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Applicability of the modified ACOG / SGO referral criteria for adnexal mass within a limited‐resource setting
Author(s) -
Battarbee Ashley,
Strohl Anna,
Zimmerman Lindsay,
Patel Ashlesha,
Burtch Radha
Publication year - 2017
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12006
Subject(s) - medicine , referral , malignancy , gynecology , gynecologic oncology , obstetrics , family medicine
Objective To evaluate the performance of the modified American Congress of Obstetricians and Gynecologists ( ACOG )/Society of Gynecologic Oncology ( SGO ) referral guidelines in a high‐risk limited‐resource setting. Methods In a retrospective study, data were assessed for all women who underwent surgery for an adnexal mass at John H. Stroger Jr Hospital, Chicago, IL , USA , between July 2006 and July 2011. Sensitivity, specificity, and positive and negative predictive values were calculated both for actual practice referral patterns and for the modified ACOG / SGO guidelines. Results Among 542 study women, 176 (32.5%) were diagnosed with ovarian malignancy. The ACOG / SGO guidelines showed 81.3% sensitivity and 71.9% specificity for the prediction of malignancy at time of surgery, with positive and negative predictive values of 58.1% and 88.9%, respectively. Actual practice patterns demonstrated lower sensitivity (68.2%; P <0.001) but higher specificity (84.2%; P <0.001). Conclusion As compared with practice patterns, the modified ACOG / SGO guidelines lacked sufficient specificity for referral and might not be applicable in high‐risk, low‐resource settings. For this population, screening should be based on stratifying patients into low‐, intermediate‐, and high‐risk categories to allow limited resources to be focused on women at highest risk.