Identifying the characteristics of and developing a predictive model for differentiating cancer-related musculoskeletal symptoms from juvenile idiopathic arthritis
Authors' conclusion
The refined predictive model is a promising clinical tool for differentiating cancer-associated MSK symptoms from JIA.
Study context
- Population
- Patients aged < 16 years diagnosed with cancer or juvenile idiopathic arthritis (JIA)646 cancer, 380 JIA
- Participants
- 1,026 patients
- Comparison
- Cancer-related musculoskeletal (MSK) symptoms vs JIA
- Cancern = 646
- JIAn = 380reference
- Outcome
- Phase 1: ability of the ONCOREUM score to identify cancer with arthropathy; phase 2: model differentiating cancer-related MSK symptoms from JIA
Methodological detailstwo phases, stepwise logistic regression, multivariable analysis
- Two phases
- Stepwise logistic regression
- Multivariable analysis
Performance
As reported in the abstract
Phase 1: ONCOREUM score (cutoff = - 6) for cancer with arthropathy
| Test or model | Sensitivity | Specificity | AUC |
|---|---|---|---|
| ONCOREUM score | 88.5% | 65.0% | 0.77 |
ONCOREUM score
Sensitivity88.5%
Specificity65.0%
AUC0.77
Further findings
Phase 2: predictors of cancer-related MSK symptms vs JIA (multivariable model)
| OR (95% CI) | P value | ||
|---|---|---|---|
| Back pain | 15.58 (2.77–87.64) | P < 0.02 | |
| Nocturnal pain | 789.97 (51.26–12,175.54) | P < 0.0001 | |
| Limb bone pain | 24.11 (6.91–84.12) | P < 0.0001 | |
| Pallor | 6.30 (1.55–25.60) | P < 0.01 | |
| Morning stiffness | 0.03 (0.002–0.57) | P < 0.02 | |
| Additive arthritis | 0.003 (0.00–0.04) | P < 0.0001 | |
| Monoarticular involvement | 0.02 (0.00–0.23) | P < 0.002 | |
| 0.050.21520Odds ratio (log scale) |
- Phase 2: predictors of cancer-related MSK symptms vs JIA (multivariable model) — Model AUC
- 0.99 (95% CI 0.98-0.99)
- Phase 2: predictors of cancer-related MSK symptms vs JIA (multivariable model): MSK symptoms present in 84 (13%) cancer cases (61 hematologic, 23 solid tumors)
Original publication
Identifying the characteristics of and developing a predictive model for differentiating cancer-related musculoskeletal symptoms from juvenile idiopathic arthritis. Pediatr Rheumatol Online J. Published 15 July 2025. doi:10.
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