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Simple Excel and ICD-10 based dataset calculator for the Charlson and Elixhauser comorbidity indices
Pärt Prommik1,2,3, Kaspar Tootsi4,5, Toomas Saluse5
1Department of Traumatology and Orthopaedics, University of Tartu, L. Puusepa 8, 50406, Tartu, Estonia. part.prommik@ut.ee.
Insights
This study introduces a user-friendly Microsoft Excel tool for calculating Charlson and Elixhauser Comorbidity Indices using ICD-10 codes. The validated calculator simplifies comorbidity assessment for researchers without programming skills.
Area of Science:
- Medical Informatics
- Health Services Research
- Biostatistics
Background:
- Charlson and Elixhauser Comorbidity Indices are standard tools in medical research for assessing patient comorbidities.
- Current calculation methods often require programming skills and command-line interfaces, limiting accessibility.
- International Classification of Diseases, 10th revision (ICD-10) is a global standard for disease coding.
Purpose of the Study:
- To develop a non-programming, Microsoft Excel-based calculator for Charlson and Elixhauser Comorbidity Indices.
- To ensure the calculator utilizes ICD-10 codes for broad applicability.
- To validate the Excel calculator's accuracy and efficiency against established R- and SAS-based methods.
Main Methods:
- Developed an Excel calculator using built-in formulas and ICD-10 algorithms for Charlson and Elixhauser Comorbidity Indices.
- Utilized population-wide hip fracture data from the Estonian Health Insurance Fund spanning nine years for validation.
- Compared the Excel calculator's output and processing speed against R- and SAS-based calculation methods.
Main Results:
- Validated the Excel calculator using 11,491 hip fracture patients' comorbidity data.
- Achieved consistent results with R- and SAS-based methods, with no discrepancies found across 192,690 (Charlson) and 353,265 (Elixhauser) output values.
- Observed a slightly slower processing speed for the Excel calculator, with differences ranging from seconds to four minutes for large datasets.
Conclusions:
- A novel, validated, non-programming method for calculating Charlson and Elixhauser Comorbidity Index scores has been developed.
- The Microsoft Excel-based calculator simplifies comorbidity assessment through a graphical user interface.
- This tool lowers the barrier to entry for researchers needing to calculate these widely used comorbidity indices.
Background:
The Charlson and Elixhauser Comorbidity Indices are the most widely used comorbidity assessment methods in medical research. Both methods are adapted for use with the International Classification of Diseases, which 10th revision (ICD-10) is used by over a hundred countries in the world. Available Charlson and Elixhauser Comorbidity Index calculating methods are limited to a few applications with command-line user interfaces, all requiring specific programming language skills. This study aims to use Microsoft Excel to develop a non-programming and ICD-10 based dataset calculator for Charlson and Elixhauser Comorbidity Index and to validate its results with R- and SAS-based methods.
Methods:
The Excel-based dataset calculator was developed using the program's formulae, ICD-10 coding algorithms, and different weights of the Charlson and Elixhauser Comorbidity Index. Real, population-wide, nine-year spanning, index hip fracture data from the Estonian Health Insurance Fund was used for validating the calculator. The Excel-based calculator's output values and processing speed were compared to R- and SAS-based methods.
Results:
A total of 11,491 hip fracture patients' comorbidities were used for validating the Excel-based calculator. The Excel-based calculator's results were consistent, revealing no discrepancies, with R- and SAS-based methods while comparing 192,690 and 353,265 output values of Charlson and Elixhauser Comorbidity Index, respectively. The Excel-based calculator's processing speed was slower but differing only from a few seconds up to four minutes with datasets including 6250-200,000 patients.
Conclusions:
This study proposes a novel, validated, and non-programming-based method for calculating Charlson and Elixhauser Comorbidity Index scores. As the comorbidity calculations can be conducted in Microsoft Excel's simple graphical point-and-click interface, the new method lowers the threshold for calculating these two widely used indices.
Trial Registration:
retrospectively registered.
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