Development of a modified Cambridge Multimorbidity Score for use with SNOMED CT: an observational English primary care sentinel network study
<p><strong>Background</strong> People with multiple health conditions are more likely to have poorer health outcomes and greater care and service needs; a reliable measure of multimorbidity would inform management strategies and resource allocation. <p><strong>Aim</...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
Royal College of General Practitioners
2023
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| _version_ | 1797110619848048640 |
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| author | Tsang, RSM Joy, M Whitaker, H Sheppard, JP Williams, J Sherlock, J Mayor, N Meza-Torres, B Button, E Williams, AJ Kar, D Delanerolle, G McManus, R Hobbs, FDR de Lusignan, S |
| author_facet | Tsang, RSM Joy, M Whitaker, H Sheppard, JP Williams, J Sherlock, J Mayor, N Meza-Torres, B Button, E Williams, AJ Kar, D Delanerolle, G McManus, R Hobbs, FDR de Lusignan, S |
| author_sort | Tsang, RSM |
| collection | OXFORD |
| description | <p><strong>Background</strong> People with multiple health conditions are more likely to have poorer health outcomes and greater care and service needs; a reliable measure of multimorbidity would inform management strategies and resource allocation.
<p><strong>Aim</strong> To develop and validate a modified version of the Cambridge Multimorbidity Score in an extended age range, using clinical terms that are routinely used in electronic health records across the world (Systematized Nomenclature of Medicine — Clinical Terms, SNOMED CT).
<p><strong>Design and setting</strong> Observational study using diagnosis and prescriptions data from an English primary care sentinel surveillance network between 2014 and 2019.
<p><strong>Method</strong> In this study new variables describing 37 health conditions were curated and the associations modelled between these and 1-year mortality risk using the Cox proportional hazard model in a development dataset (<i>n</i> = 300 000). Two simplified models were then developed — a 20-condition model as per the original Cambridge Multimorbidity Score and a variable reduction model using backward elimination with Akaike information criterion as the stopping criterion. The results were compared and validated for 1-year mortality in a synchronous validation dataset (<i>n</i> = 150 000), and for 1-year and 5-year mortality in an asynchronous validation dataset (<i>n</i> = 150 000).
<p><strong>Results</strong> The final variable reduction model retained 21 conditions, and the conditions mostly overlapped with those in the 20-condition model. The model performed similarly to the 37- and 20-condition models, showing high discrimination and good calibration following recalibration.
<p><strong>Conclusion</strong> This modified version of the Cambridge Multimorbidity Score allows reliable estimation using clinical terms that can be applied internationally across multiple healthcare settings. |
| first_indexed | 2024-03-07T07:57:22Z |
| format | Journal article |
| id | oxford-uuid:5432cf6f-b3a5-42e5-99eb-48e5fac3cbb2 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T07:57:22Z |
| publishDate | 2023 |
| publisher | Royal College of General Practitioners |
| record_format | dspace |
| spelling | oxford-uuid:5432cf6f-b3a5-42e5-99eb-48e5fac3cbb22023-09-05T13:19:33ZDevelopment of a modified Cambridge Multimorbidity Score for use with SNOMED CT: an observational English primary care sentinel network studyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:5432cf6f-b3a5-42e5-99eb-48e5fac3cbb2EnglishSymplectic ElementsRoyal College of General Practitioners2023Tsang, RSMJoy, MWhitaker, HSheppard, JPWilliams, JSherlock, JMayor, NMeza-Torres, BButton, EWilliams, AJKar, DDelanerolle, GMcManus, RHobbs, FDRde Lusignan, S<p><strong>Background</strong> People with multiple health conditions are more likely to have poorer health outcomes and greater care and service needs; a reliable measure of multimorbidity would inform management strategies and resource allocation. <p><strong>Aim</strong> To develop and validate a modified version of the Cambridge Multimorbidity Score in an extended age range, using clinical terms that are routinely used in electronic health records across the world (Systematized Nomenclature of Medicine — Clinical Terms, SNOMED CT). <p><strong>Design and setting</strong> Observational study using diagnosis and prescriptions data from an English primary care sentinel surveillance network between 2014 and 2019. <p><strong>Method</strong> In this study new variables describing 37 health conditions were curated and the associations modelled between these and 1-year mortality risk using the Cox proportional hazard model in a development dataset (<i>n</i> = 300 000). Two simplified models were then developed — a 20-condition model as per the original Cambridge Multimorbidity Score and a variable reduction model using backward elimination with Akaike information criterion as the stopping criterion. The results were compared and validated for 1-year mortality in a synchronous validation dataset (<i>n</i> = 150 000), and for 1-year and 5-year mortality in an asynchronous validation dataset (<i>n</i> = 150 000). <p><strong>Results</strong> The final variable reduction model retained 21 conditions, and the conditions mostly overlapped with those in the 20-condition model. The model performed similarly to the 37- and 20-condition models, showing high discrimination and good calibration following recalibration. <p><strong>Conclusion</strong> This modified version of the Cambridge Multimorbidity Score allows reliable estimation using clinical terms that can be applied internationally across multiple healthcare settings. |
| spellingShingle | Tsang, RSM Joy, M Whitaker, H Sheppard, JP Williams, J Sherlock, J Mayor, N Meza-Torres, B Button, E Williams, AJ Kar, D Delanerolle, G McManus, R Hobbs, FDR de Lusignan, S Development of a modified Cambridge Multimorbidity Score for use with SNOMED CT: an observational English primary care sentinel network study |
| title | Development of a modified Cambridge Multimorbidity Score for use with SNOMED CT: an observational English primary care sentinel network study |
| title_full | Development of a modified Cambridge Multimorbidity Score for use with SNOMED CT: an observational English primary care sentinel network study |
| title_fullStr | Development of a modified Cambridge Multimorbidity Score for use with SNOMED CT: an observational English primary care sentinel network study |
| title_full_unstemmed | Development of a modified Cambridge Multimorbidity Score for use with SNOMED CT: an observational English primary care sentinel network study |
| title_short | Development of a modified Cambridge Multimorbidity Score for use with SNOMED CT: an observational English primary care sentinel network study |
| title_sort | development of a modified cambridge multimorbidity score for use with snomed ct an observational english primary care sentinel network study |
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