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dc.contributor.authorTsang, RSM
dc.contributor.authorJoy, M
dc.contributor.authorWhitaker, H
dc.contributor.authorSheppard, JP
dc.contributor.authorWilliams, J
dc.contributor.authorSherlock, J
dc.contributor.authorMayor, N
dc.contributor.authorMeza-Torres, B
dc.contributor.authorButton, E
dc.contributor.authorWilliams, AJ
dc.contributor.authorKar, D
dc.contributor.authorDelanerolle, G
dc.contributor.authorMcManus, R
dc.contributor.authorHobbs, FDR
dc.contributor.authorde Lusignan, S
dc.date.accessioned2024-03-07T15:22:38Z
dc.date.available2024-03-07T15:22:38Z
dc.date.issued2023-06
dc.identifier.issn0960-1643
dc.identifier.issn1478-5242
dc.identifier.urihttps://pearl.plymouth.ac.uk/handle/10026.1/22135
dc.description.abstract

<jats:sec><jats:title>Background</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Aim</jats:title><jats:p>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).</jats:p></jats:sec><jats:sec><jats:title>Design and setting</jats:title><jats:p>Observational study using diagnosis and prescriptions data from an English primary care sentinel surveillance network between 2014 and 2019.</jats:p></jats:sec><jats:sec><jats:title>Method</jats:title><jats:p>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 (<jats:italic>n</jats:italic>= 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 (<jats:italic>n</jats:italic>= 150 000), and for 1-year and 5-year mortality in an asynchronous validation dataset (<jats:italic>n</jats:italic>= 150 000).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>This modified version of the Cambridge Multimorbidity Score allows reliable estimation using clinical terms that can be applied internationally across multiple healthcare settings.</jats:p></jats:sec>

dc.format.extente435-e442
dc.format.mediumElectronic-Print
dc.languageen
dc.publisherRoyal College of General Practitioners
dc.subjectgeneral practice;medical record systems
dc.subjectcomputerised
dc.subjectmortality
dc.subjectmultimorbidity
dc.subjectpopulation surveillance
dc.subjectSystematized Nomenclature of Medicine
dc.subjectClinical Terms
dc.titleDevelopment of a modified Cambridge Multimorbidity Score for use with SNOMED CT: an observational English primary care sentinel network study
dc.typejournal-article
dc.typeArticle
plymouth.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/37130611
plymouth.issue731
plymouth.volume73
plymouth.publisher-urlhttp://dx.doi.org/10.3399/bjgp.2022.0235
plymouth.publication-statusPublished
plymouth.journalBritish Journal of General Practice
dc.identifier.doi10.3399/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.placeEngland
dcterms.dateAccepted2022-10-07
dc.date.updated2024-03-07T15:22:38Z
dc.identifier.eissn1478-5242
dc.rights.embargoperiodforever
rioxxterms.versionofrecord10.3399/bjgp.2022.0235


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