scholarly journals Intra- and interobserver agreement with regard to describing adnexal masses using International Ovarian Tumor Analysis terminology: reproducibility study involving seven observers

2014 ◽  
Vol 44 (1) ◽  
pp. 100-108 ◽  
Author(s):  
L. Zannoni ◽  
L. Savelli ◽  
L. Jokubkiene ◽  
A. Di Legge ◽  
G. Condous ◽  
...  
Keyword(s):  
Ovarian Tumor ◽  
Interobserver Agreement ◽  
Adnexal Masses ◽  
Reproducibility Study

Simple Rules, Not So Simple: The Use of International Ovarian Tumor Analysis (IOTA) Terminology and Simple Rules in Inexperienced Hands in a Prospective Multicenter Cohort Study

2017 ◽  
Vol 38 (06) ◽  
pp. 633-641 ◽  
Author(s):  
Evelyne Meys ◽  
Iris Rutten ◽  
Roy Kruitwagen ◽  
Brigitte Slangen ◽  
Sandrina Lambrechts ◽  
...  
Keyword(s):  
Cohort Study ◽  
Ovarian Tumor ◽  
Interobserver Agreement ◽  
Tumor Type ◽  
Kappa Index ◽  
Multicenter Cohort Study ◽  
Multicenter Cohort ◽  
Simple Rules ◽  
Level Of Agreement ◽  
Ovarian Masses

Abstract Objectives To analyze how well untrained examiners – without experience in the use of International Ovarian Tumor Analysis (IOTA) terminology or simple ultrasound-based rules (simple rules) – are able to apply IOTA terminology and simple rules and to assess the level of agreement between non-experts and an expert. Methods This prospective multicenter cohort study enrolled women with ovarian masses. Ultrasound was performed by non-expert examiners and an expert. Ultrasound features were recorded using IOTA nomenclature, and used for classifying the mass by simple rules. Interobserver agreement was evaluated with Fleiss’ kappa and percentage agreement between observers. Results 50 consecutive women were included. We observed 46 discrepancies in the description of ovarian masses when non-experts utilized IOTA terminology. Tumor type was misclassified often (n = 22), resulting in poor interobserver agreement between the non-experts and the expert (kappa = 0.39, 95 %-CI 0.244 – 0.529, percentage of agreement = 52.0 %). Misinterpretation of simple rules by non-experts was observed 57 times, resulting in an erroneous diagnosis in 15 patients (30 %). The agreement for classifying the mass as benign, malignant or inconclusive by simple rules was only moderate between the non-experts and the expert (kappa = 0.50, 95 %-CI 0.300 – 0.704, percentage of agreement = 70.0 %). The level of agreement for all 10 simple rules features varied greatly (kappa index range: -0.08 – 0.74, percentage of agreement 66 – 94 %). Conclusion Although simple rules are useful to distinguish benign from malignant adnexal masses, they are not that simple for untrained examiners. Training with both IOTA terminology and simple rules is necessary before simple rules can be introduced into guidelines and daily clinical practice.

Comparison of the diagnostic accuracy of International Ovarian Tumor Analysis simple rules and the risk of malignancy index to discriminate between benign and malignant adnexal masses

2019 ◽  
Vol 146 (3) ◽  
pp. 364-369 ◽  
Author(s):  
Rapeepat Auekitrungrueng ◽  
Dangcheewan Tinnangwattana ◽  
Charuwan Tantipalakorn ◽  
Cholaros Charoenratana ◽  
Thitikarn Lerthiranwong ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Ovarian Tumor ◽  
Adnexal Masses ◽  
Simple Rules ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index

scholarly journals Estimating the Risk of Malignancy in Adnexal Masses: Validation of the ADNEX Model in the Hands of Non-expert Ultrasonographers in a Gynecological Oncology Center in China

2021 ◽  
Author(s):  
Ping He ◽  
Jingjing Wang ◽  
Wei Duan ◽  
Chao Song ◽  
Yu Yang ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Ovarian Tumor ◽  
Ovarian Metastasis ◽  
Stage I ◽  
Ca 125 ◽  
Histopathological Diagnosis ◽  
Adnexal Masses ◽  
Gynecological Oncology ◽  
Benign Ovarian Tumor ◽  
Oncology Center

Abstract Background: The diagnosis of adnexal masses depends more on ultrasonography. This study aim to validate the diagnostic accuracy of the International Ovarian Tumor Analysis (IOTA) ADNEX model in the preoperative diagnosis of adnexal masses in the hands of non-expert ultrasonographers in a gynecological oncology center in China. Methods: This was a single oncology center, retrospective diagnostic accuracy study from 620 patients. All patients underwent surgery and the histopathological diagnosis was used as reference standard. The masses were divided into five types according to the ADNEX model: benign ovarian tumor, borderline ovarian tumor (BOT), Stage-I ovarian cancer (OC), Stages-II-IV OC and ovarian metastasis. Receiver-operating characteristics (ROC) curve analysis was used to evaluate the ability of the ADNEX model to classify tumors into different histological types with and without Cancer antigen 125 (CA 125) results. Results: Of the 620 women, 402 (64.8%) had a benign ovarian tumor and, 218 (35.2%) had a malignant ovarian tumor, including 86 (13.9%) with BOT, 75 (12.1%) with Stage-I OC, 53 (8.5%) with Stages-II-IV OC and 4 (0.6%) with ovarian metastasis. The AUC of the model to differentiate between benign and malignant adnexal masses was 0.97 (95% CI, 0.96–0.98). Performance was excellent for the discrimination between benign vs Stage II-IV OC, benign vs ovarian metastasis with AUCs of 0.99 (95% CI, 0.99-1.00) and 0.99 (95% CI, 0.98-1.00), respectively. Performance of the model was less effective at distinguishing between BOT and Stage I OC and between BOT and ovarian metastasis, with AUC of 0.54 (95% CI, 0.45–0.64) and 0.66 (95% CI, 0.56–0.77), respectively. When including CA125 in the model, performance in discriminating between Stages II–IV OC with stage I OC and ovarian metastasis were improved (AUC increased from 0.88 to 0.94, P = 0.01; 0.86 to 0.97, p = 0.01, respectively). Conclusions: The IOTA ADNEX model has excellent performance in differentiating benign and malignant adnexal masses in the hands of non-expert ultrasonographers with limited experienced in China. Between classification different subtypes of ovarian cancers, the model has difficulty to differentiate BOT from stage I OC, BOT from ovarian metastases.

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