Do self-report and medical record comorbidity data predict longitudinal functional capacity and quality of life health outcomes similarly?
Do self-report and medical record comorbidity data predict longitudinal functional capacity and quality of life health outcomes similarly?
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DOI：
10.1186/1472-6963-12-398
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发表时间：
2012-11-14
影响因子：
2.8
通讯作者：
Holmes-Rovner M
中科院分区：
文献类型：
--
作者：
Olomu AB;Corser WD;Stommel M;Xie Y;Holmes-Rovner M
寻找一种可靠、有效和具有成本效益的合并症风险调整方法进行结果研究仍然是一项挑战。最广泛使用的工具，查理森共病指数（CCI）是有限的，由于经常缺少数据的医疗记录和管理数据。患者自我报告数据有可能更完整，但尚未广泛使用。本研究的目的是评估自我管理共病问卷（SCQ）的性能，以预测功能能力，生活质量（QOL）健康结果与CCI医疗记录数据的比较。对525例因急性冠脉综合征（ACS）住院的患者在基线、出院后3个月和8个月进行scq评分，并通过病历回顾产生CCI评分。线性回归模型评估了共病测量预测功能能力（活动状态指数[ASI]评分）和生活质量（EuroQOL 5D [EQ5D]评分）能力差异的程度。CCI （R2 = 0.245; p = 0.132）不能预测生活质量评分，而SCQ自我报告法（R2 = 0.265; p < 0.0005）可以预测EQ5D评分。然而，CCI在预测第3个月和第6个月的ASI评分方面几乎与SCQ一样好，在预测第8个月的ASI评分方面表现略好（R2 = 0.370; p < 0.0005 vs. R2 = 0.358; p < 0.0005）。只有年龄、性别、家庭收入和流行病学研究中心抑郁（CESD）评分与预测生活质量和功能能力这两项指标有显著关联。虽然我们的模型r平方相当低，但这些结果表明，与CCI医疗记录评分相比，自我报告SCQ指数是预测生活质量健康结果的良好替代方法。两种测量方法对身体机能的预测相似。提示患者自我报告的合并症数据可用于预测身体功能能力和生活质量，并可作为可靠的风险调整措施。自我报告的合并症数据可能为临床研究、卫生政策和组织改进分析中的风险调整提供一种具有成本效益的替代方法。临床试验网站NCT00416026
The search for a reliable, valid and cost-effective comorbidity risk adjustment method for outcomes research continues to be a challenge. The most widely used tool, the Charlson Comorbidity Index (CCI) is limited due to frequent missing data in medical records and administrative data. Patient self-report data has the potential to be more complete but has not been widely used. The purpose of this study was to evaluate the performance of the Self-Administered Comorbidity Questionnaire (SCQ) to predict functional capacity, quality of life (QOL) health outcomes compared to CCI medical records data. An SCQ-score was generated from patient interview, and the CCI score was generated by medical record review for 525 patients hospitalized for Acute Coronary Syndrome (ACS) at baseline, three months and eight months post-discharge. Linear regression models assessed the extent to which there were differences in the ability of comorbidity measures to predict functional capacity (Activity Status Index [ASI] scores) and quality of life (EuroQOL 5D [EQ5D] scores). The CCI (R2 = 0.245; p = 0.132) did not predict quality of life scores while the SCQ self-report method (R2 = 0.265; p < 0.0005) predicted the EQ5D scores. However, the CCI was almost as good as the SCQ for predicting the ASI scores at three and six months and performed slightly better in predicting ASI at eight-month follow up (R2 = 0.370; p < 0.0005 vs. R2 = 0.358; p < 0.0005) respectively. Only age, gender, family income and Center for Epidemiologic Studies-Depression (CESD) scores showed significant association with both measures in predicting QOL and functional capacity. Although our model R-squares were fairly low, these results show that the self-report SCQ index is a good alternative method to predict QOL health outcomes when compared to a CCI medical record score. Both measures predicted physical functioning similarly. This suggests that patient self-reported comorbidity data can be used for predicting physical functional capacity and QOL and can serve as a reliable risk adjustment measure. Self-report comorbidity data may provide a cost-effective alternative method for risk adjustment in clinical research, health policy and organizational improvement analyses. Clinical Trials.gov NCT00416026
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影响因子：
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