Cited by 1,198Chronic Disease Management StrategiesMusculoskeletal pain and rehabilitationHealth Systems, Economic Evaluations, Quality of Life

The development of a comorbidity index with physical function as the outcome

GROLL, D, TO, T, BOMBARDIER, C, WRIGHT, J·2005·Journal of Clinical Epidemiology

Abstract

Background and objectives Physical function is an important measure of success of many medical and surgical interventions. Ability to adjust for comorbid disease is essential in health services research and epidemiologic studies. Current indices have primarily been developed with mortality as the outcome, and are not sensitive enough when the outcome is physical function. The objective of this study was to develop a self-administered Functional Comorbidity Index with physical function as the outcome.Methods The index was developed using two databases: a cross-sectional, simple random sample of 9,423 Canadian adults and a sample of 28,349 US adults seeking treatment for spine ailments. The primary outcome measure was the SF-36 physical function (PF) subscale.Results The Functional Comorbidity Index, an 18-item list of diagnoses, showed stronger association with physical function (model R(2) = 0.29) compared with the Charlson (model R(2) = 0.18), and Kaplan-Feinstein (model R(2) = 0.07) indices. The Functional Comorbidity Index correctly classified patients into high and low function, in 77% of cases.Conclusion This new index contains diagnoses such as arthritis not found on indices used to predict mortality, and the FCI explained more variance in PF scores compared to indices designed to predict mortality.

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Crossref · 10.1016/j.jclinepi.2004.10.018

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Authors
GROLL, D., TO, T., BOMBARDIER, C., & WRIGHT, J.
Affiliations
  • Queen's University (CA)
  • University of Toronto (CA)
  • Institute for Work & Health (CA)
Corresponding author
GROLL, D
Venue
Journal of Clinical Epidemiology
Publisher
Elsevier BV
Published
2005-06
Volume
58
Issue
6
Pages
595-602
ISSN
0895-4356 (ISSN-L)
OpenAlex
W1971721633
Cited by
1,198
References
53
Citations by year
2026: 48 · 2025: 75 · 2024: 62 · 2023: 82 · 2022: 84 · 2021: 92 · 2020: 90 · 2019: 71 · 2018: 59 · 2017: 70 · 2016: 81 · 2015: 75 · 2014: 75 · 2013: 48 · 2012: 43
FWCI
6.97
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of Clinical Epidemiology (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Health Canada
  • Canadian Arthritis Network
Topics
  • Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
Keywords
comorbidity index, physical function, Functional Comorbidity Index, SF-36 physical function, Charlson Comorbidity Index, arthritis, spinal disorders
MeSH terms
Adolescent, Adult, Aged, Aged, 80 and over, Cross-Sectional Studies, Female, Health Status Indicators, Humans, Male, Middle Aged, Osteoporosis, Spinal Diseases, Comorbidity, Databases, Factual, Outcome Assessment, Health Care, Focus Groups, Recovery of Function

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