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Quality of Life Research
Gepubliceerd in:

01-10-2016

Refined comorbidity index based on dimensionality of comorbidity for use in studies of health-related quality of life

Auteurs: Huang-Tz Ou, Chung-Ying Lin, Steven R. Erickson, Rajesh Balkrishnan

Gepubliceerd in: Quality of Life Research | Uitgave 10/2016

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Abstract

Purpose

To refine two subscales of the health-related quality of life comorbidity index (HRQoL-CI) into a single index measure.

Methods

The 2010 and 2012 Medical Expenditure Panel Surveys were utilized as development and validation datasets, respectively. The least absolute shrinkage and selection operator was applied to select important comorbidity candidates associated with HRQoL. Exploratory factor analysis and confirmatory factor analysis (CFA) were used to assess dimensionality in comorbidity. Statistical weights were derived based on standardized factor loadings from CFA and regression coefficients from the model predicting HRQoL. Prediction errors and model R2 values were compared between HRQoL-CI and Charlson CI (CCI).

Results

Eighteen comorbid conditions were identified. CFA models indicated that the second-order multidimensional comorbidity structure had a better fit to the data than did the first-order unidimensional structure. The predictive performance of the refined scale under a multidimensional structure utilizing statistical weights outperformed the original scale and CCI in terms of average prediction error and R2 in the prediction models (R2 values from refined scale model are 0.25, 0.30, and 0.28 versus those from CCI of 0.10, 0.09, and 0.06 for general health, SF-6D, and EQ-5D, respectively).

Conclusion

The dimensionality of comorbidity and the weight scheme significantly improved the performance of the refined HRQoL-CI. The refined single HRQoL-CI measure appears to be an appropriate and valid instrument specific for risk adjustment in studies of HRQoL. Future research that validates the refined scales for different cultures, age groups, and healthcare settings is warranted.
vorige artikel Minimal clinically important differences in the EORTC QLQ-BM22 and EORTC QLQ-C15-PAL modules in patients with bone metastases undergoing palliative radiotherapy
volgende artikel Testing the measurement invariance of the University of Washington Self-Efficacy Scale short form across four diagnostic subgroups
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Metagegevens
Titel
Refined comorbidity index based on dimensionality of comorbidity for use in studies of health-related quality of life
Auteurs
Huang-Tz Ou
Chung-Ying Lin
Steven R. Erickson
Rajesh Balkrishnan
Publicatiedatum
01-10-2016
Uitgeverij
Springer International Publishing
Gepubliceerd in
Quality of Life Research / Uitgave 10/2016
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-016-1306-6

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