Evidence map›Paper›PMID 39134966›Full record

ArticleBMC cancer2024

Multiple myeloma: unplanned diagnostic pathways and association with risk factors and survival - a nationwide register-based cohort study in Denmark.

Linda Aagaard Rasmussen, Peter Vedsted, Henry Jensen, Henrik Frederiksen, Tarec Christoffer El-Galaly, Ida Bruun Kristensen, Line Flytkjaer Virgilsen

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In one paragraph

Article in BMC cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Linda Aagaard RasmussenResearch Unit for General Practice, Aarhus, Denmark. linda.rasmussen@ph.au.dk.
Peter VedstedResearch Unit for General Practice, Aarhus, Denmark.
Henry JensenDanish Clinical Quality Program - National Clinical Registries (RKKP), Aarhus, Denmark.
Henrik FrederiksenDepartment of Haematology, Odense University Hospital and University of Southern Denmark, Odense, Denmark.
Tarec Christoffer El-GalalyDepartment of Haematology, Odense University Hospital and University of Southern Denmark, Odense, Denmark.
Ida Bruun KristensenDepartment of Haematology, Odense University Hospital and University of Southern Denmark, Odense, Denmark.
Line Flytkjaer VirgilsenResearch Unit for General Practice, Aarhus, Denmark.

Funding

Danish General Practice Fund (Fonden for Almen Praksis) A4766Danish Health Foundation (Helsefonden) 22-B-0189The Research Foundation for General Practice in the Central Denmark Region 1-01-72-19-16
6 · The paper itself

Abstract

backgroundMultiple myeloma often presents with vague and non-specific symptoms. Many patients are diagnosed in unplanned rather than elective (planned) diagnostic pathways. This study investigates the diagnosis of multiple myeloma in unplanned pathways and the association with patient characteristics, disease profile, and survival.

methodsWe conducted a nationwide register-based study, including all patients diagnosed with multiple myeloma in Denmark in 2014-2018. Patients were categorised as diagnosed in an unplanned pathway if registered with an acute admission within 30 days prior to the multiple myeloma diagnosis and no other previously registered pathway to this diagnosis. Unplanned pathways were compared to all other pathways combined.

resultsWe included 2,213 patients diagnosed with multiple myeloma, hereof 32% diagnosed in an unplanned pathway. Comorbidity, no prior cancer diagnosis, a history of few visits to the general practitioner (GP), multiple myeloma complications at diagnosis, high-risk cytogenetics, and advanced cancer stage were associated with a higher probability of being diagnosed in an unplanned pathway. For example, 24.4% (95% confidence interval (CI): 21.8-27.0) of patients with low comorbidity (Charlson Comorbidity Index (CCI) score 0) were diagnosed in an unplanned pathway as were 50.9% (95% CI: 45.6-56.1) of patients with high comorbidity (CCI score 3+). For patients with dialysis need at the time of diagnosis the probability was 66.0% (95% CI 54.2-77.8) and 30.9% (95% CI: 28.9-32.9) for patients with no dialysis need. Patients diagnosed in an unplanned pathway had inferior survival (hazard ratio 1.44 (95% CI: 1.26-1.64)). However, this association was not seen in analyses restricted to patients surviving for more than three years.

conclusionsHigh comorbidity level, few usual GP visits, advanced disease status at diagnosis, and complications were associated with diagnosis in an unplanned pathway. Further, patients diagnosed in an unplanned pathway had inferior survival. Promoting earlier diagnosis and preventing unplanned pathways may help improve survival in multiple myeloma.

Indexed as

ComorbidityMultiple MyelomaRegistriesAdultAgedAged, 80 and overCohort StudiesDenmarkFemaleHumansMaleMiddle AgedRisk FactorsDenmarkEarly detection of cancerEmergency presentationsGeneral practiceMultiple myelomaRegistriesRoute to diagnosisSurvival

Identifiers

PMID39134966
PMCPMC11320956

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.