PurposeIn this study, a hybrid rough and grey set-based rule model is designed for diagnosis of one type of blood cancer called multiple myeloma (MM). The grey clustering method is used to combine the same condition attributes and to improve the validity of the final model.Design/methodology/approachSome tools of the rough set theory (RST) and grey incidence analysis (GIA) are used in this research to analyze the serum protein electrophoresis (SPE) test results. An RST-based rule model is extracted based on the laboratory SPE test results of patients. Also, one decision attribute and 15 condition attributes are used to extract the rules. About four rule models are constructed due to the different algorithms of data complement, discretization, reduction and rule generation. In the following phases, the condition attributes are clustered into seven clusters by using a grey clustering method, the value set of the decision attribute is decreased by using manual discretizing and the number of observations is increased in order to improve the accuracy of the model. Cross-validation is used for evaluation of the model results and finally, the best model is chosen with 5,216 rules and 98% accuracy.FindingsIn this paper, a new rule model with high accuracy is extracted based on the combination of the grey clustering method and RST modeling for diagnosis of the MM disease. Also, four primary rule models and four improved rule models have been extracted from different decision tables in order to define the result of SPE test of patients. The maximum average accuracy of improved models is equal to 95% and related to the gamma globulins percentage attribute/object-related reducts (GA/ORR) model.Research limitations/implicationsThe total number of observations for rule extraction is 115 and the results can be improved by further samples. To make the designed expert system handy in the laboratory, new computer software is under construction to import data automatically from the electrophoresis machine into the resultant rule model system.Originality/valueThe main originality of this paper is to use the RST and GST together to design and create a hybrid rule model to diagnose MM. Although many studies have been carried out on designing expert systems in medicine and cancer diagnosis, no studies have been found in designing systems to diagnose MM. On the other hand, using the grey clustering method for combining the condition attributes is a novel solution for improving the accuracy of the rule model.