Objective: To estimate the pretest probability of Cushing's syndrome (CS) diagnosis by a Bayesian approach using intuitive clinical judgment. Materials and methods: Physicians were requested, in seven endocrinology meetings, to answer three questions: "Based on your personal expertise, after obtaining clinical history and physical examination, without using laboratorial tests, what is your probability of diagnosing Cushing's Syndrome?"; "For how long have you been practicing Endocrinology?"; and "Where do you work?" . A Bayesian beta regression, using the WinBugs software was employed. Results: We obtained 294 questionnaires. The mean pretest probability of CS diagnosis was 51.6% (95%CI: 48.7-54.3). The probability was directly related to experience in endocrinology, but not with the place of work. Conclusion: Pretest probability of CS diagnosis was estimated using a Bayesian methodology. Although pretest likelihood can be context-dependent, experience based on years of practice may help the practitioner to diagnosis CS. Arq Bras Endocrinol Metab. 2012;56(9):633-7 Keywords Cushing's syndrome; Bayes theorem; pretest probability RESUMO Objetivo: Estimar a probabilidade pré-teste do diagnóstico de síndrome de Cushing (SC) por meio de julgamento clínico utilizando abordagem Bayesiana. Materiais e métodos: Médicos responderam a três perguntas, em sete congressos de endocrinologia. Após obtenção da história clínica/exame físico, sem exames laboratoriais, apenas com base em sua experiência pessoal, qual a probabilidade de diagnosticar SC?; Há quanto tempo você pratica endocrinologia?; Onde você trabalha? Uma regressão beta Bayesiana, utilizando o software WinBugs, foi empregada. Resultados: Foram obtidos 294 questionários. A estimativa Bayesiana da probabilidade média de diagnosticar SC foi 51,6% (IC 95%: 48,3). Houve relação direta entre probabilidade de diagnosticar SC e experiência da prática endócrina, porém não com o local de trabalho. Conclusão: A probabilidade pré-teste do diagnóstico de SC foi estimada utilizando uma metodologia Bayesiana. Embora a probabilidade pré-teste possa ser dependente do contexto, a experiência de anos de prática pode auxiliar no diagnóstico intuitivo da CS. Arq Bras Endocrinol Metab. 2012;56(9):633-7 Descritores Síndrome de Cushing; teorema de Bayes; probabilidade pré-teste
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