Cumulative and synergistic impact of chronic diseases on physical functioning in older adults: development and validation of a novel measure of multimorbidity

慢性病对老年人身体功能的累积和协同影响:多发病新测量方法的开发和验证

基本信息

  • 批准号:
    9925770
  • 负责人:
  • 金额:
    $ 16.74万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2017
  • 资助国家:
    美国
  • 起止时间:
    2017-09-15 至 2020-08-14
  • 项目状态:
    已结题

项目摘要

Project Summary / Abstract Multimorbidity, the coexistence of multiple chronic conditions, poses a major and growing challenge to aging adults, their families, and healthcare systems. Most older adults have multiple chronic conditions that interact to profoundly affect physical functioning and health-related quality of life. Despite this, critical gaps remain in the measurement of multimorbidity. In particular, there are few practical tools to guide clinicians, researchers, and policymakers who seek to improve the care for older adults. Current measures for multimorbidity have used mortality, healthcare cost, and utilization, but have not focused on patient-centered outcomes to quantify burden of disease. Statistical limitations in traditional methods to measure disease interactions beyond simple two-way disease interactions have also hampered our epidemiologic understanding of multimorbidity and its full impact on health and functional outcomes. To bridge these gaps, this proposal aims to 1) Develop and validate a new multimorbidity index for use in ICD-coded conditions; 2) Refine the multimorbidity index by incorporating multiple-order disease interactions and determine the incremental value of their inclusion; and 3) Assess the utility of the multimorbidity index through its association with key functional outcomes including physical and cognitive performance, basic and instrumental activities of daily living, depression, and mortality. The proposed studies will use unique data linkages between patient-reported outcomes in the nationally- representative Health and Retirement Study and Medicare claims to develop and internally validate a multimorbidity index for International Classification of Diseases (ICD)-coded chronic conditions weighted to physical functioning. Novel approaches to data shrinkage techniques will be used to select significant interactions among multiple potential disease combinations associated with physical functioning. The utility of the multimorbidity index will be assessed through its prospective associations with physical and cognitive performance, basic and instrumental activities of daily living, and mortality. The successful completion of these studies will yield a validated multimorbidity measure that captures the impact of coexisting chronic diseases on physical functioning in older adults relevant for clinical care, research, and policy. Through this award, the candidate will achieve immediate career goals to gain new specialized skills in using administrative claims, ICD coded data, and novel statistical approaches to high-dimension data, and achieve a deeper understanding of measuring key health outcomes in older adults with multimorbidity. The facilities, sponsoring department, and intellectual resources at the University of Michigan provide an exceptional milieu for this career development award and Early Stage Investigator. The training and professional development acquired through this award will contribute to the candidate's long-term goal to be an independent clinician- investigator focused on improving the management, quality of care, and prognosis of vulnerable older adults with multimorbidity.
项目总结/摘要 多种慢性疾病并存的多发病对老龄化构成了重大且日益严峻的挑战 成年人,他们的家庭和医疗保健系统。大多数老年人有多种慢性疾病, 深刻影响身体功能和健康相关的生活质量。尽管如此, 多变量的测量。特别是,几乎没有实用的工具来指导临床医生,研究人员, 以及寻求改善老年人护理的政策制定者。目前对多名受害者采取的措施包括: 使用了死亡率、医疗保健成本和利用率,但没有关注以患者为中心的结果来量化 疾病负担。传统方法测量疾病相互作用的统计局限性超出了简单的范围 双向疾病相互作用也阻碍了我们对多发性硬化症的流行病学理解, 对健康和功能结果的全面影响。为了弥补这些差距,本提案旨在1)制定和 验证一个新的多变量索引,用于ICD编码的条件; 2)通过以下方式优化多变量索引: 纳入多阶疾病相互作用,并确定其纳入的增量价值;以及3) 通过其与关键功能结果的关联来评估多发病指数的实用性,包括 身体和认知表现、日常生活的基本和工具性活动、抑郁和死亡率。 拟议的研究将使用全国范围内患者报告结果之间的独特数据联系, 代表健康和退休研究和医疗保险索赔开发和内部验证一个 国际疾病分类(ICD)编码的慢性病多发病指数加权至 身体机能数据收缩技术的新方法将用于选择重要的 与身体功能相关的多种潜在疾病组合之间的相互作用。的效用 将通过其与身体和认知的前瞻性关联来评估多情感指数, 性能、基本和工具性日常生活活动以及死亡率。成功完成这些 研究将产生一个有效的多指标,捕捉共存的慢性疾病的影响, 老年人的身体功能与临床护理、研究和政策有关。 通过这个奖项,候选人将实现直接的职业目标,以获得新的专业技能, 行政索赔,ICD编码的数据,和新的统计方法,以高维数据,并实现了 更深入地了解测量患有多发性硬化症的老年人的关键健康结果。设施, 主办部门和密歇根大学的智力资源提供了一个特殊的环境 获得职业发展奖和早期调查员奖培训和专业发展 通过这个奖项获得的将有助于候选人的长期目标是一个独立的临床医生- 研究人员专注于改善脆弱老年人的管理,护理质量和预后 在多方面。

项目成果

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Melissa Wei其他文献

Melissa Wei的其他文献

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{{ truncateString('Melissa Wei', 18)}}的其他基金

New EHR-based multimorbidity index for diverse populations across the lifespan: development, validation, and application
针对不同人群整个生命周期的新的基于 EHR 的多病指数:开发、验证和应用
  • 批准号:
    10720597
  • 财政年份:
    2023
  • 资助金额:
    $ 16.74万
  • 项目类别:
Cumulative and synergistic impact of chronic diseases on physical functioning in older adults: development and validation of a novel measure of multimorbidity
慢性病对老年人身体功能的累积和协同影响:多发病新测量方法的开发和验证
  • 批准号:
    10319278
  • 财政年份:
    2017
  • 资助金额:
    $ 16.74万
  • 项目类别:
Cumulative and Synergistic Impact of Chronic Diseases on Physical Functioning in Older Adults: Development and Validation of a Novel Measure of Multimorbidity
慢性病对老年人身体功能的累积和协同影响:多重发病新测量方法的开发和验证
  • 批准号:
    10599802
  • 财政年份:
    2017
  • 资助金额:
    $ 16.74万
  • 项目类别:

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