• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar

information for practice

news, new scholarship & more from around the world


advanced search
  • gary.holden@nyu.edu
  • @ Info4Practice
  • Archive
  • About
  • Help
  • Browse Key Journals
  • RSS Feeds

Can markers of disease severity improve the predictive power of claims‐based multimorbidity indices?

Abstract

Background

Claims-based measures of multimorbidity, which evaluate the presence of a defined list of diseases, are limited in their ability to predict future outcomes. We evaluated whether claims-based markers of disease severity could improve assessments of multimorbid burden.

Methods

We developed 7 dichotomous markers of disease severity which could be applied to a range of diseases using claims data. These markers were based on the number of disease-associated outpatient visits, emergency department visits, and hospitalizations made by an individual over a defined interval; whether an individual with a given disease had outpatient visits to a specialist who typically treats that disease; and ICD-9 codes which connote more versus less advanced or symptomatic manifestations of a disease. Using Medicare claims linked with Health and Retirement Study data, we tested whether including these markers improved ability to predict ADL decline, IADL decline, hospitalization, and death compared to equivalent models which only included the presence or absence of diseases.

Results

Of 5012 subjects, median age was 76 years and 58% were female. For a majority of diseases tested individually, adding each of the 7 severity markers yielded minimal increase in c-statistic (≤0.002) for outcomes of ADL decline and mortality compared to models considering only the presence versus absence of disease. Gains in predictive power were more substantial for a small number of individual diseases. Inclusion of the most promising marker in multi-disease multimorbidity indices yielded minimal gains in c-statistics (<0.001–0.007) for predicting ADL decline, IADL decline, hospitalization, and death compared to indices without these markers.

Conclusions

Claims-based markers of disease severity did not contribute meaningfully to the ability of multimorbidity indices to predict ADL decline, mortality, and other important outcomes.

Read the full article ›

Posted in: Journal Article Abstracts on 12/25/2022 | Link to this post on IFP |
Share

Primary Sidebar

Categories

Category RSS Feeds

  • Calls & Consultations
  • Clinical Trials
  • Funding
  • Grey Literature
  • Guidelines Plus
  • History
  • Infographics
  • Journal Article Abstracts
  • Meta-analyses - Systematic Reviews
  • Monographs & Edited Collections
  • News
  • Open Access Journal Articles
  • Podcasts
  • Video

© 1993-2023 Dr. Gary Holden. All rights reserved.

gary.holden@nyu.edu
@Info4Practice