Department of Obstetrics and Gynecology, Clinica Universidad de Navarra, Pamplona, Spain.
Department of Obstetrics and Gynecology, University and Polytechnic hospital "La Fe", Valencia, Spain.
Gynecol Obstet Invest. 2019;84(6):591-598. doi: 10.1159/000501681. Epub 2019 Jul 16.
To perform a systematic review and meta-analysis of studies comparing the diagnostic accuracy of Risk of Ovarian Malignancy Algorithm (ROMA) and risk of malignancy index (RMI) for detecting ovarian cancer.
A systematic review and meta-analysis was performed according to PRISMA statement. A search for studies evaluating the diagnostic performance of ROMA and RMI-I indices for detecting ovarian malignancy from January 2010 to October 2018 was performed in the PubMed/MEDLINE and Web of Science databases. The quality of the studies was evaluated by the Quality Assessment of Diagnostic Accuracy Studies 2.
Sixty-six citations were identified. After exclusions, 8 papers comprising 2,662 women (1,319 premenopausal and 1,343 postmenopausal) were ultimately included. The mean prevalence of ovarian malignancy was 29.0% in premenopausal women and 51.0% in postmenopausal women. High risk of bias for patient selection was observed for most studies. ROMA and RMI-I had a similar diagnostic performance in postmenopausal women (pooled sensitivity [87 vs. 77%] and specificity [75 vs. 85%], respectively. p = 0.29). In premenopausal women, RMI-I showed better specificity than ROMA (89 vs. 78%, p = 0.022) with similar sensitivity (73 vs. 80%, p= 0.27). Significant heterogeneity was found for sensitivity and specificity in comparisons of both groups.
ROMA and RMI-I have similar diagnostic performance for detecting ovarian cancer in women presenting with an adnexal mass. However, RMI-I showed a higher specificity than ROMA in premenopausal women. Notwithstanding, as the risk of bias is high in most studies, our results should be interpreted with caution.
系统评价和荟萃分析比较风险卵巢恶性肿瘤算法（ROMA）和恶性肿瘤风险指数（RMI）诊断卵巢癌的准确性的研究。
根据 PRISMA 声明进行系统评价和荟萃分析。在 PubMed/MEDLINE 和 Web of Science 数据库中搜索 2010 年 1 月至 2018 年 10 月评估 ROMA 和 RMI-I 指数检测卵巢恶性肿瘤的诊断性能的研究。通过诊断准确性研究质量评估 2 来评估研究质量。
共确定了 66 篇引文。排除后，最终纳入 8 篇论文，共 2662 名女性（1319 名绝经前和 1343 名绝经后）。绝经前女性卵巢恶性肿瘤的平均患病率为 29.0%，绝经后女性为 51.0%。大多数研究都存在患者选择的高偏倚风险。ROMA 和 RMI-I 在绝经后女性中的诊断性能相似（汇总敏感性[87%比 77%]和特异性[75%比 85%]，p=0.29）。在绝经前女性中，RMI-I 的特异性优于 ROMA（89%比 78%，p=0.022），敏感性相似（73%比 80%，p=0.27）。两组比较均存在敏感性和特异性的显著异质性。
ROMA 和 RMI-I 在诊断有附件包块的女性卵巢癌方面具有相似的诊断性能。然而，在绝经前女性中，RMI-I 的特异性高于 ROMA。尽管如此，由于大多数研究的偏倚风险较高，我们的结果应谨慎解释。
