{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:05:34Z","timestamp":1775088334451,"version":"3.50.1"},"reference-count":39,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,2,3]],"date-time":"2023-02-03T00:00:00Z","timestamp":1675382400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000289","name":"CRUK Early Detection and Diagnosis Primer award","doi-asserted-by":"publisher","award":["EDDPMA-May21\\100024"],"award-info":[{"award-number":["EDDPMA-May21\\100024"]}],"id":[{"id":"10.13039\/501100000289","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000289","name":"CRUK Early Detection and Diagnosis Primer award","doi-asserted-by":"publisher","award":["C8640\/A23385"],"award-info":[{"award-number":["C8640\/A23385"]}],"id":[{"id":"10.13039\/501100000289","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Cancer Research UK","award":["EDDPMA-May21\\100024"],"award-info":[{"award-number":["EDDPMA-May21\\100024"]}]},{"name":"Cancer Research UK","award":["C8640\/A23385"],"award-info":[{"award-number":["C8640\/A23385"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Myeloma is one of the hardest cancers to diagnose in primary care due to its rarity and non-specific symptoms. A rate-limiting step in diagnosing myeloma is the clinician considering myeloma and initiating appropriate investigations. We developed and internally validated a risk prediction model to identify those with a high risk of having undiagnosed myeloma based on results from routine blood tests taken for other reasons. A case-control study, based on 367 myeloma cases and 1488 age- and sex-matched controls, was used to develop a risk prediction model including results from 15 blood tests. The model had excellent discrimination (C-statistic 0.85 (95%CI 0.83, 0.89)) and good calibration (calibration slope 0.87 (95%CI 0.75, 0.90)). At a prevalence of 15 per 100,000 population and a probability threshold of 0.4, approximately 600 patients would need additional reflex testing to detect one case. We showed that it is possible to combine signals and abnormalities from several routine blood test parameters to identify individuals at high-risk of having undiagnosed myeloma who may benefit from additional reflex testing. Further work is needed to explore the full potential of such a strategy, including whether it is clinically useful and cost-effective and how to make it ethically acceptable.<\/jats:p>","DOI":"10.3390\/cancers15030975","type":"journal-article","created":{"date-parts":[[2023,2,3]],"date-time":"2023-02-03T03:36:57Z","timestamp":1675395417000},"page":"975","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Development and Internal Validation of a Risk Prediction Model to Identify Myeloma Based on Routine Blood Tests: A Case-Control Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4280-6323","authenticated-orcid":false,"given":"Lesley","family":"Smith","sequence":"first","affiliation":[{"name":"Leeds Diagnosis and Screening Unit, Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9JT, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Carmichael","sequence":"additional","affiliation":[{"name":"Cancer Research UK Clinical Trials Unit, Leeds Institute of Clinical Trial Research, University of Leeds, Leeds LS2 9JT, UK"},{"name":"NIHR (Leeds) Medtech & In Vitro Diagnostics Cooperative, Leeds LS2 9JT, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1717-0412","authenticated-orcid":false,"given":"Gordon","family":"Cook","sequence":"additional","affiliation":[{"name":"Cancer Research UK Clinical Trials Unit, Leeds Institute of Clinical Trial Research, University of Leeds, Leeds LS2 9JT, UK"},{"name":"NIHR (Leeds) Medtech & In Vitro Diagnostics Cooperative, Leeds LS2 9JT, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5350-1018","authenticated-orcid":false,"given":"Bethany","family":"Shinkins","sequence":"additional","affiliation":[{"name":"Leeds Diagnosis and Screening Unit, Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9JT, UK"},{"name":"NIHR (Leeds) Medtech & In Vitro Diagnostics Cooperative, Leeds LS2 9JT, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3544-2744","authenticated-orcid":false,"given":"Richard D.","family":"Neal","sequence":"additional","affiliation":[{"name":"Department of Health and Community Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter EX2 5DW, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,3]]},"reference":[{"key":"ref_1","unstructured":"Cancer Research UK (2022, July 28). 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