当前位置： SCI文献检索 > JOURNAL OF CLINICAL EPIDEMIOLOGY期刊下所有文献 > Selecting a patient characteristics index for the prediction of medical outcomes using administrative claims data.

Selecting a patient characteristics index for the prediction of medical outcomes using administrative claims data.

Abstract：

:Recently, there has been a great deal of discussion regarding the use of administrative databases to study outcomes of medical care. A major issue in this discussion is how to classify patients in terms of characteristics such as disease-severity, comorbidities, resource needs, stability, etc. Different indices have been developed in an attempt to provide a common classification scheme in terms of these characteristics. In this paper, we examine the utility of four indices in the prediction of length of stay and 30-day mortality for patients undergoing total knee replacement surgery between 1985 and 1989. The indices that we compare are the Deyo-adapted Charlson Index, the Relative Intensity Score derived from Patient Management Categories (PMCs), the Patient Severity Level derived from PMCs, and the number of diagnoses (up to five) listed in the Medicare claims data. The first three of these indices represent measures of comorbidity, resource use, and severity of illness, respectively. The number of diagnoses is likely to capture aspects of each of these characteristics. We find that all of the indices improve (in terms of model fit) over the baseline (no index) models of length of stay and mortality, and the Relative Intensity Score and Patient and Severity Level result in the greatest improvement in measures of model fit. We found, however, that these two indices have a non-monotonic relationship with length of stay and mortality. The Deyo-adapted Charlson Index performed least well of the four indices in terms of explanatory ability. The number of diagnoses performed well, and does not suffer from problems associated with miscoding on claims data.

journal_name

J Clin Epidemiol

journal_title

Journal of clinical epidemiology

authors

Melfi C,Holleman E,Arthur D,Katz B

doi

10.1016/0895-4356(94)00202-2

subject

Has Abstract

pub_date

1995-07-01 00:00:00

pages

917-26

issue

7

eissn

0895-4356

issn

1878-5921

pii

0895-4356(94)00202-2

journal_volume

48

pub_type

杂志文章

相关文献

JOURNAL OF CLINICAL EPIDEMIOLOGY文献大全
  • Responsiveness was similar between direct and mapped SF-6D in colorectal cancer patients who declined.

    abstract：OBJECTIVES:To evaluate the responsiveness of generic and mapped preference-based measures based on the anchor of global change in health condition of colorectal cancer (CRC) patients. STUDY DESIGN AND SETTING:A baseline sample of 333 Chinese CRC patients was recruited between September 2009 and July 2010 and was surve...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/j.jclinepi.2013.08.011

    authors： Wong CK,Mulhern B,Wan YF,Lam CL

    更新日期：2014-02-01 00:00:00

  • Diagnostic certainty and potential for misclassification in exocrine pancreatic cancer. PANKRAS I Project Investigations.

    abstract：:Whereas over the last decade epidemiologic studies on exocrine pancreatic cancer (EPC) continued to show a remarkable heterogeneity in diagnostic criteria applied to define caseness, the actual magnitude and consequences of misclassification remain largely unexplored. The objectives were: (1) to estimate the degree of...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/0895-4356(94)90123-6

    authors： Porta M,Malats N,Piñol JL,Rifà J,Andreu M,Real FX

    更新日期：1994-09-01 00:00:00

  • An observational study showed that explaining randomization using gambling-related metaphors and computer-agency descriptions impeded randomized clinical trial recruitment.

    abstract：OBJECTIVES:To explore how the concept of randomization is described by clinicians and understood by patients in randomized controlled trials (RCTs) and how it contributes to patient understanding and recruitment. STUDY DESIGN AND SETTING:Qualitative analysis of 73 audio recordings of recruitment consultations from fiv...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章,多中心研究

    doi：10.1016/j.jclinepi.2018.02.018

    authors： Jepson M,Elliott D,Conefrey C,Wade J,Rooshenas L,Wilson C,Beard D,Blazeby JM,Birtle A,Halliday A,Stein R,Donovan JL,CSAW study group.,Chemorad study group.,POUT study group.,ACST-2 study group.,OPTIMA prelim study group.

    更新日期：2018-07-01 00:00:00

  • Priority-based initiative for updating existing evidence-based clinical practice guidelines: the results of two iterations.

    abstract：OBJECTIVES:New evidence continues to emerge and requires attention after the release of a clinical practice guideline (CPG). The objective of this article is to describe the Document Assessment and Review (DAR) strategy designed to ensue that the CPGs remain current and their quality maintained and to present the resul...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/j.jclinepi.2014.06.013

    authors： Agbassi C,Messersmith H,McNair S,Brouwers M

    更新日期：2014-12-01 00:00:00

  • Decision making about healthcare-related tests and diagnostic test strategies. Paper 4: International guidelines show variability in their approaches.

    abstract：OBJECTIVES:The objective of the study was to describe and compare current practices in developing guidelines about the use of healthcare-related tests and diagnostic strategies (HCTDS). STUDY DESIGN AND SETTING:We sampled 37 public health and clinical practice guidelines about HCTDS from various sources without langua...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章,评审

    doi：10.1016/j.jclinepi.2017.09.004

    authors： Mustafa RA,Wiercioch W,Arevalo-Rodriguez I,Cheung A,Prediger B,Ivanova L,Ventresca M,Brozek J,Santesso N,Bossuyt P,Garg AX,Lloyd N,Lelgemann M,Bühler D,Schünemann HJ

    更新日期：2017-12-01 00:00:00

  • Minimal important change (MIC) based on a predictive modeling approach was more precise than MIC based on ROC analysis.

    abstract：OBJECTIVES:To present a new method to estimate a "minimal important change" (MIC) of health-related quality of life (HRQOL) scales, based on predictive modeling, and to compare its performance with the MIC based on receiver operating characteristic (ROC) analysis. To illustrate how the new method deals with variables t...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/j.jclinepi.2015.03.015

    authors： Terluin B,Eekhout I,Terwee CB,de Vet HC

    更新日期：2015-12-01 00:00:00

  • Present-at-admission diagnoses improved mortality risk adjustment among acute myocardial infarction patients.

    abstract：OBJECTIVE:Hospital mortality outcomes for acute myocardial infarction (AMI) patients are a focus of quality improvement programs conducted by government agencies. AMI mortality risk-adjustment models using administrative data typically adjust for baseline differences in mortality risk with a limited set of common and d...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/j.jclinepi.2006.05.014

    authors： Stukenborg GJ,Wagner DP,Harrell FE Jr,Oliver MN,Heim SW,Price AL,Han CK,Wolf AM,Connors AF Jr

    更新日期：2007-02-01 00:00:00

  • Describing reporting guidelines for health research: a systematic review.

    abstract：OBJECTIVE:To describe the process of development, content, and methods of implementation of reporting guidelines for health research. STUDY DESIGN AND SETTING:A systematic review of publications describing health research reporting guidelines developed using consensus. RESULTS:Eighty-one reporting guidelines for heal...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章,评审

    doi：10.1016/j.jclinepi.2010.09.013

    authors： Moher D,Weeks L,Ocampo M,Seely D,Sampson M,Altman DG,Schulz KF,Miller D,Simera I,Grimshaw J,Hoey J

    更新日期：2011-07-01 00:00:00

  • The evolving clinical status of patients after a myocardial infarction: the importance of post-hospital data for mortality prediction.

    abstract：:Studies predicting mortality after myocardial infarction (MI) usually rely on in-hospital data, and combine patients admitted for the first MI with recurrent MI patients. Since treatment decisions are often made or modified at the first outpatient clinic visit, this study was designed to evaluate the importance of pos...

    journal_title：Journal of clinical epidemiology

    pub_type： 临床试验,杂志文章,多中心研究,随机对照试验

    doi：10.1016/s0895-4356(96)00221-1

    authors： Elmore JG,Viscoli CM,Horwitz RI

    更新日期：1996-11-01 00:00:00

  • Mortality, hospital discharges, and case fatality for pulmonary embolism in the Twin Cities: 1980-1995.

    abstract：:Pulmonary embolism (PE) causes substantial morbidity and mortality, but little information is available regarding recent secular trends for PE. This study determined trends for PE in adults ages 30 to 84 years in the Minneapolis-St. Paul metropolitan area from 1980 to 1995. The age-adjusted mortality rate for PE decre...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/s0895-4356(99)00147-x

    authors： Janke RM,McGovern PG,Folsom AR

    更新日期：2000-01-01 00:00:00

  • Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases.

    abstract：:Administrative databases are increasingly used for studying outcomes of medical care. Valid inferences from such data require the ability to account for disease severity and comorbid conditions. We adapted a clinical comorbidity index, designed for use with medical records, for research relying on International Classi...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/0895-4356(92)90133-8

    authors： Deyo RA,Cherkin DC,Ciol MA

    更新日期：1992-06-01 00:00:00

  • A 67-item stress resilience item bank showing high content validity was developed in a psychosomatic sample.

    abstract：OBJECTIVES:To develop the first item bank to measure stress resilience (SR) in clinical populations. STUDY DESIGN AND SETTING:Qualitative item development resulted in an initial pool of 131 items covering a broad theoretical SR concept. These items were tested in n = 521 patients at a psychosomatic outpatient clinic. ...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/j.jclinepi.2018.04.004

    authors： Obbarius N,Fischer F,Obbarius A,Nolte S,Liegl G,Rose M

    更新日期：2018-08-01 00:00:00

  • Antidepressant prescriptions have not fully reflected evolving evidence from cumulative network meta-analyses and guideline recommendations.

    abstract：OBJECTIVES:This study compares three major elements of evidence-based medicine (EBM) practices, namely evidence synthesis, clinical practice guidelines (CPGs), and real-world prescriptions in the United States, regarding antidepressant treatments of major depression over the past 3 decades. STUDY DESIGN AND SETTING:We...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/j.jclinepi.2020.12.023

    authors： Luo Y,Ostinelli EG,Sahker E,Chaimani A,Kataoka Y,Ogawa Y,Cipriani A,Salanti G,Furukawa TA

    更新日期：2021-01-06 00:00:00

  • Test-retest reliability of an epidemiological instrument for Parkinson's disease.

    abstract：:Reliability testing was conducted on a survey instrument for a genetic epidemiological study of Parkinson's disease (PD). Information on demographics, medical history, places of residence, and occupations was collected. The instrument was administered to 11 pairs of siblings discordant for PD and then re-administered ...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/s0895-4356(00)00229-8

    authors： Reider CR,Hubble JP

    更新日期：2000-08-01 00:00:00

  • Current challenges in clinimetrics.

    abstract：:Clinimetrics is a methodologic discipline that focuses on the quality of clinical measurements, for example, diagnostic characteristics and disease outcomes. Different clinimetric properties, such as reproducibility and responsiveness, are important in both the development and the evaluation of measurement instruments...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/j.jclinepi.2003.08.012

    authors： de Vet HC,Terwee CB,Bouter LM

    更新日期：2003-12-01 00:00:00

  • Methodologic considerations in measuring glycosylated hemoglobin in epidemiologic studies.

    abstract：:Multiple linear regression was used to predict an incubated glycosylated hemoglobin value from the unincubated value and blood glucose. Hemoglobin A1 (HbA1) was measured by a disposable microcolumn technique in a large, geographically defined population of diabetic persons in southern Wisconsin. During the study, incu...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/0895-4356(88)90116-3

    authors： Moss SE,Klein R,Klein BE,Spennetta TL,Shrago ES

    更新日期：1988-01-01 00:00:00

  • FOOTSTEP: a randomized controlled trial investigating the clinical and cost effectiveness of a patient self-management program for basic foot care in the elderly.

    abstract：BACKGROUND AND OBJECTIVES:Podiatry (chiropody) services are one of the most frequently requested services in primary care. The elderly are given priority access to podiatry services in the UK blocking access for other priority groups. To evaluate the clinical and cost-effectiveness of a self-management program as a mea...

    journal_title：Journal of clinical epidemiology

    pub_type： 临床试验,杂志文章,随机对照试验

    doi：10.1016/s0895-4356(03)00197-5

    authors： Waxman R,Woodburn H,Powell M,Woodburn J,Blackburn S,Helliwell P

    更新日期：2003-11-01 00:00:00

  • A critical review of methods for the assessment of patient-level interactions in individual participant data meta-analysis of randomized trials, and guidance for practitioners.

    abstract：OBJECTIVE:Treatments may be more effective in some patients than others, and individual participant data (IPD) meta-analysis of randomized trials provides perhaps the best method of investigating treatment-covariate interactions. Various methods are used; we provide a comprehensive critique and develop guidance on meth...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章,评审

    doi：10.1016/j.jclinepi.2010.11.016

    authors： Fisher DJ,Copas AJ,Tierney JF,Parmar MK

    更新日期：2011-09-01 00:00:00

  • Transparent reporting of a multivariable prediction model for Individual Prognosis or Diagnosis (TRIPOD): the TRIPOD statement.

    abstract：:Prediction models are developed to aid health care providers in estimating the probability or risk that a specific disease or condition is present (diagnostic models) or that a specific event will occur in the future (prognostic models), to inform their decision making. However, the overwhelming evidence shows that th...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/j.jclinepi.2014.11.010

    authors： Collins GS,Reitsma JB,Altman DG,Moons KG

    更新日期：2015-02-01 00:00:00

  • Alcohol drinking and bladder cancer.

    abstract：:The relation between alcoholic beverage consumption and bladder cancer risk was investigated using data from a case-control study conducted between 1985 and 1992 in two areas of northern Italy. Cases were 727 patients with incident, histologically confirmed bladder cancer, and controls 1,067 patients admitted to the s...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章,多中心研究

    doi：10.1016/s0895-4356(02)00397-9

    authors： Pelucchi C,Negri E,Franceschi S,Talamini R,La Vecchia C

    更新日期：2002-07-01 00:00:00

  • Comorbidity was associated with neurologic and psychiatric diseases: a general practice-based controlled study.

    abstract：BACKGROUND AND OBJECTIVE:To comprehensively examine comorbidity in unselected cohorts of patients with depression, stroke, multiple sclerosis (MS), Parkinson's disease/parkinsonism (PD/PKM), dementia, migraine, and epilepsy. METHODS:This cross-sectional study used morbidity data recorded by Dutch general practitioners...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/j.jclinepi.2006.01.005

    authors： Nuyen J,Schellevis FG,Satariano WA,Spreeuwenberg PM,Birkner MD,van den Bos GA,Groenewegen PP

    更新日期：2006-12-01 00:00:00

  • Estimating risk difference from relative association measures in meta-analysis can infrequently pose interpretational challenges.

    abstract：OBJECTIVE:Risk difference (RD) is often estimated from relative association measures generated by meta-analysis and a particular group's baseline risk. We describe a problematic situation in using this approach. STUDY DESIGN AND SETTING:We encountered a meta-analysis in which a confidence interval (CI) of relative ris...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/j.jclinepi.2008.11.005

    authors： Murad MH,Montori VM,Walter SD,Guyatt GH

    更新日期：2009-08-01 00:00:00

  • Administrative database code accuracy did not vary notably with changes in disease prevalence.

    abstract：OBJECTIVES:Previous mathematical analyses of diagnostic tests based on the categorization of a continuous measure have found that test sensitivity and specificity varies significantly by disease prevalence. This study determined if the accuracy of diagnostic codes varied by disease prevalence. STUDY DESIGN AND SETTING...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/j.jclinepi.2016.05.009

    authors： van Walraven C,English S,Austin PC

    更新日期：2016-11-01 00:00:00

  • Comparison of two physical activity questionnaires, with a diary, for assessing physical activity in an elderly population.

    abstract：:Measurement of physical activity in epidemiological studies is usually achieved by means of a questionnaire. Little work has been done to determine which questionnaire format has greater validity in an elderly population. In this study of elderly subjects, physical activity as reported in two self-administered questio...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/0895-4356(92)90071-t

    authors： Cartmel B,Moon TE

    更新日期：1992-08-01 00:00:00

  • Using ordinal logistic regression to estimate the likelihood of colorectal neoplasia.

    abstract：:The utility of ordinal logistic regression in the prediction of colorectal neoplasia was demonstrated in a group of 461 consecutive patients undergoing colonoscopy in a community practice. One hundred twenty-nine patients had adenomatous polyps and 34 had colorectal adenocarcinoma. An ordinal logistic regression model...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/0895-4356(91)90159-7

    authors： Brazer SR,Pancotto FS,Long TT 3rd,Harrell FE Jr,Lee KL,Tyor MP,Pryor DB

    更新日期：1991-01-01 00:00:00

  • The UK version of the Seattle Angina Questionnaire (SAQ-UK): reliability, validity and responsiveness.

    abstract：:The study assesses the reliability, validity and responsiveness of the UK version of the Seattle Angina Questionnaire (SAQ-UK). The instrument was anglicised and administered by self-completed postal questionnaire to 959 patients recruited from general practices in the North East of England. A total of 655 (68.3%) pat...

    journal_title：Journal of clinical epidemiology

    pub_type： 临床试验,杂志文章,随机对照试验

    doi：10.1016/s0895-4356(01)00352-3

    authors： Garratt AM,Hutchinson A,Russell I,Network for Evidence-Based Practice in Northern and Yorkshire (NEBPINY).

    更新日期：2001-09-01 00:00:00

  • Inadequate planning and reporting of adjudication committees in clinical trials: recommendation proposal.

    abstract：OBJECTIVES:Adjudication committees (ACs) are recommended in randomized controlled trials (RCTs) to standardize the assessment of events. We aimed to assess the reporting and functioning of ACs (synonyms: clinical event committees, endpoint committees) in clinical trials. STUDY DESIGN AND SETTING:We searched five high-...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章,评审

    doi：10.1016/j.jclinepi.2008.09.011

    authors： Dechartres A,Boutron I,Roy C,Ravaud P

    更新日期：2009-07-01 00:00:00

  • Evaluation of the MOS SF-36 physical functioning scale (PF-10): I. Unidimensionality and reproducibility of the Rasch item scale.

    abstract：:Indexes developed to measure physical functioning as an essential component of general health status are often based on sets of hierarchically-structured items intended to represent a broad underlying concept. Rasch Item Response Theory (IRT) provides a methodology to examine the hierarchical structure, unidimensional...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/0895-4356(94)90215-1

    authors： Haley SM,McHorney CA,Ware JE Jr

    更新日期：1994-06-01 00:00:00

  • Does a history of hypertension influence the prognosis among diabetics with acute chest pain?

    abstract：:The purpose of this study was to relate the 1-year risk of death and development of acute myocardial infarction among diabetics with acute chest pain to whether they had a history of hypertension or not. All patients with a history of diabetes mellitus who, during 21 months, were admitted to the Emergency Room in Sahl...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/0895-4356(94)90174-0

    authors： Karlson BW,Herlitz J,Hjalmarson A

    更新日期：1994-07-01 00:00:00

  • Index event bias-a numerical example.

    abstract：:Studies of determinants of recurrent disease often give unexpected results. In particular, well-established risk factors may seem not to have much influence on the recurrence risk. Recently, it has been argued that such paradoxical findings may be because of the bias caused by the selection of patients based on the oc...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/j.jclinepi.2012.06.023

    authors： Smits LJ,van Kuijk SM,Leffers P,Peeters LL,Prins MH,Sep SJ

    更新日期：2013-02-01 00:00:00