Supplemental Table 5.
Performance of the models by varying sensitivity and specificity
| Model | Specificity | Sensitivity | L, 95% CI | U, 95% CI | PPV | L, 95% CI | U, 95% CI | NPV | L, 95% CI | U, 95% CI |
|---|---|---|---|---|---|---|---|---|---|---|
| Ultrasound plus CA125 plus HE4a | 80% | 83.3 | 75.0 | 91.7 | 17.7 | 13.9 | 22.0 | 98.9 | 98.2 | 99.4 |
| Ultrasound plus CA125a | 80.8 | 72.2 | 89.3 | 17.3 | 13.5 | 21.5 | 98.8 | 98.0 | 99.3 | |
| ROMA (CA125 plus HE4) | 73.1 | 63.1 | 83.1 | 15.9 | 12.3 | 20.1 | 98.3 | 97.4 | 98.9 | |
| Ultrasound plus HE4a | 71.8 | 61.6 | 82.0 | 15.6 | 12.0 | 19.8 | 98.2 | 97.3 | 98.9 | |
| CA125a | 73.1 | 62.8 | 83.3 | 15.9 | 12.3 | 20.1 | 98.3 | 97.4 | 98.9 | |
| RMI-mod | 76.9 | 66.8 | 87.1 | 16.5 | 12.9 | 20.8 | 98.5 | 97.7 | 99.1 | |
| Ultrasounda | 65.4 | 54.7 | 76.1 | 14.4 | 11.0 | 18.6 | 97.8 | 96.8 | 98.6 | |
| HE4a | 65.4 | 54.4 | 76.4 | 14.4 | 11.0 | 18.6 | 97.8 | 96.8 | 98.6 | |
| Ultrasound plus CA125 plus HE4a | 85% | 78.2 | 69.3 | 87.2 | 21.2 | 16.6 | 26.4 | 98.7 | 97.9 | 99.2 |
| Ultrasound plus CA125a | 78.2 | 69.2 | 87.2 | 21.2 | 16.6 | 26.4 | 98.7 | 97.9 | 99.2 | |
| ROMA (CA125 plus HE4) | 71.8 | 61.6 | 82.0 | 19.8 | 15.3 | 24.9 | 98.3 | 97.5 | 98.9 | |
| Ultrasound plus HE4a | 67.9 | 57.4 | 78.5 | 18.9 | 14.5 | 24.0 | 98.1 | 97.2 | 98.8 | |
| CA125a | 71.8 | 61.6 | 82.0 | 19.8 | 15.3 | 24.9 | 98.3 | 97.5 | 98.9 | |
| RMI-mod | 70.5 | 59.7 | 81.3 | 19.6 | 15.1 | 24.7 | 98.2 | 97.4 | 98.9 | |
| Ultrasounda | 61.5 | 50.3 | 72.7 | 17.5 | 13.2 | 22.5 | 97.7 | 96.8 | 98.5 | |
| HE4a | 60.3 | 48.6 | 71.9 | 17.2 | 12.9 | 22.1 | 97.6 | 96.7 | 98.4 | |
| Ultrasound plus CA125 plus HE4a | 90% | 75.6 | 66.2 | 85.1 | 28.1 | 22.1 | 34.7 | 98.6 | 97.9 | 99.2 |
| Ultrasound plus CA125a | 74.4 | 64.8 | 83.9 | 27.8 | 21.8 | 34.3 | 98.6 | 97.8 | 99.1 | |
| ROMA (CA125 plus HE4) | 69.2 | 58.6 | 79.9 | 26.3 | 20.5 | 32.9 | 98.3 | 97.4 | 98.9 | |
| Ultrasound plus HE4a | 67.9 | 57.3 | 78.6 | 26.0 | 20.1 | 32.6 | 98.2 | 97.3 | 98.8 | |
| CA125a | 66.7 | 55.9 | 77.4 | 25.6 | 19.8 | 32.2 | 98.1 | 97.3 | 98.8 | |
| RMI-mod | 64.1 | 53.2 | 75.0 | 24.9 | 19.1 | 31.4 | 98.0 | 97.1 | 98.7 | |
| Ultrasounda | 55.1 | 43.3 | 67.0 | 22.2 | 16.5 | 28.7 | 97.5 | 96.5 | 98.2 | |
| HE4a | 53.8 | 42.3 | 65.3 | 21.8 | 16.2 | 28.3 | 97.4 | 96.5 | 98.2 | |
| Ultrasound plus CA125 plus HE4a | 95% | 66.7 | 55.7 | 77.6 | 40.6 | 32.0 | 49.7 | 98.2 | 97.4 | 98.8 |
| Ultrasound plus CA125a | 69.2 | 58.4 | 80.1 | 41.5 | 33.0 | 50.5 | 98.4 | 97.6 | 98.9 | |
| ROMA (CA125 plus HE4) | 61.5 | 49.6 | 73.5 | 38.7 | 30.1 | 47.9 | 98.0 | 97.1 | 98.6 | |
| Ultrasound plus HE4a | 60.3 | 48.7 | 71.8 | 38.2 | 29.6 | 47.4 | 97.9 | 97.0 | 98.6 | |
| CA125a | 53.8 | 41.0 | 66.7 | 35.6 | 27.0 | 44.9 | 97.6 | 96.6 | 98.3 | |
| RMI-mod | 59.0 | 47.7 | 70.3 | 37.7 | 29.1 | 46.9 | 97.8 | 96.9 | 98.5 | |
| Ultrasounda | 43.6 | 30.3 | 56.9 | 30.9 | 22.4 | 40.4 | 97.0 | 96.0 | 97.8 | |
| HE4a | 38.5 | 26.8 | 50.1 | 28.3 | 20.0 | 37.9 | 96.8 | 95.7 | 97.6 | |
| Ultrasound plus CA125 plus HE4a | 80% | 81.5 | 66.0 | 93.1 | 18.1 | 14.2 | 22.6 | 98.7 | 97.9 | 99.3 |
| Ultrasound plus CA125a | 81.0 | 67.6 | 93.3 | 17.8 | 13.9 | 22.2 | 98.7 | 97.9 | 99.3 | |
| ROMA (CA125 plus HE4) | 68.2 | 60.3 | 90.2 | 13.1 | 10.2 | 16.4 | 98.6 | 97.7 | 99.2 | |
| Ultrasound plus HE4a | 70.2 | 57.7 | 84.7 | 12.1 | 9.4 | 15.2 | 98.5 | 97.6 | 99.1 | |
| CA125a | 74.6 | 52.6 | 87.5 | 13.9 | 10.8 | 17.5 | 98.6 | 97.7 | 99.2 | |
| RMI-mod | 78.0 | 48.7 | 84.1 | 15.7 | 12.3 | 19.7 | 98.7 | 97.8 | 99.2 | |
| Ultrasounda | 60.5 | 43.3 | 76.8 | 9.4 | 7.3 | 11.9 | 98.3 | 97.2 | 99.0 | |
| HE4a | 59.4 | 47.0 | 71.2 | 9.2 | 7.1 | 11.6 | 98.2 | 97.2 | 99.0 | |
| Ultrasound plus CA125 plus HE4a | 85% | 74.2 | 49.8 | 86.8 | 14.5 | 11.4 | 18.0 | 98.9 | 98.2 | 99.5 |
| Ultrasound plus CA125a | 70.8 | 57.7 | 87.8 | 13.0 | 10.2 | 16.2 | 98.9 | 98.1 | 99.4 | |
| ROMA (CA125 plus HE4) | 65.4 | 37.3 | 79.1 | 10.8 | 8.5 | 13.5 | 98.8 | 97.9 | 99.4 | |
| Ultrasound plus HE4a | 64.7 | 36.2 | 73.2 | 11.0 | 8.6 | 13.8 | 98.8 | 97.9 | 99.4 | |
| CA125a | 61.4 | 41.0 | 77.0 | 10.2 | 7.9 | 12.7 | 98.7 | 97.8 | 99.3 | |
| RMI-mod | 74.4 | 39.6 | 80.6 | 14.6 | 11.5 | 18.2 | 98.9 | 98.2 | 99.5 | |
| Ultrasounda | 53.4 | 40.0 | 69.9 | 8.6 | 6.7 | 10.8 | 98.5 | 97.5 | 99.2 | |
| HE4a | 51.8 | 35.3 | 64.3 | 8.3 | 6.5 | 10.4 | 98.5 | 97.4 | 99.2 | |
| Ultrasound plus CA125 plus HE4a | 90% | 64.5 | 38.6 | 80.4 | 11.5 | 9.1 | 14.3 | 99.2 | 98.4 | 99.6 |
| Ultrasound plus CA125a | 60.3 | 43.2 | 79.3 | 10.4 | 8.2 | 13.0 | 99.1 | 98.3 | 99.6 | |
| ROMA (CA125 plus HE4) | 41.7 | 19.5 | 68.6 | 8.1 | 6.4 | 10.2 | 98.9 | 97.9 | 99.5 | |
| Ultrasound plus HE4a | 48.5 | 30.9 | 67.6 | 8.2 | 6.5 | 10.3 | 98.9 | 97.9 | 99.5 | |
| CA125a | 45.9 | 28.9 | 69.3 | 7.9 | 6.2 | 9.9 | 98.9 | 97.8 | 99.5 | |
| RMI-mod | 43.0 | 19.1 | 77.7 | 7.5 | 5.9 | 9.4 | 98.8 | 97.6 | 99.5 | |
| Ultrasounda | 41.7 | 25.3 | 54.8 | 7.4 | 5.8 | 9.2 | 98.7 | 97.5 | 99.5 | |
| HE4a | 39.0 | 21.5 | 57.5 | 7.0 | 5.5 | 8.8 | 98.7 | 97.4 | 99.4 | |
| Ultrasound plus CA125 plus HE4a | 95% | 40.6 | 19.5 | 68.7 | 7.6 | 6.0 | 9.5 | 99.4 | 98.4 | 99.8 |
| Ultrasound plus CA125a | 42.1 | 10.0 | 59.5 | 7.8 | 6.2 | 9.7 | 99.4 | 98.4 | 99.8 | |
| ROMA (CA125 plus HE4) | 18.7 | 5.1 | 40.9 | 6.0 | 4.7 | 7.4 | 98.9 | 97.1 | 99.7 | |
| Ultrasound plus HE4a | 31.5 | 21.6 | 36.0 | 6.7 | 5.3 | 8.3 | 99.2 | 97.9 | 99.8 | |
| CA125a | 30.2 | 2.0 | 45.1 | 6.6 | 5.2 | 8.2 | 99.1 | 97.8 | 99.8 | |
| RMI | 18.6 | 6.9 | 43.7 | 5.7 | 4.5 | 7.1 | 98.6 | 96.4 | 99.6 | |
| Ultrasounda | 28.8 | 2.2 | 42.5 | 6.4 | 5.1 | 8.0 | 99.1 | 97.7 | 99.8 | |
| HE4a | 21.4 | 4.7 | 41.1 | 5.9 | 4.6 | 7.3 | 98.8 | 96.9 | 99.7 |
CI, confidence interval; L, lower; NPV, negative predictive value; PPV, positive predictive value; RMI, Risk of Malignancy Index; ROMA, Risk of Ovarian Malignancy Algorithm; U, upper.
Gentry-Maharaj et al. HE4 in diagnosis of ovarian cancer. Am J Obstet Gynecol 2020.
a
All models incorporate age.