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

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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

DOI 10.1016/j.jclinepi.2004.10.018

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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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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
ORCID: GROLL, D
TO, T
BOMBARDIER, C
WRIGHT, J
Venue: Journal of Clinical Epidemiology
Publisher: Elsevier BV
Published: 2005-06
Volume: 58
Issue: 6
Pages: 595-602
ISSN: 0895-4356 (ISSN-L)
DOI: 10.1016/j.jclinepi.2004.10.018
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
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
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 › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › 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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The development of a comorbidity index with physical function as the outcome

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