Table 3.

Performance estimates of ROMA and the combined 7MetP+ROMA model for early-stage OvCa the Training Set and the independent Testing Set.

	Training Set
		ROMA	ROMA + 7MetP	Difference	P
	AUC (95% CI)	0.81 (0.77 – 0.85)	0.84 (0.80 – 0.88)	0.03 (0.01 to 0.06)	< .001
At 11.4% risk threshold for premenopausal and 29.9% for postmenopausal (same risk as ROMA)	Sensitivity	0.68 (0.60 – 0.77)	0.68 (0.59 – 0.77)	0.00 (−0.06 to 0.07)	.49
	Specificity	0.79 (0.75 – 0.83)	0.88 (0.85 – 0.91)	0.09 (0.06 to 0.12)	<.001
	PPV	0.48 (0.40 – 0.55)	0.62 (0.54 – 0.69)	0.14 (0.08 to 0.20)	<.001
	NPV	0.90 (0.87 – 0.93)	0.91 (0.88 – 0.94)	0.01 (−0.01 to 0.03)	.14
	Test Set
		ROMA	ROMA + 7MetP	Difference	P
	AUC (95% CI)	0.91 (0.84–0.98)	0.93 (0.86–1.00)	0.02 (−0.01 to 0.04)	.03
At 11.4% risk threshold for premenopausal and 29.9% for postmenopausal (same risk as ROMA)	Sensitivity	0.90 (0.83 – 0.97)	0.90 (0.81 – 0.97)	0.00 (−0.09 to 0.09)	.472
	Specificity	0.77 (0.70 – 0.83)	0.91 (0.86 – 0.95)	0.14 (0.09 to 0.20)	<.001
	PPV	0.58 (0.48 – 0.68)	0.79 (0.67 – 0.87)	0.21 (0.13 to 0.28)	<.001
	NPV	0.96 (0.92 – 0.99)	0.96 (0.93 – 0.99)	0.01 (−0.03 to 0.04)	.365

Abbreviations: PPV: positive predictive value; NPV: negative predictive value. P-values for comparison of AUCs represent likelihood ratio tests. Risk threshold corresponding to 11.4% in premenopausal women and 29.9% for postmenopausal were chosen based on reported findings from Ortiz-Munoz and colleagues.(21) 1-sided P-values are reported as we expect that the combined 7MetP+ROMA will yield improved performance estimates compared to ROMA alone.