Evidence map›Paper›PMID 22412005›Full record

SynthesisAnnals of family medicine

Measures of multimorbidity and morbidity burden for use in primary care and community settings: a systematic review and guide.

Alyson L Huntley, Rachel Johnson, Sarah Purdy, Jose M Valderas, Chris Salisbury

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Annals of family medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 328 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
328citing papers in PubMed, 12 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

328 citing papers in PubMed, 12 syntheses or guidelines pooled it.

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  6. Prevalence of Multimorbidity in the Middle East: A Systematic Review of Observational Studies.International journal of environmental research and public health · 2022
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  13. Comorbidities and depressive symptoms among older adults with asthma.The Journal of asthma : official journal of the Association for the Care of Asthma · 2022
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268 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Alyson L HuntleyAcademic Unit of Primary Health Care, School of Social and Community Medicine, Bristol University, Bristol, England.
Rachel Johnson
Sarah Purdy
Jose M Valderas
Chris Salisbury

Funding

Department of Health NIHR/CS/010/024
6 · The paper itself

Abstract

purposeMany patients consulting in primary care have multiple conditions (multimorbidity). Aims of this review were to identify measures of multimorbidity and morbidity burden suitable for use in research in primary care and community populations, and to investigate their validity in relation to anticipated associations with patient characteristics, process measures, and health outcomes.

methodsStudies were identified using searches in MEDLINE and EMBASE from inception to December 2009 and bibliographies.

resultsIncluded were 194 articles describing 17 different measures. Commonly used measures included disease counts (n = 98), Chronic Disease Score (CDS)/RxRisk (n = 17), Adjusted Clinical Groups (ACG) System (n = 25), the Charlson index (n = 38), the Cumulative Index Illness Rating Scale (CIRS; n = 10) and the Duke Severity of Illness Checklist (DUSOI; n = 6). Studies that compared measures suggest their predictive validity for the same outcome differs only slightly. Evidence is strongest for the ACG System, Charlson index, or disease counts in relation to care utilization; for the ACG System in relation to costs; for Charlson index in relation to mortality; and for disease counts or Charlson index in relation to quality of life. Simple counts of diseases or medications perform almost as well as complex measures in predicting most outcomes. Combining measures can improve validity.

conclusionsThe measures most commonly used in primary care and community settings are disease counts, Charlson index, ACG System, CIRS, CDS, and DUSOI. Different measures are most appropriate according to the outcome of interest. Choice of measure will also depend on the type of data available. More research is needed to directly compare performance of different measures.

Indexed as

ComorbidityCommunity Health ServicesHumansOutcome and Process Assessment, Health CarePrimary Health Care

Identifiers

PMID22412005
PMCPMC3315139

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.