Research Article
Can Replacing CA125 with HE4 in Risk of Malignancy Indices 1–4 Improve Diagnostic Performance in the Presurgical Assessment of Adnexal Tumors?
Table 6
Diagnostic performance of classical risk of malignancy indices (RMIs) 1–4 in patients with adnexal masses.
| | Group of patients | RMI variant | Diagnostic performance of RMI | Sensitivity
(95% CI) | Specificity
(95% CI) | PPV
(95% CI) | NPV
(95% CI) | LR+
(95% CI) | LR–
(95% CI) | Diagnostic accuracy
(95% CI) |
| | Entire study sample | RMI 1 | 75.0%
(63.2–86.7%) | 95.3%
(92.8–97.9%) | 76.4%
(64.8–88.1%) | 95%
(92.3–97.6%) | 16.2
(9.1–28.8) | 0.2
(0.1–0.4) | 91.9%
(88.9–95.0%) | | RMI 2 | 78.8%
(67.7–89.9%) | 87.6%
(83.6–91.6%) | 56.1%
(44.7–67.5%) | 95.3%
(92.7–98.0%) | 6.2
(4.3–8.9) | 0.2
(0.1–0.4) | 86.1%
(82.3–90.0%) | | RMI 3 | 76.9%
(65.4–88.3%) | 91.8%
(88.5–95.2%) | 65.5%
(53.6–77.4%) | 95.2%
(92.5–97.8%) | 9.4
(6.1–14.6) | 0.2
(0.1–0.4) | 89.3%
(85.9–92.8%) | | RMI 4 | 75%
(63.2–86.7%) | 92.2%
(89–95.5%) | 66.1%
(54.0–78.1%) | 94.8%
(92.1–97.5%) | 9.7
(6.1–15.2) | 0.2
(0.1–0.4) | 89.3%
(85.9–92.8%) |
| | Premenopausal patients | RMI 1 | 45.4%
(16–74.8%) | 96.7%
(94.1–99.3%) | 45.4%
(16.0–74.8%) | 96.7%
(94.1–99.3%) | 13.9
(5–38.6) | 0.5
(0.3–0.9) | 93.8%
(90.4–97.2%) | | RMI 2 | 54.5%
(25.1–83.9%) | 92.3%
(88.4–96.2%) | 30%
(9.9–50%) | 97.1%
(94.6–99.6%) | 7.1
(3.4–14.9) | 0.4
(0.2–0.9) | 90.2%
(86.0–94.3%) | | RMI 3 | 54.5%
(25.1–83.9%) | 92.8%
(89.1–96.6%) | 31.5%
(10.6–52.4%) | 97.1%
(94.6–99.6%) | 7.6
(3.6–16.2) | 0.4
(0.2–0.9) | 90.7%
(86.6–94.8%) | | RMI 4 | 45.4%
(16–74.8%) | 94.5%
(91.2–97.8%) | 33.3%
(9.4–57.1%) | 96.6%
(94.0–99.2%) | 8.3
(3.4–20.1) | 0.5
(0.3–0.9) | 91.7%
(87.8–95.6%) |
| | Postmenopausal patients | RMI 1 | 82.9%
(71.4–94.4%) | 92.1%
(86–98.1%) | 85%
(73.9–96.0%) | 90.9%
(84.4–97.3%) | 10.5
(4.8–22.9) | 0.1
(0.09–0.3) | 88.8%
(83.1–94.5%) | | RMI 2 | 85.3%
(74.5–96.1%) | 76.3%
(66.7–85.8%) | 66%
(53.2–78.7%) | 90.6%
(83.4–97.7%) | 3.6
(2.3–5.5) | 0.1
(0.09–0.4) | 79.4%
(72.1–86.8%) | | RMI 3 | 82.9%
(71.4–94.4%) | 89.4%
(82.5–96.3%) | 80.9%
(69.0–92.8%) | 90.6%
(84.0–97.2%) | 7.8
(4–15.3) | 0.1
(0.09–0.3) | 87.1%
(81.1–93.2%) | | RMI 4 | 82.9%
(71.4–94.4%) | 86.8%
(79.2–94.4%) | 77.2%
(64.8–89.6%) | 90.4%
(83.6–97.1%) | 6.3
(3.4–11.4) | 0.19
(0.1–0.3) | 85.4%
(79.0–91.8%) |
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Data are shown with 95% confidence intervals (CIs). PPV: positive predictive value; NPV: negative predictive value; LR+: positive likelihood ratio; LR−: negative likelihood ratio.
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