Department of Internal Medicine, University of California Los Angeles, Los Angeles, California, USA
VA Greater Los Angeles Healthcare System, Los Angeles, California, USA.
BMJ Open. 2024 Feb 15;14(2):e074390. doi: 10.1136/bmjopen-2023-074390.
Map multimorbidity-weighted index (MWI) conditions to International Classification of Diseases, 10th Revision (ICD-10), expand the conditions and codes to develop a new ICD-10-coded MWI (MWI-ICD10) and updated MWI-ICD9, and assess their consistency.
Population-based retrospective cohort.
Large medical centre between 2013 and 2017.
Adults ≥18 years old with encounters in each of 4 years (2013, 2014, 2016, 2017).
MWI conditions mapped to ICD-10 codes, and additional conditions and codes added to produce a new MWI-ICD10 and updated MWI-ICD9. We compared the prevalence of ICD-coded MWI conditions within the ICD-9 era (2013-2014), within the ICD-10 era (2016-2017) and across the ICD-9-ICD-10 transition in 2015 (washout period) among adults present in both sets of comparison years. We computed the prevalence and change in prevalence of conditions when using MWI-ICD10 versus MWI-ICD9.
88 175 adults met inclusion criteria. Participants were 60.8% female, 50.5% white, with mean age 54.7±17.3 years and baseline MWI-ICD9 4.47±6.02 (range 0-64.33). Of 94 conditions, 65 had <1% difference across the ICD-9-ICD-10 transition and similar minimal changes within ICD coding eras.
MWI-ICD10 captured the prevalence of chronic conditions nearly identically to that of the validated MWI-ICD9, along with notable but explicable changes across the ICD-10 transition. This new comprehensive person-centred index enables quantification of cumulative disease burden and physical functioning in adults as a clinically meaningful measure of multimorbidity in electronic health record and claims data.
将多重疾病加权指数（MWI）的疾病映射到国际疾病分类第 10 版（ICD-10），扩展疾病和编码以开发新的 ICD-10 编码的 MWI（MWI-ICD10）和更新的 MWI-ICD9，并评估它们的一致性。
基于人群的回顾性队列研究。
2013 年至 2017 年期间的大型医疗中心。
每个 4 年（2013、2014、2016、2017）中至少有 1 次就诊的年龄≥18 岁的成年人。
MWI 疾病映射到 ICD-10 编码，以及添加其他疾病和编码以产生新的 MWI-ICD10 和更新的 MWI-ICD9。我们比较了在 ICD-9 时代（2013-2014 年）、ICD-10 时代（2016-2017 年）和 2015 年 ICD-9-ICD-10 过渡期（洗脱期）中，在两套比较年份均存在的成年人中，ICD 编码的 MWI 疾病的患病率。我们计算了当使用 MWI-ICD10 与 MWI-ICD9 时，疾病的患病率和患病率变化。
88175 名成年人符合纳入标准。参与者中女性占 60.8%，白人占 50.5%，平均年龄 54.7±17.3 岁，基线 MWI-ICD9 为 4.47±6.02（范围 0-64.33）。94 种疾病中，有 65 种疾病在 ICD-9-ICD-10 过渡期的差异<1%，在 ICD 编码时代内也有类似的微小变化。
MWI-ICD10 几乎与经过验证的 MWI-ICD9 相同地捕获了慢性疾病的患病率，并且在 ICD-10 过渡期内有显著但可解释的变化。这种新的全面的以人为中心的指数可以量化成年人的累积疾病负担和身体功能，作为电子健康记录和索赔数据中多疾病的一种有临床意义的衡量标准。
