Cited by 408Clinical Laboratory Practices and Quality ControlEstrogen and related hormone effectsScientific Measurement and Uncertainty Evaluation

Challenges to the measurement of estradiol: an Endocrine Society Position Statement

Open access
Rosner, William, Hankinson, Susan E., Sluss, Patrick M., Vesper, Hubert W., Wierman, Margaret E.·2013·The Journal of Clinical Endocrinology & Metabolism

Abstract

OBJECTIVE: The objective of the study was to evaluate the current state of clinical assays for estradiol in the context of their applications. PARTICIPANTS: The participants were appointed by the Council of The Endocrine Society and charged with attaining the objective using published data and expert opinion. EVIDENCE: Data were gathered from published sources via online databases (principally PubMed, Ovid MEDLINE, Google Scholar), and the clinical and laboratory experience of the participants. CONSENSUS PROCESS: The statement was an effort of the committee and was reviewed by each member. The Clinical Affairs Committee, the Council of The Endocrine Society, and JCEM reviewers reviewed the manuscript and made recommendations. CONCLUSIONS: The measurement of estradiol in biological fluids is important in human biology from cradle to grave. In addition to its centrality in sexual development, it has significant effects on skin, blood vessels, bone, muscle, coagulation, hepatic cells, adipose tissue, the kidney, the gastrointestinal tract, brain, lung, and pancreas. Alterations in its plasma concentration have been implicated in coronary artery disease, stroke, and breast cancer. Although modern immunoassays and liquid chromatography/tandem mass spectrometry-based methods for estradiol are reasonably well suited to the diagnosis and management of infertility (nonetheless, imprecision and method-to-method differences remain problematic), the very low concentrations that appear to be crucial in nonreproductive tissues are a separate and more difficult issue. Such levels of estradiol are too low to be routinely measured accurately or precisely, and further evolution of analytical methods and the way in which estradiol is standardized is needed.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1210/jc.2012-3780

Cites

90 of 90 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Clinicians are increasingly using newer liquid chromatography-mass spectrometric-based assays with suggested improved sensitivity and reduced interference, particularly for steroids such as estradiol and testosterone, and for thyroid and peptide hormones.

    “Clinicians are increasingly using newer liquid chromatography-mass spectrometric-based assays with suggested improved sensitivity and reduced interference.This is particularly true for steroids, namely E2, T (104,105), and thyroid and peptide hormones (78,106).”

    From Hormonal Replacement in Hypopituitarism in Adults: An Endocrine Society Clinical Practice Guideline (2016) · cites this paper as [106]

    Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

    Experimental — accuracy not yet measured
  • For clinical and sports applications, testosterone must be measured by LC-MS rather than immunoassays.

    “A reliable threshold for circulating testosterone must be set using measurement by the reference method of liquid chromatography–mass spectrometry (LC-MS) rather than using one of the various available commercial testosterone immunoassays.”

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 5

  1. [3]3. Rosner W, Vesper H. Preface. CDC workshop report improving steroid hormone measurements in patient care and research trans- lation. Steroids. 2008;73:1285.
  2. [4]4. Data replication and reproducibility. Science. 2011;334:1225- 1233.
  3. [6]6. Abraham GE. Solid-phase immunoassay for estradiol 17-␤. J Clin Endocrinol Metab. 1969;29:866 -870.
  4. [16]16. Dawling S, Roodi N, Mernaugh RL, Wang X, Parl FF. Catechol- O-methyltransferase (COMT)-mediated metabolism of catechol es- trogens. Cancer Res. 2001;61:6716 -6722.
  5. [63]63. Bernstein L, Lipworth L, Ross RK, Trichopoulos D. Correlation of estrogen levels between successive pregnancies. Am J Epidemiol. 1995;142:625-628.

Cited by

Sorted by citations

Authors
Rosner, W., Hankinson, S. E., Sluss, P. M., Vesper, H. W., & Wierman, M. E.
Affiliations
  • St. Luke's-Roosevelt Hospital Center (US)
  • Brigham and Women's Hospital (US)
  • Harvard University (US)
  • Centers for Disease Control and Prevention (US)
  • Denver VA Medical Center (US)
Corresponding author
Rosner, William
Venue
The Journal of Clinical Endocrinology & Metabolism
Published
2013-04-01
Volume
98
Issue
4
Pages
1376-1387
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
OpenAlex
W1987499470
Cited by
408
References
90
Citations by year
2026: 30 · 2025: 36 · 2024: 34 · 2023: 29 · 2022: 33 · 2021: 14 · 2020: 46 · 2019: 23 · 2018: 25 · 2017: 33 · 2016: 28 · 2015: 34 · 2014: 27 · 2013: 16
FWCI
24.31
Type
journal article
Language
en
Open access
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (5r01ca049449-18, R01 CA49449, R01 CA49449 and)
  • National Cancer Institute (R01-CA49449, R01‐CA049449, R01 CA6762)
Topics
  • Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Estrogen and related hormone effects
  • Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Scientific Measurement and Uncertainty Evaluation
Keywords
estradiol measurement, liquid chromatography-tandem mass spectrometry, assay imprecision, low-dose estradiol, infertility diagnosis, plasma estradiol, biological fluids
MeSH terms
Diagnostic Techniques, Endocrine, Diagnostic Errors, Endocrinology, Estradiol, Humans, Professional Practice, Research Design, Societies, Medical, Practice Guidelines as Topic

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review