There is currently not enough evidence to recommend the routine adoption of the IOTA ADNEX model, Overa (MIA2G), RMI I (at thresholds other than 200 or 250), ROMA or IOTA Simple Rules in secondary care in the NHS to help decide whether to refer people with suspected ovarian cancer to a specialist multidisciplinary team (MDT).
The NICE guideline on ovarian cancer recommends that people with an RMI I of 250 or more are referred to a specialist MDT. Evidence suggests that there is no substantial change in accuracy if the threshold for RMI I is lowered to 200.
The IOTA ADNEX model, Overa (MIA2G), RMI I (at thresholds other than 250), ROMA and IOTA Simple Rules show promise. Further research is recommended on test accuracy and the impact of the test results on clinical decision-making (see section 6 for detailed research recommendations).