ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2018
Early detection of multiple myeloma in primary care using blood tests: a case-control study in primary care.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05539079 (A Prospective Long-term Observational Study in Patients With Monoclonal Gammopathy of Undetermined Significance), which is not on this map. Cited by 37 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Prospective Long-term Observational Study in Patients With Monoclonal Gammopathy of Undetermined Significance
Who cites it
37 citing papers in PubMed, 60 citations in OpenAlex.
- The use of blood test trends in cancer detection: a scoping review.Diagnostic and prognostic research · 2026Review
- Adhesion of Immunoglobulins to Band3 Promotes Increased Erythrocyte Sedimentation Rate in Multiple Myeloma.Cell proliferation · 2026Article
- Concordant Shared Transcriptomic Signatures and Candidate Regulatory Features in Chronic Lymphocytic Leukemia and Multiple Myeloma.Oncology research · 2026Article
- Economic Evaluation of Combined Testing Strategies Using Erythrocyte Sedimentation Rate and C-Reactive Protein Tests.ClinicoEconomics and outcomes research : CEOR · 2026Article
- Calcium and Albumin Blood Tests, Ethnicity, and Cancer Incidence in Primary Care in the UK.Cancers · 2025Article
- Challenges, Difficulties, and Delayed Diagnosis of Multiple Myeloma.Diagnostics (Basel, Switzerland) · 2025Review
- Article
- Prevalence and patterns of testing for anaemia in primary care in England: a cohort study using an electronic health records database.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- Diagnostic Window Prior to a Haematological Cancer Diagnosis and the Association With Patient Pathways: A Nationwide Register-Based Cohort Study on Healthcare Utilization in Denmark.European journal of haematology · 2025Article
- Prioritising primary care patients with unexpected weight loss for cancer investigation: diagnostic accuracy study (update).BMJ (Clinical research ed.) · 2024Article
- Article
- The Association between Blood Test Trends and Undiagnosed Cancer: A Systematic Review and Critical Appraisal.Cancers · 2024Review
- A taxonomy of early diagnosis research to guide study design and funding prioritisation.British journal of cancer · 2023Review
- Pre-Referral Primary Care Blood Tests and Symptom Presentation before Cancer Diagnosis: National Cancer Diagnosis Audit Data.Cancers · 2023Article
- Article
- What causes delays in diagnosing blood cancers? A rapid review of the evidence.Primary health care research & development · 2023Review
- A Stepwise Screening Protocol for Multiple Myeloma.Journal of clinical medicine · 2023Article
- Article
- BLOod Test Trend for cancEr Detection (BLOTTED): protocol for an observational and prediction model development study using English primary care electronic health record data.Diagnostic and prognostic research · 2023Article
- Patient-reported symptoms and diagnostic journey in Multiple Myeloma.Frontiers in oncology · 2023Article
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMultiple myeloma is a haematological cancer characterised by numerous non-specific symptoms leading to diagnostic delay in a large proportion of patients.
aimTo identify which blood tests are useful in suggesting or excluding a diagnosis of myeloma. DESIGN AND
settingA matched case-control study set in UK primary care using routinely collected data from the Clinical Practice Research Datalink.
methodSymptom prevalence and blood tests were analysed up to 5 years before diagnosis in 2703 cases and 12 157 matched controls. Likelihood ratios (LR) were used to classify tests or their combinations as useful rule-in tests (LR+ = ≥5), or rule-out tests (LR- = ≤0.2).
resultsRaised plasma viscosity (PV) had an LR+ = 2.0, 95% confidence interval [CI] = 1.7 to 2.3; erythrocyte sedimentation rate (ESR) 1.9, 95% CI = 1.7 to 2.0; and C-reactive protein (CRP) 1.2, 95% CI = 1.1 to 1.4. A normal haemoglobin had an LR- = 0.42, 95% CI = 0.39 to 0.45; calcium LR- = 0.81, 95% CI = 0.78 to 0.83; and creatinine LR- = 0.80, 95% CI = 0.77 to 0.83. The test combination with the lowest LR- was all normal haemoglobin with calcium and PV, which had an LR- = 0.06, 95% CI = 0.02 to 0.18, though the LR- for normal haemoglobin and PV together was 0.12 (95% CI = 0.07 to 0.23).
conclusionPlasma viscosity and ESR are better for both ruling in and ruling out the disease compared with C-reactive protein. A combination of a normal ESR or PV and normal haemoglobin is a simple rule-out approach for patients currently being tested in primary care.
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