Clinical Utility of Risk Models to Refer Patients with Adnexal Masses to Specialized Oncology Care: Multicenter External Validation Using Decision Curve Analysis

Clinical Cancer Research : an Official Journal of the American Association for Cancer Research
Laure WynantsBen Van Calster

Abstract

Purpose: To evaluate the utility of preoperative diagnostic models for ovarian cancer based on ultrasound and/or biomarkers for referring patients to specialized oncology care. The investigated models were RMI, ROMA, and 3 models from the International Ovarian Tumor Analysis (IOTA) group [LR2, ADNEX, and the Simple Rules risk score (SRRisk)].Experimental Design: A secondary analysis of prospectively collected data from 2 cross-sectional cohort studies was performed to externally validate diagnostic models. A total of 2,763 patients (2,403 in dataset 1 and 360 in dataset 2) from 18 centers (11 oncology centers and 7 nononcology hospitals) in 6 countries participated. Excised tissue was histologically classified as benign or malignant. The clinical utility of the preoperative diagnostic models was assessed with net benefit (NB) at a range of risk thresholds (5%-50% risk of malignancy) to refer patients to specialized oncology care. We visualized results with decision curves and generated bootstrap confidence intervals.Results: The prevalence of malignancy was 41% in dataset 1 and 40% in dataset 2. For thresholds up to 10% to 15%, RMI and ROMA had a lower NB than referring all patients. SRRisks and ADNEX demonstrated the highest N...Continue Reading

References

May 15, 1980·The New England Journal of Medicine·S G Pauker, J P Kassirer
Nov 30, 2005·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Dirk TimmermanUNKNOWN International Ovarian Tumor Analysis Group
Feb 2, 2006·Journal of the National Cancer Institute·Craig C EarleJoan L Warren
Nov 14, 2006·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Andrew J Vickers, Elena B Elkin
May 28, 2008·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·D TimmermanL Valentin
Jan 22, 2009·Obstetrics and Gynecology·Peggy GeominiBen W J Mol
Jul 1, 2009·BMJ : British Medical Journal·Jonathan A C SterneJames R Carpenter
May 11, 2010·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·D TimmermanL Valentin
Jun 29, 2010·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·L VerleyeA G J van der Zee
May 25, 2011·Obstetrics and Gynecology·Frederick R UelandZhen Zhang
Mar 16, 2012·The Cochrane Database of Systematic Reviews·Yin Ling WooHeather O Dickinson
Aug 23, 2012·Annals of Internal Medicine·A Russell Localio, Steven Goodman
Sep 15, 2012·Statistics in Medicine·Andrew J VickersMithat Gönen
Nov 28, 2012·Gynecologic Oncology·Robert E BristowDonald G Munroe
Jan 28, 2015·JAMA : the Journal of the American Medical Association·Mark FitzgeraldRoger J Lewis
Apr 8, 2015·The Lancet Oncology·Vinod P BalachandranRonald P DeMatteo
May 1, 2015·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·E EpsteinS Nikman
May 20, 2015·Asian Pacific Journal of Cancer Prevention : APJCP·Dangcheewan TinnangwattanaTheera Tongsong
Jan 24, 2016·American Journal of Obstetrics and Gynecology·Dirk TimmermanLil Valentin
Jan 27, 2016·BMJ : British Medical Journal·Andrew J VickersEwout W Steyerberg
Feb 29, 2016·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·E M J MeysT Van Gorp
May 20, 2016·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·K G AraujoS Derchain
Jun 2, 2016·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Kathleen F KerrHolly Janes
Jul 5, 2016·Gynecologic Oncology·Sebastian SzubertJuan Luis Alcazar
Aug 16, 2016·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·E M J MeysT Van Gorp

❮ Previous
Next ❯

Citations

Jan 25, 2020·Scandinavian Journal of Gastroenterology·Yue WangYan Zhao
Nov 30, 2019·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Sebastian SzubertRafał Moszyński
Jun 23, 2020·Acta Radiologica·Esmee E MulderJurgen Mj Piek
Apr 24, 2021·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Alba Liliana Esquivel VillabonaJuan Luis Alcázar
Apr 2, 2021·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·D TimmermanC Fotopoulou
Jun 12, 2021·International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society·Dirk TimmermanChristina Fotopoulou
Jun 11, 2021·Facts, Views & Vision in ObGyn·D TimmermanC Fotopoulou
Dec 20, 2021·Clinical Oncology : a Journal of the Royal College of Radiologists·M CraddockC Faivre-Finn

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cancer Genomics (Keystone)

Cancer genomics approaches employ high-throughput technologies to identify the complete catalog of somatic alterations that characterize the genome, transcriptome and epigenome of cohorts of tumor samples. Discover the latest research using such technologies in this feed.

Cancer Imaging

Imaging techniques, including CT and MR, have become essential to tumor detection, diagnosis, and monitoring. Here is the latest research on cancer imaging.

Related Papers

Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology
A Di LeggeLil Valentin
Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology
Juan Luis AlcázarStefano Guerriero
Clinical Cancer Research : an Official Journal of the American Association for Cancer Research
Caroline Van HolsbekeDirk Timmerman
© 2022 Meta ULC. All rights reserved