Validating a Patient-Reported Comorbidity Measure with Respect to Quality of Life in End-Stage Renal Disease.

PURPOSE:Medical record-derived comorbidity measures such as the Charlson Comorbidity Index (CCI) do not predict functional limitations or quality of life (QoL) in the chronically ill. Although these shortcomings are known since the 1980s, they have been largely ignored by the international literatur...

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Main Authors: Maxi Robinski, Franz Strich, Wilfried Mau, Matthias Girndt
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2016-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC4905653?pdf=render
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author Maxi Robinski
Franz Strich
Wilfried Mau
Matthias Girndt
author_facet Maxi Robinski
Franz Strich
Wilfried Mau
Matthias Girndt
author_sort Maxi Robinski
collection DOAJ
description PURPOSE:Medical record-derived comorbidity measures such as the Charlson Comorbidity Index (CCI) do not predict functional limitations or quality of life (QoL) in the chronically ill. Although these shortcomings are known since the 1980s, they have been largely ignored by the international literature. Recently, QoL has received growing interest as an end-point of interventional trials in Nephrology. The aim of this study is to compare a patient-reported comorbidity measure and the CCI with respect to its validity regarding QoL. METHODS:The German Self-Administered Comorbidity Questionnaire (SCQ-G) was completed by 780 adult end-stage renal disease-patients recruited from 55 dialysis units throughout Germany. Acceptance was evaluated via response rates. Content validity was examined by comparing the typical comorbidity pattern in dialysis patients and the pattern retrieved from our data. Convergent validity was assessed via kappa statistics. Data was compared to the CCI. Linear associations with QoL were examined (criterion validity). RESULTS:The SCQ-G was very well accepted by dialysis patients of all ages (response rate: 99%). Content validity can be interpreted as high (corresponding comorbidity items: 73.7%). Convergent validity was rather weak (.27≤ρ≤.29) but increased when comparing only concordant items (.39≤ρ≤.43). With respect to criterion validity, the SCQ-G performed better than the CCI regarding the correlation with QoL (e.g., SF-12-physical: SCQ-G total score: ρ = -.49 vs. CCI: ρ = -.36). CONCLUSIONS:The patient-reported measure proved to be more valid than the external assessment when aiming at insights on QoL. Due to the inclusion of subjective limitations, the SCQ-G is more substantial with respect to patient-centered outcomes and might be used as additional measure in clinical trials.
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spelling doaj.art-25e37d8d9e5c4e63b40547a54b78b4b32022-12-22T02:26:18ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-01116e015750610.1371/journal.pone.0157506Validating a Patient-Reported Comorbidity Measure with Respect to Quality of Life in End-Stage Renal Disease.Maxi RobinskiFranz StrichWilfried MauMatthias GirndtPURPOSE:Medical record-derived comorbidity measures such as the Charlson Comorbidity Index (CCI) do not predict functional limitations or quality of life (QoL) in the chronically ill. Although these shortcomings are known since the 1980s, they have been largely ignored by the international literature. Recently, QoL has received growing interest as an end-point of interventional trials in Nephrology. The aim of this study is to compare a patient-reported comorbidity measure and the CCI with respect to its validity regarding QoL. METHODS:The German Self-Administered Comorbidity Questionnaire (SCQ-G) was completed by 780 adult end-stage renal disease-patients recruited from 55 dialysis units throughout Germany. Acceptance was evaluated via response rates. Content validity was examined by comparing the typical comorbidity pattern in dialysis patients and the pattern retrieved from our data. Convergent validity was assessed via kappa statistics. Data was compared to the CCI. Linear associations with QoL were examined (criterion validity). RESULTS:The SCQ-G was very well accepted by dialysis patients of all ages (response rate: 99%). Content validity can be interpreted as high (corresponding comorbidity items: 73.7%). Convergent validity was rather weak (.27≤ρ≤.29) but increased when comparing only concordant items (.39≤ρ≤.43). With respect to criterion validity, the SCQ-G performed better than the CCI regarding the correlation with QoL (e.g., SF-12-physical: SCQ-G total score: ρ = -.49 vs. CCI: ρ = -.36). CONCLUSIONS:The patient-reported measure proved to be more valid than the external assessment when aiming at insights on QoL. Due to the inclusion of subjective limitations, the SCQ-G is more substantial with respect to patient-centered outcomes and might be used as additional measure in clinical trials.http://europepmc.org/articles/PMC4905653?pdf=render
spellingShingle Maxi Robinski
Franz Strich
Wilfried Mau
Matthias Girndt
Validating a Patient-Reported Comorbidity Measure with Respect to Quality of Life in End-Stage Renal Disease.
PLoS ONE
title Validating a Patient-Reported Comorbidity Measure with Respect to Quality of Life in End-Stage Renal Disease.
title_full Validating a Patient-Reported Comorbidity Measure with Respect to Quality of Life in End-Stage Renal Disease.
title_fullStr Validating a Patient-Reported Comorbidity Measure with Respect to Quality of Life in End-Stage Renal Disease.
title_full_unstemmed Validating a Patient-Reported Comorbidity Measure with Respect to Quality of Life in End-Stage Renal Disease.
title_short Validating a Patient-Reported Comorbidity Measure with Respect to Quality of Life in End-Stage Renal Disease.
title_sort validating a patient reported comorbidity measure with respect to quality of life in end stage renal disease
url http://europepmc.org/articles/PMC4905653?pdf=render
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