Comparison Of The Diagnostic Efficiency Between The O-RADS US Risk Stratification System And Doctors’ Subjective Judgment

Objectives: This study analyzed the influence of doctors’ experience on the diagnostic efficiency of Ovarian-Adnexal Reporting and Data System(O-RADS)by comparing the difference between the diagnostic efficiency of O-RADS US risk stratification for benign and malignant adnexal masses(AMs)and doctors’ subjective judgment.Methods: The clinical information,preoperative pelvic ultrasound images and postoperative pathological diagnosis of 599 patients who underwent AM resection in our hospital from 2017 to 2020 were collected.Two senior doctors and two junior doctors respectively judged the benign and malignant of each AM through the doctor’s subjective judgment and the application of O-RADS system.A mass with an O-RADS score of 1 to 3 was a benign tumor,and a mass with an O-RADS score of 4-5 was a malignant tumor.All outcomes were compared with the pathological diagnosis.Results: A total of 616 AMs were collected,of which 469(76.1%)were benign and 147(23.9%)were malignant.For the junior doctors,there was no difference between the area under the curve(AUC)of O-RADS system and its subjective judgment(P = 0.0888),which was0.83(95% CI: 0.79-0.87)vs 0.79(95% CI: 0.76-0.83);The AUCs of O-RADS and subjective judgment were equal for senior doctors(P=0.8904),which was 0.86(95% CI: 0.83-0.89)vs 0.86(95% CI:0.83-0.90).For the judgment of malignant AMs,O-RADS had much higher sensitivity than the subjective judgment in detecting malignant tumors for junior doctors(84.4% vs.70.1%)and senior doctors(91.2% vs.81.0%).For the judgment of typical benign AMs,the accuracy of O-RADS system in the diagnosis of mature cystic teratoma(86.6%vs.92.6%)and ovarian endometriosis cyst(80.0% vs.86.7%)in the junior doctors was obviously worse than that in the senior doctors.Conclusions:(1)The experience of doctors has an impact on the diagnostic efficiency of O-RADS system.(2)The sensitivity of O-RADS system in the diagnosis of malignant AMs is higher than the subjective judgment of doctors,which can make up for the lack of experience of junior doctors to a certain extent.(3)The rules of O-RADS in the diagnosis of typical benign AMs need to be improved.