Primary outcomes
In total, 78 patients had evaluable data 6 months after surgery, of whom 77 achieved at least one of the hierarchical primary outcomes. Of the 78 patients with evaluable data, 69 (88%) achieved complete biochemical success and 24 (31%) achieved complete clinical success (Fig. Accuracy was influenced mainly by the proportion of true to false positive diagnoses, since adrenal glands were not removed from the patients in the medical group to validate negative diagnoses. Indeed, for estimation of false positive rates, we assumed that all patients assigned to medical therapy were true negatives (Extended Data Fig. An additional analysis found a small impact of AVS failures on the relative accuracy of MTO and AVS in predicting partial or complete biochemical success, but not on the other three PASO outcomes (Supplementary Table 