ArticleBMC medicine2023
Impact of data source choice on multimorbidity measurement: a comparison study of 2.3 million individuals in the Welsh National Health Service.
Article in BMC medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 2 of them syntheses that pooled it.
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Who cites it
30 citing papers in PubMed, 2 syntheses or guidelines pooled it, 34 citations in OpenAlex.
- Prevalence and representation of comorbidities and multimorbidity in randomised controlled trials in sepsis or septic shock: a systematic review.Critical care (London, England) · 2026Pooled it
- Identifying clusters of multimorbid disease and differences by age, sex, and socioeconomic status: A systematic review.PloS one · 2025Pooled it
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- Systematic mapping of rare genetic disease studies using UK primary care electronic health records.European journal of human genetics : EJHG · 2026Review
- The kidney failure risk equation in people with CKD and multimorbidity: the effect of competing mortality risks.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2026Observational
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- Neighbourhood social gifting and multiple long-term conditions: a nationally representative analysis of the Scottish population aged 40-75 years.European journal of public health · 2026Article
- A comprehensive nationwide registry study of noncommunicable disease comorbidities and death in cancer patients in Norway-the NCDNOR project.Scientific reports · 2026Article
- Characteristics, Complications, Comorbidities, and Other Manifestations of Inflammatory Bowel Disease: A 7-Year Tertiary Center Experience.Clinics and practice · 2026Article
- Harmonising definitions of multiple long term conditions for inflammation research: a co-production approach.BMC research notes · 2026Article
- Effects of household and neighbourhood attributes on four definitions of multimorbidity: a comparative multilevel analysis of linked clinical and census data of Wales.BMJ public health · 2026Article
- The desirable health indicator: a new indicator of population health and healthcare utilisation.International journal of population data science · 2026Article
- Article
- Long-term accrual of conditions following myocardial infarction: a study of disease trajectories in the Wales Multimorbidity e-Cohort.BMC medicine · 2025Article
- Delirium is associated with incident dementia across the multimorbidity spectrum: a population-based cohort study.medRxiv : the preprint server for health sciences · 2025Article
- Concordance of number of chronic conditions estimated from electronic health record or self-report.Annals of epidemiology · 2025Article
- Measuring frailty: a comparison of the cumulative deficit model of frailty in survey and routine data.European geriatric medicine · 2025Observational
- Impact of primary, specialist, and hospital care data on disease frequency estimates in older adults in Sweden.Scientific reports · 2025Article
- Robustly measuring multimorbidity using disparate linked datasets.Communications medicine · 2025Article
- Frailty in Adults with CKD and Validation of the Kidney Failure Risk Equation in Frailty Subgroups.Clinical journal of the American Society of Nephrology : CJASN · 2025Article
Corrections and comments
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Authors and funding
17 authors at 6 institutions in 6 countries.
Funding
Abstract
backgroundMeasurement of multimorbidity in research is variable, including the choice of the data source used to ascertain conditions. We compared the estimated prevalence of multimorbidity and associations with mortality using different data sources.
methodsA cross-sectional study of SAIL Databank data including 2,340,027 individuals of all ages living in Wales on 01 January 2019. Comparison of prevalence of multimorbidity and constituent 47 conditions using data from primary care (PC), hospital inpatient (HI), and linked PC-HI data sources and examination of associations between condition count and 12-month mortality.
resultsUsing linked PC-HI compared with only HI data, multimorbidity was more prevalent (32.2% versus 16.5%), and the population of people identified as having multimorbidity was younger (mean age 62.5 versus 66.8 years) and included more women (54.2% versus 52.6%). Individuals with multimorbidity in both PC and HI data had stronger associations with mortality than those with multimorbidity only in HI data (adjusted odds ratio 8.34 [95% CI 8.02-8.68] versus 6.95 (95%CI 6.79-7.12] in people with ≥ 4 conditions). The prevalence of conditions identified using only PC versus only HI data was significantly higher for 37/47 and significantly lower for 10/47: the highest PC/HI ratio was for depression (14.2 [95% CI 14.1-14.4]) and the lowest for aneurysm (0.51 [95% CI 0.5-0.5]). Agreement in ascertainment of conditions between the two data sources varied considerably, being slight for five (kappa < 0.20), fair for 12 (kappa 0.21-0.40), moderate for 16 (kappa 0.41-0.60), and substantial for 12 (kappa 0.61-0.80) conditions, and by body system was lowest for mental and behavioural disorders. The percentage agreement, individuals with a condition identified in both PC and HI data, was lowest in anxiety (4.6%) and highest in coronary artery disease (62.9%).
conclusionsThe use of single data sources may underestimate prevalence when measuring multimorbidity and many important conditions (especially mental and behavioural disorders). Caution should be used when interpreting findings of research examining individual and multiple long-term conditions using single data sources. Where available, researchers using electronic health data should link primary care and hospital inpatient data to generate more robust evidence to support evidence-based healthcare planning decisions for people with multimorbidity.
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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.