Supplemental Table 6.

Performance of the models (at fixed specificity of 90%) by different prevalence of ovarian cancer

Model	Prevalence of ovarian cancer	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	10%	75.6	65.4	84.3	45.7	40.9	50.6	97.1	95.7	98.0
Ultrasound plus CA125a		74.4	63.8	83.3	45.3	40.4	50.3	96.9	95.6	97.9
ROMA (CA125 plus HE4)		69.2	58.2	78.9	43.5	38.4	48.8	96.3	95	97.4
Ultrasound plus HE4a		67.9	57.5	78.4	43.1	37.9	48.4	96.2	94.8	97.2
CA125a		66.7	55.7	76.6	42.6	37.4	48	96	94.7	97.1
RMI-mod		64.1	52.9	73.8	41.6	36.3	47.2	95.8	94.4	96.8
Ultrasounda		55.1	43.7	67.1	38	32.3	44.1	94.8	93.4	95.9
HE4a		53.8	43.0	65.6	37.5	31.7	43.6	94.6	93.2	95.7
Ultrasound plus CA125 plus HE4a	15%	75.6	65.4	84.3	57.2	52.3	61.9	95.4	93.4	96.9
Ultrasound plus CA125a		74.4	63.8	83.3	56.8	51.8	61.6	95.2	93.2	96.7
ROMA (CA125 plus HE4)		69.2	58.2	78.9	55.0	49.7	60.2	94.3	92.2	95.9
Ultrasound plus HE4a		67.9	57.5	78.4	54.6	49.2	59.8	94.1	92	95.7
CA125a		66.7	55.7	76.6	54.1	48.6	59.4	93.9	91.8	95.4
RMI-mod		64.1	52.9	73.8	53.1	47.5	58.6	93.4	91.3	95
Ultrasounda		55.1	43.7	67.1	49.3	43.1	55.6	91.9	89.9	93.6
HE4a		53.8	43.0	65.6	48.8	42.4	55.1	91.7	89.7	93.4

CI, confidence interval; HE4, human epididymis 4; L, lower; RMI, Risk of Malignancy Index; RMI-mod, RMI modified; ROMA, Risk of Ovarian Malignancy Algorithm; U, upper.

Gentry-Maharaj et al. HE4 in diagnosis of ovarian cancer. Am J Obstet Gynecol 2020.

^aAll models incorporate age.