{"doi":"10.1002/cnr2.1755","title":"Identifying monoclonal gammopathy of undetermined significance from electronic health records","abstract":"BACKGROUND: Monoclonal gammopathy of undetermined significance (MGUS) precedes multiple myeloma (MM). Use of electronic health records may facilitate large-scale epidemiologic research to elucidate risk factors for the progression of MGUS to MM or other lymphoid malignancies. AIMS: We evaluated the accuracy of an electronic health records-based approach for identifying clinically diagnosed MGUS cases for inclusion in studies of patient outcomes/ progression risk. METHODS AND RESULTS: Data were retrieved from Kaiser Permanente Southern California's comprehensive electronic health records, which contain documentation of all outpatient and inpatient visits, laboratory tests, diagnosis codes and a cancer registry. We ascertained potential MGUS cases diagnosed between 2008 and 2014 using the presence of an MGUS ICD-9 diagnosis code (273.1). We initially excluded those diagnosed with MM within 6 months after MGUS diagnosis, then subsequently those with any lymphoid malignancy diagnosis from 2007 to 2014. We reviewed medical charts for 100 randomly selected potential cases for evidence of a physician diagnosis of MGUS, which served as our gold standard for case confirmation. To assess sensitivity, we also investigated the presence of the ICD-9 code in the records of 40 randomly selected and chart review-confirmed MGUS cases among patients with a laboratory report of elevated circulating monoclonal (M-) protein (a key test for MGUS diagnosis) and no subsequent lymphoid malignancy (as described above). The positive predictive value (PPV) for the ICD-9 code was 98%. All MGUS cases confirmed by chart review also had confirmatory laboratory test results. Of the confirmed cases first identified via M-protein test results, 88% also had the ICD-9 diagnosis code. CONCLUSION: The diagnosis code-based approach has excellent PPV and likely high sensitivity for detecting clinically diagnosed MGUS. The generalizability of this approach outside an integrated healthcare system warrants further evaluation.","journal":"Cancer Reports","year":2022,"id":293434,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9617,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":260278,"name":"Brenda M. Birmann","orcid":"0000-0002-7550-5498","position":1,"is_corresponding":false},{"id":299777,"name":"Kimberly A. Bertrand","orcid":"0000-0002-4565-7618","position":2,"is_corresponding":false},{"id":302478,"name":"Lauren R. Teras","orcid":"0000-0003-2419-8536","position":3,"is_corresponding":false},{"id":25426,"name":"Amrita Krishnan","orcid":null,"position":4,"is_corresponding":false},{"id":955034,"name":"Hoda Pourhassan","orcid":"0000-0003-3862-4612","position":5,"is_corresponding":false},{"id":368561,"name":"Scott Goldsmith","orcid":"0000-0001-9216-2418","position":6,"is_corresponding":false},{"id":542569,"name":"Kimberly L. Cannavale","orcid":"0000-0003-3892-9686","position":7,"is_corresponding":false},{"id":386153,"name":"Sophia Wang","orcid":"0000-0003-2597-9393","position":8,"is_corresponding":false},{"id":349847,"name":"Chun Chao","orcid":"0000-0002-6072-4954","position":9,"is_corresponding":false},{"id":518116,"name":"Hilary C. Tanenbaum","orcid":"0000-0003-2282-1662","position":0,"is_corresponding":true}],"reference_count":16,"raw_metadata":null,"created_at":"2026-07-19T00:30:53.818562Z","pmid":"36464325","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}