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Establishment of Multiple Myeloma Diagnostic Model Based on Logistic Regression in Clinical Laboratory by Ruifang Cui, Shunli Zhang, Mo Wang, Tingting Jia, Yuhua Zhai, Yuhong Yue, Rui Zhang, Yufang Liang, Qingtao Wang

Background: Due to the insidious onset of multiple myeloma (MM), missed diagnosis and misdiagnosis have a serious impact on the health of MM patients. Simple, rapid, and valid laboratory screening is critical for MM clinical diagnosis.
Methods: We used routine laboratory tests to establish a simple, inexpensive, and non-invasive diagnostic model for MM based on logistic regression. In the retrospective analysis, a total of 273 newly diagnosed MM inpatients and 288 non-MM participants, from January 2016 to December 2018 in Beijing Chaoyang hospital, Capital Medical University, were divided into training set and validation set. Age, gender, and the related routine laboratory tests for MM, including albumin (ALB), globulin (GLB), lactate dehydrogenase (LDH), creatinine (Cr), calcium (Ca2+), hemoglobin (Hb) and platelet (PLT), were analyzed by multivariate logistic regression to develop a diagnostic model.
Results: A diagnostic model was calculated using the formula MM index=-((-18×gender-3×ALB-Hb)/10), based on the logistic regression. The MM index [22 (20 - 25)] of MM patients was significantly lower than that of non-MM [30 (29 - 31)] in the training set (p < 0.001). It showed an excellent diagnostic performance in diagnosing MM through a receiver operating characteristic (ROC) curve, and its corresponding sensitivity, specificity, and area under the curve (AUC) were 95.6%, 96.7%, and 0.982 (0.968, 0.997), respectively. At a diagnostic risk threshold of 28, the model identified MM with a sensitivity of 95.6% and a specificity of 98.1% by using independent validation data. There was a significant positive correlation (r = 0.845, p < 0.001) between the DS grading and the MM index among all the participants.
Conclusions: The established diagnostic model of MM index can successfully identify newly diagnosed MM from healthy controls. The diagnostic model of MM index may also act as a predictor of the severity of MM without therapy.

DOI: 10.7754/Clin.Lab.2019.190832