Prospective evaluation of a logistic model based on sonographic morphologic and color Doppler findings developed to predict adnexal malignancy

To assess prospectively a logistic model based on sonographic morphologic a nd color Doppler findings, which had been developed to predict adnexal mali gnancy, 167 consecutive and unselected patients (mean age, 45.7 yr; range, 17 to 81 yr; 113 [67.7%] premenopausal a:nd 54 [32.3%] postmenopausal) diag nosed as having an adnexal mass and scheduled for surgery were prospectivel y included in this study. All patients were evaluated by transvaginal color Doppler ultrasonography. The probability of adnexal malignancy was estimat ed prior to surgery, applying a logistic model developed previously. A prob ability of malignancy greater than 75% was considered to assess model perfo rmance. Sensitivity, specificity, positive predictive value, negative predi ctive value, and accuracy were calculated for the model. In all cases defin itive histopathologic diagnosis was obtained. One hundred and twenty-five ( 74.9%) benign and 42 (25.1%) malignant tumors were found. The sensitivity, specificity, positive predictive value, and negative predictive value of th e model were 85.7% (95% confidence intervals, 71.4% to 94.6%), 100% (95% co nfidence intervals, 97.1% to 100%), 100% (95% confidence intervals, 90.3% t o 100%), and 95.4% (95% confidence intervals, 90.3% to 98.3%), respectively . Overall accuracy was 96.4% (95% confidence intervals, 91.3% to 98.7%). Ou r results confirm the validity of the proposed logistic model in predicting adnexal malignancy.