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Evaluation of IOTA-ADNEX Model and Simple Rules for Identifying Adnexal Masses by Operators with Varying Levels of Expertise: A Single-Center Diagnostic Accuracy Study

Objectives The discrimination of ovarian lesions presents a significant problem in everyday clinical practice with ultrasonography appearing to be the most effective diagnostic technique. The aim of our study was to externally evaluate the performance of different diagnostic models when applied by e...

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Autores principales: Giourga, Maria, Pouliakis, Abraham, Vlastarakos, Panagiotis, Stavrou, Sofoklis, Tsiriva, Maria, Gerede, Angeliki, Daskalakis, Georgios, Voros, Charalampos, Drakakis, Petros, Domali, Ekaterini
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Georg Thieme Verlag KG 2023
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10446913/
https://www.ncbi.nlm.nih.gov/pubmed/37621952
http://dx.doi.org/10.1055/a-2044-2855
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author Giourga, Maria
Pouliakis, Abraham
Vlastarakos, Panagiotis
Stavrou, Sofoklis
Tsiriva, Maria
Gerede, Angeliki
Daskalakis, Georgios
Voros, Charalampos
Drakakis, Petros
Domali, Ekaterini
author_facet Giourga, Maria
Pouliakis, Abraham
Vlastarakos, Panagiotis
Stavrou, Sofoklis
Tsiriva, Maria
Gerede, Angeliki
Daskalakis, Georgios
Voros, Charalampos
Drakakis, Petros
Domali, Ekaterini
author_sort Giourga, Maria
collection PubMed
description Objectives The discrimination of ovarian lesions presents a significant problem in everyday clinical practice with ultrasonography appearing to be the most effective diagnostic technique. The aim of our study was to externally evaluate the performance of different diagnostic models when applied by examiners with various levels of experience. Methods This was a diagnostic accuracy study including women who were admitted for adnexal masses, between July 2018 and April 2021, to a Greek tertiary oncology center. Preoperatively sonographic data were evaluated by an expert gynecologist, a 6 (th) and a 1 (st) year gynecology resident, who applied the International Ovarian Tumor Analysis (IOTA) Simple Rules (SR) and Assessment of Different NEoplasias in the adneXa (ADNEX) model to discriminate between benign and malignant ovarian tumors. The explant pathology report was used as the reference diagnosis. Kappa statistics were used for the investigation of the level of agreement between the examined systems and the raters. Results We included 66 women, 39 with benign and 27 with malignant ovarian tumors. ADNEX (with and without “CA-125”) had high sensitivity (96–100%) when applied by all raters but a rather low specificity (36%) when applied by the 1st year resident. SR could not be applied in 6% to 17% of the cases. It had slightly lower sensitivity, higher specificity, and higher overall accuracy, especially when applied by the 1st year resident (61% vs. 92%), compared to ADNEX. Conclusion Both ADNEX and SR can be utilized for screening in non-oncology centers since they offer high sensitivity even when used by less experienced examiners. In the hands of inexperienced examiners, SR appears to be the best model for assessing ovarian lesions.
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spelling pubmed-104469132023-08-24 Evaluation of IOTA-ADNEX Model and Simple Rules for Identifying Adnexal Masses by Operators with Varying Levels of Expertise: A Single-Center Diagnostic Accuracy Study Giourga, Maria Pouliakis, Abraham Vlastarakos, Panagiotis Stavrou, Sofoklis Tsiriva, Maria Gerede, Angeliki Daskalakis, Georgios Voros, Charalampos Drakakis, Petros Domali, Ekaterini Ultrasound Int Open Objectives The discrimination of ovarian lesions presents a significant problem in everyday clinical practice with ultrasonography appearing to be the most effective diagnostic technique. The aim of our study was to externally evaluate the performance of different diagnostic models when applied by examiners with various levels of experience. Methods This was a diagnostic accuracy study including women who were admitted for adnexal masses, between July 2018 and April 2021, to a Greek tertiary oncology center. Preoperatively sonographic data were evaluated by an expert gynecologist, a 6 (th) and a 1 (st) year gynecology resident, who applied the International Ovarian Tumor Analysis (IOTA) Simple Rules (SR) and Assessment of Different NEoplasias in the adneXa (ADNEX) model to discriminate between benign and malignant ovarian tumors. The explant pathology report was used as the reference diagnosis. Kappa statistics were used for the investigation of the level of agreement between the examined systems and the raters. Results We included 66 women, 39 with benign and 27 with malignant ovarian tumors. ADNEX (with and without “CA-125”) had high sensitivity (96–100%) when applied by all raters but a rather low specificity (36%) when applied by the 1st year resident. SR could not be applied in 6% to 17% of the cases. It had slightly lower sensitivity, higher specificity, and higher overall accuracy, especially when applied by the 1st year resident (61% vs. 92%), compared to ADNEX. Conclusion Both ADNEX and SR can be utilized for screening in non-oncology centers since they offer high sensitivity even when used by less experienced examiners. In the hands of inexperienced examiners, SR appears to be the best model for assessing ovarian lesions. Georg Thieme Verlag KG 2023-08-23 /pmc/articles/PMC10446913/ /pubmed/37621952 http://dx.doi.org/10.1055/a-2044-2855 Text en The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/). https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Giourga, Maria
Pouliakis, Abraham
Vlastarakos, Panagiotis
Stavrou, Sofoklis
Tsiriva, Maria
Gerede, Angeliki
Daskalakis, Georgios
Voros, Charalampos
Drakakis, Petros
Domali, Ekaterini
Evaluation of IOTA-ADNEX Model and Simple Rules for Identifying Adnexal Masses by Operators with Varying Levels of Expertise: A Single-Center Diagnostic Accuracy Study
title Evaluation of IOTA-ADNEX Model and Simple Rules for Identifying Adnexal Masses by Operators with Varying Levels of Expertise: A Single-Center Diagnostic Accuracy Study
title_full Evaluation of IOTA-ADNEX Model and Simple Rules for Identifying Adnexal Masses by Operators with Varying Levels of Expertise: A Single-Center Diagnostic Accuracy Study
title_fullStr Evaluation of IOTA-ADNEX Model and Simple Rules for Identifying Adnexal Masses by Operators with Varying Levels of Expertise: A Single-Center Diagnostic Accuracy Study
title_full_unstemmed Evaluation of IOTA-ADNEX Model and Simple Rules for Identifying Adnexal Masses by Operators with Varying Levels of Expertise: A Single-Center Diagnostic Accuracy Study
title_short Evaluation of IOTA-ADNEX Model and Simple Rules for Identifying Adnexal Masses by Operators with Varying Levels of Expertise: A Single-Center Diagnostic Accuracy Study
title_sort evaluation of iota-adnex model and simple rules for identifying adnexal masses by operators with varying levels of expertise: a single-center diagnostic accuracy study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10446913/
https://www.ncbi.nlm.nih.gov/pubmed/37621952
http://dx.doi.org/10.1055/a-2044-2855
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