Barnett Mitchell J, Khosraviani Vista, Doroudgar Shadi, Ip Eric J
Touro University California College of Pharmacy, Clinical Sciences Department, 1310 Club Drive, Mare Island, Vallejo, CA, 94592, USA; Iowa Public Health, Board of Pharmacy, Prescription Monitoring Program, 4688 400 SW 8th St E, Des Moines, IA 50309, USA.
Touro University California College of Pharmacy, Clinical Sciences Department, 1310 Club Drive, Mare Island, Vallejo, CA, 94592, USA.
Res Social Adm Pharm. 2022 Feb;18(2):2283-2300. doi: 10.1016/j.sapharm.2021.06.016. Epub 2021 Jun 24.
The use of claims data for identifying comorbid conditions in patients for research purposes has been widely explored. Traditional measures of comorbid adjustment included diagnostic data (e.g., ICD-9-CM or ICD-10-CM codes), with the Charlson and Elixhauser methodology being the two most common approaches. Prescription data has also been explored for use in comorbidity adjustment, however early methodologies were disappointing when compared to diagnostic measures.
The objective of this methodological review is to compare results from newer studies using prescription-based data with more traditional diagnostic measures.
A review of studies found on PubMed, Medline, Embase or CINAHL published between January 1990 and December 2020 using prescription data for comorbidity adjustment. A total of 50 studies using prescription drug measures for comorbidity adjustment were found.
Newer prescription-based measures show promise fitting models, as measured by predictive ability, for research, especially when the primary outcomes are utilization or drug expenditure rather than diagnostic measures. More traditional diagnostic-based measures still appear most appropriate if the primary outcome is mortality or inpatient readmissions.
为研究目的而利用索赔数据识别患者的共病状况已得到广泛探索。共病调整的传统方法包括诊断数据（如ICD-9-CM或ICD-10-CM编码），其中Charlson法和Elixhauser法是最常用的两种方法。也有人探索将处方数据用于共病调整，然而与诊断方法相比，早期方法的效果并不理想。
本方法学综述的目的是比较使用基于处方的数据的较新研究结果与更传统的诊断方法的结果。
检索1990年1月至2020年12月期间在PubMed、Medline、Embase或CINAHL上发表的使用处方数据进行共病调整的研究。共找到50项使用处方药措施进行共病调整的研究。
以预测能力衡量，更新的基于处方的措施在研究中显示出有望拟合模型，尤其是当主要结局是利用率或药物支出而非诊断指标时。如果主要结局是死亡率或住院再入院率，更传统的基于诊断的措施似乎仍然是最合适的。
