A novel superior medication-based chronic disease score predicted all-cause mortality in independent geriatric cohorts
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 elderl...
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| Main Authors: | , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2019
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| In: |
Journal of clinical epidemiology
Year: 2019, Volume: 105, Pages: 112-124 |
| ISSN: | 1878-5921 |
| DOI: | 10.1016/j.jclinepi.2018.09.004 |
| Online Access: | Verlag, Pay-per-use, Volltext: http://dx.doi.org/10.1016/j.jclinepi.2018.09.004 Verlag, Pay-per-use, Volltext: http://www.sciencedirect.com/science/article/pii/S0895435618302208 
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| Author Notes: | Renate Quinzler, Michael H. Freitag, Birgitt Wiese, Martin Beyer, Hermann Brenner, Anne Dahlhaus, Angela Döring, Tobias Freund, Margit Heier, Hildtraud Knopf, Melanie Luppa, Jana Prokein, Steffi G. Riedel-Heller, Ingmar Schäfer, Christa Scheidt-Nave, Martin Scherer, Ben Schöttker, Joachim Szecsenyi, Petra Thürmann, Hendrik van den Bussche, Jochen Gensichen, Walter E. Haefeli |
| Summary: | 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. |
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| Item Description: | Gesehen am 15.11.2018 Available online: 22 September 2018 |
| Physical Description: | Online Resource |
| ISSN: | 1878-5921 |
| DOI: | 10.1016/j.jclinepi.2018.09.004 |