Table 4.

Performance estimates of ROMA and the combined 7MetP+ROMA model for all OvCa in the Training Set and the independent Testing Set.

	Training Set
		ROMA	ROMA + 7MetP	Difference	P
	AUC (95% CI)	0.91 (0.89 – 0.93)	0.93 (0.91 – 0.94)	0.01 (0.00 to 0.03)	<.001
At 11.4% risk threshold for premenopausal and 29.9% for postmenopausal (same risk as ROMA)	Sensitivity	0.87 (0.83 – 0.91)	0.86 (0.82 – 0.90)	−0.01 (−0.04 to 0.02)	.22
	Specificity	0.79 (0.75 – 0.83)	0.88 (0.85 – 0.91)	0.09 (0.06 to 0.12)	<.001
	PPV	0.76 (0.71 – 0.80)	0.84 (0.81 – 0.89)	0.09 (0.05 to 0.12)	<.001
	NPV	0.89 (0.86 – 0.92)	0.89 (0.86 – 0.92)	0.00 (−0.02 to 0.02)	.36
	Test Set
		ROMA	ROMA + 7MetP	Difference	P
	AUC (95% CI)	0.96 (0.94–0.99)	0.97 (0.94–0.99)	0.01 (0.00 to 0.01)	.06
At 11.4% risk threshold for premenopausal and 29.9% for postmenopausal (same risk as ROMA)	Sensitivity	0.96 (0.93 – 0.98)	0.93 (0.90 – 0.96)	−0.03 (−0.05 to −0.01)	.008
	Specificity	0.76 (0.70 – 0.83)	0.91 (0.86 – 0.95)	0.15 (0.10 to 0.20)	< .001
	PPV	0.89 (0.86 – 0.93)	0.96 (0.93 – 0.97)	0.06 (0.04 to 0.09)	< .001
	NPV	0.89 (0.84 – 0.94)	0.86 (0.81 – 0.91)	−0.03 (−0.08 to 0.01)	.07

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.