{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T15:59:21Z","timestamp":1781020761303,"version":"3.54.1"},"reference-count":25,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100011033","name":"The Binding Site Inc., part of Thermo Fisher Scientific","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011033","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Bioinformatics, LLC"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Our aim was to assess the knowledge, awareness, and confidence of US primary care providers (PCPs) in assessing multiple myeloma (MM) and related plasma cell disorders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A survey with quantitative and qualitative questions was conducted from October to December 2024. A total of 560 respondents met the criteria of a representative US PCP cohort, but only 300 respondents were invited to continue the rest of the survey. These respondents had ordered serum protein electrophoresis (SPEP) in the past 12 months and believed that SPEP should be ordered for plasma cell disorder diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Nearly half of the representative US PCP cohort (46%) do not order tests for plasma cell disorders. Among the 300 who do, there is generally good awareness of symptoms and high-risk characteristics, but only 28% follow guideline-recommended paired testing of SPEP and serum free light chains. The majority (80%) lack confidence in appropriate test selection and interpretation, often relying on peers and hematologists for guidance. Additionally, only 15% of the US PCPs have access to and use myeloma diagnostic ordering sets and panels, while 54% express interest in utilizing such tools. The PCPs identified barriers like insufficient education, collaboration, and specialist support to patient care and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The study reveals significant gaps in the understanding and practice of MM diagnostic testing in primary care. Results indicate insufficient knowledge and inadequate utilization of testing guidelines, including low confidence in test ordering and interpretation. The survey suggests a lack of comprehensive, guideline-adherent MM diagnostic panels offered by US laboratories.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jalm\/jfag087","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T11:52:30Z","timestamp":1779450750000},"source":"Crossref","is-referenced-by-count":0,"title":["Addressing Diagnostics Delay in Multiple Myeloma: Insights from a National Survey of Primary Care Providers"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5819-7892","authenticated-orcid":false,"given":"Bhrugu","family":"Yagnik","sequence":"first","affiliation":[{"name":"The Binding Site Inc., part of Thermo Fisher Scientific Scientific Affairs, , San Diego, CA ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill","family":"Pauli","sequence":"additional","affiliation":[{"name":"The Binding Site Inc., part of Thermo Fisher Scientific Scientific Affairs, , San Diego, CA ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brittany","family":"Watson","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, Wake Forest University School of Medicine , Winston-Salem, NC ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Mikhael","sequence":"additional","affiliation":[{"name":"Clinical Genomics and Therapeutics Division, Translational Genomics Research Institute (TGen), City of Hope Cancer Center , Phoenix, AZ ,","place":["United States"]},{"name":"International Myeloma Foundation , Studio City, CA ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,9]]},"reference":[{"key":"2026060910490806600_jfag087-B1","doi-asserted-by":"crossref","first-page":"e538","DOI":"10.1016\/S1470-2045(14)70442-5","article-title":"International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma.","volume":"15","author":"Rajkumar","year":"2014","journal-title":"Lancet Oncol"},{"key":"2026060910490806600_jfag087-B2","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1007\/978-3-540-85772-3_2","article-title":"Epidemiology of multiple myeloma.","volume":"183","author":"Becker","year":"2011","journal-title":"Recent Results Cancer Res"},{"key":"2026060910490806600_jfag087-B3","author":"National Institutes of Health Surveillance, Epidemiology, and End Results Program"},{"key":"2026060910490806600_jfag087-B4","author":"National Comprehensive Cancer Network"},{"key":"2026060910490806600_jfag087-B5","doi-asserted-by":"crossref","first-page":"e106","DOI":"10.3399\/bjgp15X683545","article-title":"Quantifying the risk of multiple myeloma from symptoms reported in primary care patients: a large case\u2013control study using electronic records.","volume":"65","author":"Shephard","year":"2015","journal-title":"Br J Gen Pract"},{"key":"2026060910490806600_jfag087-B6","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2017-019758","article-title":"Quantifying intervals to diagnosis in myeloma: a systematic review and meta-analysis.","volume":"8","author":"Koshiaris","year":"2018","journal-title":"BMJ Open"},{"key":"2026060910490806600_jfag087-B7","doi-asserted-by":"crossref","DOI":"10.1002\/cam4.71563","article-title":"Treatment initiation among black and white older adults with multiple myeloma: a SEER-medicare analysis.","volume":"15","author":"LeBlanc","year":"2026","journal-title":"Cancer Med"},{"key":"2026060910490806600_jfag087-B8","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.amjmed.2022.08.030","article-title":"Multiple myeloma for the primary care provider: a practical review to promote earlier diagnosis among diverse populations.","volume":"136","author":"Mikhael","year":"2023","journal-title":"Am J Med"},{"key":"2026060910490806600_jfag087-B9","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1111\/bjh.14513","article-title":"Multiple myeloma: routes to diagnosis, clinical characteristics and survival\u2013findings from a UK population-based study.","volume":"177","author":"Howell","year":"2017","journal-title":"Br J Haematol"},{"key":"2026060910490806600_jfag087-B10","doi-asserted-by":"crossref","first-page":"3007","DOI":"10.1182\/blood-2021-150848","article-title":"An in depth analysis of factors contributing to diagnostic delay in myeloma: a retrospective UK study of patients journey from primary care to specialist secondary care.","volume":"138","author":"Hossain","year":"2021","journal-title":"Blood"},{"key":"2026060910490806600_jfag087-B11","doi-asserted-by":"crossref","first-page":"21","DOI":"10.4065\/78.1.21","article-title":"Review of 1027 patients with newly diagnosed multiple myeloma.","volume":"78","author":"Kyle","year":"2003","journal-title":"Mayo Clin Proc"},{"key":"2026060910490806600_jfag087-B12","author":"National Comprehensive Cancer Network (NCCN)"},{"key":"2026060910490806600_jfag087-B13","doi-asserted-by":"crossref","first-page":"575","DOI":"10.5858\/arpa.2020-0794-CP","article-title":"Laboratory detection and initial diagnosis of monoclonal gammopathies: guideline from the college of American pathologists in collaboration with the American Association for Clinical Chemistry and the American Society for Clinical Pathology.","volume":"146","author":"Keren","year":"2022","journal-title":"Arch Pathol Lab Med"},{"key":"2026060910490806600_jfag087-B14","doi-asserted-by":"crossref","DOI":"10.1016\/j.canep.2026.103021","article-title":"The association between body fatness and prevalent MGUS in the US general population.","volume":"101","author":"Ji","year":"2026","journal-title":"Cancer Epidemiol"},{"key":"2026060910490806600_jfag087-B15","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1016\/j.clml.2015.06.003","article-title":"Risk factors for multiple myeloma: a systematic review of meta-analyses.","volume":"15","author":"Sergentanis","year":"2015","journal-title":"Clin Lymphoma Myeloma Leuk"},{"key":"2026060910490806600_jfag087-B16","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1177\/2040620712466863","article-title":"Serum free light-chain assay for the detection and monitoring of multiple myeloma and related conditions.","volume":"4","author":"Tosi","year":"2013","journal-title":"Ther Adv Hematol"},{"key":"2026060910490806600_jfag087-B17","doi-asserted-by":"crossref","first-page":"3414","DOI":"10.1182\/blood-2013-12-542662","article-title":"Serum free immunoglobulin light chain evaluation as a marker of impact from intraclonal heterogeneity on myeloma outcome.","volume":"123","author":"Brioli","year":"2014","journal-title":"Blood"},{"key":"2026060910490806600_jfag087-B18","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1111\/bjh.17410","article-title":"Guidelines on the diagnosis, investigation and initial treatment of myeloma: a British Society for Haematology\/UK Myeloma Forum Guideline.","volume":"193","author":"Sive","year":"2021","journal-title":"Br J Haematol"},{"key":"2026060910490806600_jfag087-B19","author":"Grenache"},{"key":"2026060910490806600_jfag087-B20","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1093\/ajcp\/aqac151","article-title":"Use of clinical decision support to improve the laboratory evaluation of monoclonal gammopathies.","volume":"159","author":"Pearson","year":"2023","journal-title":"Am J Clin Pathol"},{"key":"2026060910490806600_jfag087-B21","doi-asserted-by":"crossref","first-page":"3392","DOI":"10.3324\/haematol.2023.283191","article-title":"Disease associations with monoclonal gammopathy of undetermined significance can only be evaluated using screened cohorts: results from the population-based iStopMM study.","volume":"108","author":"Sigurbergsd\u00f3ttir","year":"2023","journal-title":"Haematologica"},{"key":"2026060910490806600_jfag087-B22","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1038\/s41408-023-00961-0","article-title":"Addressing the disparities: the approach to the African American patient with multiple myeloma.","volume":"13","author":"Bhutani","year":"2023","journal-title":"Blood Cancer J"},{"key":"2026060910490806600_jfag087-B23","doi-asserted-by":"crossref","first-page":"e384","DOI":"10.1016\/j.clml.2020.11.013","article-title":"Multiple myeloma in Hispanics: incidence, characteristics, survival, results of discovery, and validation using real-world and connect MM registry data.","volume":"21","author":"Kaur","year":"2021","journal-title":"Clin Lymphoma Myeloma Leuk"},{"key":"2026060910490806600_jfag087-B24","doi-asserted-by":"crossref","first-page":"e187","DOI":"10.1515\/cclm-2013-0116","article-title":"Diagnostic sensitivity of a panel of tests to detect monoclonal protein in Korean multiple myeloma patients.","volume":"51","author":"Jeong","year":"2013","journal-title":"Clin Chem Lab Med"},{"key":"2026060910490806600_jfag087-B25","doi-asserted-by":"crossref","first-page":"1517","DOI":"10.1373\/clinchem.2009.126664","article-title":"Screening panels for detection of monoclonal gammopathies.","volume":"55","author":"Katzmann","year":"2009","journal-title":"Clin Chem"}],"container-title":["The Journal of Applied Laboratory Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jalm\/advance-article-pdf\/doi\/10.1093\/jalm\/jfag087\/68494451\/jfag087.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jalm\/advance-article-pdf\/doi\/10.1093\/jalm\/jfag087\/68494451\/jfag087.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T15:18:23Z","timestamp":1781018303000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jalm\/advance-article\/doi\/10.1093\/jalm\/jfag087\/8704410"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,9]]},"references-count":25,"URL":"https:\/\/doi.org\/10.1093\/jalm\/jfag087","relation":{},"ISSN":["2475-7241"],"issn-type":[{"value":"2475-7241","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,9]]},"article-number":"jfag087"}}