Validation of the Rheumatic Disease Comorbidity Index
Validation of the Rheumatic Disease Comorbidity Index
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DOI：
10.1002/acr.22456
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发表时间：
2015-06-01
影响因子：
4.7
通讯作者：
Michaud, Kaleb
中科院分区：
文献类型：
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作者：
England, Bryant R.;Sayles, Harlan;Michaud, Kaleb
对于风湿性疾病健康结果研究的最佳合并症指数没有共识。我们比较了一个新的风湿性疾病合并症指数（RDCI）与Charlson-Deyo指数（CDI），功能性合并症指数（FCI），Elixhauser总评分（ETS），Elixhauser评分系统（EPS），和一个简单的合并症计数（ECOR）使用美国类风湿性关节炎（RA）患者队列。EPS和2个结局的EPS和EPS：全因死亡率和身体功能。指数进行了比较，使用3个模型：裸（包括年龄，性别和种族），行政（裸加访问频率，体重指数，和治疗），和诊所（行政加红细胞沉降率，结节，类风湿因子阳性，患者活动量表）。FCI最好的预测功能，ETS和RDCI的表现也差不多。CDI预测功能较差。指数的顺序保持相对不变，在不同的模型，虽然赤池的信息标准的改善幅度下降，在行政和诊所models.ConclusionThe RDCI和ETS是优秀的指标作为一种手段，占共病时，RA相关的死亡和身体功能的结果进行了研究，使用行政数据。RDCI是一个通用的索引，似乎对自我报告数据和管理数据都有很好的表现。进一步的研究是必要的，以比较这些指数使用其他结果在不同的研究人群。
ObjectiveThere is no consensus on which comorbidity index is optimal for rheumatic health outcomes research. We compared a new Rheumatic Disease Comorbidity Index (RDCI) with the Charlson-Deyo Index (CDI), Functional Comorbidity Index (FCI), Elixhauser Total Score (ETS), Elixhauser Point System (EPS), and a simple comorbidity count (COUNT) using a US cohort of rheumatoid arthritis (RA) patients.MethodsUsing administrative diagnostic codes and patient self-reporting, we tested predictive values of the RDCI, CDI, FCI, ETS, EPS, and COUNT for 2 outcomes: all-cause mortality and physical functioning. Indices were compared using 3 models: bare (consisting of age, sex, and race), administrative (bare plus visit frequency, body mass index, and treatments), and clinic (administrative plus erythrocyte sedimentation rate, nodules, rheumatoid factor positivity, and patient activity scale).ResultsThe ETS and RDCI best predicted death, with FCI performing the worst. The FCI best predicted function, with ETS and RDCI performing nearly as well. CDI predicted function poorly. The order of indices remained relatively unchanged in the different models, though the magnitude of improvement in Akaike's information criterion decreased in the administrative and clinic models.ConclusionThe RDCI and ETS are excellent indices as a means of accounting for comorbid illness when the RA-related outcomes of death and physical functioning are studied using administrative data. The RDCI is a versatile index and appears to perform well with self-report data as well as administrative data. Further studies are warranted to compare these indices using other outcomes in diverse study populations.