Bwj. Mol et al., Distinguishing the benign and malignant adnexal mass: An external validation of prognostic models, GYNECOL ONC, 80(2), 2001, pp. 162-167
Objective. Because external validation of the present models has not been r
eported, the purpose of the present study was to assess existing diagnostic
models that are used to distinguish malignant from benign masses.
Methods. We tested the performance of existing models in a prospectively as
sembled data set of 170 patients with an adnexal mass. Twenty-one models th
at have been reported previously were assessed. The models were based on co
mbinations of ultrasound findings, color Doppler tests, CA-125 measurement,
age, and/or menopausal status. For each model, we constructed ROC curves a
nd calculated an area under the ROC curve.
Results. Of the 170 adnexal masses that were operated on, 30 (18%) were mal
ignant. The area under the ROC curve of 21. models that were externally val
idated varied between 0.69 and 0.90. We found the performance of the existi
ng models to be inferior to the performance reported in the initial studies
. Even models that incorporated multiple diagnostic tools and that were dev
eloped using logistic regression models or neural networks had an area unde
r the ROC curve of 0.86 at maximum. In the case where we focused on almost
perfect sensitivity, the highest specificities varied between 0.45 and 0.60
.
Conclusion. Although diagnostic models might be of value in the preoperativ
e assessment of the adnexal mass, their diagnostic performance is not as go
od as that reported in the original publications. (C) 2001 Academic Press.