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Most cysts are benign and can be treated safely in a general hospital. In the Netherlands, approximately 87 surgical procedures for ovarian cysts are performed annually per 100,000 women. When malignancy is suspected, referral to a specialized oncology center is required, as centralized treatment has been shown to improve the prognosis of women with ovarian cancer. Reliable preoperative risk stratification is essential for optimal care and efficient use of healthcare resources. Physicians use predictive models based on ultrasound findings, blood test results, and patient’s age to estimate the risk of malignancy.\n\nOBJECTIVE\nThe aim of the ACCEPT study was to determine which risk stratification strategy is most accurate and cost-effective for distinguishing between benign and malignant ovarian cysts. In addition to diagnostic accuracy, we evaluated costs and the impact on quality of life, anxiety, and cancer-related worry.\n\nSTUDY DESIGN\nProspective multicenter cohort study combined with a systematic review and meta-analysis and a model-based cost-effectiveness analysis.\n\nOBJECTS/UNITS OF ANALYSIS\n584 women aged ≥18 years with an ovarian cyst and an indication for surgery, included in 27 Dutch hospitals. Patients were seen at outpatient clinics in general hospitals and were able to understand Dutch. Patients with an evidently benign tumor on ultrasound, clear malignancy, a history of ovarian or other recent malignancy, or a known genetic high-risk for ovarian cancer were excluded. Data collection included patient-reported outcomes, healthcare utilization, and referral patterns.\n\nINTERVENTION\nUse of predictive models for risk stratification (such as RMI, ADNEX and subjective assessment) to support referral decisions."},"dsDescriptionDate":{"typeName":"dsDescriptionDate","multiple":false,"typeClass":"primitive","value":"2026-07-01"}}]},{"typeName":"subject","multiple":true,"typeClass":"controlledVocabulary","value":["Medicine, Health and Life Sciences"]},{"typeName":"keyword","multiple":true,"typeClass":"compound","value":[{"keywordValue":{"typeName":"keywordValue","multiple":false,"typeClass":"primitive","value":"ovarian tumors"},"keywordVocabulary":{"typeName":"keywordVocabulary","multiple":false,"typeClass":"primitive","value":"Neoplasm, Ovarian"}},{"keywordValue":{"typeName":"keywordValue","multiple":false,"typeClass":"primitive","value":"IOTA models"}},{"keywordValue":{"typeName":"keywordValue","multiple":false,"typeClass":"primitive","value":"costeffectiveness"},"keywordVocabulary":{"typeName":"keywordVocabulary","multiple":false,"typeClass":"primitive","value":"Costs and Cost Analyses"}}]},{"typeName":"topicClassification","multiple":true,"typeClass":"compound","value":[{"topicClassValue":{"typeName":"topicClassValue","multiple":false,"typeClass":"primitive","value":"ovarian tumors"},"topicClassVocab":{"typeName":"topicClassVocab","multiple":false,"typeClass":"primitive","value":"Neoplasm, Ovarian"}}]},{"typeName":"grantNumber","multiple":true,"typeClass":"compound","value":[{"grantNumberAgency":{"typeName":"grantNumberAgency","multiple":false,"typeClass":"primitive","value":"ZonMW"},"grantNumberValue":{"typeName":"grantNumberValue","multiple":false,"typeClass":"primitive","value":"852002128"}}]},{"typeName":"depositor","multiple":false,"typeClass":"primitive","value":"Maastricht University"},{"typeName":"dateOfDeposit","multiple":false,"typeClass":"primitive","value":"2026-06-23"},{"typeName":"dateOfCollection","multiple":true,"typeClass":"compound","value":[{"dateOfCollectionStart":{"typeName":"dateOfCollectionStart","multiple":false,"typeClass":"primitive","value":"2021"},"dateOfCollectionEnd":{"typeName":"dateOfCollectionEnd","multiple":false,"typeClass":"primitive","value":"2024"}}]},{"typeName":"kindOfData","multiple":true,"typeClass":"primitive","value":["Clinical data"]},{"typeName":"software","multiple":true,"typeClass":"compound","value":[{"softwareName":{"typeName":"softwareName","multiple":false,"typeClass":"primitive","value":"Castor"}},{"softwareName":{"typeName":"softwareName","multiple":false,"typeClass":"primitive","value":"SPSS"}},{"softwareName":{"typeName":"softwareName","multiple":false,"typeClass":"primitive","value":"R"}}]},{"typeName":"relatedDatasets","multiple":true,"typeClass":"primitive","value":["Lems E, Koch AH, Delvaux EJLG, Leemans JC, Bongers MY, Lok CAR, Ramaekers BL, Geomini PMAJ. Diagnostic accuracy of ultrasound models for assessment of ovarian tumors: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2026 May;67(5):590-603. doi: 10.1002/uog.70135. Epub 2025 Dec 4. PMID: 41346086; PMCID: PMC13136063."]},{"typeName":"accessToSources","multiple":false,"typeClass":"primitive","value":"The standard Data Transfer Agreement (DTA) of Máxima MC must be signed without adjustments. This DTA is in compliance with Dutch law. 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