{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T02:04:11Z","timestamp":1779933851259,"version":"3.53.1"},"reference-count":8,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2016,9,28]],"date-time":"2016-09-28T00:00:00Z","timestamp":1475020800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Biochem"],"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The Endocrine Society Clinical Practice Guideline on Phaeochomocytoma and Paraganglioma recommends phlebotomy for plasma-free metanephrines with patients fasted and supine using appropriately defined reference intervals. Studies have shown higher diagnostic sensitivities using these criteria. Further, with seated-sampling protocols, for result interpretation, reference intervals that do not compromise diagnostic sensitivity should be employed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine the impact on diagnostic performance and financial cost of using supine reference intervals for result interpretation with our current plasma-free metanephrines fasted\/seated-sampling protocol.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study of patients who underwent screening for PPGL using plasma-free metanephrines from 2009 to 2014 at Galway University Hospitals. Plasma-free metanephrines were measured using liquid chromatography-tandem mass spectrometry. Supine thresholds for plasma normetanephrine and metanephrine set at 610\u2009pmol\/L and 310\u2009pmol\/L, respectively, were used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 183 patients were evaluated. Mean age of participants was 53.4 (\u00b116.3) years. Five of 183 (2.7%) patients had histologically confirmed PPGL (males, n=4). Using seated reference intervals for plasma-free metanephrines, diagnostic sensitivity and specificity were 100% and 98.9%, respectively, with two false-positive cases. Application of reference intervals established in subjects supine and fasted to this cohort gave diagnostic sensitivity of 100% with specificity of 74.7%. Financial analysis of each pretesting strategy demonstrated cost-equivalence (\u20ac147.27\/patient).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our cost analysis, together with the evidence that fasted\/supine-sampling for plasma-free metanephrines, offers more reliable exclusion of PPGL mandates changing our current practice. This study highlights the important advantages of standardized diagnostic protocols for plasma-free metanephrines to ensure the highest diagnostic accuracy for investigation of PPGL.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0004563216646395","type":"journal-article","created":{"date-parts":[[2016,5,10]],"date-time":"2016-05-10T23:01:28Z","timestamp":1462921288000},"page":"170-173","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":31,"title":["Screening for phaeochromocytoma and paraganglioma: impact of using supine reference intervals for plasma metanephrines with samples collected from fasted\/seated patients"],"prefix":"10.1177","volume":"54","author":[{"given":"R","family":"Casey","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Centre of Diabetes, Endocrinology and Metabolism, Galway University Hospitals & Saolta Hospital Group, Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"TP","family":"Griffin","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Centre of Diabetes, Endocrinology and Metabolism, Galway University Hospitals & Saolta Hospital Group, Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Wall","sequence":"additional","affiliation":[{"name":"School of Mathematics, Statistics and Applied Mathematics, National University of Ireland, Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MC","family":"Dennedy","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Centre of Diabetes, Endocrinology and Metabolism, Galway University Hospitals & Saolta Hospital Group, Galway, Ireland"},{"name":"Discipline of Pharmacology & Therapeutics, School of Medicine, National University of Ireland, Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Bell","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Centre of Diabetes, Endocrinology and Metabolism, Galway University Hospitals & Saolta Hospital Group, Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"PM","family":"O\u2019Shea","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry, Galway University Hospitals & Saolta Hospital Group, Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2016,9,28]]},"reference":[{"key":"bibr1-0004563216646395","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-1498"},{"key":"bibr2-0004563216646395","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2006.076489"},{"key":"bibr3-0004563216646395","doi-asserted-by":"publisher","DOI":"10.1111\/cen.12587"},{"key":"bibr4-0004563216646395","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2010.01.012"},{"key":"bibr5-0004563216646395","doi-asserted-by":"publisher","DOI":"10.1111\/cen.12327"},{"key":"bibr6-0004563216646395","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2004.045484"},{"key":"bibr7-0004563216646395","doi-asserted-by":"publisher","DOI":"10.1111\/cen.12602"},{"key":"bibr8-0004563216646395","doi-asserted-by":"publisher","DOI":"10.1111\/cen.12624"}],"container-title":["Annals of Clinical Biochemistry: International Journal of Laboratory Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0004563216646395","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0004563216646395","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0004563216646395","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:22:45Z","timestamp":1777378965000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0004563216646395"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,9,28]]},"references-count":8,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2017,1]]}},"alternative-id":["10.1177\/0004563216646395"],"URL":"https:\/\/doi.org\/10.1177\/0004563216646395","relation":{},"ISSN":["0004-5632","1758-1001"],"issn-type":[{"value":"0004-5632","type":"print"},{"value":"1758-1001","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,9,28]]}}}