Abstract
Objectives: On the basis of current treatment guidelines, we developed and validated a medication-based chronic disease score (medCDS) and tested its association with all-cause mortality of older outpatients. Study Design and Setting: Considering the most prevalent chronic diseases in the elderly German population, we compiled a list of evidence-based medicines used to treat these disorders. Based on this list, a score (medCDS) was developed to predict mortality using data of a large longitudinal cohort of older outpatients (training sample; MultiCare Cohort Study). By assessing receiver-operating characteristics (ROC) curves, the performance of medCDS was then confirmed in independent cohorts (ESTHER, KORA-Age) of community-dwelling older patients and compared with already existing medication-based scores and a score using selected anatomical-therapeutic-chemical (ATC) codes. Results: The final medCDS score had an ROC area under the curve (AUC) of 0.73 (95% CI 0.70-0.76). In the validation cohorts, its ROC AUCs were 0.79 (0.76-0.82, KORA-Age) and 0.74 (0.71-0.78, ESTHER), which were superior to already existing medication-based scores (RxRisk, CDS) and scores based on pharmacological ATC code subgroups (ATC3) or age and sex alone (Age&Sex). Conclusions: A new medCDS, which is based on actual treatment standards, predicts mortality of older outpatients significantly better than already existing scores.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 112-124 |
| Number of pages | 13 |
| Journal | Journal of clinical epidemiology |
| Volume | 105 |
| DOIs | |
| State | Published - Jan 1 2019 |
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Keywords
- Elderly
- Medication-based chronic disease score
- Mortality
- Multimorbidity
- Risk assessment
ASJC Scopus subject areas
- Epidemiology
Cite this
A novel superior medication-based chronic disease score predicted all-cause mortality in independent geriatric cohorts. / Quinzler, Renate; Freitag, Michael H.; Wiese, Birgitt; Beyer, Martin; Brenner, Hermann; Dahlhaus, Anne; Döring, Angela; Freund, Tobias; Heier, Margit; Knopf, Hildtraud; Luppa, Melanie; Prokein, Jana; Riedel-Heller, Steffi G.; Schäfer, Ingmar; Scheidt-Nave, Christa; Scherer, Martin; Schöttker, Ben; Szecsenyi, Joachim; Thürmann, Petra; van den Bussche, Hendrik; Gensichen, Jochen; Haefeli, Walter E.
In: Journal of clinical epidemiology, Vol. 105, 01.01.2019, p. 112-124.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A novel superior medication-based chronic disease score predicted all-cause mortality in independent geriatric cohorts
AU - Quinzler, Renate
AU - Freitag, Michael H.
AU - Wiese, Birgitt
AU - Beyer, Martin
AU - Brenner, Hermann
AU - Dahlhaus, Anne
AU - Döring, Angela
AU - Freund, Tobias
AU - Heier, Margit
AU - Knopf, Hildtraud
AU - Luppa, Melanie
AU - Prokein, Jana
AU - Riedel-Heller, Steffi G.
AU - Schäfer, Ingmar
AU - Scheidt-Nave, Christa
AU - Scherer, Martin
AU - Schöttker, Ben
AU - Szecsenyi, Joachim
AU - Thürmann, Petra
AU - van den Bussche, Hendrik
AU - Gensichen, Jochen
AU - Haefeli, Walter E.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Objectives: On the basis of current treatment guidelines, we developed and validated a medication-based chronic disease score (medCDS) and tested its association with all-cause mortality of older outpatients. Study Design and Setting: Considering the most prevalent chronic diseases in the elderly German population, we compiled a list of evidence-based medicines used to treat these disorders. Based on this list, a score (medCDS) was developed to predict mortality using data of a large longitudinal cohort of older outpatients (training sample; MultiCare Cohort Study). By assessing receiver-operating characteristics (ROC) curves, the performance of medCDS was then confirmed in independent cohorts (ESTHER, KORA-Age) of community-dwelling older patients and compared with already existing medication-based scores and a score using selected anatomical-therapeutic-chemical (ATC) codes. Results: The final medCDS score had an ROC area under the curve (AUC) of 0.73 (95% CI 0.70-0.76). In the validation cohorts, its ROC AUCs were 0.79 (0.76-0.82, KORA-Age) and 0.74 (0.71-0.78, ESTHER), which were superior to already existing medication-based scores (RxRisk, CDS) and scores based on pharmacological ATC code subgroups (ATC3) or age and sex alone (Age&Sex). Conclusions: A new medCDS, which is based on actual treatment standards, predicts mortality of older outpatients significantly better than already existing scores.
AB - Objectives: On the basis of current treatment guidelines, we developed and validated a medication-based chronic disease score (medCDS) and tested its association with all-cause mortality of older outpatients. Study Design and Setting: Considering the most prevalent chronic diseases in the elderly German population, we compiled a list of evidence-based medicines used to treat these disorders. Based on this list, a score (medCDS) was developed to predict mortality using data of a large longitudinal cohort of older outpatients (training sample; MultiCare Cohort Study). By assessing receiver-operating characteristics (ROC) curves, the performance of medCDS was then confirmed in independent cohorts (ESTHER, KORA-Age) of community-dwelling older patients and compared with already existing medication-based scores and a score using selected anatomical-therapeutic-chemical (ATC) codes. Results: The final medCDS score had an ROC area under the curve (AUC) of 0.73 (95% CI 0.70-0.76). In the validation cohorts, its ROC AUCs were 0.79 (0.76-0.82, KORA-Age) and 0.74 (0.71-0.78, ESTHER), which were superior to already existing medication-based scores (RxRisk, CDS) and scores based on pharmacological ATC code subgroups (ATC3) or age and sex alone (Age&Sex). Conclusions: A new medCDS, which is based on actual treatment standards, predicts mortality of older outpatients significantly better than already existing scores.
KW - Elderly
KW - Medication-based chronic disease score
KW - Mortality
KW - Multimorbidity
KW - Risk assessment
UR - http://www.scopus.com/inward/record.url?scp=85055335902&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85055335902&partnerID=8YFLogxK
U2 - 10.1016/j.jclinepi.2018.09.004
DO - 10.1016/j.jclinepi.2018.09.004
M3 - Article
VL - 105
SP - 112
EP - 124
JO - Journal of Clinical Epidemiology
JF - Journal of Clinical Epidemiology
SN - 0895-4356
ER -