Pituitary Society Delphi Survey: an international perspective on endocrine management of patients undergoing transsphenoidal surgery for pituitary adenomas

Research output: Contribution to journalArticlepeer-review

Authors

  • Pituitary Society Delphi Collaborative Group

Colleges, School and Institutes

Abstract

Purpose: In adults and children, transsphenoidal surgery (TSS) represents the cornerstone of management for most large or functioning sellar lesions with the exception of prolactinomas. Endocrine evaluation and management are an essential part of perioperative care. However, the details of endocrine assessment and care are not universally agreed upon.

Methods: To build consensus on the endocrine evaluation and management of adults undergoing TSS, a Delphi process was used. Thirty-five statements were developed by the Pituitary Society’s Education Committee. Fifty-five pituitary endocrinologists, all members of the Pituitary Society, were invited to participate in two Delphi rounds and rate their extent of agreement with statements pertaining to perioperative endocrine evaluation and management, using a Likert-type scale. Anonymized data on the proportion of panelists’ agreeing with each item were summarized. A list of items that achieved consensus, based on predefined criteria, was tabulated.

Results: Strong consensus (≥ 80% of panelists rating their agreement as 6–7 on a scale from 1 to 7) was achieved for 68.6% (24/35) items. If less strict agreement criteria were applied (ratings 5–7 on the Likert-type scale), consensus was achieved for 88% (31/35) items.

Conclusions: We achieved consensus on a large majority of items pertaining to perioperative endocrine evaluation and management using a Delphi process. This provides an international real-world clinical perspective from an expert group and facilitates a framework for future guideline development. Some of the items for which consensus was not reached, including the assessment of immediate postoperative remission in acromegaly or Cushing’s disease, represent areas where further research is needed.

Details

Original languageEnglish
JournalPituitary
Early online date20 Jul 2021
Publication statusE-pub ahead of print - 20 Jul 2021

Keywords

  • Delphi process, Pituitary adenoma, Transsphenoidal surgery, Hypopituitarism, Perioperative, Postoperative assessment