Mehta Hemalkumar B, Sura Sneha D, Sharma Manvi, Johnson Michael L, Riall Taylor S
*Department of Surgery, University of Texas Medical Branch, Galveston †Department of Pharmaceutical Health Outcomes and Policy, University of Houston, Houston, TX ‡Department of Surgery, University of Arizona, Tuscon, AZ.
Med Care. 2016 May;54(5):519-27. doi: 10.1097/MLR.0000000000000517.
To compare the performance of the health-related quality of life-comorbidity index (HRQoL-CI) with the diagnosis-based Charlson, Elixhauser, and combined comorbidity scores and the prescription-based chronic disease score (CDS) in predicting HRQoL in Agency of Healthcare Research and Quality priority conditions (asthma, breast cancer, diabetes, and heart failure).
The Medical Expenditure Panel Survey (2005 and 2007-2011) data was used for this retrospective study. Four disease-specific cohorts were developed that included adult patients (age 18 y and above) with the particular disease condition. The outcome HRQoL [physical component score (PCS) and mental component score (MCS)] was measured using the Short Form Health Survey, Version 2 (SF-12v2). Multiple linear regression analyses were conducted with the PCS and MCS as dependent variables. Comorbidity scores were compared using adjusted R.
Of 140,046 adult participants, the study cohort included 7436 asthma (5.3%), 1054 breast cancer (0.8%), 13,829 diabetes (9.9%), and 937 heart failure (0.7%) patients. Among individual scores, HRQoL-CI was best at predicting PCS and MCS. Adding prescription-based comorbidity scores to HRQoL-CI in the same model improved prediction of PCS and MCS. HRQoL-CI+CDS performed the best in predicting PCS (adjusted R): asthma (43.7%), breast cancer (31.7%), diabetes (32.7%), and heart failure (20.0%). HRQoL-CI+CDS and Elixhauser+CDS had superior and comparable performance in predicting MCS (adjusted R): asthma (HRQoL-CI+CDS=20.1%; Elixhauser+CDS=19.6%), breast cancer (HRQoL-CI+CDS=12.9%; Elixhauser+CDS=14.1%), diabetes (HRQoL-CI+CDS=17.7%; Elixhauser+CDS=17.7%), and heart failure (HRQoL-CI+CDS=18.1%; Elixhauser+CDS=17.7%).
HRQoL-CI performed best in predicting HRQoL. Combining prescription-based scores to diagnosis-based scores improved the prediction of HRQoL.
比较健康相关生活质量合并症指数（HRQoL-CI）与基于诊断的查尔森指数、埃利克斯豪泽指数、合并合并症评分以及基于处方的慢性病评分（CDS）在预测医疗保健研究与质量局重点疾病（哮喘、乳腺癌、糖尿病和心力衰竭）患者健康相关生活质量方面的表现。
本回顾性研究使用了医疗支出小组调查（2005年以及2007 - 2011年）的数据。建立了四个特定疾病队列，纳入患有特定疾病的成年患者（年龄18岁及以上）。使用简明健康调查问卷第2版（SF - 12v2）测量健康相关生活质量结局[身体成分评分（PCS）和心理成分评分（MCS）]。以PCS和MCS作为因变量进行多元线性回归分析。使用调整后的R比较合并症评分。
在140,046名成年参与者中，研究队列包括7436名哮喘患者（5.3%）、1054名乳腺癌患者（0.8%）、13,829名糖尿病患者（9.9%）和937名心力衰竭患者（0.7%）。在各项评分中，HRQoL-CI在预测PCS和MCS方面表现最佳。在同一模型中，将基于处方的合并症评分添加到HRQoL-CI中可改善对PCS和MCS的预测。HRQoL-CI + CDS在预测PCS方面表现最佳（调整后的R）：哮喘（43.7%）、乳腺癌（31.7%）、糖尿病（32.7%）和心力衰竭（20.0%）。HRQoL-CI + CDS和埃利克斯豪泽指数 + CDS在预测MCS方面具有卓越且相当的表现（调整后的R）：哮喘（HRQoL-CI + CDS = 20.1%；埃利克斯豪泽指数 + CDS = 19.6%）、乳腺癌（HRQoL-CI + CDS = 12.9%；埃利克斯豪泽指数 + CDS = 14.1%）、糖尿病（HRQoL-CI + CDS = 17.7%；埃利克斯豪泽指数 + CDS = 17.7%）和心力衰竭（HRQoL-CI + CDS = 18.1%；埃利克斯豪泽指数 + CDS = 17.7%）。
HRQoL-CI在预测健康相关生活质量方面表现最佳。将基于处方的评分与基于诊断的评分相结合可改善对健康相关生活质量的预测。
