Validation of a Diagnostic Model to Differentiate Multiple Myeloma from Bone Metastasis.
bone metastases
clinical prediction model
diagnosis
multiple myeloma
primary care
referral
Journal
Clinical epidemiology
ISSN: 1179-1349
Titre abrégé: Clin Epidemiol
Pays: New Zealand
ID NLM: 101531700
Informations de publication
Date de publication:
2023
2023
Historique:
received:
06
04
2023
accepted:
18
07
2023
medline:
31
7
2023
pubmed:
31
7
2023
entrez:
31
7
2023
Statut:
epublish
Résumé
A diagnostic model to differentiate multiple myeloma (MM) from bone metastasis (BM) in patients with destructive bone lesions (MM-BM DDx) was developed to promote timely and appropriate referral of patients with MM to hematologists. External validation has never been conducted. This study aims to externally validate the performance of the MM-BM DDx model. This multi-center external validation study was conducted using retrospective data of patients over 45 years old diagnosed with MM or BM at six university-affiliated hospitals in Thailand from 2016 to 2022. The MM-BM DDx development dataset, including patients from 2012 to 2015, was utilized during external validation. Diagnostic indicators for MM included in the MM-BM DDx model are serum creatinine, serum globulin, and serum alkaline phosphatase (ALP). MM and BM diagnosis was based on the documented International Classification of Diseases 10th Revision codes. Model performance was evaluated in terms of discrimination, calibration, and accuracy. A total of 3018 patients were included in the validation dataset (586 with MM and 2432 with BM). Clinical characteristics were similar between the validation and development datasets. The MM-BM DDx model's predictions showed an AUC of 0.89 (95% CI, 0.87, 0.90). The predicted probabilities of MM from the model increased concordantly with the observed proportion of MM within the validation dataset. The estimated sensitivity, specificity, and LR for each odds class in the validation dataset were similar to those of the development dataset. The discriminative ability and calibration of the MM-BM DDx model were found to be preserved during external validation. These findings provide support for the practical use of the MM-BM DDx model to assist clinicians in identifying patients with destructive bone lesions who are likely to have MM and enable them to arrange timely referrals for further evaluation by hematologists.
Identifiants
pubmed: 37522153
doi: 10.2147/CLEP.S416028
pii: 416028
pmc: PMC10377591
doi:
Types de publication
Journal Article
Langues
eng
Pagination
881-890Informations de copyright
© 2023 Phinyo et al.
Déclaration de conflit d'intérêts
The authors report no conflicts of interest in this work.
Références
J Clin Oncol. 2005 May 20;23(15):3412-20
pubmed: 15809451
BMJ Open. 2021 Oct 6;11(10):e052759
pubmed: 34615682
BMC Cancer. 2021 May 25;21(1):606
pubmed: 34034700
J Gen Intern Med. 2002 Aug;17(8):646-9
pubmed: 12213147
Front Oncol. 2021 Feb 24;11:601699
pubmed: 33718148
Br J Gen Pract. 2021 Apr 29;71(706):e347-e355
pubmed: 33824161
Int J Hematol Oncol. 2019 Feb 26;8(1):IJH13
pubmed: 30863530
J Clin Epidemiol. 2015 Mar;68(3):279-89
pubmed: 25179855
Blood Rev. 1999 Jun;13(2):79-90
pubmed: 10414944
BMC Med Res Methodol. 2014 Jun 05;14:75
pubmed: 24903709
Int Orthop. 2011 Aug;35(8):1209-13
pubmed: 20862584
J Int Med Res. 2021 Mar;49(3):300060521997736
pubmed: 33682516
J Bone Oncol. 2020 Nov 18;26:100338
pubmed: 33304804
BMC Med Res Methodol. 2009 Jul 28;9:57
pubmed: 19638200
BMC Fam Pract. 2020 Oct 22;21(1):215
pubmed: 33087068
BMC Prim Care. 2022 Jul 28;23(1):189
pubmed: 35902790
Stat Med. 2021 Aug 30;40(19):4230-4251
pubmed: 34031906
Cancers (Basel). 2023 Feb 03;15(3):
pubmed: 36765931
BMC Med. 2015 Jan 06;13:1
pubmed: 25563062
Clin Imaging. 1999 Mar-Apr;23(2):125-33
pubmed: 10416091
Lancet Oncol. 2014 Nov;15(12):e538-48
pubmed: 25439696
BMC Cancer. 2020 Mar 3;20(1):170
pubmed: 32126974
Anticancer Res. 2016 Jun;36(6):2631-7
pubmed: 27272771
PLoS One. 2018 Dec 17;13(12):e0208860
pubmed: 30557373
Bone. 2022 May;158:115783
pubmed: 33276151
JAMA. 2013 Nov 27;310(20):2191-4
pubmed: 24141714
Int J Hematol Oncol. 2020 Jul 21;9(3):IJH27
pubmed: 33014331
North Clin Istanb. 2022 Jul 05;9(3):256-260
pubmed: 36199864
Leuk Lymphoma. 2007 Feb;48(2):337-41
pubmed: 17325894
QJM. 2007 Oct;100(10):635-40
pubmed: 17846059
J Orthop. 2020 Aug 17;22:346-351
pubmed: 32921951
Br J Cancer. 2019 Mar;120(6):640-646
pubmed: 30792532
J Am Acad Orthop Surg. 2010 Mar;18(3):169-79
pubmed: 20190107
Anticancer Res. 2014 Aug;34(8):4299-306
pubmed: 25075062
Am J Epidemiol. 2010 Oct 15;172(8):971-80
pubmed: 20807737
JAMIA Open. 2023 Feb 03;6(1):ooad005
pubmed: 36751467