Evidence map›Paper›PMID 32015079›Full record

ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2020

Development and validation of the Cambridge Multimorbidity Score.

Rupert A Payne, Silvia C Mendonca, Marc N Elliott, Catherine L Saunders, Duncan A Edwards, Martin Marshall, Martin Roland

Abstract readValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 91 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
91citing papers in PubMed, 1 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

91 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  4. Projected population health, demographics, and associated healthcare resource requirements from 2025 to 2047: Modelling study in England.The European journal of health economics : HEPAC : health economics in prevention and care · 2026
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  6. Impact of structured medication reviews on prescribing in English primary care: a retrospective observational cohort study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026
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  15. Consultations with locum doctors in UK general practice: longitudinal analysis of electronic health records.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026
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31 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

7 authors.

Rupert A PayneCentre for Academic Primary Care (Payne), Population Health Sciences, University of Bristol, Bristol, UK; Primary Care Unit (Mendonca, Saunders, Edwards, Roland), Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, UK; RAND Corporation (Elliott), Santa Monica, Calif.; Research Department of Primary Care and Population Health (Marshall), University College London Medical School, Royal Free Campus, London, UK r.payne@bristol.ac.uk.
Silvia C MendoncaCentre for Academic Primary Care (Payne), Population Health Sciences, University of Bristol, Bristol, UK; Primary Care Unit (Mendonca, Saunders, Edwards, Roland), Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, UK; RAND Corporation (Elliott), Santa Monica, Calif.; Research Department of Primary Care and Population Health (Marshall), University College London Medical School, Royal Free Campus, London, UK.
Marc N ElliottCentre for Academic Primary Care (Payne), Population Health Sciences, University of Bristol, Bristol, UK; Primary Care Unit (Mendonca, Saunders, Edwards, Roland), Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, UK; RAND Corporation (Elliott), Santa Monica, Calif.; Research Department of Primary Care and Population Health (Marshall), University College London Medical School, Royal Free Campus, London, UK.
Catherine L SaundersCentre for Academic Primary Care (Payne), Population Health Sciences, University of Bristol, Bristol, UK; Primary Care Unit (Mendonca, Saunders, Edwards, Roland), Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, UK; RAND Corporation (Elliott), Santa Monica, Calif.; Research Department of Primary Care and Population Health (Marshall), University College London Medical School, Royal Free Campus, London, UK.
Duncan A EdwardsCentre for Academic Primary Care (Payne), Population Health Sciences, University of Bristol, Bristol, UK; Primary Care Unit (Mendonca, Saunders, Edwards, Roland), Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, UK; RAND Corporation (Elliott), Santa Monica, Calif.; Research Department of Primary Care and Population Health (Marshall), University College London Medical School, Royal Free Campus, London, UK.
Martin MarshallCentre for Academic Primary Care (Payne), Population Health Sciences, University of Bristol, Bristol, UK; Primary Care Unit (Mendonca, Saunders, Edwards, Roland), Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, UK; RAND Corporation (Elliott), Santa Monica, Calif.; Research Department of Primary Care and Population Health (Marshall), University College London Medical School, Royal Free Campus, London, UK.
Martin RolandCentre for Academic Primary Care (Payne), Population Health Sciences, University of Bristol, Bristol, UK; Primary Care Unit (Mendonca, Saunders, Edwards, Roland), Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, UK; RAND Corporation (Elliott), Santa Monica, Calif.; Research Department of Primary Care and Population Health (Marshall), University College London Medical School, Royal Free Campus, London, UK.

Funding

Department of Health DRF-2013-06-049
6 · The paper itself

Abstract

backgroundHealth services have failed to respond to the pressures of multimorbidity. Improved measures of multimorbidity are needed for conducting research, planning services and allocating resources.

methodsWe modelled the association between 37 morbidities and 3 key outcomes (primary care consultations, unplanned hospital admission, death) at 1 and 5 years. We extracted development (

resultsModels that included all 37 conditions were acceptable predictors of general practitioner consultations (C-index 0.732, 95% confidence interval [CI] 0.731-0.734), unplanned hospital admission (C-index 0.742, 95% CI 0.737-0.747) and death at 1 year (C-index 0.912, 95% CI 0.905-0.918). Models reduced to the 20 conditions with the greatest combined prevalence/weight showed similar predictive ability (C-indices 0.727, 95% CI 0.725-0.728; 0.738, 95% CI 0.732-0.743; and 0.910, 95% CI 0.904-0.917, respectively). They also predicted 5-year outcomes similarly for consultations and death (C-indices 0.735, 95% CI 0.734-0.736, and 0.889, 95% CI 0.885-0.892, respectively) but performed less well for admissions (C-index 0.708, 95% CI 0.705-0.712). The performance of the general-outcome score was similar to that of the outcome-specific models. These models performed significantly better than those based on the Charlson Comorbidity Index for consultations (C-index 0.691, 95% CI 0.690-0.693) and admissions (C-index 0.703, 95% CI 0.697-0.709) and similarly for mortality (C-index 0.907, 95% CI 0.900-0.914).

interpretationThe Cambridge Multimorbidity Score is robust and can be either tailored or not tailored to specific health outcomes. It will be valuable to those planning clinical services, policymakers allocating resources and researchers seeking to account for the effect of multimorbidity.

Indexed as

MultimorbidityAdultAgedAged, 80 and overElectronic Health RecordsFemaleHumansMaleMiddle AgedMortalityOutcome and Process Assessment, Health CarePatient AdmissionPredictive Value of TestsPrimary Health CareProportional Hazards ModelsReferral and Consultation

Identifiers

PMID32015079
PMCPMC7004217

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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.