Development of the OncoScore: A Diagnostic Prediction Score for Previously Unrecognized Malignancy in Patients with Acute Pulmonary Embolism

Background/Objectives: Pulmonary embolism (PE) may represent the first clinical manifestation of a previously unrecognized malignancy. We aimed to develop the OncoScore, a diagnostic prediction score for estimating the probability of previously unrecognized malignancy being diagnosed during the index hospitalization for acute PE.

Methods

We conducted a retrospective diagnostic prediction model derivation study using prospectively collected data from the multicenter Regional Pulmonary Embolism Registry (REPER). Candidate predictors were assessed using logistic regression and Chi-square Automatic Interaction Detection (CHAID) analysis, and independent predictors were incorporated into the OncoScore. Discrimination was assessed by receiver operating characteristic (ROC) analysis, calibration by calibration slope and a calibration plot, and internal validation by bootstrap resampling. Diagnostic performance measures were calculated using the cut-off value determined by the Youden index.