We developed the extracellular vesicle machine learning analysis platform (EVMAP) to improve the prediction of diseases such as cancer. The platform combines extracellular vesicle analysis using microscale cytometry with a machine learning approach to generate predictive models. In this work, we utilized EVMAP to generate a blood test to predict high-grade prostate cancer in men that was significantly more accurate than the prostate-specific antigen test. This platform could be applied to many different diseases.