Related Experiment Videos
Can comorbidity be measured by questionnaire rather than medical record review?
J N Katz1, L C Chang, O Sangha
1Department of Rheumatology and Immunology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Insights
A new questionnaire accurately measures patient comorbidity, offering a reproducible and valid alternative to costly medical record reviews. This tool simplifies assessing patient health status and resource utilization.
Area of Science:
- Clinical Epidemiology
- Health Services Research
Background:
- Comorbidity assessment traditionally relies on medical record abstraction, which is resource-intensive and often impractical.
- Accurate comorbidity measurement is crucial for patient care, research, and resource allocation.
Purpose of the Study:
- To evaluate the reproducibility and validity of a novel, brief comorbidity questionnaire.
- To compare the questionnaire's performance against the established medical record-based Charlson index.
Main Methods:
- Development of a questionnaire mirroring the Charlson index components.
- Administration to 170 inpatients, with subsequent medical record abstraction for Charlson index calculation.
- Assessment of test-retest reliability (intraclass correlation coefficient) and correlation (Spearman) between measures.
Main Results:
- High test-retest reliability was observed for both the questionnaire (0.91) and the Charlson index (0.92).
- A moderate correlation (0.63) was found between the questionnaire and the Charlson index.
- Comorbidity measures showed similar correlations with health resource utilization indicators.
Conclusions:
- The questionnaire version of the Charlson index is a reproducible and valid tool for comorbidity assessment.
- This questionnaire presents practical advantages over traditional medical record abstraction, particularly for research and clinical practice.
Abstract:
Comorbidity generally is measured by medical record abstraction, which is expensive and often impractical. The aim of this study was to assess the reproducibility and validity of a comorbidity questionnaire. The authors developed a brief comorbidity questionnaire that included items corresponding to each element of the medical record-based Charlson index. The questionnaire was administered to 170 inpatients. Charlson scores were abstracted from these patients' medical records. We assessed test-retest reliability of the questionnaire and the Charlson index, the correlation between the questionnaire and the Charlson index, and correlations between each comorbidity measure and indicators of health resource utilization including medication use, hospitalizations in the past year, and hospital charges. Test-retest reliability, assessed with the intraclass correlation coefficient, was 0.91 for the questionnaire and 0.92 for the chart-based Charlson index. The Spearman correlation between these two measures was 0.63. The correlation between comorbidity measures was weaker in less educated patients. Correlations with indicators of resource utilization were similar for the two comorbidity instruments. The authors found that a questionnaire version of the Charlson index is reproducible, valid, and offers practical advantages over medical record-based assessments.