Examining different measures of multimorbidity, using a large prospective cross-sectional study in Australian general practice.
Examining different measures of multimorbidity, using a large prospective cross-sectional study in Australian general practice.
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DOI：
10.1136/bmjopen-2013-004694
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发表时间：
2014-07-11
期刊：
影响因子：
2.9
通讯作者：
Henderson J
中科院分区：
文献类型：
--
作者：
Harrison C;Britt H;Miller G;Henderson J
由于定义和测量方法不一致，多发性硬化的患病率估计值差异很大。本研究探讨了如何定义“疾病实体”对患病率估计的独立影响-作为一种单一的慢性疾病或国际初级保健分类中的章节/领域（V.2; ICPC-2），国际疾病分类（第10次修订; ICD-10）或累积疾病评定量表（CIRS），多发病所需的疾病实体数量，以及研究的慢性疾病的数量。全国前瞻性横断面研究。澳大利亚的一般做法。8707随机同意去识别患者遇到290随机选择的全科医生。使用不同定义估计多发性硬化症的患病率。分类到ICPC-2章节、ICD-10章节或CIRS领域的数据产生了类似的多发病率估计值。当多发病被定义为两个或两个以上（2+）疾病实体时：计算单个慢性疾病和慢性疾病组产生了类似的估计值; 12种最流行的慢性疾病确定了使用所有慢性疾病确定的患者的约80%。当多发病被定义为3+疾病实体时：计数单个慢性疾病产生的估计值显著高于计数慢性疾病组; 12种最流行的慢性疾病仅确定了使用所有慢性疾病确定的患者的三分之二。定义为2+疾病实体的多发病可以使用疾病实体的不同定义来测量，其中只有12种流行的慢性疾病，但缺乏特异性，特别是在老年人中。多发病，定义为3+，需要更多的测量一致性和包括所有慢性疾病，但提供更大的特异性比2+定义。所提出的“复杂多发病”概念，即在一个人体内同时出现三种或三种以上影响三种或三种以上不同身体系统的慢性疾病，而不定义指数慢性疾病，可能有助于确定高需求个体。
Prevalence estimates of multimorbidity vary widely due to inconsistent definitions and measurement methods. This study examines the independent effects on prevalence estimates of how ‘disease entity’ is defined—as a single chronic condition or chapters/domains in the International Classification of Primary Care (V.2; ICPC-2), International Classification of Disease (10th revision; ICD-10) or the Cumulative Illness Rating Scale (CIRS), the number of disease entities required for multimorbidity, and the number of chronic conditions studied. National prospective cross-sectional study. Australian general practice. 8707 random consenting deidentified patient encounters with 290 randomly selected general practitioners. Prevalence estimates of multimorbidity using different definitions. Data classified to ICPC-2 chapters, ICD-10 chapters or CIRS domains produce similar multimorbidity prevalence estimates. When multimorbidity was defined as two or more (2+) disease entities: counting individual chronic conditions and groups of chronic conditions produced similar estimates; the 12 most prevalent chronic conditions identified about 80% of those identified using all chronic conditions. When multimorbidity was defined as 3+ disease entities: counting individual chronic conditions produced significantly higher estimates than counting groups of chronic conditions; the 12 most prevalent chronic conditions identified only two-thirds of patients identified using all chronic conditions. Multimorbidity defined as 2+ disease entities can be measured using different definitions of disease entity with as few as 12 prevalent chronic conditions, but lacks specificity to be useful, especially in older people. Multimorbidity, defined as 3+, requires more measurement conformity and inclusion of all chronic conditions, but provides greater specificity than the 2+ definition. The proposed concept of “complex multimorbidity”, the co-occurrence of three or more chronic conditions affecting three or more different body systems within one person without defining an index chronic condition, may be useful in identifying high-need individuals.
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影响因子：
2.2
作者：
Bayliss, Elizabeth A.;Edwards, Allison E.;Main, Deborah S.
通讯作者：
Main, Deborah S.
影响因子：
3.7
作者：
Harrison, Christopher;Britt, Helena;Henderson, Joan
通讯作者：
Henderson, Joan
影响因子：
2.2
作者：
O'Halloran, J;Miller, GC;Britt, H
通讯作者：
Britt, H
影响因子：
11.4
作者：
Britt, Helena C.;Harrison, Christopher M.;Knox, Stephanie A.
通讯作者：
Knox, Stephanie A.
影响因子：
7.2
作者：
van den Akker, M;Buntinx, F;Knottnerus, JA
通讯作者：
Knottnerus, JA