Can Replacing CA125 with HE4 in Risk of Malignancy Indices 1–4 Improve Diagnostic Performance in the Presurgical Assessment of Adnexal Tumors?

Table 7

Diagnostic performance of classical RMIs 1–4 for differentiation of malignant stage I (FIGO) from nonmalignant adnexal tumors.

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)
RMI 1	25%; (3.7–46.2%)	95.3%; (92.8–97.9%)	25%; (3.7–46.2%)	95.3%; (92.8–97.9%)	5.4; (1.9–14.9)	0.7; (0.5–1)	91.3%; (87.9–94.6%)
RMI 2	37.5%; (13.7–61.2%)	87.6%; (83.6–91.6%)	15.7%; (4.1–27.3%)	95.7%; (93.2–98.3%)	3; (1.4–6.1)	0.7; (0.4–1)	84.7%; (80.4–88.9%)
RMI 3	31.2%; (8.5–53.9%)	91.8%; (88.5–95.2%)	19.2%; (4–34.3%)	95.5%; (93–98.1%)	3.8; (1.6–8.8)	0.7; (0.5–1)	88.3%; (84.5–92.1%)
RMI 4	25%; (3.7–46.2%)	92.2%; (89–95.5%)	16.6%; (1.7–31.5%)	95.2%; (92.5–97.8)	3.2; (1.2–8.3)	0.8; (0.6–1)	88.3%; (84.5–92.1%)

Data are shown with 95% confidence intervals (CIs). PPV: positive predictive value; NPV: negative predictive value; LR+: positive likelihood ratio; LR−: negative likelihood ratio; FIGO: Fédération Internationale de Gynécologie et d’Obstétrique.