Evidence map›Paper›PMID 33469380›Full record

ArticleClinical epidemiology2021

Adaptation of the Charlson Comorbidity Index for Register-Based Research in Sweden.

Jonas F Ludvigsson, Peter Appelros, Johan Askling, Liisa Byberg, Juan-Jesus Carrero, Anna Mia Ekström, Magnus Ekström, Karin Ekström Smedby, Hannes Hagström, Stefan James and 6 more

Erratum issuedAbstract read
In one paragraph

Article in Clinical epidemiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 171 papers.

0numbers the graph read from it
0cells of the map it votes in
171citing papers in PubMed
–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

171 citing papers in PubMed.

  1. Trial
  2. Trial
  3. Article
  4. Article
  5. Article
  6. Observational
  7. Article
  8. Article
  9. Article
  10. Long-Term Mortality and Morbidity After Pediatric Sepsis.Open forum infectious diseases · 2026
    Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Real-world patterns of healthcare use, costs, and survival in diffuse large B-cell lymphoma: a nationwide Swedish register study.The European journal of health economics : HEPAC : health economics in prevention and care · 2026
    Article
  20. Article

111 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors.

Jonas F LudvigssonDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0003-1024-5602
Peter AppelrosUniversity Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro SE-701 82, Sweden.
Johan AsklingClinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
Liisa BybergDepartment of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Juan-Jesus CarreroDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0003-4763-2024
Anna Mia EkströmGlobal & Sexual Health Research Group (GloSH), Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
Magnus EkströmDepartment of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden.ORCID 0000-0002-7227-5113
Karin Ekström SmedbyClinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
Hannes HagströmDivision of Hepatology, Department of Upper GI Diseases, Karolinska University Hospital, Stockholm, Sweden.
Stefan JamesDepartment of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden.
Bengt JärvholmDepartment of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
Karl MichaelssonDepartment of Surgical Sciences, Uppsala University, Uppsala, Sweden.ORCID 0000-0003-2815-1217
Nancy L PedersenDepartment of Medical Epidemiology, Karolinska Institutet, Stockholm, Sweden.
Helene SundelinNeuropediatric Unit, Department of Women's and Children's Health, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
Kristina SundquistCenter for Primary Health Care Research, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden.
Johan SundströmDepartment of Medical Sciences, Uppsala University, Uppsala, Sweden.ORCID 0000-0003-2247-8454

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeComorbidity indices are often used to measure comorbidities in register-based research. We aimed to adapt the Charlson comorbidity index (CCI) to a Swedish setting.

methodsFour versions of the CCI were compared and evaluated by disease-specific experts.

resultsWe created a cohesive coding system for CCI to 1) harmonize the content between different international classification of disease codes (ICD-7,8,9,10), 2) delete incorrect codes, 3) enhance the distinction between mild, moderate or severe disease (and between diabetes with and without end-organ damage), 4) minimize duplication of codes, and 5) briefly explain the meaning of individual codes in writing.

conclusionThis work may provide an integrated and efficient coding algorithm for CCI to be used in medical register-based research in Sweden.

Indexed as

Charlson comorbidity scorecomorbiditydiseaseepidemiologypublic healthSweden

Identifiers

PMID33469380
PMCPMC7812935

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.