IOTA LR2模型与医师经验诊断效能的比较

Comparison of diagnostic efficiency between IOTA LR2 model and doctors’experiences

目的:国际卵巢肿瘤分析(International Ovarian Tumor Analysis,IOTA)工作组提出的logistic回归模型(IOTA LR2模型)是子宫附件肿瘤良恶性风险的预测模型。本研究对比分析IOTA LR2模型与医师主观判断对子宫附件肿块(adnexal mass,AM)良恶性的诊断效能。方法:回顾性分析616例AM的超声图像,高年资组和低年资组医师运用IOTA LR2模型及主观判断诊断AM的良恶性。以术后病理诊断为金标准,比较两种方法的诊断效能。结果:高年资组运用主观判断及IOTA LR2模型诊断恶性AM的曲线下面积分别为0.86和0.90,低年资组为0.79和0.88。高年资组主观判断诊断AM的灵敏度和特异度分别为81.0%和91.3%,低年资组为70.1%和88.7%;高年资组运用IOTA LR2模型诊断AM的灵敏度和特异度分别为79.6%和88.1%,低年资组为79.6%和81.7%。两组医师运用IOTA LR2模型诊断恶性AM的灵敏度与高年资组主观判断差异无统计学意义(均P>0.05)。结论:IOTA LR2模型对恶性AM的诊断效能与高年资医师的经验相当,可帮助低年资医师减少对恶性AM的漏诊。

Objective:International Ovarian Tumor Analysis(IOTA)working group proposed a logistic regression(IOTA LR2)model.It is served as a risk prediction model for benign and malignant adnexal tumors.This study aims to compare the diagnostic efficiency between the IOTA LR2 model and doctors’subjective assessment on diagnosing benign and malignant adnexal mass.Methods:The ultrasonographic images of 616 adnexal masses were retrospectively analyzed by the senior doctors’group and the junior doctors’group using the IOTA LR2model and subjective assessment.The postoperative pathological diagnosis was used as the gold standard to compare the diagnostic efficiency of the 2 methods.Results:The area under the curves of subjective assessment and IOTA LR2 model for diagnosing malignant adnexal masses were 0.86 and 0.90 for the senior doctors’group and0.79 and 0.88 for the junior doctors’group,respectively.The sensitivity and specificity of subjective assessment for diagnosing the malignant adnexal masses were 81.0%and 91.3%for the senior doctors’group and 70.1%and 88.7%for the junior doctors’group,respectively.The sensitivity and specificity of the IOTA LR2 model for diagnosing the malignant adnexal masses were 79.6%and 88.1%for the senior doctors’group,and 79.6%and 81.7%for the junior doctors’group,respectively.There were no significant difference in the sensitivities between the senior doctors’group and junior doctors’group using the IOTA LR2 model and the senior doctors’group using subjective assessment(both P>0.05).Conclusion:The diagnostic efficiency of the IOTA LR2 model is equal to the senior doctors’experiences.This model can help junior doctors to reduce the missed diagnosis of malignant adnexal masses.