Comparative Performance of Diagnosis-based and Prescription-based Comorbidity Scores to Predict Health-related Quality of Life. Mehta, H. B., Sura, S. D., Sharma, M., Johnson, M. L., & Riall, T. S. Medical Care, 54(5):519–527, May, 2016.
doi  abstract   bibtex   
OBJECTIVES: To compare the performance of the health-related quality of life-comorbidity index (HRQoL-CI) with the diagnosis-based Charlson, Elixhauser, and combined comorbidity scores and the prescription-based chronic disease score (CDS) in predicting HRQoL in Agency of Healthcare Research and Quality priority conditions (asthma, breast cancer, diabetes, and heart failure). METHODS: The Medical Expenditure Panel Survey (2005 and 2007-2011) data was used for this retrospective study. Four disease-specific cohorts were developed that included adult patients (age 18 y and above) with the particular disease condition. The outcome HRQoL [physical component score (PCS) and mental component score (MCS)] was measured using the Short Form Health Survey, Version 2 (SF-12v2). Multiple linear regression analyses were conducted with the PCS and MCS as dependent variables. Comorbidity scores were compared using adjusted R. RESULTS: Of 140,046 adult participants, the study cohort included 7436 asthma (5.3%), 1054 breast cancer (0.8%), 13,829 diabetes (9.9%), and 937 heart failure (0.7%) patients. Among individual scores, HRQoL-CI was best at predicting PCS and MCS. Adding prescription-based comorbidity scores to HRQoL-CI in the same model improved prediction of PCS and MCS. HRQoL-CI+CDS performed the best in predicting PCS (adjusted R): asthma (43.7%), breast cancer (31.7%), diabetes (32.7%), and heart failure (20.0%). HRQoL-CI+CDS and Elixhauser+CDS had superior and comparable performance in predicting MCS (adjusted R): asthma (HRQoL-CI+CDS=20.1%; Elixhauser+CDS=19.6%), breast cancer (HRQoL-CI+CDS=12.9%; Elixhauser+CDS=14.1%), diabetes (HRQoL-CI+CDS=17.7%; Elixhauser+CDS=17.7%), and heart failure (HRQoL-CI+CDS=18.1%; Elixhauser+CDS=17.7%). CONCLUSIONS: HRQoL-CI performed best in predicting HRQoL. Combining prescription-based scores to diagnosis-based scores improved the prediction of HRQoL.
@article{mehta_comparative_2016,
	title = {Comparative {Performance} of {Diagnosis}-based and {Prescription}-based {Comorbidity} {Scores} to {Predict} {Health}-related {Quality} of {Life}},
	volume = {54},
	issn = {1537-1948},
	doi = {10.1097/MLR.0000000000000517},
	abstract = {OBJECTIVES: To compare the performance of the health-related quality of life-comorbidity index (HRQoL-CI) with the diagnosis-based Charlson, Elixhauser, and combined comorbidity scores and the prescription-based chronic disease score (CDS) in predicting HRQoL in Agency of Healthcare Research and Quality priority conditions (asthma, breast cancer, diabetes, and heart failure).
METHODS: The Medical Expenditure Panel Survey (2005 and 2007-2011) data was used for this retrospective study. Four disease-specific cohorts were developed that included adult patients (age 18 y and above) with the particular disease condition. The outcome HRQoL [physical component score (PCS) and mental component score (MCS)] was measured using the Short Form Health Survey, Version 2 (SF-12v2). Multiple linear regression analyses were conducted with the PCS and MCS as dependent variables. Comorbidity scores were compared using adjusted R.
RESULTS: Of 140,046 adult participants, the study cohort included 7436 asthma (5.3\%), 1054 breast cancer (0.8\%), 13,829 diabetes (9.9\%), and 937 heart failure (0.7\%) patients. Among individual scores, HRQoL-CI was best at predicting PCS and MCS. Adding prescription-based comorbidity scores to HRQoL-CI in the same model improved prediction of PCS and MCS. HRQoL-CI+CDS performed the best in predicting PCS (adjusted R): asthma (43.7\%), breast cancer (31.7\%), diabetes (32.7\%), and heart failure (20.0\%). HRQoL-CI+CDS and Elixhauser+CDS had superior and comparable performance in predicting MCS (adjusted R): asthma (HRQoL-CI+CDS=20.1\%; Elixhauser+CDS=19.6\%), breast cancer (HRQoL-CI+CDS=12.9\%; Elixhauser+CDS=14.1\%), diabetes (HRQoL-CI+CDS=17.7\%; Elixhauser+CDS=17.7\%), and heart failure (HRQoL-CI+CDS=18.1\%; Elixhauser+CDS=17.7\%).
CONCLUSIONS: HRQoL-CI performed best in predicting HRQoL. Combining prescription-based scores to diagnosis-based scores improved the prediction of HRQoL.},
	language = {eng},
	number = {5},
	journal = {Medical Care},
	author = {Mehta, Hemalkumar B. and Sura, Sneha D. and Sharma, Manvi and Johnson, Michael L. and Riall, Taylor S.},
	month = may,
	year = {2016},
	pmid = {26918403},
	keywords = {Adolescent, Adult, Aged, Asthma, Breast Neoplasms, Chronic Disease, Comorbidity, Data Collection, Diabetes Mellitus, Female, Health Status, Heart Failure, Humans, Male, Middle Aged, Quality of Life, Retrospective Studies, Young Adult},
	pages = {519--527}
}
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