Evaluation of the IOTA ADNEX Model, Two-Step Strategy and RMI in Routine Gyneacologic Care in Denmark and Implications for Implementation: A Prospective Multicenter Cohort Study

The authors aimed to evaluate the effectiveness of the IOTA ADNEX model and the Two-Step Strategy in improving the triage and referral of adnexal masses in routine gynecologic care compared to the RMI, while identifying an appropriate malignancy-risk threshold. Their findings suggest that while IOTA models enhance early detection of malignancies, they also increase referral rates, with a 15% risk threshold providing a favorable balance between sensitivity and referral burden. Overall, the study indicates that IOTA-based models offer some diagnostic advantages but may not significantly outperform existing strategies in certain clinical settings.