External validation and comparison of two variants of the Elixhauser comorbidity measures for all-cause mortality
Publication Date
March 28, 2017
Authors
Yannick Fortin, James A. G. Crispo, Deborah Cohen, Douglas S. Mc Nair, et al
Volume
12
Issue
3
Pages
e0174379
DOI
https://dx.plos.org/10.1371/journal.pone.0174379
Publisher URL
http://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0174379
Scopus
85016271206
Mendeley
http://www.mendeley.com/research/external-validation-comparison-two-variants-elixhauser-comorbidity-measures-allcause-mortality
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Mendeley | Further Information

{"title"=>"External validation and comparison of two variants of the Elixhauser comorbidity measures for all-cause mortality", "type"=>"journal", "authors"=>[{"first_name"=>"Yannick", "last_name"=>"Fortin", "scopus_author_id"=>"56685228800"}, {"first_name"=>"James A.G.", "last_name"=>"Crispo", "scopus_author_id"=>"57190362373"}, {"first_name"=>"Deborah", "last_name"=>"Cohen", "scopus_author_id"=>"7404417899"}, {"first_name"=>"Douglas S.", "last_name"=>"McNair", "scopus_author_id"=>"13609299500"}, {"first_name"=>"Donald R.", "last_name"=>"Mattison", "scopus_author_id"=>"7005724234"}, {"first_name"=>"Daniel", "last_name"=>"Krewski", "scopus_author_id"=>"24565152100"}], "year"=>2017, "source"=>"PLoS ONE", "identifiers"=>{"sgr"=>"85016271206", "pmid"=>"28350807", "pui"=>"615010177", "scopus"=>"2-s2.0-85016271206", "doi"=>"10.1371/journal.pone.0174379", "issn"=>"19326203"}, "id"=>"c24925b5-b098-3f5b-ad4e-e13025dccd54", "abstract"=>"Assessing prevalent comorbidities is a common approach in health research for identifying clinical differences between individuals. The objective of this study was to validate and compare the predictive performance of two variants of the Elixhauser comorbidity measures (ECM) for inhospital mortality at index and at 1-year in the Cerner Health Facts® (HF) U.S. DATABASE We estimated the prevalence of select comorbidities for individuals 18 to 89 years of age who received care at Cerner contributing health facilities between 2002 and 2011 using the AHRQ (version 3.7) and the Quan Enhanced ICD-9-CM ECMs. External validation of the ECMs was assessed with measures of discrimination [c-statistics], calibration [Hosmer-Lemeshow goodness-of-fit test, Brier Score, calibration curves], added predictive ability [Net Reclassification Improvement], and overall model performance [R2]. Of 3,273,298 patients with a mean age of 43.9 years and a female composition of 53.8%, 1.0% died during their index encounter and 1.5% were deceased at 1-year. Calibration measures were equivalent between the two ECMs. Calibration performance was acceptable when predicting inhospital mortality at index, although recalibration is recommended for predicting inhospital mortality at 1 year. Discrimination was marginally better with the Quan ECM compared the AHRQ ECM when predicting inhospital mortality at index (cQuan = 0.887, 95% CI: 0.885-0.889 vs. cAHRQ = 0.880, 95% CI: 0.878-0.882; p < .0001) and at 1-year (cQuan = 0.884, 95% CI: 0.883-0.886 vs. cAHRQ = 0.880, 95% CI: 0.878-0.881, p < .0001). Both the Quan and the AHRQ ECMs demonstrated excellent discrimination for inhospital mortality of all-causes in Cerner Health Facts®, a HIPAA compliant observational research and privacy-protected data warehouse. While differences in discrimination performance between the ECMs were statistically significant, they are not likely clinically meaningful.", "link"=>"http://www.mendeley.com/research/external-validation-comparison-two-variants-elixhauser-comorbidity-measures-allcause-mortality", "reader_count"=>15, "reader_count_by_academic_status"=>{"Unspecified"=>1, "Researcher"=>4, "Student > Ph. D. Student"=>3, "Student > Postgraduate"=>2, "Other"=>2, "Student > Bachelor"=>2, "Student > Master"=>1}, "reader_count_by_user_role"=>{"Unspecified"=>1, "Researcher"=>4, "Student > Ph. D. Student"=>3, "Student > Postgraduate"=>2, "Other"=>2, "Student > Bachelor"=>2, "Student > Master"=>1}, "reader_count_by_subject_area"=>{"Nursing and Health Professions"=>3, "Medicine and Dentistry"=>3, "Arts and Humanities"=>1, "Pharmacology, Toxicology and Pharmaceutical Science"=>1, "Psychology"=>1, "Social Sciences"=>4, "Computer Science"=>2}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>3}, "Social Sciences"=>{"Social Sciences"=>4}, "Psychology"=>{"Psychology"=>1}, "Computer Science"=>{"Computer Science"=>2}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>3}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>1}, "Arts and Humanities"=>{"Arts and Humanities"=>1}}, "group_count"=>2}

Scopus | Further Information

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