External validation of diagnostic models to estimate the risk of malignancy in adnexal masses.
نویسندگان
چکیده
PURPOSE To externally validate and compare the performance of previously published diagnostic models developed to predict malignancy in adnexal masses. EXPERIMENTAL DESIGN We externally validated the diagnostic performance of 11 models developed by the International Ovarian Tumor Analysis (IOTA) group and 12 other (non-IOTA) models on 997 prospectively collected patients. The non-IOTA models included the original risk of malignancy index (RMI), three modified versions of the RMI, six logistic regression models, and two artificial neural networks. The ability of the models to discriminate between benign and malignant adnexal masses was expressed as the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and likelihood ratios (LR(+), LR(-)). RESULTS Seven hundred and forty-two (74%) benign and 255 (26%) malignant masses were included. The IOTA models did better than the non-IOTA models (AUCs between 0.941 and 0.956 vs. 0.839 and 0.928). The difference in AUC between the best IOTA and the best non-IOTA model was 0.028 [95% confidence interval (CI), 0.011-0.044]. The AUC of the RMI was 0.911 (difference with the best IOTA model, 0.044; 95% CI, 0.024-0.064). The superior performance of the IOTA models was most pronounced in premenopausal patients but was also observed in postmenopausal patients. IOTA models were better able to detect stage I ovarian cancer. CONCLUSION External validation shows that the IOTA models outperform other models, including the current reference test RMI, for discriminating between benign and malignant adnexal masses.
منابع مشابه
Evaluation of diagnostic accuracy of RMI and ROMA indices in comparison to HE4 and CA125 parameters for estimating the risk of malignancy of adnexal masses.
Background: Ovarian cancer is the fifth leading cancer-related cause of death in women worldwide and is often diagnosed at advanced stages. Regarding the low sensitivity and specificity of the currently available diagnostic techniques, in the present study, we aimed to evaluate the accuracy of RMI and ROMA indexes and comparing these two indexes with CA-125 and HE4 parameters for the diagnosis ...
متن کاملI-41: Imaging Strategy for Diagnosis of Adnexal Masses Including US,CT Scan and MRI
Adnexal masses are spectrum of diseases from benign non neoplastic and neoplastic masses to malignant neoplasms. Endovaginal ultrasonography (US) is the fisrt and invaluable modality for assessment of adnexal masses because it is available and has a high negative predictive value. Important morphologic features are solid (vascularized) tissue, vascular and thick septations, and papillary projec...
متن کاملSimple ultrasound rules to distinguish between benign and malignant adnexal masses before surgery: prospective validation by IOTA group
OBJECTIVES To prospectively assess the diagnostic performance of simple ultrasound rules to predict benignity/malignancy in an adnexal mass and to test the performance of the risk of malignancy index, two logistic regression models, and subjective assessment of ultrasonic findings by an experienced ultrasound examiner in adnexal masses for which the simple rules yield an inconclusive result. ...
متن کاملOvarian cancer prediction in adnexal masses using ultrasound-based logistic regression models: a temporal and external validation study by the IOTA group.
OBJECTIVES The aims of the study were to temporally and externally validate the diagnostic performance of two logistic regression models containing clinical and ultrasound variables in order to estimate the risk of malignancy in adnexal masses, and to compare the results with the subjective interpretation of ultrasound findings carried out by an experienced ultrasound examiner ('subjective asse...
متن کاملProspective internal validation of mathematical models to predict malignancy in adnexal masses: results from the international ovarian tumor analysis study.
PURPOSE To prospectively test the mathematical models for calculation of the risk of malignancy in adnexal masses that were developed on the International Ovarian Tumor Analysis (IOTA) phase 1 data set on a new data set and to compare their performance with that of pattern recognition, our standard method. METHODS Three IOTA centers included 507 new patients who all underwent a transvaginal u...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Clinical cancer research : an official journal of the American Association for Cancer Research
دوره 18 3 شماره
صفحات -
تاریخ انتشار 2012