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
基本信息
- 批准号:10599802
- 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 2023-05-31
- 项目状态:已结题
- 来源:
- 关键词:AddressAdultAffectAgingAwardCaringChronicChronic DiseaseClinicalCommunitiesComplexConflict (Psychology)DataData LinkagesDevelopmentDiseaseElderlyEnsureEpidemiologyFamilyFoundationsFutureGoalsHealthHealth Care CostsHealth PolicyHealth and Retirement StudyHealth systemHealthcare SystemsImpairmentInternational Classification of Disease CodesK-Series Research Career ProgramsLinkMeasurementMeasuresMedicareMedicare claimMental DepressionMentorshipMethodsMichiganModelingOutcomePatient CarePatient Outcomes AssessmentsPatient Self-ReportPatient-Centered CarePatient-Focused OutcomesPatientsPerformancePharmaceutical PreparationsPhysical FunctionPhysical PerformancePhysiciansPoliciesPopulationPositioning AttributePrevalencePrognosisProviderQuality of CareRegimenResearchResearch ActivityResearch PersonnelResourcesSeveritiesTechniquesTestingTrainingTraining ActivityUniversitiesValidationWeightWorkadverse outcomebaseburden of illnesscareerclinical careclinically relevantcognitive performancecohortcomorbidity Indexdata reductiondisabilityfrailtyfunctional disabilityfunctional outcomeshealth related quality of lifehigh riskimprovedindexinginstrumental activity of daily livingmortalitymultidimensional datamultiple chronic conditionsnovelnovel strategiespatient orientedpatient stratificationphysical conditioningpoint of carepreventprospectiverisk stratificationskillsstandard measuresynergismtool
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 patient-oriented career development 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.
项目摘要/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,
严重影响身体功能和健康相关的生活质量。尽管如此,
测量多变量。特别是,很少有实用的工具来指导临床医生,研究人员,
寻求改善老年人护理的政策制定者。目前对多人死亡的措施使用了
死亡率、医疗保健成本和利用率,但尚未关注以患者为中心的结局来量化负担
疾病。传统方法测量疾病相互作用的统计局限性超出了简单的双向
疾病间的相互作用也阻碍了我们对多发病及其全面影响的流行病学理解
健康和功能结果。为了弥合这些差距,本提案旨在:1)开发和验证一个新的
ICD编码条件下使用的多模态指数; 2)通过合并多个
对疾病相互作用进行排序,并确定其纳入的增量价值;以及3)评估
多功能指数通过其与关键功能结果的关联,包括身体和认知
表现、基本和工具性日常生活活动、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相互作用
与身体功能相关的多种潜在疾病组合。的效用
将通过其与身体和认知功能的前瞻性关联来评估多项指标。
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。
通过这个以病人为导向的职业发展奖,候选人将实现直接的职业目标,
获得新的专业技能,使用行政索赔,ICD编码数据和新的统计方法,
高维度数据,并更深入地了解衡量老年人关键健康结果的方法
在多方面。密歇根大学的设施、主办部门和智力资源
为这个职业发展奖和早期研究员提供一个特殊的环境。培训和
通过这个奖项获得的专业发展将有助于候选人的长期目标是一个
独立的临床研究者,专注于改善管理,护理质量和预后,
易受伤害的老年人
项目成果
期刊论文数量(6)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Multimorbidity of four cardiometabolic and chronic pulmonary disease groups: prevalence and attributable fraction in US adults, 2007-2012.
- DOI:10.15256/joc.2017.7.89
- 发表时间:2017-01-01
- 期刊:
- 影响因子:0
- 作者:Staimez, Lisa R;Wei, Melissa Y;Saydah, Sharon H
- 通讯作者:Saydah, Sharon H
Association of multimorbidity patterns with incident disability and recovery of independence among middle-aged and older adults.
- DOI:10.1093/ageing/afac177
- 发表时间:2022-08
- 期刊:
- 影响因子:6.7
- 作者:Jiayi Zhou;M. Wei;Jingyi Zhang;Hua Liu;Chenkai Wu
- 通讯作者:Jiayi Zhou;M. Wei;Jingyi Zhang;Hua Liu;Chenkai Wu
Measuring Multimorbidity: Selecting the Right Instrument for the Purpose and the Data Source.
- DOI:10.1097/mlr.0000000000001566
- 发表时间:2021-08-01
- 期刊:
- 影响因子:3
- 作者:Suls J;Bayliss EA;Berry J;Bierman AS;Chrischilles EA;Farhat T;Fortin M;Koroukian SM;Quinones A;Silber JH;Ward BW;Wei M;Young-Hyman D;Klabunde CN
- 通讯作者:Klabunde CN
Focus and features of prescribing indications spanning multiple chronic conditions in older adults: A narrative review.
- DOI:10.1177/26335565211012876
- 发表时间:2021-01
- 期刊:
- 影响因子:0
- 作者:Aubert, Carole E;Kerr, Eve A;Klamerus, Mandi L;Hofer, Timothy P;Wei, Melissa Y
- 通讯作者:Wei, Melissa Y
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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:多发病新测量方法的开发和验证
- 批准号:
9925770 - 财政年份:2017
- 资助金额:
$ 16.74万 - 项目类别:
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