ArticlePharmacoepidemiology and drug safety2015
Using claims data to predict dependency in activities of daily living as a proxy for frailty.
Article in Pharmacoepidemiology and drug safety, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 115 papers, 1 of them a synthesis that pooled it.
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Who cites it
115 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Prediction models for functional status in community dwelling older adults: a systematic review.BMC geriatrics · 2022Pooled it
- Quality, Cost, and Timeliness of Cancer Treatment in Medicare Advantage and Traditional Medicare.JAMA internal medicine · 2026Article
- Comparative Effectiveness of Different Influenza Vaccine Formulations among Patients Undergoing Maintenance Hemodialysis.Journal of the American Society of Nephrology : JASN · 2026Article
- Frailty and Quality of Life in Older Patients Treated with Chemotherapy.Current oncology reports · 2026Review
- Burden and Impact of Frailty and Comorbidity in Individuals Screened for Lung Cancer.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2026Article
- Provider billing margin and cancer treatment selection: population based cohort study.BMJ (Clinical research ed.) · 2025Article
- Patterns of Benzodiazepines and Hypnotic Drugs Dispensing After Hip Fracture Among Older US Adults Previously on the Drugs.Journal of the American Geriatrics Society · 2025Article
- A systematic approach to evaluating instrumental variable assumptions: applied example of glucose-lowering medications and risk for hospitalized heart failure in older adults.American journal of epidemiology · 2025Article
- Development and indirect validation of a model predicting frailty in the French healthcare claims database.Scientific reports · 2025Article
- Frailty Trajectories Following Adjuvant Chemotherapy and Mortality in Older Women With Breast Cancer.JAMA network open · 2025Article
- Quality of Treatment Selection for Medicare Beneficiaries With Cancer.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2025Article
- Impact of Lookback Duration on the Performance of a Claims-Based Frailty Proxy in Women With Stage I-III Breast Cancer.Pharmacoepidemiology and drug safety · 2025Article
- Unleashing frailty from laboratory into real world: A critical step toward frailty-guided clinical care of older adults.Journal of the American Geriatrics Society · 2024Article
- Longitudinal trajectories of a claims-based frailty measure during adjuvant chemotherapy in women with stage I-III breast cancer.The oncologist · 2024Article
- Longitudinal Changes in a Claims-Based Frailty Proxy Measure Compared to Concurrent Changes in the Fried Frailty Phenotype.The journals of gerontology. Series A, Biological sciences and medical sciences · 2024Article
- Article
- Frailty and Clinical Outcomes of Ticagrelor Versus Clopidogrel in Older Adults With Acute Myocardial Infarction.Journal of the American Heart Association · 2024Article
- Relative Effectiveness of the MF59-Adjuvanted Influenza Vaccine Versus High-Dose Influenza Vaccine in Older Adults With Influenza Risk Factors During the 2019-2020 US Influenza Season.Open forum infectious diseases · 2024Article
- Assessing the Benefits and Harms of Pharmacotherapy in Older Adults with Frailty: Insights from Pharmacoepidemiologic Studies of Routine Health Care Data.Drugs & aging · 2024Review
- Commercial Versus Medicaid Insurance and Use of High-Priced Anticancer Treatments.The oncologist · 2024Article
55 more citing papers are in PubMed but not listed here.
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Authors and funding
8 authors.
Funding
Abstract
purposeEstimating drug effectiveness and safety among older adults in population-based studies using administrative health care claims can be hampered by unmeasured confounding as a result of frailty. A claims-based algorithm that identifies patients likely to be dependent, a proxy for frailty, may improve confounding control. Our objective was to develop an algorithm to predict dependency in activities of daily living (ADL) in a sample of Medicare beneficiaries.
methodsCommunity-dwelling respondents to the 2006 Medicare Current Beneficiary Survey, >65 years old, with Medicare Part A, B, home health, and hospice claims were included. ADL dependency was defined as needing help with bathing, eating, walking, dressing, toileting, or transferring. Potential predictors were demographics, International Classification of Diseases, Ninth Revision Clinical Modification diagnosis/procedure and durable medical equipment codes for frailty-associated conditions. Multivariable logistic regression was used to predict ADL dependency. Cox models estimated hazard ratios for death as a function of observed and predicted ADL dependency.
resultsOf 6391 respondents, 57% were female, 88% white, and 38% were ≥80. The prevalence of ADL dependency was 9.5%. Strong predictors of ADL dependency were charges for a home hospital bed (OR = 5.44, 95%CI = 3.28-9.03) and wheelchair (OR = 3.91, 95%CI = 2.78-5.51). The c-statistic of the final model was 0.845. Model-predicted ADL dependency of 20% or greater was associated with a hazard ratio for death of 3.19 (95%CI: 2.78, 3.68).
conclusionsAn algorithm for predicting ADL dependency using health care claims was developed to measure some aspects of frailty. Accounting for variation in frailty among older adults could lead to more valid conclusions about treatment use, safety, and effectiveness.
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