Development of a modified Cambridge Multimorbidity Score for use with SNOMED CT: an observational English primary care sentinel network study.
dc.contributor.author | Tsang, RS | |
dc.contributor.author | Joy, M | |
dc.contributor.author | Whitaker, H | |
dc.contributor.author | Sheppard, JP | |
dc.contributor.author | Williams, J | |
dc.contributor.author | Sherlock, J | |
dc.contributor.author | Mayor, N | |
dc.contributor.author | Meza-Torres, B | |
dc.contributor.author | Button, E | |
dc.contributor.author | Williams, AJ | |
dc.contributor.author | Kar, D | |
dc.contributor.author | Delanerolle, G | |
dc.contributor.author | McManus, R | |
dc.contributor.author | Hobbs, FR | |
dc.contributor.author | de Lusignan, S | |
dc.date.accessioned | 2024-03-07T15:22:38Z | |
dc.date.available | 2024-03-07T15:22:38Z | |
dc.date.issued | 2023-06 | |
dc.identifier.issn | 0960-1643 | |
dc.identifier.issn | 1478-5242 | |
dc.identifier.uri | https://pearl.plymouth.ac.uk/handle/10026.1/22135 | |
dc.description.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. | |
dc.format.extent | e435-e442 | |
dc.format.medium | Electronic-Print | |
dc.language | eng | |
dc.publisher | Royal College of General Practitioners | |
dc.subject | Systematized Nomenclature of Medicine–Clinical Terms | |
dc.subject | general practice | |
dc.subject | medical record systems, computerised | |
dc.subject | mortality | |
dc.subject | multimorbidity | |
dc.subject | population surveillance | |
dc.subject | Humans | |
dc.subject | Systematized Nomenclature of Medicine | |
dc.subject | Multimorbidity | |
dc.subject | Cross-Sectional Studies | |
dc.subject | Electronic Health Records | |
dc.subject | Primary Health Care | |
dc.title | Development of a modified Cambridge Multimorbidity Score for use with SNOMED CT: an observational English primary care sentinel network study. | |
dc.type | Journal Article | |
plymouth.author-url | https://www.ncbi.nlm.nih.gov/pubmed/37130611 | |
plymouth.issue | 731 | |
plymouth.volume | 73 | |
plymouth.publication-status | Published online | |
plymouth.journal | Br J Gen Pract | |
dc.identifier.doi | 10.3399/BJGP.2022.0235 | |
plymouth.organisational-group | |Plymouth | |
plymouth.organisational-group | |Plymouth|Faculty of Health | |
plymouth.organisational-group | |Plymouth|Users by role | |
plymouth.organisational-group | |Plymouth|Users by role|Academics | |
plymouth.organisational-group | |Plymouth|Faculty of Health|Peninsula Medical School | |
dc.publisher.place | England | |
dcterms.dateAccepted | 2022-10-07 | |
dc.date.updated | 2024-03-07T15:22:38Z | |
dc.identifier.eissn | 1478-5242 | |
dc.rights.embargoperiod | forever | |
rioxxterms.versionofrecord | 10.3399/BJGP.2022.0235 |
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