ArticleAging clinical and experimental research2025
A head-to-head comparison of the validity and predictive ability for health outcomes of diagnosis versus medication-based comorbidity indices.
Article in Aging clinical and experimental research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundVarious comorbidity indices have been validated for individual health outcomes. However, systematic concurrent comparisons of multiple outcome measures in a single study remain relatively underrepresented but needed for practical decision support.
aimsTo compare the performance of the Charlson Comorbidity Index (CCI) and Rx-Risk Comorbidity Index (Rx-Risk).
methodsBaseline and six-month follow-up data from n = 221 patients recruited in n = 70 practices were used. CCI and Rx-Risk scores were calculated using documented diagnoses and prescribed medications. Outcomes assessed were health-related quality of life (HRQoL, EQ-5D-5 L), functional impairment (B-ADL), cognitive decline (MMSE), and healthcare utilization (physician visits, hospitalizations). Indices performance was evaluated regarding agreement (Cohens Kappa (k)), known-groups validity (ANOVA, t-test), convergent validity (correlation coefficient (r
resultsPatients were, on average, 80 years old, mostly female (55%), with 12 diagnoses and seven medications. Agreement between both indices was poor for all conditions except diabetes (k = 0.645) and chronic airway diseases (k = 0.486). Rx-Risk differed more in known groups, especially for HRQoL and hospitalizations, and showed stronger correlations with the EQ-5D index (r
conclusionsRx-Risk demonstrated slightly superior validity and predictive ability for HRQoL and healthcare utilization, making it a promising option for studies focused on these outcomes. However, limitations regarding functional and cognitive impairment suggest alternative instruments are needed.
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