Performance of the different diagnostic approaches in a population of 100 000 tested individuals based on the validation cohort measures
| Variable | Per 100 000 patients (60 myeloma cases), n | Ratio of false alarms to cancers diagnosed | Ratio of true negatives to cancers missed | |||
|---|---|---|---|---|---|---|
| Cancers diagnosed | False alarms | Cancers missed | Correctly spared investigations | |||
| Symptoms | ||||||
| Back pain | 13 | 8995 | 47 | 90 945 | 692 to 1 | 1935 to 1 |
| Chest pain | 5 | 5996 | 55 | 93 944 | 1199 to 1 | 1708 to 1 |
| Rib pain | 1 | 500 | 59 | 99 440 | 500 to 1 | 1685 to 1 |
| Nosebleeds | 1 | 800 | 59 | 99 140 | 800 to 1 | 1680 to 1 |
| FBC (index test) | ||||||
| Anaemia (any type) | 34 | 16 990 | 26 | 82 950 | 500 to 1 | 3190 to 1 |
| Low platelets | 5 | 2998 | 55 | 96 942 | 600 to 1 | 1763 to 1 |
| Low WCC | 4 | 2999 | 56 | 96 941 | 750 to 1 | 1731 to 1 |
| High MCV | 14 | 7995 | 46 | 91 945 | 571 to 1 | 1998 to 1 |
| Other tests | ||||||
| Hypercalcemiaa | 4 | 1999 | 56 | 97 941 | 500 to 1 | 1748 to 1 |
| High ESRa | 48 | 44 973 | 12 | 54 967 | 936 to 1 | 4581 to 1 |
| High ESR or anaemiaa | 54 | 49 970 | 6 | 49 970 | 925 to 1 | 8328 to 1 |
| High ESR and anaemiaa | 27 | 11 993 | 33 | 87 947 | 444 to 1 | 2665 to 1 |
| FBC model | ||||||
| Prevalence | 48 | 22 986 | 12 | 76 954 | 479 to 1 | 6412 to 1 |
| 90th percentile | 37 | 9994 | 23 | 89 946 | 270 to 1 | 3910 to 1 |
| 95th percentile | 25 | 4997 | 35 | 94 943 | 200 to 1 | 2712 to 1 |
| 99th percentile | 11 | 999 | 49 | 98 941 | 91 to 1 | 2019 to 1 |
| All-test modela | ||||||
| Prevalence | 50 | 16 090 | 10 | 83 850 | 322 to 1 | 8385 to 1 |
| 90th percentile | 43 | 9994 | 17 | 89 946 | 232 to 1 | 5290 to 1 |
| 95th percentile | 37 | 4997 | 23 | 94 943 | 135 to 1 | 4127 to 1 |
| 99th percentile | 20 | 999 | 40 | 98 941 | 25 to 1 | 2473 to 1 |
↵a Corresponds to the performance measures if ESR and calcium were to be ordered for all patients in the sample. ESR = erythrocyte sedimentation rate. FBC = full blood count.
MCV = mean corpuscular volume. WCC = white cell count.