CONTEXT: The diagnosis of @entity1887 is clinically challenging and often requires ACTH stimulation tests. OBJECTIVE: To determine the diagnostic accuracy of the high- (250 mcg) and low- (1 mcg) dose ACTH stimulation tests in the diagnosis of @entity1887 . METHODS: We searched six databases through February 2014. Pairs of independent reviewers selected studies and appraised the risk of bias. Diagnostic association measures were pooled across studies using a bivariate model. DATA SYNTHESIS: For secondary @entity1887 , we included 30 studies enrolling 1209 adults and 228 @entity1 . High- and low-dose ACTH stimulation tests had similar diagnostic accuracy in adults and @entity1 using different peak serum @entity701 cutoffs. In general, both tests had low sensitivity and high specificity resulting in reasonable likelihood ratios for a positive test (adults: high dose, 9.1; low dose, 5.9; @entity1 : high dose, 43.5; low dose, 7.7), but a fairly suboptimal likelihood ratio for a negative test (adults: high dose, 0.39; low dose, 0.19; @entity1 : high dose, 0.65; low dose, 0.34). For primary @entity1887 , we included five studies enrolling 100 @entity1 . Data were only available to estimate the sensitivity of high dose ACTH stimulation test (92%; 95% confidence interval, 81-97%). CONCLUSION: Both high- and low-dose ACTH stimulation tests had similar diagnostic accuracy. Both tests are adequate to rule in, but not rule out, secondary @entity1887 . Our confidence in these estimates is low to moderate because of the likely risk of bias, heterogeneity, and imprecision.

ACTH Stimulation Tests for the Diagnosis of XXXX : Systematic Review and Meta-Analysis.

@entity1 :: ('9606', 'Species') :: ['children', 'patients'] @entity1887 :: ('MESH:D000309', 'Disease') :: ['adrenal insufficiency'] @entity701 :: ('MESH:D006854', 'Chemical') :: ['cortisol']
@entity1887 :: (MESH:D000309,Disease) :: ['Adrenal Insufficiency']
