{
  "abstract": "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. Results: Among 2615 patients with acute PE, 91 had newly diagnosed malignancy, 265 had previously known malignancy, and 2259 had no malignancy. The final OncoScore included hemoglobin, C-reactive protein, platelet count, and leukocyte count, with a total score ranging from 0 to 7 points. The OncoScore yielded an area under the curve (AUC) of 0.702 (95% confidence interval [CI] 0.653–0.751; p < 0.001). Bootstrap internal validation of the fixed score yielded an optimism-corrected AUC of 0.7013 and an optimism-corrected calibration slope of 1.015. When predictor selection and CHAID cut-point determination were repeated within the bootstrap procedure, the optimism-corrected AUC was 0.6560. Patients were stratified as low (≤2), intermediate (3–4), and high risk (≥5), with observed malignancy prevalences of 1.1%, 5.5%, and 10.8%, respectively. At a cut-off of ≥3 points, sensitivity was 87.5%, specificity 46.5%, positive predictive value 6.4%, and negative predictive value 98.9%. Conclusions: The OncoScore is a simple laboratory-based prediction tool that showed moderate discrimination and identified clinically distinct risk strata for malignancy diagnosed during the index hospitalization for acute PE. The score should be considered a preliminary derivation-stage model, and independent external validation is required before clinical implementation.",
  "abstract_shown": true,
  "affiliations": [
    "Medical Faculty of the Military Medical Academy, University of Defence, 17 Crnotravska, 11000 Belgrade, Serbia",
    "Clinic of Cardiology, University Clinical Center Nis, 18000 Nis, Serbia",
    "Faculty of Medicine, University of Nis, 18000 Nis, Serbia",
    "Clinic for Emergency Internal Medicine, Military Medical Academy, 11000 Belgrade, Serbia",
    "Clinic for Intensive Care Medicine and Pulmonary Vascular Diseases, Institute for Pulmonary Diseases Vojvodina, 21204 Sremska Kamenica, Serbia",
    "Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia",
    "Clinic of Cardiology, University Clinical Center Kragujevac, 34000 Kragujevac, Serbia",
    "Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia",
    "Clinic of Cardiology, University Clinical Center of the Republic of Srpska, 78000 Banja Luka, Republic of Srpska, Bosnia and Herzegovina",
    "Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, Republic of Srpska, Bosnia and Herzegovina",
    "Clinic of Cardiology, Clinical Center of Montenegro, 81000 Podgorica, Montenegro",
    "University Clinic for Cardiology and Cardiovascular Surgery, National Center for Cardiovascular Diseases, 1000 Skopje, North Macedonia",
    "Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 1000 Skopje, North Macedonia",
    "Department for Internal Medicine, General Hospital Pancevo, 26000 Pancevo, Serbia",
    "Department of Cardiology, Clinical Hospital Center Zemun, 11080 Belgrade, Serbia",
    "Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia",
    "Clinic for Cardiology, Military Medical Academy, 11000 Belgrade, Serbia"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 17,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Aleksandra Kozic",
      "orcid": "0009-0004-2060-5776"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Sonja Salinger",
      "orcid": "0000-0001-9657-1665"
    },
    {
      "affs": [
        0,
        3
      ],
      "name": "Boris Dzudovic",
      "orcid": "0000-0001-9665-6052"
    },
    {
      "affs": [
        4,
        5
      ],
      "name": "Jovan Matijasevic"
    },
    {
      "affs": [
        4
      ],
      "name": "Marija Benic"
    },
    {
      "affs": [
        6,
        7
      ],
      "name": "Vladimir Miloradovic"
    },
    {
      "affs": [
        6
      ],
      "name": "Ema Jevtic",
      "orcid": "0000-0001-8528-6017"
    },
    {
      "affs": [
        8,
        9
      ],
      "name": "Tamara Kovacevic Preradovic",
      "orcid": "0000-0002-7100-5189"
    },
    {
      "affs": [
        8,
        9
      ],
      "name": "Ljiljana Kos",
      "orcid": "0000-0002-5656-5524"
    },
    {
      "affs": [
        10
      ],
      "name": "Bjanka Bozovic"
    },
    {
      "affs": [
        11,
        12
      ],
      "name": "Irena Mitevska",
      "orcid": "0000-0002-2774-8559"
    },
    {
      "affs": [
        11,
        12
      ],
      "name": "Marijan Bosevski",
      "orcid": "0000-0003-1897-7832"
    },
    {
      "affs": [
        13
      ],
      "name": "Ana Kovacevic-Kuzmanovic"
    },
    {
      "affs": [
        14,
        15
      ],
      "name": "Aleksandar Neskovic",
      "orcid": "0000-0001-8617-966X"
    },
    {
      "affs": [
        14,
        15
      ],
      "name": "Bojan Mitrovic",
      "orcid": "0000-0003-0921-7911"
    },
    {
      "affs": [
        14
      ],
      "name": "Srdjan Kafedzic"
    },
    {
      "affs": [
        0,
        16
      ],
      "name": "Slobodan Obradovic",
      "orcid": "0000-0001-5711-5851"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/dz2cc5g0x9e5b.bib",
  "cited_by": 0,
  "doi": "10.3390/cancers18213440",
  "fulltext_url": null,
  "id": "dz2cc5g0x9e5b",
  "issns": [
    "2072-6694"
  ],
  "landing_url": "https://www.mdpi.com/2072-6694/18/21/3440",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2724|Venous Thromboembolism Diagnosis and Management"
    ]
  ],
  "openalex": "W7223656887",
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-24",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/dz2cc5g0x9e5b.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:58Z",
      "native_id": "10.3390/cancers18213440",
      "source": "crossref",
      "url": "https://www.mdpi.com/2072-6694/18/21/3440"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:2072-6694",
      "subfield": "oncology"
    }
  ],
  "title": "Development of the OncoScore: A Diagnostic Prediction Score for Previously Unrecognized Malignancy in Patients with Acute Pulmonary Embolism",
  "title_text": "Development of the OncoScore: A Diagnostic Prediction Score for Previously Unrecognized Malignancy in Patients with Acute Pulmonary Embolism",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:58Z",
  "url": "https://research.draconitic.com/paper/dz2cc5g0x9e5b",
  "venue": "Cancers",
  "versions": []
}