Prospective temporal validation of mathematical models to calculate risk of endometrial malignancy in patients with postmenopausal bleeding

• DOI: 10.1002/uog.15941
• Publication Date: 2016-04-13T08:55:13Z
• Authors: P. Sladkevicius; G. Opolskiene; L. Valentin
• Keywords: POSTMENOPAUSAL BLEEDING; Echogenicity; Gold standard (test)

Abstract Objectives To validate prospectively five mathematical models published in 2007 for calculating the risk of endometrial malignancy a defined high‐risk group patients with postmenopausal bleeding and sonographic thickness ≥ 4.5 mm. Methods Of 1012 consecutive patients, 379 fulfilled our inclusion criteria, which were same as those original study created (endometrial mm, no fluid uterine cavity, detectable Doppler signals endometrium). A standardized history was taken, clinical transvaginal grayscale power ultrasound examinations performed following protocol. All data collected applied to patients' assess their malignancy. Using histological diagnosis endometrium gold standard, we calculated area under receiver–operating characteristics curve ( AUC ), sensitivity, specificity likelihood ratios when using cut‐offs study, each models. Results Ninety‐three (25%) had malignant endometrium. The performance similar that AUCs ranging from 0.86 0.90. model best diagnostic included thickness, heterogeneous echogenicity areas densely packed vessels on , 0.90; 81%; specificity, 84% at preselected cut‐off). well calibrated. Conclusions On temporal validation, retained good make it possible reclassify having low or relatively risk, moderately high very cancer, so can be used individualized patient management. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.