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The database, provided by each center and\u00a0composed of Excel\u00ae spreadsheets with requested specific information on leading and supporting teams, was reviewed by two blinded referees and all 9 candidate centers satisfied the overall PTCOE definition, according to referees\u2019 evaluations. To obtain objective numerical criteria, median values for each activity\/parameter were considered as the preferred PTCOE definition target, whereas the low limit of the range was selected as the acceptable target for each respective parameter.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Three dedicated pituitary neurosurgeons are preferred, whereas one dedicated surgeon is acceptable. Moreover, 100 surgical procedures per center per year are preferred, while the results indicated that 50 surgeries per year are acceptable. Acute post-surgery complications, including mortality and readmission rates, should preferably be negligible or nonexistent, but acceptable criterion is a rate lower than 10% of patients with complications requiring readmission within 30\u00a0days after surgery. Four endocrinologists devoted to pituitary diseases are requested in a PTCOE and the total population of patients followed in a PTCOE should not be less than 850. It appears acceptable that at least one dedicated\/expert in pituitary diseases is present in neuroradiology, pathology, and ophthalmology groups, whereas at least two expert radiation oncologists are needed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This is, to our knowledge, the first study to survey and evaluate the activity of a relevant number of high-volume centers in the pituitary field. This effort, internally validated by ad hoc reviewers, allowed for transformation of previously formulated theoretical criteria for the definition of a PTCOE to precise numerical definitions based on real-life evidence. The application of a derived synopsis of criteria could be used by independent bodies for accreditation of pituitary centers as PTCOEs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11102-023-01345-0","type":"journal-article","created":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T12:04:21Z","timestamp":1693224261000},"page":"583-596","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":64,"title":["Pilot study to define criteria for Pituitary Tumors Centers of Excellence (PTCOE): results of an audit of leading international centers"],"prefix":"10.1007","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6783-3398","authenticated-orcid":false,"given":"A.","family":"Giustina","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6569-8142","authenticated-orcid":false,"given":"M. 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Giustina is Consultant for Ipsen, Pfizer, Recordati and Takeda and received Research Grants to Institutions from Abiogen, Pfizer and Takeda. M.M. Uygur received a Grant from Pfizer. S. Frara received consultancy and speaker fees from Ipsen, Pfizer, Novartis and Recordati. A.J. van der Lely received consultancy and\/or speakers\u2019 fees from Amoly Pharma SA, Dexel, Cambian, Crinetics, Ipsen and Pfizer. S. Melmed is a Consultant for Ionis, Ipsen and NovoNordisk and receives a Research Grant from Recordati. A. Barkan, F.F. Casanueva, P. Chanson, P. Freda, M. Gadelha, S. Lamberts, U.B. Kaiser, L.B. Nachtigall, V. Popovic, M. Reincke, C. Strasburger, J.A.H. Wass have no conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Ethical approval is not required for this study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}