- Title
- A clinical decision rule to aid ordering of serum and urine protein electrophoresis for case-finding of paraproteins in hospitalized inpatients
- Creator
- Thakkinstian, Ammarin; Tran, Huy; Reeves, Glenn; Murch, Stuart; Attia, John
- Relation
- Journal of General Internal Medicine Vol. 23, Issue 10, p. 1688-1692
- Publisher Link
- http://dx.doi.org/10.1007/s11606-008-0712-z
- Publisher
- Springer
- Resource Type
- journal article
- Date
- 2008
- Description
- Objective: To develop a simple clinical decision rule that could increase the yield of serum and urine protein electrophoresi(SPE/UPE) without loss of sensitivity. Design: A cross-sectional study of inpatients with a SPE/UPE performed over a 5-year period (2001–2006) with complete data on electrolytes, globulins, full blood count, creatinine, age, and gender. Setting: A tertiary-care general teaching hospital serving the Hunter Valley in New South Wales, with a referral population of over 1 million. Participants: A total of 14,374 adult patients admitted between January 2001–November 2006. Main outcome measures Paraprotein on serum and/or urine protein electrophoresis (SPE/UPE). Results: Five points were assigned for globulin >41 g/l, 3 points for age ≥60, 2 points for each of hemoglobin <121 and male gender, and 1 point for estimated glomerular filtration rate (eGFR) <60.Total scores of 0–5, 6–10, and ≥11 corresponded to positive likelihood ratios of an abnormal SPE/UPE of 1, 2.5, and 6.6, respectively. The predictive ability of this model was strong, with an area under the curve of ~0.8. Results in the validation set were almost identical. Conclusion: A clinical decision rule using simple clinical variables has the potential to improve the yield of SPE/UPE.This rule however needs to be verified prospectively.
- Subject
- clinical decision rule; protein electrophoresis; predictive score; paraprotein
- Identifier
- http://hdl.handle.net/1959.13/40489
- Identifier
- uon:4617
- Identifier
- ISSN:0884-8734
- Language
- eng
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