Ovarian Tumor Referral Guidelines
Miller RW, Smith A, Desimone CP, et al. Performance of the American College of Obstetricians and Gynecologists’ ovarian tumor referral guidelines with a multivariate index assay. Obstet Gynecol 2011;117: 1298-1306.
Researchers estimated the performance of the American College of Obstetricians and Gynecologists (ACOG) guidelines for women with a pelvic mass with the addition of a new multivariate index assay in this prospective, multi-institutional trial of 27 US primary care and specialty sites with women scheduled for surgery for an ovarian mass. Clinical data was collected before surgery. Miller et al used a standard CA 125-II assay and the value was applied to the multivariate index assay algorithm and the CA 125 analysis. There were 161 malignancies (45 premenopausal and 116 postmenopausal). The ACOG referral criteria were found to have a modest sensitivity in detecting malignancy. When CA 125 was replaced with the multivariate index assay, sensitivity and negative predictive value increased (77%-94% and 87%-93%, respectively), while specificity and positive predictive value decreased (68%-35% and 52%-40%, respectively). Trends were similar in premenopausal women and early-stage disease.
Abstract and Introduction
Abstract
Miller RW, Smith A, Desimone CP, et al. Performance of the American College of Obstetricians and Gynecologists’ ovarian tumor referral guidelines with a multivariate index assay. Obstet Gynecol 2011;117: 1298-1306.
Introduction
Researchers estimated the performance of the American College of Obstetricians and Gynecologists (ACOG) guidelines for women with a pelvic mass with the addition of a new multivariate index assay in this prospective, multi-institutional trial of 27 US primary care and specialty sites with women scheduled for surgery for an ovarian mass. Clinical data was collected before surgery. Miller et al used a standard CA 125-II assay and the value was applied to the multivariate index assay algorithm and the CA 125 analysis. There were 161 malignancies (45 premenopausal and 116 postmenopausal). The ACOG referral criteria were found to have a modest sensitivity in detecting malignancy. When CA 125 was replaced with the multivariate index assay, sensitivity and negative predictive value increased (77%-94% and 87%-93%, respectively), while specificity and positive predictive value decreased (68%-35% and 52%-40%, respectively). Trends were similar in premenopausal women and early-stage disease.
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