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Replication Data for External Validation and Comparison of Two Variants of the Elixhauser Comorbidity Measures for All-Cause Mortality

Harvard Dataverse (Africa Rice Center, Bioversity International, CCAFS, CIAT, IFPRI, IRRI and WorldFish)

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Title Replication Data for External Validation and Comparison of Two Variants of the Elixhauser Comorbidity Measures for All-Cause Mortality
 
Identifier https://doi.org/10.7910/DVN/BAMNCP
 
Creator Fortin, Yannick
 
Publisher Harvard Dataverse
 
Description 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], 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
 
Subject Medicine, Health and Life Sciences
Comorbidity adjustment
Multimorbidity
Electronic Health records
Hospital mortality
Databases
 
Contributor Fortin, Yannick