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Table of Contents
Vol. 66, No. 4, 2004
Issue release date: July–August 2004

The Impact of Comorbidity on Outcomes

Piccirillo J.F. · Costas I.
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Abstract

Patients often have other diseases, illnesses, or conditions in addition to the disease under study. These other medical conditions are referred to as comorbidity. Comorbidity can impact on diagnosis, prognosis, and selection of therapy. There are a variety of instruments available to measure the type and severity of comorbid ailments. Comorbidity information can be obtained from direct discussions with the patient, a review of the medical record, or from electronic databases that contain billing information. The method of comorbidity assessment can impact on the interpretation of results. Accurate comorbid information will improve the conduct of and generalizability of clinical trials, evaluation of outcomes from observational research, population-based epidemiological studies, and patient-physician communication.



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References

  1. Feinstein AR: The pre-therapeutic classification of co-morbidity in chronic disease. J Chronic Dis 1970;23:455–469.

    External Resources

  2. Katz JN, Chang LC, Sangha O, Fossel AH, Bates DW: Can comorbidity be measured by questionnaire rather than medical record review? Med Care 1996;34:73–84.
  3. Silliman RA, Lash TL: Comparison of interview-based and medical-record-based indices of comorbidity among breast cancer patients. Med Care 1999;37:339–349.
  4. Fan VS, Au D, Heagerty P, Deyo RA, McDonell MB, Fihn SD: Validation of case-mix measures derived from self-reports of diagnoses and health. J Clin Epidemiol 2002;55:371–380.
  5. Kaplan MH, Feinstein AR: The importance of classifying initial co-morbidity in evaluating the outcome of diabetes mellitus. J Chronic Dis 1974;27:387–404.
  6. Charlson ME, Pompei P, Ales KL, MacKenzie CR: A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. J Chronic Dis 1987;40:373–383.
  7. Greenfield S, Apolone G, McNeil BJ, Cleary PD: The importance of co-existent disease in the occurrence of postoperative complications and one-year recovery in patients undergoing total hip replacement. Comorbidity and outcomes after hip replacement. Med Care 1993;31:141–154.
  8. Johnston AS, Piccirillo JF, Creech CM, Littenberg B, Jeffe D, Spitznagel ELJ: Validation of a comorbidity education program. J Reg Manag 2001;28:125–131.
  9. Piccirillo JF, Costas I, Claybour P, Borah AJ, Grove L, Jeffe D: The measurement of comorbidity by cancer registries. J Reg Manag 2003;30:8–14.
  10. Klabunde CN, Warren JL, Legler JM: Assessing comorbidity using claims data: An overview. Med Care 2002;40(8 suppl):26–35.
  11. Deyo RA, Cherkin DC, Ciol MA: Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol 1992;45:613–619.
  12. Romano PS, Roos LL, Luft HS, Jollis JG, Doliszny K: A comparison of administrative versus clinical data: Coronary artery bypass surgery as an example. Ischemic Heart Disease Patient Outcomes Research Team. J Clin Epidemiol 1994;47:249–260.
  13. Ghali WA, Hall RE, Rosen AK, Ash AS, Moskowitz MA: Searching for an improved clinical comorbidity index for use with ICD-9-CM administrative data. J Clin Epidemiol 1996;49:273–278.
  14. Cleves MA, Sanchez N, Draheim M: Evaluation of two competing methods for calculating Charlson’s comorbidity index when analyzing short-term mortality using administrative data. J Clin Epidemiol 1997;50:903–908.
  15. Kieszak SM, Flanders WD, Kosinski AS, Shipp CC, Karp H: A comparison of the Charlson Comorbidity Index derived from medical record data and administrative billing data. J Clin Epidemiol 1998;52:137–142.
  16. Justice AC, Covinsky KE, Berlin JA: Assessing the generalizability of prognostic information. Ann Intern Med 1999;130:515–524.
  17. Potosky AL, Riley GF, Lubitz JD, Mentnech RM, Kessler LG: Potential for cancer related health services research using a linked Medicare-tumor registry database. Med Care 1993;31:732–748.
  18. Romano PS: Asking too much of administrative data? J Am Coll Surg 2003;196:337–338.
  19. Elixhauser A, Steiner C, Harris R, Coffey RM: Comorbidity measures for use with administrative data. Med Care 1998;36:8–27.
  20. Ellis RP, Pope GC, Iezzoni L, Ayanian JZ, Bates DW, Burstin H, et al: Diagnosis-based risk adjustment for Medicare capitation payments. Health Care Financ Rev 1996;17:101–128.
  21. Bach PB, Cramer LD, Warren JL, Begg CB: Racial differences in the treatment of early-stage lung cancer. N Engl J Med 1999;341:1198–1205.
  22. Romano PS, Roos LL, Jollis JG: Adapting a clinical comorbidity index for use with ICD-9-CM administrative data: Differing perspectives. J Clin Epidemiol 1993;46:1075–1090.
  23. Klabunde CN, Potosky AL, Legler JM, Warren JL: Development of a comorbidity index using physician claims data. J Clin Epidemiol 2000;53:1258–1267.
  24. Piccirillo JF, Wells CK, Sasaki CT, Feinstein AR: New clinical severity staging system for cancer of the larynx. Five-year survival rates. Ann Otol Rhinol Laryngol 1994;103:83–92.
  25. Fleming ST, Rastogi A, Dmitrienko A, Johnson KD: A comprehensive prognostic index to predict survival based on multiple comorbidities. Med Care 1999;37:601–614.


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