Preoperative Risk Stratification of Adnexal Masses in the Pediatric and Adolescent Population: Evaluating the Decision Tree System.
J Pediatr Adolesc Gynecol
; 32(6): 633-638, 2019 Dec.
Article
em En
| MEDLINE
| ID: mdl-31330247
ABSTRACT
STUDY OBJECTIVE:
To evaluate the diagnostic performance of the Decision Tree System (DTS) rules 2 and 3 for surgically managed adnexal masses in the North American population and to compare it with the risk stratification criteria used at The Hospital for Sick Children (≥8 cm and complex/solid).DESIGN:
A retrospective cohort study of patients who presented with adnexal masses and were surgically treated between April 2011 and March 2016.SETTING:
The Hospital for Sick Children (Toronto, Ontario, Canada).PARTICIPANTS:
Patients 1-18 years of age with adnexal masses who underwent surgical treatment. INTERVENTIONS AND MAIN OUTCOMEMEASURES:
Main outcome measures included diagnostic performance (preoperative sensitivity, specificity, positive predictive value [PPV], and negative predictive value [NPV] for malignancy) of the DTS rules 2 and 3 and ≥8 cm and complex/solid criteria.RESULTS:
The malignancy rate was 10.4%. The DTS rules 2 and 3 had a sensitivity of 84% (95% confidence interval [CI], 79-90), specificity of 77% (95% CI, 71-83), PPV of 30% (95% CI, 17-42), and NPV of 98% (95% CI, 94-100). The 8 cm or larger and complex/solid criteria had a sensitivity of 89% (95% CI, 85-94), specificity of 71% (95% CI, 64-77), PPV of 27% (95% CI, 16-38), and NPV of 98% (95% CI, 96-100).CONCLUSION:
Our study showed that DTS rules 2 and 3 had similar diagnostic performance as the 8 cm or larger and complex/solid criteria in the same population, with a very high NPV and a low PPV. Future prospective investigations should be conducted to further assess how DTS components can be incorporated into future algorithms for the management of adnexal masses in the pediatric population.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Árvores de Decisões
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Doenças dos Anexos
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Medição de Risco
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Tomada de Decisão Clínica
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Neoplasias dos Genitais Femininos
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Evaluation_studies
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Health_economic_evaluation
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adolescent
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Child
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Child, preschool
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Female
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Humans
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Infant
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article