Comparison of the Diagnostic Performance of Ovarian Adnexal Reporting Data System (O‐RADS) With IOTA Simple Rules and ADNEX Model for Classifying Adnexal Masses: A Head‐To‐Head Meta‐Analysis

ABSTRACT Objective To compare the diagnostic accuracy of O‐RADS (Ovarian Reporting and Data System) and IOTA (international Ovarian Tumor Analysis group) simple rules (SR) and ADNEX (Assessment of Different NEoplasias in the adnexa) model for discriminating benign from malignant adnexal masses using meta‐analysis. Methods A systematic search of studies comparing O‐RADS with SR and/or ADNEX in the same set of patients with an adnexal mass was performed in Medline, Web of Science, and Scopus databases from January 2020 to September 2023. Quality was assessed using the QUADAS‐2 tool. Quantitative meta‐analysis was performed. Results Nine articles comprising 3924 women (3979 adnexal masses) were ultimately included after exclusions. Three studies compared O‐RADS versus SR, three studies compared O‐RADS versus ADNEX, and three studies compared all three methods. The risk of bias was high for patient selection in QUADAS‐2 in all studies. Six studies compared O‐RADS versus SR; no significant differences were found (pooled sensitivity and specificity of O‐RADS and IOTA SR were 94.0% and 77.0%, and 91.0% and 87.0%, respectively. p = 0.2204). Six studies compared O‐RADS versus ADNEX; no significant differences were found (pooled sensitivity and specificity of O‐RADS classification system and ADNEX were 95.0% and 79.0%, and 91.0% and 88.0%, respectively. p = 0.2307). Conclusion O‐RADS classification has a similar diagnostic performance to IOTA SR and ADNEX for discriminating benign and malignant adnexal masses.