A Clinical-Genetic Risk Score for Predicting Cancer-Associated Venous Thromboembolism: A Development and Validation Study Involving Two Independent Prospective Cohorts
Venous thromboembolism (VTE) is a leading cause of death among patients with cancer. The Khorana score was developed for assessing the risk of VTE in outpatients with cancer receiving chemotherapy, but its accuracy in identifying patients at high risk has been questioned. The aim of this study was t...
Gespeichert in:
| Veröffentlicht in: | Journal of clinical oncology 2023-06, Vol.41 (16), p.2911-2925 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 2925 |
|---|---|
| container_issue | 16 |
| container_start_page | 2911 |
| container_title | Journal of clinical oncology |
| container_volume | 41 |
| creator | Muñoz, Andrés Ay, Cihan Grilz, Ella López, Sonia Font, Carme Pachón, Vanesa Castellón, Victoria Martínez-Marín, Virginia Salgado, Mercedes Martínez, Eva Calzas, Julia Ortega, Laura Rupérez, Ana Salas, Eduardo Pabinger, Ingrid Soria, Jose Manuel |
| description | Venous thromboembolism (VTE) is a leading cause of death among patients with cancer. The Khorana score was developed for assessing the risk of VTE in outpatients with cancer receiving chemotherapy, but its accuracy in identifying patients at high risk has been questioned. The aim of this study was to develop and validate a clinical-genetic score that improves the assessment of VTE risk in oncology outpatients within 6 months of diagnosis.
The new score was developed using the data of 364 outpatients belonging to the Spanish ONCOTHROMB 12-01 population. In this cohort, clinical data associated with the risk of VTE were collected at the time of diagnosis, including the Khorana score. These patients were also genotyped for the 51 genetic variants known to be associated with VTE. Multivariate logistic regression was performed to determine the weight of each genetic and clinical variable in relation to VTE risk, allowing a clinical-genetic risk score (the ONCOTHROMB score) to be developed. The Khorana and the ONCOTHROMB scores were then compared via the area under the receiver operating characteristic curve (AUC), calibration, and the number of patients needed to treat. The new score was then validated in a study of 263 patients in the Vienna Cancer and Thrombosis Study population.
Nine genetic variants, tumor site, TNM stage, and a body mass index of > 25 kg/m
were found to be associated with VTE and were used to build the ONCOTHROMB score, which better predicted the overall risk of VTE than did the Khorana score (AUC, 0.781
0.580;
< .001). Similar AUC results were recorded in the validation study the Vienna Cancer and Thrombosis Study cohort involving patients with the same type of tumor (AUC for the ONCOTHROMB score
the Khorana score: 0.686
0.577;
< .001) and with all type of tumors (AUC for the ONCOTHROMB score
the Khorana score: 0.720
0.561;
< .0001).
The ONCOTHROMB score for VTE risk in outpatients with cancer, which takes into account both clinical and genetic variables, better identifies patients who might benefit from primary thromboprophylaxis than does the Khorana score. |
| doi_str_mv | 10.1200/JCO.22.00255 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10414737</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2773125553</sourcerecordid><originalsourceid>FETCH-LOGICAL-c385t-75529ca182cb20fd126a670e3d84ba4cf5b71c141c74c57ffda5a93eebb1e0103</originalsourceid><addsrcrecordid>eNpVkU1vFSEUhomxsdfqzrVh6cK58jFcpm7Mzai1TZM29mrcEYY504syMAXumP4i_2ap_YgugBCevOccHoReUbKkjJB3J-3ZkrElIUyIJ2hBBZOVlEI8RQsiOatow3_so-cp_SSE1g0Xz9A-X0lOmqZeoD9r3DrrrdGuOgIP2Rr81aZf-MKECHgIEZ9H6K3J1l_iVnsDsVqnFIzVGXr8HXzYJbzZxjB2AcpyNo3v8Rp_hBlcmEbwGWtfSO1sr7MNHl_kXX-Nj_0c3Hwbu_kdyq2HCcpW8PMY0gSl5Ay4DdsQc3qB9gbtEry8Pw_Qt8-fNu2X6vTs6Lhdn1aGNyJXZW52aDRtmOkYGXrKVnolCfC-qTtdm0F0khpaUyNrI-Qw9FroQw7QdRQIJfwAfbjLnXbdCL0p7UTt1BTtqOO1Ctqq_1-83arLMCtKalpLLkvCm_uEGK52kLIabTLgnPZQvkoxKTktrgQv6Ns71JSBU4ThsQ4l6lauKnIVY-qv3IK__re3R_jBJr8BStikPQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2773125553</pqid></control><display><type>article</type><title>A Clinical-Genetic Risk Score for Predicting Cancer-Associated Venous Thromboembolism: A Development and Validation Study Involving Two Independent Prospective Cohorts</title><source>MEDLINE</source><source>American Society of Clinical Oncology Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><creator>Muñoz, Andrés ; Ay, Cihan ; Grilz, Ella ; López, Sonia ; Font, Carme ; Pachón, Vanesa ; Castellón, Victoria ; Martínez-Marín, Virginia ; Salgado, Mercedes ; Martínez, Eva ; Calzas, Julia ; Ortega, Laura ; Rupérez, Ana ; Salas, Eduardo ; Pabinger, Ingrid ; Soria, Jose Manuel</creator><creatorcontrib>Muñoz, Andrés ; Ay, Cihan ; Grilz, Ella ; López, Sonia ; Font, Carme ; Pachón, Vanesa ; Castellón, Victoria ; Martínez-Marín, Virginia ; Salgado, Mercedes ; Martínez, Eva ; Calzas, Julia ; Ortega, Laura ; Rupérez, Ana ; Salas, Eduardo ; Pabinger, Ingrid ; Soria, Jose Manuel</creatorcontrib><description>Venous thromboembolism (VTE) is a leading cause of death among patients with cancer. The Khorana score was developed for assessing the risk of VTE in outpatients with cancer receiving chemotherapy, but its accuracy in identifying patients at high risk has been questioned. The aim of this study was to develop and validate a clinical-genetic score that improves the assessment of VTE risk in oncology outpatients within 6 months of diagnosis.
The new score was developed using the data of 364 outpatients belonging to the Spanish ONCOTHROMB 12-01 population. In this cohort, clinical data associated with the risk of VTE were collected at the time of diagnosis, including the Khorana score. These patients were also genotyped for the 51 genetic variants known to be associated with VTE. Multivariate logistic regression was performed to determine the weight of each genetic and clinical variable in relation to VTE risk, allowing a clinical-genetic risk score (the ONCOTHROMB score) to be developed. The Khorana and the ONCOTHROMB scores were then compared via the area under the receiver operating characteristic curve (AUC), calibration, and the number of patients needed to treat. The new score was then validated in a study of 263 patients in the Vienna Cancer and Thrombosis Study population.
Nine genetic variants, tumor site, TNM stage, and a body mass index of > 25 kg/m
were found to be associated with VTE and were used to build the ONCOTHROMB score, which better predicted the overall risk of VTE than did the Khorana score (AUC, 0.781
0.580;
< .001). Similar AUC results were recorded in the validation study the Vienna Cancer and Thrombosis Study cohort involving patients with the same type of tumor (AUC for the ONCOTHROMB score
the Khorana score: 0.686
0.577;
< .001) and with all type of tumors (AUC for the ONCOTHROMB score
the Khorana score: 0.720
0.561;
< .0001).
The ONCOTHROMB score for VTE risk in outpatients with cancer, which takes into account both clinical and genetic variables, better identifies patients who might benefit from primary thromboprophylaxis than does the Khorana score.</description><identifier>ISSN: 0732-183X</identifier><identifier>ISSN: 1527-7755</identifier><identifier>EISSN: 1527-7755</identifier><identifier>DOI: 10.1200/JCO.22.00255</identifier><identifier>PMID: 36730884</identifier><language>eng</language><publisher>United States: Wolters Kluwer Health</publisher><subject>Anticoagulants - therapeutic use ; Humans ; Neoplasms - complications ; Neoplasms - drug therapy ; Neoplasms - genetics ; ORIGINAL REPORTS ; Prospective Studies ; Risk Assessment ; Risk Factors ; Thrombosis ; Venous Thromboembolism - genetics</subject><ispartof>Journal of clinical oncology, 2023-06, Vol.41 (16), p.2911-2925</ispartof><rights>2023 by American Society of Clinical Oncology 2023 American Society of Clinical Oncology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c385t-75529ca182cb20fd126a670e3d84ba4cf5b71c141c74c57ffda5a93eebb1e0103</citedby><cites>FETCH-LOGICAL-c385t-75529ca182cb20fd126a670e3d84ba4cf5b71c141c74c57ffda5a93eebb1e0103</cites><orcidid>0000-0002-9416-9514 ; 0000-0003-0456-7322 ; 0000-0002-6837-2471 ; 0000-0003-2338-4257 ; 0000-0002-6226-4293 ; 0000-0002-3547-7373 ; 0000-0001-6977-8249</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,3729,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36730884$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Muñoz, Andrés</creatorcontrib><creatorcontrib>Ay, Cihan</creatorcontrib><creatorcontrib>Grilz, Ella</creatorcontrib><creatorcontrib>López, Sonia</creatorcontrib><creatorcontrib>Font, Carme</creatorcontrib><creatorcontrib>Pachón, Vanesa</creatorcontrib><creatorcontrib>Castellón, Victoria</creatorcontrib><creatorcontrib>Martínez-Marín, Virginia</creatorcontrib><creatorcontrib>Salgado, Mercedes</creatorcontrib><creatorcontrib>Martínez, Eva</creatorcontrib><creatorcontrib>Calzas, Julia</creatorcontrib><creatorcontrib>Ortega, Laura</creatorcontrib><creatorcontrib>Rupérez, Ana</creatorcontrib><creatorcontrib>Salas, Eduardo</creatorcontrib><creatorcontrib>Pabinger, Ingrid</creatorcontrib><creatorcontrib>Soria, Jose Manuel</creatorcontrib><title>A Clinical-Genetic Risk Score for Predicting Cancer-Associated Venous Thromboembolism: A Development and Validation Study Involving Two Independent Prospective Cohorts</title><title>Journal of clinical oncology</title><addtitle>J Clin Oncol</addtitle><description>Venous thromboembolism (VTE) is a leading cause of death among patients with cancer. The Khorana score was developed for assessing the risk of VTE in outpatients with cancer receiving chemotherapy, but its accuracy in identifying patients at high risk has been questioned. The aim of this study was to develop and validate a clinical-genetic score that improves the assessment of VTE risk in oncology outpatients within 6 months of diagnosis.
The new score was developed using the data of 364 outpatients belonging to the Spanish ONCOTHROMB 12-01 population. In this cohort, clinical data associated with the risk of VTE were collected at the time of diagnosis, including the Khorana score. These patients were also genotyped for the 51 genetic variants known to be associated with VTE. Multivariate logistic regression was performed to determine the weight of each genetic and clinical variable in relation to VTE risk, allowing a clinical-genetic risk score (the ONCOTHROMB score) to be developed. The Khorana and the ONCOTHROMB scores were then compared via the area under the receiver operating characteristic curve (AUC), calibration, and the number of patients needed to treat. The new score was then validated in a study of 263 patients in the Vienna Cancer and Thrombosis Study population.
Nine genetic variants, tumor site, TNM stage, and a body mass index of > 25 kg/m
were found to be associated with VTE and were used to build the ONCOTHROMB score, which better predicted the overall risk of VTE than did the Khorana score (AUC, 0.781
0.580;
< .001). Similar AUC results were recorded in the validation study the Vienna Cancer and Thrombosis Study cohort involving patients with the same type of tumor (AUC for the ONCOTHROMB score
the Khorana score: 0.686
0.577;
< .001) and with all type of tumors (AUC for the ONCOTHROMB score
the Khorana score: 0.720
0.561;
< .0001).
The ONCOTHROMB score for VTE risk in outpatients with cancer, which takes into account both clinical and genetic variables, better identifies patients who might benefit from primary thromboprophylaxis than does the Khorana score.</description><subject>Anticoagulants - therapeutic use</subject><subject>Humans</subject><subject>Neoplasms - complications</subject><subject>Neoplasms - drug therapy</subject><subject>Neoplasms - genetics</subject><subject>ORIGINAL REPORTS</subject><subject>Prospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Thrombosis</subject><subject>Venous Thromboembolism - genetics</subject><issn>0732-183X</issn><issn>1527-7755</issn><issn>1527-7755</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkU1vFSEUhomxsdfqzrVh6cK58jFcpm7Mzai1TZM29mrcEYY504syMAXumP4i_2ap_YgugBCevOccHoReUbKkjJB3J-3ZkrElIUyIJ2hBBZOVlEI8RQsiOatow3_so-cp_SSE1g0Xz9A-X0lOmqZeoD9r3DrrrdGuOgIP2Rr81aZf-MKECHgIEZ9H6K3J1l_iVnsDsVqnFIzVGXr8HXzYJbzZxjB2AcpyNo3v8Rp_hBlcmEbwGWtfSO1sr7MNHl_kXX-Nj_0c3Hwbu_kdyq2HCcpW8PMY0gSl5Ay4DdsQc3qB9gbtEry8Pw_Qt8-fNu2X6vTs6Lhdn1aGNyJXZW52aDRtmOkYGXrKVnolCfC-qTtdm0F0khpaUyNrI-Qw9FroQw7QdRQIJfwAfbjLnXbdCL0p7UTt1BTtqOO1Ctqq_1-83arLMCtKalpLLkvCm_uEGK52kLIabTLgnPZQvkoxKTktrgQv6Ns71JSBU4ThsQ4l6lauKnIVY-qv3IK__re3R_jBJr8BStikPQ</recordid><startdate>20230601</startdate><enddate>20230601</enddate><creator>Muñoz, Andrés</creator><creator>Ay, Cihan</creator><creator>Grilz, Ella</creator><creator>López, Sonia</creator><creator>Font, Carme</creator><creator>Pachón, Vanesa</creator><creator>Castellón, Victoria</creator><creator>Martínez-Marín, Virginia</creator><creator>Salgado, Mercedes</creator><creator>Martínez, Eva</creator><creator>Calzas, Julia</creator><creator>Ortega, Laura</creator><creator>Rupérez, Ana</creator><creator>Salas, Eduardo</creator><creator>Pabinger, Ingrid</creator><creator>Soria, Jose Manuel</creator><general>Wolters Kluwer Health</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-9416-9514</orcidid><orcidid>https://orcid.org/0000-0003-0456-7322</orcidid><orcidid>https://orcid.org/0000-0002-6837-2471</orcidid><orcidid>https://orcid.org/0000-0003-2338-4257</orcidid><orcidid>https://orcid.org/0000-0002-6226-4293</orcidid><orcidid>https://orcid.org/0000-0002-3547-7373</orcidid><orcidid>https://orcid.org/0000-0001-6977-8249</orcidid></search><sort><creationdate>20230601</creationdate><title>A Clinical-Genetic Risk Score for Predicting Cancer-Associated Venous Thromboembolism: A Development and Validation Study Involving Two Independent Prospective Cohorts</title><author>Muñoz, Andrés ; Ay, Cihan ; Grilz, Ella ; López, Sonia ; Font, Carme ; Pachón, Vanesa ; Castellón, Victoria ; Martínez-Marín, Virginia ; Salgado, Mercedes ; Martínez, Eva ; Calzas, Julia ; Ortega, Laura ; Rupérez, Ana ; Salas, Eduardo ; Pabinger, Ingrid ; Soria, Jose Manuel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c385t-75529ca182cb20fd126a670e3d84ba4cf5b71c141c74c57ffda5a93eebb1e0103</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Anticoagulants - therapeutic use</topic><topic>Humans</topic><topic>Neoplasms - complications</topic><topic>Neoplasms - drug therapy</topic><topic>Neoplasms - genetics</topic><topic>ORIGINAL REPORTS</topic><topic>Prospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Thrombosis</topic><topic>Venous Thromboembolism - genetics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Muñoz, Andrés</creatorcontrib><creatorcontrib>Ay, Cihan</creatorcontrib><creatorcontrib>Grilz, Ella</creatorcontrib><creatorcontrib>López, Sonia</creatorcontrib><creatorcontrib>Font, Carme</creatorcontrib><creatorcontrib>Pachón, Vanesa</creatorcontrib><creatorcontrib>Castellón, Victoria</creatorcontrib><creatorcontrib>Martínez-Marín, Virginia</creatorcontrib><creatorcontrib>Salgado, Mercedes</creatorcontrib><creatorcontrib>Martínez, Eva</creatorcontrib><creatorcontrib>Calzas, Julia</creatorcontrib><creatorcontrib>Ortega, Laura</creatorcontrib><creatorcontrib>Rupérez, Ana</creatorcontrib><creatorcontrib>Salas, Eduardo</creatorcontrib><creatorcontrib>Pabinger, Ingrid</creatorcontrib><creatorcontrib>Soria, Jose Manuel</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of clinical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Muñoz, Andrés</au><au>Ay, Cihan</au><au>Grilz, Ella</au><au>López, Sonia</au><au>Font, Carme</au><au>Pachón, Vanesa</au><au>Castellón, Victoria</au><au>Martínez-Marín, Virginia</au><au>Salgado, Mercedes</au><au>Martínez, Eva</au><au>Calzas, Julia</au><au>Ortega, Laura</au><au>Rupérez, Ana</au><au>Salas, Eduardo</au><au>Pabinger, Ingrid</au><au>Soria, Jose Manuel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Clinical-Genetic Risk Score for Predicting Cancer-Associated Venous Thromboembolism: A Development and Validation Study Involving Two Independent Prospective Cohorts</atitle><jtitle>Journal of clinical oncology</jtitle><addtitle>J Clin Oncol</addtitle><date>2023-06-01</date><risdate>2023</risdate><volume>41</volume><issue>16</issue><spage>2911</spage><epage>2925</epage><pages>2911-2925</pages><issn>0732-183X</issn><issn>1527-7755</issn><eissn>1527-7755</eissn><abstract>Venous thromboembolism (VTE) is a leading cause of death among patients with cancer. The Khorana score was developed for assessing the risk of VTE in outpatients with cancer receiving chemotherapy, but its accuracy in identifying patients at high risk has been questioned. The aim of this study was to develop and validate a clinical-genetic score that improves the assessment of VTE risk in oncology outpatients within 6 months of diagnosis.
The new score was developed using the data of 364 outpatients belonging to the Spanish ONCOTHROMB 12-01 population. In this cohort, clinical data associated with the risk of VTE were collected at the time of diagnosis, including the Khorana score. These patients were also genotyped for the 51 genetic variants known to be associated with VTE. Multivariate logistic regression was performed to determine the weight of each genetic and clinical variable in relation to VTE risk, allowing a clinical-genetic risk score (the ONCOTHROMB score) to be developed. The Khorana and the ONCOTHROMB scores were then compared via the area under the receiver operating characteristic curve (AUC), calibration, and the number of patients needed to treat. The new score was then validated in a study of 263 patients in the Vienna Cancer and Thrombosis Study population.
Nine genetic variants, tumor site, TNM stage, and a body mass index of > 25 kg/m
were found to be associated with VTE and were used to build the ONCOTHROMB score, which better predicted the overall risk of VTE than did the Khorana score (AUC, 0.781
0.580;
< .001). Similar AUC results were recorded in the validation study the Vienna Cancer and Thrombosis Study cohort involving patients with the same type of tumor (AUC for the ONCOTHROMB score
the Khorana score: 0.686
0.577;
< .001) and with all type of tumors (AUC for the ONCOTHROMB score
the Khorana score: 0.720
0.561;
< .0001).
The ONCOTHROMB score for VTE risk in outpatients with cancer, which takes into account both clinical and genetic variables, better identifies patients who might benefit from primary thromboprophylaxis than does the Khorana score.</abstract><cop>United States</cop><pub>Wolters Kluwer Health</pub><pmid>36730884</pmid><doi>10.1200/JCO.22.00255</doi><tpages>15</tpages><orcidid>https://orcid.org/0000-0002-9416-9514</orcidid><orcidid>https://orcid.org/0000-0003-0456-7322</orcidid><orcidid>https://orcid.org/0000-0002-6837-2471</orcidid><orcidid>https://orcid.org/0000-0003-2338-4257</orcidid><orcidid>https://orcid.org/0000-0002-6226-4293</orcidid><orcidid>https://orcid.org/0000-0002-3547-7373</orcidid><orcidid>https://orcid.org/0000-0001-6977-8249</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0732-183X |
| ispartof | Journal of clinical oncology, 2023-06, Vol.41 (16), p.2911-2925 |
| issn | 0732-183X 1527-7755 1527-7755 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10414737 |
| source | MEDLINE; American Society of Clinical Oncology Journals; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Anticoagulants - therapeutic use Humans Neoplasms - complications Neoplasms - drug therapy Neoplasms - genetics ORIGINAL REPORTS Prospective Studies Risk Assessment Risk Factors Thrombosis Venous Thromboembolism - genetics |
| title | A Clinical-Genetic Risk Score for Predicting Cancer-Associated Venous Thromboembolism: A Development and Validation Study Involving Two Independent Prospective Cohorts |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-28T01%3A07%3A31IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=A%20Clinical-Genetic%20Risk%20Score%20for%20Predicting%20Cancer-Associated%20Venous%20Thromboembolism:%20A%20Development%20and%20Validation%20Study%20Involving%20Two%20Independent%20Prospective%20Cohorts&rft.jtitle=Journal%20of%20clinical%20oncology&rft.au=Mu%C3%B1oz,%20Andr%C3%A9s&rft.date=2023-06-01&rft.volume=41&rft.issue=16&rft.spage=2911&rft.epage=2925&rft.pages=2911-2925&rft.issn=0732-183X&rft.eissn=1527-7755&rft_id=info:doi/10.1200/JCO.22.00255&rft_dat=%3Cproquest_pubme%3E2773125553%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2773125553&rft_id=info:pmid/36730884&rfr_iscdi=true |