Can comorbidity be measured by questionnaire rather than medical record review?
Can comorbidity be measured by questionnaire rather than medical record review?
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DOI：
10.1097/00005650-199601000-00006
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发表时间：
1996-01-01
期刊：
影响因子：
3
通讯作者：
Bates, DW
中科院分区：
文献类型：
--
作者：
Katz, JN;Chang, LC;Bates, DW
并发症通常是通过医疗记录摘要来衡量的，这是昂贵的，往往是不切实际的。本研究的目的是评估共病问卷的重复性和有效性。作者开发了一个简短的合并症问卷，其中包括与基于病历的Charlson指数的每个元素相对应的项目。问卷调查了170名住院患者。Charlson评分从这些患者的病历中提取。我们评估了问卷和Charlson指数的重测信度，问卷和Charlson指数之间的相关性，以及每项合并指标与卫生资源利用指标（包括药物使用、过去一年的住院次数和医院收费）之间的相关性。重测信度，与组内相关系数进行评估，为0.91的问卷和0.92的图表为基础的Charlson指数。这两个指标之间的斯皮尔曼相关系数为0.63。在受教育程度较低的患者中，合并症指标之间的相关性较弱。这两个共同体工具与资源利用指标的相关性相似。作者发现，Charlson指数的问卷版本是可重复的，有效的，并提供了基于病历的评估的实际优势。
Comorbidity generally is measured by medical record abstraction, which is expensive and often impractical. The aim of this study was to assess the reproducibility and validity of a comorbidity questionnaire. The authors developed a brief comorbidity questionnaire that included items corresponding to each element of the medical record-based Charlson index. The questionnaire was administered to 170 inpatients. Charlson scores were abstracted from these patients' medical records. We assessed test-retest reliability of the questionnaire and the Charlson index, the correlation between the questionnaire and the Charlson index, and correlations between each comorbidity measure and indicators of health resource utilization including medication use, hospitalizations in the past year, and hospital charges. Test-retest reliability, assessed with the intraclass correlation coefficient, was 0.91 for the questionnaire and 0.92 for the chart-based Charlson index. The Spearman correlation between these two measures was 0.63. The correlation between comorbidity measures was weaker in less educated patients. Correlations with indicators of resource utilization were similar for the two comorbidity instruments. The authors found that a questionnaire version of the Charlson index is reproducible, valid, and offers practical advantages over medical record-based assessments.