{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T05:42:48Z","timestamp":1784871768559,"version":"3.55.0"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,9,24]],"date-time":"2021-09-24T00:00:00Z","timestamp":1632441600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The diagnosis of adult GH deficiency (GHD) relies on a reduced GH response to provocative tests. Their diagnostic accuracy, however, is not perfect, and a reliable estimation of pre-test GHD probability could be helpful for a better interpretation of their results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Eighty patients showing concordant GH response to two provocative tests, i.e. the insulin tolerance test and the GHRH + arginine test, were enrolled. Data on IGF-I values and on the presence\/absence of other pituitary deficits were collected and integrated for the estimation of GHD probability prior to stimulation tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>An independent statistically significant association with the diagnosis of GHD was found both for IGF-I SDS (OR 0.34, 95%-CI 0.18-0.65, p=0.001) and for the presence of other pituitary deficits (OR 6.55, 95%-CI 2.06-20.83, p=0.001). A low (&amp;lt;25%) pre-test GHD probability could be predicted when IGF-I SDS &amp;gt; +0.91 in the presence of other pituitary deficits or IGF-I SDS &amp;gt; -0.52 in the absence of other pituitary deficits. A high (&amp;gt;75%) pre-test GHD probability could be predicted when IGF-I SDS &amp;lt; -0.82 in the presence of other pituitary deficits or IGF-I SDS &amp;lt; -2.26 in the absence of other pituitary deficits.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This is the first study that proposes a quantitative estimation of GHD probability prior to stimulation tests. Our risk class stratification represents a simple tool that could be adopted for a Bayesian interpretation of stimulation test results, selecting patients who may benefit from a second stimulation test and possibly reducing the risk of wrong GHD diagnosis.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2021.737947","type":"journal-article","created":{"date-parts":[[2021,9,25]],"date-time":"2021-09-25T00:38:14Z","timestamp":1632530294000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Development and Internal Validation of a Predictive Model for Adult GH Deficiency Prior to Stimulation Tests"],"prefix":"10.3389","volume":"12","author":[{"given":"Fabio","family":"Bioletto","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirko","family":"Parasiliti-Caprino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro 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