title: ACROSCORE: a new and simple tool for the diagnosis of acromegaly, a rare and underdiagnosed disease.
abstract: OBJECTIVE
  Acromegaly, a disease caused by GH/IGF-I hypersecretion, is associated with a high mortality rate; early recognition is therefore necessary to ensure successful treatment and to avoid comorbidities. We have created a symptom/sign scoring tool (ACROSCORE) for physicians to use to identify acromegaly.
  
  
  METHODS
  To compare cases of acromegaly diagnosed between 1990 and 2014 against a control group affected by non-GH-secreting pituitary tumours to identify symptoms and signs that are most discriminative for acromegaly.
  
  
  METHODS
  Confirmed acromegaly patients and patients affected by non-GH-secreting pituitary tumours.
  
  
  METHODS
  In all patients, signs, symptoms and comorbidities were recorded from medical records and collected using a specifically designed questionnaire.
  
  
  RESULTS
  A total of 194 acromegaly patients [115 women; mean (SD) age 47·2 (14·2) years] and 243 patients affected by non-GH-secreting pituitary tumours [131 women; mean (SD) age 45·8 (15·8) years] were included. A strong association was observed for type 2/secondary diabetes [odds ratio (OR) 3·7], hyperhidrosis (OR 6·1), thyroid hyperplasia (OR 13·9), colorectal polyps (OR 10·4), spaced teeth (OR 25·4) and carpal tunnel syndrome (OR 4·3). Based on this information, a multivariable logistic model was built and a 14-point scoring system developed. A score of 0 excludes the risk of acromegaly [positive predictive value (PV(+)) = 0·6%]; scores 1-5 comprise a grey area; scores >5 indicate that a diagnosis of acromegaly cannot be excluded (PV(+) = 46·1%).
  
  
  CONCLUSIONS
  Once validated in independent studies, ACROSCORE may represent a new tool for the clinical screening of acromegaly that can be used by general practitioners and nonendocrinology specialists.
authors.affiliation: Department of Medical Science, Division of Endocrinology, Diabetology and Metabolism, Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy.
authors.forename: Nunzia
authors.initials: N
authors.lastname: Prencipe
authors.affiliation: Department of Oncology, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy.
authors.forename: Irene
authors.initials: I
authors.lastname: Floriani
authors.affiliation: Department of Medical Science, Division of Endocrinology, Diabetology and Metabolism, Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Guaraldi
authors.affiliation: Department of Medical Science, Division of Endocrinology, Diabetology and Metabolism, Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy.
authors.forename: Stellina V
authors.initials: SV
authors.lastname: Di Giacomo
authors.affiliation: Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Cannavo
authors.affiliation: Endocrinology Division, Department of Clinical and Molecular Sciences, Politecnica delle Marche University, Ancona, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Arnaldi
authors.affiliation: Department of Medical Science, Division of Endocrinology, Diabetology and Metabolism, Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Berton
authors.affiliation: Department of Oncology, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy.
authors.forename: Valter
authors.initials: V
authors.lastname: Torri
authors.affiliation: Novartis Farma, Origgio (VA), Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Spinello
authors.affiliation: Department of Medical Science, Division of Oncological Endocrinology, Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Arvat
authors.affiliation: Department of Medical Science, Division of Endocrinology, Diabetology and Metabolism, Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy.
authors.forename: Ezio
authors.initials: E
authors.lastname: Ghigo
authors.affiliation: Department of Medical Science, Division of Endocrinology, Diabetology and Metabolism, Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Grottoli
mesh_terms: D000172:Acromegaly / Q000175:diagnosis*; D000236:Adenoma / Q000175:diagnosis*; D000328:Adult; D016022:Case-Control Studies; D003937:Diagnosis, Differential; D003940:Diagnostic Techniques, Endocrine / Q000592:standards*; D042241:Early Diagnosis; D004704:Endocrinology / Q000379:methods; D005260:Female; D049912:Growth Hormone-Secreting Pituitary Adenoma / Q000175:diagnosis*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010911:Pituitary Neoplasms / Q000175:diagnosis*; D012372:ROC Curve; D015203:Reproducibility of Results