Measuring Multimorbidity: Selecting the Right Instrument for the Purpose and the Data Source

Area of Science:

• Health Services Research
• Clinical Epidemiology
• Health Policy

Background:

• Multimorbidity, defined as the presence of multiple chronic health conditions, is more common in adults than single conditions.
• Choosing appropriate assessment tools for multimorbidity presents a significant challenge for researchers, clinicians, and policymakers.

Purpose of the Study:

• To comprehensively review available instruments and data sources for assessing multimorbidity.
• To provide evidence-based guidance for selecting the most appropriate multimorbidity measurement tools.

Main Methods:

• Expert workshop convened by the National Institutes of Health (NIH) to review multimorbidity assessment instruments and data sources.
• Identification of common purposes for multimorbidity measurement and evaluation of major data sources (e.g., electronic health records, surveys).
• Survey and characterization of 15 instruments and 2 public health data systems, focusing on validity and selection criteria.

Main Results:

• Five major data sources for multimorbidity assessment were identified, each with distinct advantages and disadvantages.
• Guidance for instrument selection emphasizes aligning the measurement purpose with the chosen approach, data source, and relevant contextual factors.
• Consideration of specific populations (e.g., underrepresented racial/ethnic groups, children, older adults) is crucial for accurate multimorbidity burden assessment.

Conclusions:

• Appropriate selection of multimorbidity measurement tools, combined with data source integration, enhances assessment accuracy.
• Electronic health record systems offer novel opportunities for comprehensive multimorbidity data collection.
• Tailored measurement strategies are essential for accurately capturing the burden of multimorbidity across diverse patient populations.