Variation exists in the current evidence base with regard to the optimum RMI I threshold that should be applied in secondary care. The cut-off levels used will have implications for both the management options considered and the number of women who will be referred for specialist treatment. Therefore it is important to establish the relative sensitivities and specificities at the different levels. The research should be a prospective observational cohort study evaluating women referred with suspected ovarian cancer. Diagnostic accuracy, sensitivity, specificity and cost effectiveness should be examined at the different RMI I thresholds. .