A Simple Method for Evaluating Within Sample Prognostic Balance Achieved by Published Comorbidity Summary Measures.
A Simple Method for Evaluating Within Sample Prognostic Balance Achieved by Published Comorbidity Summary Measures.
复制标题
一种评估已发布的合并症总结措施所实现的样本预后平衡的简单方法。
DOI：
10.1111/1475-6773.12276
复制
发表时间：
2015
影响因子：
3.4
通讯作者：
Wong,Yu-Ning
中科院分区：
文献类型：
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作者：
Egleston,BrianL;Uzzo,RobertG;Beck,JRobert;Wong,Yu-Ning
目的：研究人员如何调查已发表的合并症汇总测量方法在给定样本中的适用性。与医疗保险索赔数据相关的监测、流行病学和最终结果。研究设计：我们在合并症综合测量Charlson合并症指数的分层中检验了四种疾病的Kaplan-Meier估计生存曲线。数据收集我们确定了1995年至2009年间诊断为早期肾癌的个体。我们记录了在诊断前一年出现的合并症。主要发现：在适当的条件下，许多合并症汇总测量方法的使用是有效的。一个条件是，在研究人员自己的人群中，合并症与感兴趣的结果之间的关系与已发表的算法人群中的关系相当。Charlson共病指数的原始共病权重似乎足以满足我们样本中的三种疾病。我们发现证据表明，查尔森合并症指数可能低估了我们样本中一种疾病的影响。结论通过合并症汇总测量确定地层内的生存曲线，可以作为确定已发表的方法是否恰当地解释合并症的有用工具。合并症评分仅与这些变量一样好。
ObjectiveTo demonstrate how a researcher can investigate the appropriateness of a published comorbidity summary measure for use with a given sample.Data SourceSurveillance, Epidemiology, and End Results linked to Medicare claims data.Study DesignWe examined Kaplan–Meier estimated survival curves for four diseases within strata of a comorbidity summary measure, the Charlson Comorbidity Index.Data CollectionWe identified individuals with early‐stage kidney cancer diagnosed from 1995 to 2009. We recorded comorbidities present in the year before diagnosis.Principal FindingsThe use of many comorbidity summary measures is valid under appropriate conditions. One condition is that the relationships of the comorbidities with the outcome of interest in a researcher's own population are comparable to the relationships in a published algorithm's population. The original comorbidity weights from the Charlson Comorbidity Index seemed adequate for three of the diseases in our sample. We found evidence that the Charlson Comorbidity Index might underestimate the impact of one disease in our sample.ConclusionExamination of survival curves within strata defined by a comorbidity summary measure can be a useful tool for determining whether a published method appropriately accounts for comorbidities. A comorbidity score is only as good as those variables included.