{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T02:12:04Z","timestamp":1761271924458,"version":"build-2065373602"},"reference-count":10,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:00:00Z","timestamp":1761004800000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100009530","name":"Jawaharlal Institute Of Postgraduate Medical Education and Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009530","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the performance of the risk of endometrial malignancy (REM) scoring system using its existing cut\u2010off value (0.3185) in stratifying risk for endometrial malignancy and to determine an optimal cut\u2010off value in a tertiary care setting in South India.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross\u2010sectional diagnostic accuracy study enrolled 220 women aged 40\u201380\u2009years who underwent surgical interventions for abnormal uterine bleeding (AUB), postmenopausal bleeding (PMB), or ultrasonographic abnormalities. Data on clinical, ultrasonographic, and biochemical parameters (including HE4 levels) were collected, and REM scores were calculated. Histopathological outcomes served as the gold standard for assessing performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median REM score was significantly higher in women with malignancy (0.5581, IQR: 0.3442\u20130.7489) compared to those without (0.1709, IQR: 0.0993\u20130.3628,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). At the existing cut\u2010off value (0.3185), the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 79.6%, 72.67%, 51.65%, and 90.7%, respectively. An optimal cut\u2010off value of 0.3348 demonstrated improved sensitivity and specificity in the study population.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The REM scoring system effectively stratifies patients at high risk for endometrial malignancy. Adjusting the cut\u2010off value for this population may further enhance its diagnostic utility.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jog.70108","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:39:37Z","timestamp":1761093577000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Utility of the\n                    <scp>REM<\/scp>\n                    Score in Stratifying Endometrial Malignancy Risk: Insights From a Tertiary Care Centre in South India"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2703-0210","authenticated-orcid":false,"given":"K. M.","family":"Ashika","sequence":"first","affiliation":[{"name":"HIBA Women's Clinic  Tirunelveli India"},{"name":"Department of Obstetrics and Gynecology JIPMER  Puducherry India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Jayalakshmi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology JIPMER  Puducherry India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0832-8321","authenticated-orcid":false,"given":"P.","family":"Veena","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology JIPMER  Puducherry India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7152-1143","authenticated-orcid":false,"given":"H.","family":"Nandeesha","sequence":"additional","affiliation":[{"name":"Department of Biochemistry JIPMER  Puducherry India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,21]]},"reference":[{"key":"e_1_2_13_2_1","first-page":"1","article-title":"Expression of HE4 in Endometrial Cancer and Its Clinical Significance","volume":"2015","author":"Li X.","year":"2015","journal-title":"BioMed Research International"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318162f690"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.33.1595"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-13-1376"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6605620"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/IGC.0b013e31820c4cd6"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12032-017-0945-y"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/130569"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mefs.2017.01.009"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.16455"}],"container-title":["Journal of Obstetrics and Gynaecology Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jog.70108","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T02:05:29Z","timestamp":1761271529000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/jog.70108"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":10,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1111\/jog.70108"],"URL":"https:\/\/doi.org\/10.1111\/jog.70108","archive":["Portico"],"relation":{},"ISSN":["1341-8076","1447-0756"],"issn-type":[{"type":"print","value":"1341-8076"},{"type":"electronic","value":"1447-0756"}],"subject":[],"published":{"date-parts":[[2025,10]]},"assertion":[{"value":"2025-03-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70108"}}