Moore et al developed the Risk of Ovarian Malignancy Algorithm (ROMA) to identify a woman with a pelvic mass who is likely to have an ovarian epithelial carcinoma. The authors are from Brown University and other universities in the United States.
Patient selection: woman with a pelvic mass
Parameters:
(1) premenopausal vs postmenopausal
(2) serum CA125 in U/mL (upper limit of reference range 35 U/mL)
(3) serum HE4 (human epididymis protein 4) in pmol/L (by EIA)
X for premenopausal woman =
= (2.38 * LN(HE4)) + (0.0626 * LN(CA125)) - 12.0
X for postmenopausal woman =
= (1.04 * LN(HE4)) + (0.732 * LN(CA125)) - 8.09
probability of malignancy =
= 1 / (1 + EXP((-1) * X)
Performance:
• The evaluations are done on women with a pelvic mass.
• The performance of the algorithm depends on the analytical methods.
• Montagnana et al found that the algorithm was excellent in postmenopausal women but not in premenopausal women and that HE4 alone was just as good.
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