title: Comparative evaluation of the risk of malignancy index scoring systems (1-4) used in differential diagnosis of adnexal masses.
abstract: BACKGROUND
  To determine the cut-off values of the preoperative risk of malignancy index (RMI) used in differentiating benign or malignant adnexal masses and to determine their significance in differential diagnosis by comparison of different systems.
  
  
  METHODS
  191 operated women were assessed retrospectively. RMI of 1, 2, 3 and 4; cut-off values for an effective benign or malignant differentiation together with sensitivity, specificity, negative and positive predictive values were calculated.
  
  
  RESULTS
  Cut-off value for RMI 1 was found to be 250; there was significant (p<0.001) compatibility at this level with sensitivity of 60%, positive predictive value (PPV) of 75%, specificity of 93%, negative predictive value (NPV) of 88% and an overall compliance rate of 85%. When RMI 2 and 3 was obtained with a cut-off value of 200, there was significant (p<0.001) compatibility at this level for RMI 2 with sensitivity of 67%, PPV of 67%, specificity of 89%, NPV of 89%, histopathologic correlation of 84% while RMI 3 had significant (p<0.001) compatibility at the same level with sensitivity of 63%, PPV of 69%, specificity of 91%, NPV of 88% and a histopathologic correlation of 84%. Significant (p<0.001) compatibility for RMI 4 with a sensitivity of 67%, PPV of 73%, specificity of 92%, NPV of 89% and a histopathologic correlation of 86% was obtained at the cut-off level 400.
  
  
  CONCLUSIONS
  RMI have a significant predictability in differentiating benign and malignant adnexal masses, thus can effectively be used in clinical practice.
authors: Department of Obstetrics and Gynecology, Aydin Obstetrics and Pediatrics Hospital, Aydin, Turkey E-mail : drmuzaffer@yahoo.com.
authors: Pelin Ozun
authors: PO
authors: Ozbay
authors: Tekin
authors: T
authors: Ekinci
authors: Melike Demir
authors: MD
authors: Caltekin
authors: Hasan Taylan
authors: HT
authors: Yilmaz
authors: Muzaffer
authors: M
authors: Temur
authors: Ozgur
authors: O
authors: Yilmaz
authors: Selda
authors: S
authors: Uysal
authors: Emine
authors: E
authors: Demirel
authors: Sefa
authors: S
authors: Kelekci
mesh_terms: D005185:Fallopian Tube Neoplasms / Q000175:diagnosis / Q000473:pathology*; D005260:Female; D006801:Humans; D060787:Neoplasm Grading / Q000379:methods*; D018294:Neoplasms, Adnexal and Skin Appendage / Q000175:diagnosis / Q000473:pathology*; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000473:pathology*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment