The ADNEX model to triage adnexal masses: An external validation study and comparison with the IOTA two-step strategy and subjective assessment by an experienced ultrasound operator

Viora, E.; Piovano, Elisa; Poma, Cinzia Baima; Cotrino, Ilenia; Castiglione, Anna; Cavallero, Camilla; Sciarrone, Andrea; Bastonero, S.; Iskra, Lilliana; Zola, Paolo

doi:10.1016/j.ejogrb.2020.02.022

Cited by 30 publications

(30 citation statements)

References 20 publications

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“…Several external validation studies have shown good to excellent performance of the ADNEX model in discriminating different types of ovarian tumor, with a higher clinical value than the RMI 55–61 . A study aiming to validate the ADNEX model when applied by Level‐II examiners has confirmed that it can be used successfully by less‐experienced examiners 62 . A large multicenter cohort study of 4905 masses in 17 centers, comparing six different prediction models (RMI, LR2, Simple Rules, Simple Rules risk model and ADNEX model with or without CA 125), demonstrated the IOTA ADNEX model and the IOTA Simple Rules risk model to be the best models for the characterization of ovarian masses in patients who present with an adnexal lesion 63 .…”

Section: Resultsmentioning

confidence: 95%

ESGO/ISUOG/IOTA/ESGE Consensus Statement on preoperative diagnosis of ovarian tumors

Timmerman

Bourne

Landolfo

et al. 2021

Ultrasound in Obstet & Gyne

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The European Society of Gynaecological Oncology (ESGO), the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG), the International Ovarian Tumour Analysis (IOTA) group and the European Society for Gynaecological Endoscopy (ESGE) jointly developed clinically relevant and evidence-based statements on the preoperative diagnosis of ovarian tumors, including imaging techniques, biomarkers and prediction models.ESGO/ISUOG/IOTA/ESGE nominated a multidisciplinary international group, including expert practising clinicians and researchers who have demonstrated leadership and expertise in the preoperative diagnosis of ovarian tumors and management of patients with ovarian cancer (19 experts across Europe). A patient representative was also included in the group. To ensure that the statements were evidence-based, the current literature was reviewed and critically appraised.Preliminary statements were drafted based on the review of the relevant literature. During a conference call, the whole group discussed each preliminary statement and a first round of voting was carried out. Statements were removed when consensus among group members was not obtained. The voters had the opportunity to provide comments/suggestions with their votes. The statements were then revised accordingly. Another round of voting was carried out according to the same rules to allow the whole group to evaluate the revised version of the statements. The group achieved consensus on 18 statements.This Consensus Statement presents these ESGO/ ISUOG/IOTA/ESGE statements on the preoperative diagnosis of ovarian tumors and the assessment of carcinomatosis, together with a summary of the evidence supporting each statement.

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Section: Resultsmentioning

confidence: 95%

ESGO/ISUOG/IOTA/ESGE Consensus Statement on preoperative diagnosis of ovarian tumors

Timmerman

Bourne

Landolfo

et al. 2021

Ultrasound in Obstet & Gyne

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show abstract

“…Several external validation studies have shown good to excellent performance of the ADNEX model in discriminating different types of ovarian tumour, with a higher clinical value than the RMI (Araujo et al, 2017;Meys et al, 2017;Sayasneh et al, 2016;Szubert et al, 2016;Van Calster, 2017;Van Calster et al, 2016;Wynants et al, 2017). A study aiming to validate the ADNEX model when applied by Level-II examiners has confirmed that it can be used successfully by less-experienced examiners (Viora et al, 2020). A large multicentre cohort study of 4905 masses in 17 centres, comparing six different prediction models (RMI, LR2, Simple Rules, Simple Rules risk model and ADNEX model with or without CA 125), demonstrated the IOTA ADNEX model and the IOTA Simple Rules risk model to be the best models for the characterization of ovarian masses in patients who present with an adnexal lesion (Van Calster et al, 2020).…”

Section: Iota Methodsmentioning

confidence: 90%

ESGO/ISUOG/IOTA/ESGE Consensus Statement on preoperative diagnosis of ovarian tumours

Timmerman¹,

Bourne²,

Landolfo³

et al. 2021

Facts Views Vis ObGyn

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The European Society of Gynaecological Oncology (ESGO), the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG), the International Ovarian Tumour Analysis (IOTA) group and the European Society for Gynaecological Endoscopy (ESGE) jointly developed clinically relevant and evidence-based statements on the preoperative diagnosis of ovarian tumours, including imaging techniques, biomarkers and prediction models. ESGO/ISUOG/IOTA/ESGE nominated a multidisciplinary international group, including expert practising clinicians and researchers who have demonstrated leadership and expertise in the preoperative diagnosis of ovarian tumours and management of patients with ovarian cancer (19 experts across Europe). A patient representative was also included in the group. To ensure that the statements were evidence-based, the current literature was reviewed and critically appraised. Preliminary statements were drafted based on the review of the relevant literature. During a conference call, the whole group discussed each preliminary statement and a first round of voting was carried out. Statements were removed when a consensus among group members was not obtained. The voters had the opportunity to provide comments/suggestions with their votes. The statements were then revised accordingly. Another round of voting was carried out according to the same rules to allow the whole group to evaluate the revised version of the statements. The group achieved consensus on 18 statements. This Consensus Statement presents these ESGO/ISUOG/IOTA/ESGE statements on the preoperative diagnosis of ovarian tumours and the assessment of carcinomatosis, together with a summary of the evidence supporting each statement.

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“…So we only discussed the diagnostic accuracy in the identification of ovarian cancer from benign tumors. The remaining two studies indicated that the ADNEX model is less effective in differentiating stage I ovarian cancer from borderline tumors and stage II-IV ovarian cancer from metastasis (17,23,28). Still, future studies are needed to assess the diagnostic accuracy in different subtypes.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

“…RMI and the ADNEX model), and the results showed that the ADNEX model performs better than the other three models, but the subjective assessment of expert sonographers still performs the best. However, Viora et al(23) andEpstein et al…”

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confidence: 99%

Diagnostic Accuracy of the ADNEX Model for Ovarian Cancer at the 15% Cut-Off Value: A Systematic Review and Meta-Analysis

et al. 2021

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ObjectivesTo evaluate the diagnostic accuracy of the ADNEX model for ovarian cancer at the 15% cut-off value.MethodsStudies on the identified diagnosis of the ADNEX model for ovarian cancer published in PubMed, Embase, the Cochrane Library and Web of Science databases from January 1st, 2014 to February 20th, 2021 were searched. Two researchers independently screened the retrieved studies and extracted the basic features and parameter data. The quality of the eligible studies was evaluated by Quality Assessment of Diagnostic Accuracy Studies-2, and the result was summarized by Review Manager 5.3. Meta-Disc 1.4 and STATA 16.0 were used in statistical analysis. Heterogeneity of this meta-analysis was calculated. Meta-regression was performed to investigate the potential sources of heterogeneity. Sensitivity analysis and Deek’s funnel plot analysis were conducted to evaluate the stability and publication bias, respectively.Results280 studies were initially retrieved through the search strategy, and 10 eligible studies were ultimately included. The random-effects model was selected for data synthesis. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio and the area under the summary receiver operating characteristic curve were 0.92 (95% CI: 0.89–0.94), 0.82 (95% CI: 0.78–0.86), 5.2 (95% CI: 4.1–6.4), 0.10 (95% CI: 0.07–0.13), 54.0 (95% CI: 37.0–77.0) and 0.95 (95% CI: 0.91–0.95). Meta-regression based on study design, country, enrollment and blind method was not statistically significant. This meta-analysis was stable with no obvious publication bias.ConclusionsThe ADNEX model at the 15% cut-off had high diagnostic accuracy in identifying ovarian cancer.

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The ADNEX model to triage adnexal masses: An external validation study and comparison with the IOTA two-step strategy and subjective assessment by an experienced ultrasound operator

Cited by 30 publications

References 20 publications

ESGO/ISUOG/IOTA/ESGE Consensus Statement on preoperative diagnosis of ovarian tumors

ESGO/ISUOG/IOTA/ESGE Consensus Statement on preoperative diagnosis of ovarian tumors

ESGO/ISUOG/IOTA/ESGE Consensus Statement on preoperative diagnosis of ovarian tumours

Diagnostic Accuracy of the ADNEX Model for Ovarian Cancer at the 15% Cut-Off Value: A Systematic Review and Meta-Analysis

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