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María Dolores Rodríguez Arnao Pediatric Endocrinology Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain

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Amparo Rodríguez Sánchez Pediatric Endocrinology Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain

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Ignacio Díez López Hospital Universitario Araba, Araba/Alava, Spain

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Joaquín Ramírez Fernández Hospital Universitario Príncipe de Asturias, Oviedo, Spain

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Jose Antonio Bermúdez de la Vega Centro Nuevas Tecnologias, Sevilla, Spain

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Diego Yeste Fernández Hospital Vall d’Hebrón, Barcelona, Spain

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María Chueca Guindulain Complejo Hospitalario de Navarra, Pamplona, Spain

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Raquel Corripio Collado Corporació Sanitària Parc Taulí, Sabadell, Barcelona, Spain

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Jacobo Pérez Sánchez Corporació Sanitària Parc Taulí, Sabadell, Barcelona, Spain

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Ana Fernández González Merck S.L.U., Madrid, Spain

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ECOS Spain Study Collaborative Investigator Group
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, to provide an e-health tool to patients ( 13 ). Despite this term has evolved in the last decade, e-health is defined by the World Health Organization (WHO) as ‘the use of information and communication technologies for health’ ( 14 ). Since easypod

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Amir H Zamanipoor Najafabadi Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
Department of Medicine, Division of Endocrinology and Centre for Endocrine Tumors, Leiden University Medical Centre, Leiden, The Netherlands
Department of Neurosurgery, University Neurosurgical Centre Holland (UNCH), Leiden University Medical Centre, Haaglanden Medical Centre and Haga Teaching Hospitals, Leiden and The Hague, The Netherlands

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Merel van der Meulen Department of Medicine, Division of Endocrinology and Centre for Endocrine Tumors, Leiden University Medical Centre, Leiden, The Netherlands

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Ana Luisa Priego Zurita Department of Medicine, Division of Endocrinology and Centre for Endocrine Tumors, Leiden University Medical Centre, Leiden, The Netherlands

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S Faisal Ahmed Chair of Work Package of E-Health & ICT of Endo-ERN, Developmental Endocrinology Research Group, School of Medicine, Dentistry & Nursing, University of Glasgow and Office for Rare Conditions, Royal Hospital for Children & Queen Elizabeth University Hospital, Glasgow, UK

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Wouter R van Furth Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands

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Evangelia Charmandari Pediatric Chair Main Thematic Group 6 Pituitary of Endo-ERN, Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, Athens, Greece

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Olaf Hiort Pediatric Chair and Deputy Coordinator of Endo-ERN, Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, University of Lübeck, Lübeck, Germany

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Alberto M Pereira Adult Chair and Coordinator of Endo-ERN, Department of Endocrinology and Metabolism, Amsterdam University Medical Center, Amsterdam, The Netherlands

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Mehul Dattani London Centre for Pediatric Endocrinology and Diabetes at Great Ormond Street Children's Hospital and University College London Hospitals, London, UK

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Diana Vitali SOD ITALIA (Italian Organization for Septo Optic Dysplasia and other Neuroendocrine Disorders), European Patient Advocacy Group, Rome, Italy

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Johan P de Graaf Dutch Pituitary Foundation, European Patient Advocacy Group, Nijkerk, The Netherlands

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Nienke R Biermasz Adult Chair Main Thematic Group 6 Pituitary of Endo-ERN, Department of Medicine, Division of Endocrinology and Centre for Endocrine Tumors, Leiden University Medical Centre, Leiden, The Netherlands

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Objective

The European Reference Network on Rare Endocrine Conditions (Endo-ERN) aims to organize high-quality healthcare throughout Europe, including care for pituitary adenoma patients. As surgery is the mainstay of treatment, we aimed to describe the current surgical practice and published surgical outcomes of pituitary adenoma within Endo-ERN.

Design and Methods

Systematic review and meta-analysis of studies reporting surgical outcomes of pituitary adenoma patients within Endo-ERN MTG6 pituitary reference centers between 2010 and 2019. A survey was completed by reference centers on their current surgical practice.

Results

A total of 18 out of 43 (42%) reference centers located in 7 of the 20 (35%) MTG6-represented countries published 48 articles. Remission rates were 50% (95% CI: 42–59) for patients with acromegaly, 68% (95% CI: 60–75) for Cushing’s disease, and 53% (95% CI: 39–66%) for prolactinoma. Gross total resection was achieved in 49% (95% CI: 37–61%) of patients and visual improvement in 78% (95% CI: 68–87). Mortality, hemorrhage, and carotid injury occurred in less than 1% of patients. New-onset hypopituitarism occurred in 16% (95% CI: 11–23), transient diabetes insipidus in 12% (95% CI: 6–21), permanent diabetes insipidus in 4% (95% CI: 3–6), syndrome of inappropriate secretion of antidiuretic hormone (SIADH) in 9% (95% CI: 5–14), severe epistaxis in 2% (95% CI: 0–4), and cerebrospinal fluid leak in 4% (95% CI: 2–6). Thirty-five (81%) centers completed the survey: 54% were operated endoscopically and 57% were together with an ENT surgeon.

Conclusion

The results of this study could be used as a first benchmark for the outcomes of pituitary adenoma surgery within Endo-ERN. However, the heterogeneity between studies in the reporting of outcomes hampers comparability and warrants outcome collection through registries.

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Ekaterina Koledova Biopharma Global Medical Affairs, General Medicine and Endocrinology, Merck KGaA, Darmstadt, Germany

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George Stoyanov Biopharma Global Medical Affairs, General Medicine and Endocrinology, Merck KGaA, Darmstadt, Germany

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Leroy Ovbude Business & Decision Life Sciences, Brussels, Woluwe-Saint-Lambert, Belgium

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Peter S W Davies Children’s Nutrition Research Centre, Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia

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Design Excellence Awards ( 13 ) and received the 2017 Pharmaceutical Market Excellence Awards innovation for e-Health award ( 14 ). Easypod was developed to improve patient convenience during long-term GH treatment ( 15 ) and to provide accurate, unbiased

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Po-Chung Cheng Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan

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Chia-Hung Kao Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan

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.0000000000012962 ) 17 Bashshur RL Shannon GW Smith BR Woodward MA . The empirical evidence for the telemedicine intervention in diabetes management . Telemedicine Journal and e-Health 2015 21 321 – 354 . ( https://doi.org/10.1089/tmj.2015

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Ram P Narayanan Vascular Research Group, School of Community Based Medicine, Centre for Integrated Genomic Medical Research, Cardiovascular Research Group, Endocrinology and Diabetes, Salford R&D, Department of Endocrinology and Diabetes, Faculty of Medical, Human and Life Sciences, The University of Manchester, Manchester M13 9PT, UK

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Bo Fu Vascular Research Group, School of Community Based Medicine, Centre for Integrated Genomic Medical Research, Cardiovascular Research Group, Endocrinology and Diabetes, Salford R&D, Department of Endocrinology and Diabetes, Faculty of Medical, Human and Life Sciences, The University of Manchester, Manchester M13 9PT, UK

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Adrian H Heald Vascular Research Group, School of Community Based Medicine, Centre for Integrated Genomic Medical Research, Cardiovascular Research Group, Endocrinology and Diabetes, Salford R&D, Department of Endocrinology and Diabetes, Faculty of Medical, Human and Life Sciences, The University of Manchester, Manchester M13 9PT, UK

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Kirk W Siddals Vascular Research Group, School of Community Based Medicine, Centre for Integrated Genomic Medical Research, Cardiovascular Research Group, Endocrinology and Diabetes, Salford R&D, Department of Endocrinology and Diabetes, Faculty of Medical, Human and Life Sciences, The University of Manchester, Manchester M13 9PT, UK

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Robert L Oliver Vascular Research Group, School of Community Based Medicine, Centre for Integrated Genomic Medical Research, Cardiovascular Research Group, Endocrinology and Diabetes, Salford R&D, Department of Endocrinology and Diabetes, Faculty of Medical, Human and Life Sciences, The University of Manchester, Manchester M13 9PT, UK

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Julie E Hudson Vascular Research Group, School of Community Based Medicine, Centre for Integrated Genomic Medical Research, Cardiovascular Research Group, Endocrinology and Diabetes, Salford R&D, Department of Endocrinology and Diabetes, Faculty of Medical, Human and Life Sciences, The University of Manchester, Manchester M13 9PT, UK

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Antony Payton Vascular Research Group, School of Community Based Medicine, Centre for Integrated Genomic Medical Research, Cardiovascular Research Group, Endocrinology and Diabetes, Salford R&D, Department of Endocrinology and Diabetes, Faculty of Medical, Human and Life Sciences, The University of Manchester, Manchester M13 9PT, UK

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Simon G Anderson Vascular Research Group, School of Community Based Medicine, Centre for Integrated Genomic Medical Research, Cardiovascular Research Group, Endocrinology and Diabetes, Salford R&D, Department of Endocrinology and Diabetes, Faculty of Medical, Human and Life Sciences, The University of Manchester, Manchester M13 9PT, UK

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Anne White Vascular Research Group, School of Community Based Medicine, Centre for Integrated Genomic Medical Research, Cardiovascular Research Group, Endocrinology and Diabetes, Salford R&D, Department of Endocrinology and Diabetes, Faculty of Medical, Human and Life Sciences, The University of Manchester, Manchester M13 9PT, UK

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William E R Ollier Vascular Research Group, School of Community Based Medicine, Centre for Integrated Genomic Medical Research, Cardiovascular Research Group, Endocrinology and Diabetes, Salford R&D, Department of Endocrinology and Diabetes, Faculty of Medical, Human and Life Sciences, The University of Manchester, Manchester M13 9PT, UK
Vascular Research Group, School of Community Based Medicine, Centre for Integrated Genomic Medical Research, Cardiovascular Research Group, Endocrinology and Diabetes, Salford R&D, Department of Endocrinology and Diabetes, Faculty of Medical, Human and Life Sciences, The University of Manchester, Manchester M13 9PT, UK

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J Martin Gibson Vascular Research Group, School of Community Based Medicine, Centre for Integrated Genomic Medical Research, Cardiovascular Research Group, Endocrinology and Diabetes, Salford R&D, Department of Endocrinology and Diabetes, Faculty of Medical, Human and Life Sciences, The University of Manchester, Manchester M13 9PT, UK
Vascular Research Group, School of Community Based Medicine, Centre for Integrated Genomic Medical Research, Cardiovascular Research Group, Endocrinology and Diabetes, Salford R&D, Department of Endocrinology and Diabetes, Faculty of Medical, Human and Life Sciences, The University of Manchester, Manchester M13 9PT, UK

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The authors wish to acknowledge the assistance of the Manchester Academic Health Science Centre and the Salford Royal Hospital NHS Foundation Trust for facilitating this study and North West e-health, Manchester for assistance with data extraction

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Violeta Iotova Endo-ERN Work Package ‘Education & Training’ Paediatric Chair, Department of Pediatrics, Medical University of Varna, Varna, Bulgaria

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Camilla Schalin-Jäntti Endo-ERN Work Package ‘Education & Training’ Adult Chair, Endocrinology, Abdominal Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

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Petra Bruegmann Endo-ERN Work Package ‘Education & Training’ European Patient Advocacy Group (ePAG) representative co-chair, Endo-ERN, Leiden, The Netherlands

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Manuela Broesamle Endo-ERN Work Package ‘Education & Training’ European Patient Advocacy Group (ePAG) representative co-chair, Endo-ERN, Leiden, The Netherlands

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Natasa Bratina Department of Endocrinology, Diabetes and Metabolic Disorders, University Medical Center, University Childrens Hospital, Ljubljana, Slovenia

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Vallo Tillmann Children’s Clinic, Tartu University Hospital, Tartu, Estonia

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Olaf Hiort Endo-ERN, Division of Paediatric Endocrinology and Diabetes, Department of Paediatric and Adolescent Medicine, University of Lübeck, Lübeck, Germany

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Alberto M Pereira Endo-ERN, Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, the Netherlands

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and an adult patient advocacy group (ePAGs) representative. The specific activities that the Network should fulfill for the initial 5 years of existence were defined ‘horizontally’ in Work Packages (WPs) – WP1: Education and Training, WP2: E-health and

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Eeva M Ryhänen
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Ilkka Heiskanen
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Harri Sintonen Endocrinology, Department of Public Health, Group Administration, Helsinki University Hospital, University of Eastern Finland, Abdominal Center, University of Helsinki and Helsinki University Hospital, Post Box 340, FI-00290 Helsinki, Finland

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Matti J Välimäki
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Risto P Roine Endocrinology, Department of Public Health, Group Administration, Helsinki University Hospital, University of Eastern Finland, Abdominal Center, University of Helsinki and Helsinki University Hospital, Post Box 340, FI-00290 Helsinki, Finland
Endocrinology, Department of Public Health, Group Administration, Helsinki University Hospital, University of Eastern Finland, Abdominal Center, University of Helsinki and Helsinki University Hospital, Post Box 340, FI-00290 Helsinki, Finland
Endocrinology, Department of Public Health, Group Administration, Helsinki University Hospital, University of Eastern Finland, Abdominal Center, University of Helsinki and Helsinki University Hospital, Post Box 340, FI-00290 Helsinki, Finland

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Camilla Schalin-Jäntti
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– 1118, discussion 1118-1119 . ( doi:10.1016/j.surg.2010.09.008 ). 31 Andersson LB Marcusson J Wressle E . Health-related quality of life and activities of daily living in 85-year-olds in Sweden . Health & Social Care in the Community 2014 22

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Shanhong Li Department of Medical Informatics, Medical School of Nantong University, Nantong, Jiangsu Province, China

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Jincheng Tao Department of Medical Informatics, Medical School of Nantong University, Nantong, Jiangsu Province, China
Department of Neurosurgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China

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Jie Tang Department of Medical Informatics, Medical School of Nantong University, Nantong, Jiangsu Province, China

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Yanting Chu Department of Medical Informatics, Medical School of Nantong University, Nantong, Jiangsu Province, China

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Huiqun Wu Department of Medical Informatics, Medical School of Nantong University, Nantong, Jiangsu Province, China

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research and care. Sensors (Basel) 2019 19 3319 . ( https://doi.org/10.3390/s19153319 ) 53 BinDhim NF Hawkey A & Trevena L . A systematic review of quality assessment methods for smartphone health apps. Telemedicine Journal and e-Health 2015 21

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