Table 2.

The rule-out value of individual and combinations of blood investigations for myeloma

InvestigationsBlood test resultsSensitivity, % (95% CI)Specificity, % (95% CI)LR- (95% CI)
Number tested,a nTrue positiveFalse positiveFalse negativeTrue negative
Individual tests
  ESR219284454615464885 (82 to 87)54 (51 to 57)0.28 (0.24 to 0.33)
  PV433162953913781 (74 to 86)59 (52 to 64)0.32 (0.24 to 0.44)
  Hb59341243912596318368 (65 to 70)78 (76 to 79)0.42 (0.39 to 0.45)
  CAL280924643893162722 (19 to 24)98 (97 to 0.98)0.81 (0.78 to 0.83)b
  CREAT740764810211202453635 (33 to 37)82 (81 to 83)0.80 (0.77 to 0.83)b
  CRP127431628131935846 (42 to 50)63 (59 to 67)0.87 (0.78 to 0.94)b
Combinations (two tests)
  Hb and PV396175119109295 (90 to 97)44 (37 to 50)0.12 (0.07 to 0.23)c
  Hb and ESR20718846037251293 (91 to 94)46 (43 to 49)0.16 (0.13 to 0.21)c
  Hb and CRP119349131111128084 (80 to 86)47 (43 to 52)0.39 (0.32 to 0.47)
Combinations (three tests)
  Hb, CREAT, and PV35616511167497 (93 to 99)40 (33 to 47)0.09 (0.04 to 0.20)c
  Hb, CAL, and PV2131284933398 (94 to 100)40 (30 to 52)0.06 (0.02 to 0.18)c
  Hb, CREAT, and ESR18648235995438894 (92 to 95)39 (36 to 42)0.16 (0.12 to 0.21)c
  Hb, CAL, and ESR11465902864522593 (91 to 95)44 (40 to 49)0.16 (0.12 to 0.22)c
  Hb, CREAT, and CRP11155053417019988 (85 to 90)37 (33 to 41)0.33 (0.26 to 0.42)
  Hb, CAL, and CRP7223631606413585 (81 to 88)46 (40 to 52)0.33 (0.25 to 0.42)
Combinations (four tests)
  Hb, CAL, CREAT, and PV2111275033198 (93 to 100)38 (28 to 50)0.06 (0.02 to 0.19)c
  Hb, CAL, CREAT, and ESR11035693093918694 (91 to 95)38 (33 to 42)0.17 (0.12 to 0.24)c
  Hb, CAL, CREAT, and CRP7063731894410089 (86 to 92)35 (29 to 40)0.31 (0.22 to 0.42)
  • a Sample size corresponds to the number of patients who had the test or a particular combination of tests.

  • b NRL = negative likelihood ratio (LR) >0.8.

  • c NRL0.2. CAL = calcium. CREAT = creatinine. CRP = C-reactive protein. ESR = erythrocyte sedimentation rate. Hb = haemoglobin. LR= negative likelihood ratio. PV = plasma viscosity.