Tsang, R.S.M. orcid.org/0000-0002-2520-526X, Joy, M. orcid.org/0000-0002-4974-3724, Whitaker, H. orcid.org/0000-0001-5833-1863 et al. (12 more authors) (2023) Development of a modified Cambridge Multimorbidity Score for use with SNOMED CT: an observational English primary care sentinel network study. British Journal of General Practice, 73 (731). e435. ISSN 0960-1643
Abstract
Background 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.
Aim 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).
Design and setting Observational study using diagnosis and prescriptions data from an English primary care sentinel surveillance network between 2014 and 2019.
Method 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 (n = 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 (n = 150 000), and for 1-year and 5-year mortality in an asynchronous validation dataset (n = 150 000).
Results 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.
Conclusion This modified version of the Cambridge Multimorbidity Score allows reliable estimation using clinical terms that can be applied internationally across multiple healthcare settings.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © The Authors. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
Keywords: | Systematized Nomenclature of Medicine–Clinical Terms; general practice; medical record systems, computerised; mortality; multimorbidity; population surveillance; Humans; Systematized Nomenclature of Medicine; Multimorbidity; Cross-Sectional Studies; Electronic Health Records; Primary Health Care |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Health and Related Research (Sheffield) > ScHARR - Sheffield Centre for Health and Related Research |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 26 Jan 2024 10:45 |
Last Modified: | 26 Jan 2024 10:45 |
Published Version: | http://dx.doi.org/10.3399/bjgp.2022.0235 |
Status: | Published |
Publisher: | Royal College of General Practitioners |
Refereed: | Yes |
Identification Number: | 10.3399/bjgp.2022.0235 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:207999 |