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Do self-report and medical record comorbidity data predict longitudinal functional capacity and quality of life health outcomes similarly?

BACKGROUND: The search for a reliable, valid and cost-effective comorbidity risk adjustment method for outcomes research continues to be a challenge. The most widely used tool, the Charlson Comorbidity Index (CCI) is limited due to frequent missing data in medical records and administrative data. Pa...

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Autores principales: Olomu, Adesuwa B, Corser, William D, Stommel, Manfred, Xie, Yan, Holmes-Rovner, Margaret
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3538524/
https://www.ncbi.nlm.nih.gov/pubmed/23151237
http://dx.doi.org/10.1186/1472-6963-12-398
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author Olomu, Adesuwa B
Corser, William D
Stommel, Manfred
Xie, Yan
Holmes-Rovner, Margaret
author_facet Olomu, Adesuwa B
Corser, William D
Stommel, Manfred
Xie, Yan
Holmes-Rovner, Margaret
author_sort Olomu, Adesuwa B
collection PubMed
description BACKGROUND: The search for a reliable, valid and cost-effective comorbidity risk adjustment method for outcomes research continues to be a challenge. The most widely used tool, the Charlson Comorbidity Index (CCI) is limited due to frequent missing data in medical records and administrative data. Patient self-report data has the potential to be more complete but has not been widely used. The purpose of this study was to evaluate the performance of the Self-Administered Comorbidity Questionnaire (SCQ) to predict functional capacity, quality of life (QOL) health outcomes compared to CCI medical records data. METHOD: An SCQ-score was generated from patient interview, and the CCI score was generated by medical record review for 525 patients hospitalized for Acute Coronary Syndrome (ACS) at baseline, three months and eight months post-discharge. Linear regression models assessed the extent to which there were differences in the ability of comorbidity measures to predict functional capacity (Activity Status Index [ASI] scores) and quality of life (EuroQOL 5D [EQ5D] scores). RESULTS: The CCI (R(2) = 0.245; p = 0.132) did not predict quality of life scores while the SCQ self-report method (R(2) = 0.265; p < 0.0005) predicted the EQ5D scores. However, the CCI was almost as good as the SCQ for predicting the ASI scores at three and six months and performed slightly better in predicting ASI at eight-month follow up (R(2) = 0.370; p < 0.0005 vs. R(2) = 0.358; p < 0.0005) respectively. Only age, gender, family income and Center for Epidemiologic Studies-Depression (CESD) scores showed significant association with both measures in predicting QOL and functional capacity. CONCLUSIONS: Although our model R-squares were fairly low, these results show that the self-report SCQ index is a good alternative method to predict QOL health outcomes when compared to a CCI medical record score. Both measures predicted physical functioning similarly. This suggests that patient self-reported comorbidity data can be used for predicting physical functional capacity and QOL and can serve as a reliable risk adjustment measure. Self-report comorbidity data may provide a cost-effective alternative method for risk adjustment in clinical research, health policy and organizational improvement analyses. TRIAL REGISTRATION: Clinical Trials.gov NCT00416026
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spelling pubmed-35385242013-01-10 Do self-report and medical record comorbidity data predict longitudinal functional capacity and quality of life health outcomes similarly? Olomu, Adesuwa B Corser, William D Stommel, Manfred Xie, Yan Holmes-Rovner, Margaret BMC Health Serv Res Research Article BACKGROUND: The search for a reliable, valid and cost-effective comorbidity risk adjustment method for outcomes research continues to be a challenge. The most widely used tool, the Charlson Comorbidity Index (CCI) is limited due to frequent missing data in medical records and administrative data. Patient self-report data has the potential to be more complete but has not been widely used. The purpose of this study was to evaluate the performance of the Self-Administered Comorbidity Questionnaire (SCQ) to predict functional capacity, quality of life (QOL) health outcomes compared to CCI medical records data. METHOD: An SCQ-score was generated from patient interview, and the CCI score was generated by medical record review for 525 patients hospitalized for Acute Coronary Syndrome (ACS) at baseline, three months and eight months post-discharge. Linear regression models assessed the extent to which there were differences in the ability of comorbidity measures to predict functional capacity (Activity Status Index [ASI] scores) and quality of life (EuroQOL 5D [EQ5D] scores). RESULTS: The CCI (R(2) = 0.245; p = 0.132) did not predict quality of life scores while the SCQ self-report method (R(2) = 0.265; p < 0.0005) predicted the EQ5D scores. However, the CCI was almost as good as the SCQ for predicting the ASI scores at three and six months and performed slightly better in predicting ASI at eight-month follow up (R(2) = 0.370; p < 0.0005 vs. R(2) = 0.358; p < 0.0005) respectively. Only age, gender, family income and Center for Epidemiologic Studies-Depression (CESD) scores showed significant association with both measures in predicting QOL and functional capacity. CONCLUSIONS: Although our model R-squares were fairly low, these results show that the self-report SCQ index is a good alternative method to predict QOL health outcomes when compared to a CCI medical record score. Both measures predicted physical functioning similarly. This suggests that patient self-reported comorbidity data can be used for predicting physical functional capacity and QOL and can serve as a reliable risk adjustment measure. Self-report comorbidity data may provide a cost-effective alternative method for risk adjustment in clinical research, health policy and organizational improvement analyses. TRIAL REGISTRATION: Clinical Trials.gov NCT00416026 BioMed Central 2012-11-14 /pmc/articles/PMC3538524/ /pubmed/23151237 http://dx.doi.org/10.1186/1472-6963-12-398 Text en Copyright ©2012 Olomu et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Olomu, Adesuwa B
Corser, William D
Stommel, Manfred
Xie, Yan
Holmes-Rovner, Margaret
Do self-report and medical record comorbidity data predict longitudinal functional capacity and quality of life health outcomes similarly?
title Do self-report and medical record comorbidity data predict longitudinal functional capacity and quality of life health outcomes similarly?
title_full Do self-report and medical record comorbidity data predict longitudinal functional capacity and quality of life health outcomes similarly?
title_fullStr Do self-report and medical record comorbidity data predict longitudinal functional capacity and quality of life health outcomes similarly?
title_full_unstemmed Do self-report and medical record comorbidity data predict longitudinal functional capacity and quality of life health outcomes similarly?
title_short Do self-report and medical record comorbidity data predict longitudinal functional capacity and quality of life health outcomes similarly?
title_sort do self-report and medical record comorbidity data predict longitudinal functional capacity and quality of life health outcomes similarly?
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3538524/
https://www.ncbi.nlm.nih.gov/pubmed/23151237
http://dx.doi.org/10.1186/1472-6963-12-398
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