Department of Disability and Human Development, University of Illinois at Chicago, Chicago, IL, USA.
Department of Health Policy and Administration, University of Illinois at Chicago, Chicago, IL, USA.
Med Care Res Rev. 2021 Oct;78(5):572-584. doi: 10.1177/1077558720950880. Epub 2020 Aug 26.
An estimated 31.5 million Americans have a mobility limitation. Health care administrative data could be a valuable resource for research on this population but methods for cohort identification are lacking. We developed and tested an algorithm to reliably identify adults with mobility limitation in U.S. Department of Veterans Affairs health care data. We linked diagnosis, encounter, durable medical equipment, and demographic data for 964 veterans to their self-reported mobility limitation from the Medicare Current Beneficiary Survey. We evaluated performance of logistic regression models in classifying mobility limitation. The binary approach (yes/no limitation) had good sensitivity (70%) and specificity (79%), whereas the multilevel approach did not perform well. The algorithms for predicting a binary mobility limitation outcome performed well at discriminating between veterans who did and did not have mobility limitation. Future work should focus on multilevel approaches to predicting mobility limitation and samples with greater proportions of women and younger adults.
据估计,有 3150 万美国人存在行动障碍。医疗保健管理数据可能是研究这一人群的宝贵资源,但缺乏队列识别方法。我们开发并测试了一种算法,以可靠地识别美国退伍军人事务部医疗保健数据中存在行动障碍的成年人。我们将 964 名退伍军人的诊断、就诊、耐用医疗设备和人口统计数据与其在医疗保险当前受益人大调查中的自我报告的行动障碍相关联。我们评估了逻辑回归模型在分类行动障碍方面的性能。二元方法(存在/不存在障碍)具有良好的敏感性(70%)和特异性(79%),而多层次方法表现不佳。预测二元行动障碍结果的算法在区分有和没有行动障碍的退伍军人方面表现良好。未来的工作应侧重于预测行动障碍的多层次方法以及女性和年轻成年人比例更大的样本。