title: Addition of parity to the risk of malignancy index score in evaluating adnexal masses.
abstract: OBJECTIVE
  The aim of our study was to evaluate the individual contribution of parity when incorporated as another parameter into the four risk of malignancy indices (RMI 1-4) to differentiate noninvasive benign lesions from invasive malignant ovarian lesions.
  
  
  METHODS
  After calculating RMI 1-4 for each patient included in this study, the resulting RMI scores were further multiplied by the parity score (P) of each patient to calculate the RMI parity (RMIP) score.
  
  
  RESULTS
  A cutoff value of 300 for RMIP 1 yielded 95.0% specificity, 97.4% negative predictive value (NPV), 88.5% sensitivity, and 79.3% positive predictive value (PPV) and performed better than RMI 1 in the preoperative diagnosis of invasive malignant lesions. RMIP 2 with a cutoff value of 400 yielded 95.0% specificity, 97.4% NPV, 88.5% sensitivity, and 79.3% PPV, and it also performed better than RMI 2. A cutoff value of 400 for RMIP 3 provided 97.5% specificity, 97.5% NPV, 88.5% sensitivity, and 88.5% PPV and performed better than RMI 3. However, a cutoff value of 400 for RMIP 4 provided 90.0% specificity, 97.3% NPV, 88.5% sensitivity, and 65.7% PPV but did not perform better than RMI 4 in the preoperative diagnosis of invasive malignant lesions.
  
  
  CONCLUSIONS
  RMIP 1-3 scales were more reliable tools for the preoperative diagnosis of invasive adnexal masses compared with the traditional RMI 1-3 scales.
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medicine, Düzce University, Düzce, Turkey. Electronic address: draliyavuzcan@yahoo.com.
authors.forename: Ali
authors.initials: A
authors.lastname: Yavuzcan
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medicine, Düzce University, Düzce, Turkey.
authors.forename: Mete
authors.initials: M
authors.lastname: Çağlar
authors.affiliation: Department of Obstetrics and Gynaecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Emre
authors.initials: E
authors.lastname: Özgü
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medicine, Düzce University, Düzce, Turkey.
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Üstün
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medicine, Düzce University, Düzce, Turkey.
authors.forename: Serdar
authors.initials: S
authors.lastname: Dilbaz
authors.affiliation: Department of Obstetrics and Gynaecology, Medicana International Istanbul Hospital, Istanbul, Turkey.
authors.forename: Ismail
authors.initials: I
authors.lastname: Ozdemir
authors.affiliation: Department of Obstetrics and Gynaecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Tayfun
authors.initials: T
authors.lastname: Güngör
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medicine, Düzce University, Düzce, Turkey.
authors.forename: Selahattin
authors.initials: S
authors.lastname: Kumru
mesh_terms: D000328:Adult; D003661:Decision Support Techniques; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008875:Middle Aged; D010049:Ovarian Diseases / Q000175:diagnosis; D010051:Ovarian Neoplasms / Q000175:diagnosis*; D010298:Parity; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity
keywords: adnexal lesion; parity; risk of malignancy index