{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T05:34:44Z","timestamp":1790832884754,"version":"4.1.0"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,1,9]],"date-time":"2020-01-09T00:00:00Z","timestamp":1578528000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Primary aldosteronism (PA) is the most frequent cause of secondary hypertension. In Southern Thailand, the aldosterone\u2010renin ratio (ARR) is only available within a small number of tertiary centres, necessitating need for a simple clinical assessment to determine the requirement for ARR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aimed to identify predictive factors for the diagnosis of PA and generate a predictive scoring system (PSS) for use in screening and diagnosis of PA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p>A total of 420 patients aged &gt;15\u00a0years with paired plasma aldosterone concentration and plasma renin activity values allowing calculation of ARR were identified from the electronic hospital database between 2011 and 2016.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The overall prevalence of PA was 16.7% (range; adrenal incidentaloma 5.6% to hypokalaemia 30%). Predictive factors for diagnosis of PA were as follows: age &lt;60\u00a0years, BMI\u00a0&lt;\u00a025\u00a0kg\/m<jats:sup>2<\/jats:sup>, presence of diabetes, \u22653 antihypertensive agents, serum sodium\u00a0\u2265\u00a0141\u00a0mmol\/L and serum potassium\u00a0&lt;\u00a03.5\u00a0mmol\/L. A predictive scoring system (PSS) (range \u22122 to 13) was generated by the coefficients of the variables with ROC curve AUC 0.87 [95% CI: 0.83\u20100.91]. Using the PSS, a total score &lt;4 provided a robust negative predictive value (sensitivity, 0.97; specificity, 0.48; NPV, 0.99; PPV, 0.27) for PA. In patients at high risk of PA (PAC\u00a0&gt;\u00a015\u00a0ng\/dL and PRA\u00a0&lt;\u00a01.0\u00a0ng\/mL\/hr), a PSS score\u00a0&gt;\u00a09 had specificity and PPV of 100%, essentially confirming PA in these individuals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The proposed PSS for PA will enable more focused and cost\u2010effective use of ARR screening and confirmatory testing. In our cohort, 40% and 42% of patients would not require ARR screening or confirmatory tests, respectively.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.14142","type":"journal-article","created":{"date-parts":[[2019,12,16]],"date-time":"2019-12-16T09:45:19Z","timestamp":1576489519000},"page":"196-205","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Construction of a predictive scoring system as a guide to screening and confirmation of the diagnosis of primary aldosteronism"],"prefix":"10.1111","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5076-4450","authenticated-orcid":false,"given":"Noppadol","family":"Kietsiriroje","sequence":"first","affiliation":[{"name":"Division of Endocrinology and Metabolism Department of Internal Medicine Faculty of Medicine Prince of Songkla University Hat Yai 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