当前位置： SCI文献检索 > BMC Medical Informatics and Decision Making期刊下所有文献 > The predictability of claim-data-based comorbidity-adjusted models could be improved by using medication data.

The predictability of claim-data-based comorbidity-adjusted models could be improved by using medication data.

Abstract：

BACKGROUND:Recently, claim-data-based comorbidity-adjusted methods such as the Charlson index and the Elixhauser comorbidity measures have been widely used among researchers. At the same time, there have been an increasing number of attempts to improve the predictability of comorbidity-adjusted models. We tried to improve the predictability of models using the Charlson and Elixhauser indices by using medication data; specifically, we used medication data to estimate omitted comorbidities in the claim data. METHODS:We selected twelve major diseases (other than malignancies) that caused large numbers of in-hospital mortalities during 2008 in hospitals with 700 or more beds in South Korea. Then, we constructed prediction models for in-hospital mortality using the Charlson index and Elixhauser comorbidity measures, respectively. Inferring missed comorbidities using medication data, we built enhanced Charlson and Elixhauser comorbidity-measures-based prediction models, which included comorbidities inferred from medication data. We then compared the c-statistics of each model. RESULTS:247,712 admission cases were enrolled. 55 generic drugs were used to infer 8 out of 17 Charlson comorbidities, and 106 generic drugs were used to infer 14 out of 31 Elixhauser comorbidities. Before the inclusion of comorbidities inferred from medication data, the c-statistics of models using the Charlson index were 0.633-0.882 and those of the Elixhauser index were 0.699-0.917. After the inclusion of comorbidities inferred from medication data, 9 of 12 models using the Charlson index and all of the models using the Elixhauser comorbidity measures were improved in predictability but, the differences were relatively small. CONCLUSION:Prediction models using Charlson index or Elixhauser comorbidity measures might be improved by including comorbidities inferred from medication data.

journal_name

BMC Med Inform Decis Mak

journal_title

BMC medical informatics and decision making

authors

Bang JH,Hwang SH,Lee EJ,Kim Y

doi

10.1186/1472-6947-13-128

subject

Has Abstract

pub_date

2013-11-20 00:00:00

pages

128

issn

1472-6947

pii

1472-6947-13-128

journal_volume

pub_type

杂志文章

在线工具

The predictability of claim-data-based comorbidity-adjusted models could be improved by using medication data.