastos, Luísa Barros, Nuno Vicente, Davide Carvalho and Manuel C Lemos

likely due to the location of the mutation in the last exon. Four patients had biallelic mutations (either homozygous or compound heterozygous), which is in agreement with the typical autosomal recessive inheritance of GNRHR . However, one patient had

Open access

Marieke S Velema, Evie J M Linssen, Ad R M M Hermus, Hans J M M Groenewoud, Gert-Jan van der Wilt, Antonius E van Herwaarden, Jacques W M Lenders, Henri J L M Timmers and Jaap Deinum


To develop a prediction model to confirm or exclude primary aldosteronism (PA) in patients with an inconclusive salt loading test (SLT).


Diagnosis in patients with a suspicion of PA can be confirmed using an SLT. In case of inconclusive test results the decision about how to manage the patient is usually based on contextual clinical data.


We included a retrospective cohort of 276 patients in the final analysis.


All patients underwent an SLT between 2005 and 2016 in our university medical center. The SLT was inconclusive (post-infusion aldosterone levels 140–280 pmol/L) in 115 patients. An expert panel then used contextual clinical data to diagnose PA in 45 of them. Together with 101 patients with a positive SLT this resulted in a total of 146 patients with PA. A total of 11 variables were used in a multivariable logistic regression analysis. We assessed internal validity by bootstrapping techniques.


The following variables were independently associated with PA: more intense potassium supplementation, lower plasma potassium concentration, lower plasma renin concentration before SLT and higher plasma aldosterone concentration after SLT. The resulting prediction model had a sensitivity of 84.4% and a specificity of 94.3% in patients with an inconclusive SLT. The positive and negative predictive values were 90.5 and 90.4%, respectively.


We developed a prediction model for the diagnosis of PA in patients with an inconclusive SLT that results in a diagnosis that was in high agreement with that of an expert panel.

Open access

Krzysztof C Lewandowski, Justyna Płusajska, Wojciech Horzelski, Ewa Bieniek and Andrzej Lewiński


Though insulin resistance (IR) is common in polycystic ovary syndrome (PCOS), there is no agreement as to what surrogate method of assessment of IR is most reliable.

Subjects and methods

In 478 women with PCOS, we compared methods based on fasting insulin and either fasting glucose (HOMA-IR and QUICKI) or triglycerides (McAuley Index) with IR indices derived from glucose and insulin during OGTT (Belfiore, Matsuda and Stumvoll indices).


There was a strong correlation between IR indices derived from fasting values HOMA-IR/QUICKI, r = −0.999, HOMA-IR/McAuley index, r = −0.849 and between all OGTT-derived IR indices (e.g. r = −0.876, for IRI/Matsuda, r = −0.808, for IRI/Stumvoll, and r = 0.947, for Matsuda/Stumvoll index, P < 0.001 for all), contrasting with a significant (P < 0.001), but highly variable correlation between IR indices derived from fasting vs OGTT-derived variables, ranging from r = −0.881 (HOMA-IR/Matsuda), through r = 0.58, or r = −0.58 (IRI/HOMA-IR, IRI/QUICKI, respectively) to r = 0.41 (QUICKI/Stumvoll), and r = 0.386 for QUICKI/Matsuda indices. Detailed comparison between HOMA-IR and IRI revealed that concordance between HOMA and IRI was poor for HOMA-IR/IRI values above 75th and 90th percentile. For instance, only 53% (70/132) women with HOMA-IR >75th percentile had IRI value also above 75th percentile. There was a significant, but weak correlation of all IR indices with testosterone concentrations.


Significant number of women with PCOS can be classified as being either insulin sensitive or insulin resistant depending on the method applied, as correlation between various IR indices is highly variable. Clinical application of surrogate indices for assessment of IR in PCOS must be therefore viewed with an extreme caution.

Open access

Selina Mäkinen, Yen H Nguyen, Paulina Skrobuk and Heikki A Koistinen

hepatic fat content and may improve insulin resistance in viscerally obese people ( 22 ). Our data on human myotubes are also in agreement with other in vitro studies. The beneficial effect of adding monounsaturated oleate to cells exposed to saturated