title: Simple descriptors and simple rules of the International Ovarian Tumor Analysis (IOTA) Group: a prospective study of combined use for the description of adnexal masses.
abstract: OBJECTIVE
  External validation of the IOTA group's three-step diagnostic model (Strategy 1) and comparison with assessment by an expert sonographer (Strategy 2).
  
  
  METHODS
  Prospective study in patients with persistent adnexal masses, in which an inexperienced sonographer performed transvaginal ultrasound applying simple descriptors (SD) and rules (SR) for classifying as benign or malignant. Any non-classifiable mass was then submitted to an expert examiner for subjective assessment (SA).
  
  
  RESULTS
  Eighty-one patients (mean age, 43; 27.2% postmenopausal) were included in this prospective study. Surgery was performed for 30 (8 malignant and 22 benign) masses; 51 masses were considered as benign and managed expectantly (they were assumed to be benign for statistical purposes). Diagnostic performance for Strategy 1 (SD+SR+SA) was sensitivity (SN): 87.5% (7/8, 95% CI, 47.3-99.7%) and specificity (SP): 100% (73/73, 95% CI, 95.1-100%). For Strategy 2 (SA only) it was SN 87.5% (7/8, 95% CI, 47.3-99.7%), SP 98.6% (72/73, 95% CI, 92.6-100%).
  
  
  CONCLUSIONS
  The three-step diagnostic strategy designed by the IOTA group for adnexal masses has a diagnostic performance comparable to that of subjective expert assessment and could be used as a triage method by nonexpert sonographers.
authors.affiliation: Department of Obstetrics and Gynecology, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain. Electronic address: almudenapeces@gmail.com.
authors.forename: Almudena
authors.initials: A
authors.lastname: Peces Rama
authors.affiliation: Department of Obstetrics and Gynecology, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain.
authors.forename: María Carmen
authors.initials: MC
authors.lastname: Llanos Llanos
authors.affiliation: Department of Obstetrics and Gynecology, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain.
authors.forename: María Luisa
authors.initials: ML
authors.lastname: Sánchez Ferrer
authors.affiliation: Department of Obstetrics and Gynecology, Clínica Universidad de Navarra, Pamplona, Spain.
authors.forename: Juan Luis
authors.initials: JL
authors.lastname: Alcázar Zambrano
authors.affiliation: Department of Obstetrics and Gynecology, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Martínez Mendoza
authors.affiliation: Department of Obstetrics and Gynecology, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain.
authors.forename: Aníbal
authors.initials: A
authors.lastname: Nieto Díaz
mesh_terms: D000038:Abscess / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery; D018262:Adenocarcinoma, Clear Cell / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D018269:Carcinoma, Endometrioid / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery; D015331:Cohort Studies; D062625:Cystadenofibroma / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery; D018291:Cystadenoma, Mucinous / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery; D018293:Cystadenoma, Serous / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery; D004715:Endometriosis / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D018297:Neoplasms, Cystic, Mucinous, and Serous / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery; D010048:Ovarian Cysts / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery; D010049:Ovarian Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013724:Teratoma / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery; D014463:Ultrasonography; D055815:Young Adult
keywords: Adnexal disease; Diagnosis; Gynecology; Ultrasound