Table 4.

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

^aCorresponds 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.