Phichayut Phinyo1, Jayanton Patumanond2, Panprapha Saenrungmuaeng3, Watcharin Chirdchim4, Tanyong Pipanmekaporn5, Apichat Tantraworasin6, Theera Tongsong7, Charuwan Tantipalakorn7. 1. Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand. 2. Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand. 3. Department of Obstetrics and Gynecology, Faculty of Medicine, Mahasarakham University, Maha Sarakham 44150, Thailand. 4. Department of Obstetrics and Gynecology, Phrapokklao Hospital, Chanthaburi 22000, Thailand. 5. Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand. 6. Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand. 7. Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
Abstract
Background and objectives: To compare the diagnostic accuracy and clinical utility of the Early-stage Ovarian Malignancy (EOM) score with the Risk of Malignancy Index (RMI) in the presurgical assessment of women presenting with adnexal masses. Materials and Methods: A secondary analysis was carried out in a retrospective cohort of women who presented with an adnexal mass and were scheduled for surgery at Phrapokklao Hospital between September 2013 and December 2017. The clinical characteristics, ultrasonographic features of the masses, and preoperative CA-125 levels were recorded. The EOM and the RMI score were calculated and compared in terms of accuracy and clinical utility. Decision curve analysis (DCA), which examined the net benefit (NB) of applying the EOM and the RMI in practice at a range of threshold probabilities, was presented. Results: In this study, data from 270 patients were analyzed. Fifty-four (20.0%) women in the sample had early-stage ovarian cancer. All four RMI versions demonstrated a lower sensitivity for the detection of patients with early-stage ovarian cancer compared to an EOM score ≥ 15. An EOM ≥ 15 resulted in a higher proportion of net true positive or NB than all versions of the RMIs from a threshold probability of 5% to 30%. Conclusions: It also showed a higher capability to reduce the number of inappropriate referrals than the RMIs at a threshold probability between 5% and 30%. The EOM score showed higher diagnostic sensitivity and has the potential to be clinically more useful than the RMIs to triage women who present with adnexal masses for referral to oncologic gynecologists. Further external validation is required to support our findings.
Background and objectives: To compare the diagnostic accuracy and clinical utility of the Early-stage Ovarian Malignancy (EOM) score with the Risk of Malignancy Index (RMI) in the presurgical assessment of women presenting with adnexal masses. Materials and Methods: A secondary analysis was carried out in a retrospective cohort of women who presented with an adnexal mass and were scheduled for surgery at Phrapokklao Hospital between September 2013 and December 2017. The clinical characteristics, ultrasonographic features of the masses, and preoperative CA-125 levels were recorded. The EOM and the RMI score were calculated and compared in terms of accuracy and clinical utility. Decision curve analysis (DCA), which examined the net benefit (NB) of applying the EOM and the RMI in practice at a range of threshold probabilities, was presented. Results: In this study, data from 270 patients were analyzed. Fifty-four (20.0%) women in the sample had early-stage ovarian cancer. All four RMI versions demonstrated a lower sensitivity for the detection of patients with early-stage ovarian cancer compared to an EOM score ≥ 15. An EOM ≥ 15 resulted in a higher proportion of net true positive or NB than all versions of the RMIs from a threshold probability of 5% to 30%. Conclusions: It also showed a higher capability to reduce the number of inappropriate referrals than the RMIs at a threshold probability between 5% and 30%. The EOM score showed higher diagnostic sensitivity and has the potential to be clinically more useful than the RMIs to triage women who present with adnexal masses for referral to oncologic gynecologists. Further external validation is required to support our findings.
Entities:
Keywords:
adnexal mass; clinical utility; decision curve analysis; net benefit; ovarian cancer
Authors: Melissa Matz; Michel P Coleman; Helena Carreira; Diego Salmerón; Maria Dolores Chirlaque; Claudia Allemani Journal: Gynecol Oncol Date: 2016-12-02 Impact factor: 5.482
Authors: J Kaijser; T Bourne; L Valentin; A Sayasneh; C Van Holsbeke; I Vergote; A C Testa; D Franchi; B Van Calster; D Timmerman Journal: Ultrasound Obstet Gynecol Date: 2013-01 Impact factor: 7.299