Connie Rees

76 factors. Tests for multicollinearity were performed as well to assess potential correlation between predictors. Individual variables were used for inclusion into the multivariate logistic regression model if they had a p-value <.10 in the univariate logistic regression analysis, or if they were considered clinically relevant, and if they had a high diagnostic performance (sensitivity/specificity>70% or AUC >0.70). Overfitting of the model was avoided by reducing the number of variables included in the model and by using shrinkage factors. Model fit was further improved by including additional predictive power of continuous variables based on locally weighted smoothing (LOESS). The final model was evaluated for discrimination and calibration performance. The AUC was obtained to discriminate between women with and without a histopathological adenomyosis diagnosis after hysterectomy. To assess the calibration of the predicted probabilities, and to show the relation between predicted and observed probabilities for the histopathological adenomyosis diagnosis, an observed to expected ratio was calculated and a Hosmer and Lemeshow Test was performed. Ethics Statement: This study was approved by the local medical ethical review board, with study number nWMO-2020.135. Informed consent was waived due to the retrospective study design.

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