Risk of Ovarian Malignancy Algorithm (ROMA Index) — free guideline decision tool
Combine HE4, CA-125 and menopausal status to compute ROMA% and triage an adnexal mass into high or low risk of epithelial ovarian cancer. Instant, browser-side.
Open guideline tool →Guideline-based
Implements the decision logic from published clinical guidelines.
Runs in your browser
No installation. Enter the patient's values and get a guideline recommendation instantly.
Data stays local
Nothing is uploaded. Results are for licensed clinicians only.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| HE4 | 70 pmol/L |
|---|---|
| CA-125 | 35 U/mL |
| Menopausal status | Premenopausal |
| Assay platform (different cut-offs) | Roche Elecsys (11.4 / 29.9%) |
→ROMA15.9%
- ROMA value：15.9% (premenopausal)
- Interpretation：≥ cut-off 11.4%: high risk of epithelial ovarian cancer → gyn-oncology evaluation / surgery by a gyn-oncologist
- Cut-off：High-risk cut-off: Roche Elecsys premenopausal 11.4% / postmenopausal 29.9% (varies by assay platform/reagent; use your laboratory's platform)
| HE4 | 70 pmol/L |
|---|---|
| CA-125 | 35 U/mL |
| Menopausal status | Postmenopausal |
| Assay platform (different cut-offs) | Abbott Architect (13.1 / 27.7%) |
→ROMA25.6%
- ROMA value：25.6% (postmenopausal)
- Interpretation：< cut-off 27.7%: low risk (interpret with clinical and imaging context)
- Cut-off：High-risk cut-off: Abbott Architect premenopausal 13.1% / postmenopausal 27.7% (varies by assay platform/reagent; use your laboratory's platform)
Common questions
What is Risk of Ovarian Malignancy Algorithm (ROMA Index)?
Combine HE4, CA-125 and menopausal status to compute ROMA% and triage an adnexal mass into high or low risk of epithelial ovarian cancer. Instant, browser-side.
How is Risk of Ovarian Malignancy Algorithm (ROMA Index) calculated? What is the core formula?
PI(pre) = −12.0 + 2.38·ln(HE4) + 0.0626·ln(CA125); PI(post) = −8.09 + 1.04·ln(HE4) + 0.732·ln(CA125); ROMA = e^PI/(1 + e^PI) × 100. High-risk cut-off varies by platform.
When is Risk of Ovarian Malignancy Algorithm (ROMA Index) used?
Pre-operative benign/malignant triage of an adnexal mass (not population screening), complementary to RMI and O-RADS.
What are the key clinical points for Risk of Ovarian Malignancy Algorithm (ROMA Index)?
High-risk cut-offs differ by assay and menopausal status (Roche Elecsys 11.4/29.9%; Abbott Architect 13.1/27.7%) — use your laboratory's platform. A high ROMA warrants referral for gyn-oncology evaluation and surgery by a gyn-oncologist. ROMA is for triage of a known adnexal mass, not for screening asymptomatic women. It is complementary to imaging-based O-RADS and to the CA-125-based RMI.
What are the limits and cautions when using Risk of Ovarian Malignancy Algorithm (ROMA Index)?
For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
How is Risk of Ovarian Malignancy Algorithm (ROMA Index) calculated in practice? Can you show a worked example?
Inputs: HE4 70 pmol/L, CA-125 35 U/mL, Menopausal status Premenopausal, Assay platform (different cut-offs) Roche Elecsys (11.4 / 29.9%) → Result: ROMA 15.9%（ROMA value: 15.9% (premenopausal), Interpretation: ≥ cut-off 11.4%: high risk of epithelial ovarian cancer → gyn-oncology evaluation / surgery by a gyn-oncologist, Cut-off: High-risk cut-off: Roche Elecsys premenopausal 11.4% / postmenopausal 29.9% (varies by assay platform/reagent; use your laboratory's platform)） Inputs: HE4 70 pmol/L, CA-125 35 U/mL, Menopausal status Postmenopausal, Assay platform (different cut-offs) Abbott Architect (13.1 / 27.7%) → Result: ROMA 25.6%（ROMA value: 25.6% (postmenopausal), Interpretation: < cut-off 27.7%: low risk (interpret with clinical and imaging context), Cut-off: High-risk cut-off: Abbott Architect premenopausal 13.1% / postmenopausal 27.7% (varies by assay platform/reagent; use your laboratory's platform)）
Run Risk of Ovarian Malignancy Algorithm (ROMA Index) now
Combine HE4, CA-125 and menopausal status to compute ROMA% and triage an adnexal mass into high or low risk of epithelial ovarian cancer. Instant, browser-side.
Open guideline tool →For licensed clinicians. Not a substitute for clinical judgement.
Paste the link in Slack, Teams, X, or LinkedIn — the preview image comes from this page’s Open Graph card.