Evidence map›Paper›PMID 24962929›Full record

ReviewPharmacoepidemiology and drug safety2014

Measuring frailty using claims data for pharmacoepidemiologic studies of mortality in older adults: evidence and recommendations.

Dae Hyun Kim, Sebastian Schneeweiss

Registry-linked trialOpen access · greenAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Pharmacoepidemiology and drug safety, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03907553 (Aging of Hematopoietic Stem Cells - Molecular Architecture of Marrow Dysplasia and Clinical Contribution of Ineffective Hematopoiesis to Frailty in the Elderly), which is not on this map. Cited by 85 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
85citing papers in PubMed, 2 pooled it
4.3field-weighted citation impact, top 7% of its field
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.

NCT03907553 completednot on this map

Aging of Hematopoietic Stem Cells - Molecular Architecture of Marrow Dysplasia and Clinical Contribution of Ineffective Hematopoiesis to Frailty in the Elderly

TypeobservationalSponsorIstituto Clinico HumanitasRan2003Enrolled5,000ConditionsAnemia, Clonal HematopoiesisArmstargeted genome sequencing
3 · Its place in the literature

Who cites it

85 citing papers in PubMed, 2 syntheses or guidelines pooled it, 134 citations in OpenAlex.

  1. Pooled it
  2. Fracture Risk After Initiation of Use of Canagliflozin: A Cohort Study.Annals of internal medicine · 2019 · on this map
    Pooled it
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  7. External validation of an AI-based preoperative frailty index using real-world data.The journals of gerontology. Series A, Biological sciences and medical sciences · 2025
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25 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

2 authors at 2 institutions in 1 country.

Dae Hyun KimDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Sebastian Schneeweiss
Beth Israel Deaconess Medical Center · USBrigham and Women's Hospital · US

Funding

Harvard Clinical and Translational Science CenterKL2TR001100 · NCATS · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2013 to 2017
$8.5M
NCATS NIH HHS 1KL2 TR001100-01NCATS NIH HHS KL2 TR001100
6 · The paper itself

Abstract

purposeGeriatric frailty is a common syndrome of older adults that is characterized by increased vulnerability to adverse health outcomes and influences treatment choice. Pharmacoepidemiologic studies that rely on administrative claims data in older adults are limited by confounding due to unmeasured frailty. A claims-based frailty score may be useful to minimize confounding by frailty in such databases. We provide an overview of definitions and measurement of frailty, evaluated the claims-based models of frailty in literature, and recommend ways to improve frailty adjustment in claims analysis.

methodsWe searched MEDLINE and EMBASE from inception to April 2014, without language restriction, to identify claims-based multivariable models that predicted frailty or its related outcome, disability. We critically appraised their approach, including population, predictor selection, outcome definition, and model performance.

resultsOf 152 reports, three models were identified. One model that predicted poor functional status using healthcare service claims in a representative sample of community-dwelling and institutionalized older adults showed an excellent discrimination (C statistic, 0.92). The other two models that predicted disability using either diagnosis codes or prescription claims alone in institutionalized or frail adults had limited generalizability and modest model performance. None of the models have been applied to reduce confounding bias in pharmacoepidemiologic studies of drug therapy.

conclusionsWe found little research conducted on development and application of a claims-based frailty index for confounding adjustment in pharmacoepidemiologic studies in older adults. More research is needed to advance this innovative, potentially useful approach by incorporating the expertise from aging research.

Indexed as

Models, StatisticalAgedBiasConfounding Factors, EpidemiologicDatabases, FactualEpidemiologic Research DesignFrail ElderlyHumansMortalityMultivariate AnalysisPharmacoepidemiologyadministrative claims databasefrailtypharmacoepidemiologyprediction

Identifiers

PMID24962929
PMCPMC4149846
OpenAlexW1560983288

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

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.