{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T15:52:36Z","timestamp":1791042756962,"version":"4.1.0"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T00:00:00Z","timestamp":1790985600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T00:00:00Z","timestamp":1790985600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Arch Otorhinolaryngol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Intraoperative parathyroid hormone (IOPTH) monitoring supports focused parathyroidectomy by confirming biochemical response after gland excision, but standard assays may be logistically burdensome. Whole-blood point-of-care (POC) assays offer faster turnaround but may have reduced sensitivity. We compared a whole-blood POC IOPTH assay (NBCL CONNECT) with a standard laboratory assay and evaluated candidate IOPTH criteria and sampling timepoints.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a single-centre retrospective cohort study of consecutive patients undergoing parathyroidectomy for primary hyperparathyroidism with IOPTH monitoring over an 18-month period. Paired samples were collected pre-incision, pre-excision, and approximately 5 and 10\u00a0min post-excision and analysed using NBCL CONNECT assay performed in theatre, and the laboratory PTH assay performed in the hospital laboratory. The reference outcome was early biochemical success defined by postoperative calcium normalisation and appropriate postoperative PTH profile during the postoperative period. Diagnostic accuracy (sensitivity, specificity, PPV, NPV) was assessed for prespecified IOPTH criteria at 5 and 10\u00a0min.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 103 patients, early biochemical success was achieved in 98 (95.1%). Across evaluated criteria, the laboratory assay demonstrated higher overall diagnostic performance than NBCL CONNECT at both 5 and 10\u00a0min (Online Resource 1). For NBCL CONNECT, the prespecified 10-minute criterion (&gt;\u200950% PTH decline from the lower pre-excision value) yielded a PPV of 96.9% (95% CI 89.3\u201399.6) and NPV of 51.4% (95% CI 34.0\u201368.6). ROC analyses showed consistently higher AUCs for the laboratory assay; differences were less marked at 10\u00a0min.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Whole-blood POC IOPTH using NBCL CONNECT provides a practical intraoperative adjunct but has limited negative predictive value. A 10-minute sample interpreted as a\u2009&gt;\u200950% decline from the lower pre-excision value maximised diagnostic performance within this cohort, supporting a rule-in role for confirming adequacy of excision while cautioning against reliance on a negative POC result alone.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00405-026-10642-w","type":"journal-article","created":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T02:31:15Z","timestamp":1790994675000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Whole-blood versus laboratory intraoperative parathyroid hormone assays and optimisation of intraoperative monitoring during parathyroidectomy: A retrospective cohort study"],"prefix":"10.1007","author":[{"given":"O","family":"O\u2019Connor","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Senbeto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Balasubramanian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,3]]},"reference":[{"issue":"1","key":"10642_CR1","doi-asserted-by":"publisher","first-page":"21","DOI":"10.5005\/jpjournals-10002-1016","volume":"2","author":"MA Guerrero","year":"2010","unstructured":"Guerrero MA, Clark OH (2010) A comprehensive review of intraoperative parathyroid hormone monitoring. World J Endocr Surg 2(1):21\u201327. https:\/\/doi.org\/10.5005\/jpjournals-10002-1016","journal-title":"World J Endocr Surg"},{"issue":"12","key":"10642_CR2","first-page":"807","volume":"38","author":"S Fraser","year":"2020","unstructured":"Fraser S (2020) Surgical management of parathyroid disease. Endocr Surg 38(12):807\u2013813","journal-title":"Endocr Surg"},{"key":"10642_CR3","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1186\/1471-2482-13-36","volume":"13","author":"PG Calo","year":"2013","unstructured":"Calo PG, Pisano G, Loi G, Medas F, Barca L, Atzeni M et al (2013) Intraoperative parathyroid hormone assay during focused parathyroidectomy: the importance of 20 minutes measurement. BMC Surg 13:36. https:\/\/doi.org\/10.1186\/1471-2482-13-36","journal-title":"BMC Surg"},{"issue":"2","key":"10642_CR4","doi-asserted-by":"publisher","first-page":"69","DOI":"10.4174\/astr.2018.94.2.69","volume":"94","author":"SH Paek","year":"2018","unstructured":"Paek SH, Kim SJ, Choi JY, Lee KE (2018) Clinical usefulness of intraoperative parathyroid hormone monitoring for primary hyperparathyroidism. Ann Surg Treat Res 94(2):69\u201373. https:\/\/doi.org\/10.4174\/astr.2018.94.2.69","journal-title":"Ann Surg Treat Res"},{"issue":"3","key":"10642_CR5","doi-asserted-by":"publisher","first-page":"585","DOI":"10.1097\/SLA.0b013e318208fed9","volume":"253","author":"R Udelsman","year":"2011","unstructured":"Udelsman R, Lin Z, Donovan P (2011) The superiority of minimally invasive parathyroidectomy based on 1650 consecutive patients with primary hyperparathyroidism. Ann Surg 253(3):585\u2013591. https:\/\/doi.org\/10.1097\/SLA.0b013e318208fed9","journal-title":"Ann Surg"},{"issue":"7","key":"10642_CR6","doi-asserted-by":"publisher","first-page":"516","DOI":"10.1308\/rcsann.2016.0201","volume":"98","author":"J Helbrow","year":"2016","unstructured":"Helbrow J, Owais AE, Sidwell AG, Frank LM, Lucarotti ME (2016) The use of intraoperative parathyroid hormone monitoring in minimally invasive parathyroid surgery. Ann R Coll Surg Engl 98(7):516\u2013519. https:\/\/doi.org\/10.1308\/rcsann.2016.0201","journal-title":"Ann R Coll Surg Engl"},{"issue":"4","key":"10642_CR7","doi-asserted-by":"publisher","first-page":"512","DOI":"10.4103\/2230-8210.183451","volume":"20","author":"CG Nair","year":"2016","unstructured":"Nair CG, Babu MJ, Jacob P, Menon R, Mathew J (2016) Is intraoperative parathyroid hormone monitoring necessary in symptomatic primary hyperparathyroidism with concordant imaging? Indian J Endocrinol Metab 20(4):512\u2013516. https:\/\/doi.org\/10.4103\/2230-8210.183451","journal-title":"Indian J Endocrinol Metab"},{"issue":"1","key":"10642_CR8","doi-asserted-by":"publisher","first-page":"9","DOI":"10.5152\/UCD.2014.2572","volume":"31","author":"A Soyder","year":"2015","unstructured":"Soyder A, Unubol M, Omurlu IK, Guney E, Ozbas S (2015) Minimally invasive parathyroidectomy without using intraoperative parathyroid hormone monitoring or gamma probe. Ulus Cerrahi Derg 31(1):9\u201314. https:\/\/doi.org\/10.5152\/UCD.2014.2572","journal-title":"Ulus Cerrahi Derg"},{"key":"10642_CR9","doi-asserted-by":"publisher","first-page":"1198894","DOI":"10.3389\/fendo.2023.1198894","volume":"14","author":"R Mohan Kumar","year":"2023","unstructured":"Mohan Kumar R et al (2023) Findings of pilot study following the implementation of point of care intraoperative PTH assay using whole blood during surgery for primary hyperparathyroidism. Front Endocrinol 14:1198894. https:\/\/doi.org\/10.3389\/fendo.2023.1198894","journal-title":"Front Endocrinol"},{"issue":"5","key":"10642_CR10","doi-asserted-by":"publisher","first-page":"znae101","DOI":"10.1093\/bjs\/znae101","volume":"111","author":"TR Kurzawinski","year":"2024","unstructured":"Kurzawinski TR et al (2024) Ultrafast intraoperative parathyroid hormone monitoring system: prospective, multicentre, clinical validity study. Br J Surg 111(5):znae101. https:\/\/doi.org\/10.1093\/bjs\/znae101","journal-title":"Br J Surg"},{"key":"10642_CR11","doi-asserted-by":"publisher","unstructured":"Carneiro DM et al (2003) Comparison of intraoperative iPTH assay (QPTH) criteria in guiding parathyroidectomy: Which criterion is the most accurate? 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Surg 142(3):398\u2013404. https:\/\/doi.org\/10.1016\/j.surg.2007.05.004","journal-title":"Surg"},{"issue":"11","key":"10642_CR16","doi-asserted-by":"publisher","first-page":"2293","DOI":"10.1002\/jbmr.4677","volume":"37","author":"JP Bilezikian","year":"2022","unstructured":"Bilezikian JP et al (2022) International Workshop on Primary Hyperparathyroidism. Evaluation and Management of Primary Hyperparathyroidism: Summary Statement and Guidelines from the Fifth International Workshop. 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