Methods and Materials: This study (cross-sectional, test-diagnosis) was conducted on all women with abnormal endometrial bleeding referred to the gynecology ward and clinic of Ayatollah Rouhani Hospital from 2018 to 2019. Patients underwent transvaginal ultrasound (TVS) examination by a sonographer after hospitalization. Patients’ information, including age, menopausal status, history of underlying diseases such as diabetes, hypertension, obesity (body mass index >30 kg/m2), hormonal therapy, and use of tamoxifen, was recorded in a checklist by the responsible resident.

Results: There was good agreement between non-invasive screening tools and pathology to detect AUB (agreement coefficient=0.90 and P < 0.001). There was an unfavorable agreement between screening tools with body mass index and pathology to detect AUB (agreement coefficient=0.68 and P < 0.001). The cut-off point of the non-invasive screening tool was 9 in women with a normal pathologic diagnosis, giving it a sensitivity of 97% and a specificity of 98%. The cut-off point of the non-invasive screening tool was 11.5 in women diagnosed with benign pathology, giving it a sensitivity of 96% and a specificity of 97%. The cut-off point of the non-invasive screening tool was 16.5 in women with malignant pathology, giving it a sensitivity of 94% and a specificity of 98%.

Conclusions: The 90% agreement of screening tools with pathology indicates that these tools can be used to predict diagnostic features of pathology in women suffering from AUB.