The DOI matches its Crossref record; 53 of the 53 references it cites were found in a registry or an index.
The development of a comorbidity index with physical function as the outcome
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.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“We measured co-morbidities that are included in the Functional Co-morbidity Index (9) and have previously been reported to be highly correlated to the physical function component of the SF-36.(10)”
From Urinary incontinence and disability in community-dwelling women: A cross-sectional study: Urinary Incontinence and Disability in Ambulatory Women (2015) · cites this paper as [9]
Citations
Cites
Charlson, M. E., Pompei, P., Ales, K. L., & MacKenzie, C. R. (1987) · Journal of Chronic Diseases · doi:10.1016/0021-9681(87)90171-8 · Cited by 49,742
(1992) · PubMed · Cited by 33,716
SF-36 health survey: Manual and interpretation guide
Ware, J. (2003) · Medical Entomology and Zoology · Cited by 11,424
Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases
DEYO, R. (1992) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(92)90133-8 · Cited by 10,452
Comorbidity measures for use with administrative data.
Elixhauser, A., Steiner, C., Harris, D. R., & Coffey, R. M. (1998) · Medical Care · doi:10.1097/00005650-199801000-00004 · Cited by 9,921
Health Measurement Scales: A Practical Guide to Their Development and Use
Streiner, D. L., Norman, G. R., & Cairney, J. (1989) · Cited by 9,595
Population-Based Norms for the Mini-Mental State Examination by Age and Educational Level
Crum, R. M. (1993) · JAMA · doi:10.1001/jama.1993.03500180078038 · Cited by 2,958
CUMULATIVE ILLNESS RATING SCALE
Linn, B. S., Linn, M. W., & Gurel, L. (1968) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1968.tb02103.x · Cited by 2,332
Stuck, A. E., Walthert, J. M., Nikolaus, T., Büla, C., Hohmann, C., & Beck, J. C. (1999) · Social Science & Medicine · doi:10.1016/s0277-9536(98)00370-0 · Cited by 1,887
Development of a comorbidity index using physician claims data
Klabunde, C. N., Potosky, A. L., Legler, J. M., & Warren, J. L. (2000) · Journal of Clinical Epidemiology · doi:10.1016/s0895-4356(00)00256-0 · Cited by 1,846
Romano, P. S., Roos, L. L., & Jollis, J. G. (1993) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(93)90103-8 · Cited by 1,717
Comorbidity and functional status are independent in older cancer patients.
Extermann, M., Overcash, J. A., Lyman, G. H., Parr, J., & Balducci, L. (1998) · Journal of Clinical Oncology · doi:10.1200/jco.1998.16.4.1582 · Cited by 986
A chronic disease score from automated pharmacy data
Korff, M. V., Wagner, E. H., & Saunders, K. W. (1992) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(92)90016-g · Cited by 962
Causes and consequences of comorbidity
Gijsen, R., Hoeymans, N., Schellevis, F. G., Ruwaard, D., Satariano, W. A., & van den Bos, G. A. M. (2001) · Journal of Clinical Epidemiology · doi:10.1016/s0895-4356(00)00363-2 · Cited by 962
Risk Adjustment for Measuring Healthcare Outcomes
Iezzoni, L. I. (1994) · Cited by 950
Repetto, L., Fratino, L., Audisio, R. A., Venturino, A., Gianni, W., Vercelli, M., Parodi, S., Lago, D. D., Gioia, F., Monfardini, S., et al. (2002) · Journal of Clinical Oncology · doi:10.1200/jco.20.2.494 · Cited by 912
MORGAN, D. E. (1998) · Sage eBooks · doi:10.4135/9781483328171 · Cited by 862
The Effect of Comorbidity on 3-Year Survival of Women with Primary Breast Cancer
Satariano, W. A., & Ragland, D. R. (1994) · Annals of Internal Medicine · doi:10.7326/0003-4819-120-2-199401150-00002 · Cited by 739
Walter, L. C. (2001) · JAMA · doi:10.1001/jama.285.23.2987 · Cited by 673
The importance of classifying initial co-morbidity in evaluating the outcome of diabetes mellitus
Kaplan, M. H., & Feinstein, A. R. (1974) · Journal of Chronic Diseases · doi:10.1016/0021-9681(74)90017-4 · Cited by 668
Berkman, L. F., Seeman, T. E., Albert, M., Blazer, D. G., Kahn, R. L., Mohs, R. C., Finch, C. E., Schneider, E. L., Cotman, C. W., McClearn, G. E., et al. (1993) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(93)90112-e · Cited by 499
Greenfield, S., Apolone, G., McNeil, B. J., & Cleary, P. D. (1993) · Medical Care · doi:10.1097/00005650-199302000-00005 · Cited by 492
Beaton, D. E., Hogg‐Johnson, S., & Bombardier, C. (1997) · Journal of Clinical Epidemiology · doi:10.1016/s0895-4356(96)00296-x · Cited by 406
Self-citationImportance of Comorbidity in Head and Neck Cancer
Piccirillo, J. F. (2000) · The Laryngoscope · doi:10.1097/00005537-200004000-00011 · Cited by 398
Seven chronic conditions: their impact on US adults' activity levels and use of medical services
Verbrugge, L. M., & Patrick, D. L. (1995) · American Journal of Public Health · doi:10.2105/ajph.85.2.173 · Cited by 356
Lingard, E. A., Katz, J. N., Wright, R. J., Wright, E. A., & Sledge, C. B. (2001) · Journal of Bone and Joint Surgery · doi:10.2106/00004623-200112000-00014 · Cited by 335
Predictors of successful aging: a twelve-year study of Manitoba elderly.
Roos, N. P., & Havens, B. (1991) · American Journal of Public Health · doi:10.2105/ajph.81.1.63 · Cited by 286
Bombardier, C., Melfi, C. A., Paul, J., Green, R., HAWKER, G. A., Wright, J. G., & Coyte, P. C. (1995) · PubMed · Cited by 262
Self-citationPhysical disability in older adults: A physiological approach
Fried, L. P., Ettinger, W. H., Lind, B. K., Newman, A. B., & Gardin, J. M. (1994) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(94)90172-4 · Cited by 244
The Impact of Spinal Problems on the Health Status of Patients
Fanuele, J. C., Birkmeyer, N. J. O., Abdu, W. A., Tosteson, T. D., & Weinstein, J. N. (2000) · Spine · doi:10.1097/00007632-200006150-00009 · Cited by 229
Research Notes: The Canadian Multicentre Osteoporosis Study (CaMos): Background, Rationale, Methods
Kreiger, N., Tenenhouse, A., Joseph, L., MacKenzie, T. C., Poliquin, S., Brown, J. P., Prior, J. C., & Rittmaster, R. S. (1999) · Canadian Journal on Aging / La Revue canadienne du vieillissement · doi:10.1017/s0714980800009934 · Cited by 220
Geriatric Index of Comorbidity: validation and comparison with other measures of comorbidity
Rozzini, R. (2002) · Age and Ageing · doi:10.1093/ageing/31.4.277 · Cited by 220
Lyketsos, C. G., Galik, E. M., Steele, C., Steinberg, M., Rosenblatt, A., Warren, A., Leoutsakos, J., Baker, A. S., & Brandt, J. (1999) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1999.tb07245.x · Cited by 182
Risk factors for disability among U.S. adults with arthritis
Verbrugge, L. M., GATES, D. M., & Ike, R. W. (1991) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(91)90264-a · Cited by 178
Development of a New Head and Neck Cancer–Specific Comorbidity Index
Piccirillo, J. F., Lacy, P. D., Basu, A., & Spitznagel, E. L. (2002) · Archives of Otolaryngology - Head and Neck Surgery · doi:10.1001/archotol.128.10.1172 · Cited by 177
Validation of case-mix measures derived from self-reports of diagnoses and health
Fan, V. S., Au, D. H., Heagerty, P. J., Deyo, R. A., McDonell, M. B., & Fihn, S. D. (2002) · Journal of Clinical Epidemiology · doi:10.1016/s0895-4356(01)00493-0 · Cited by 164
The effect of medical conditions on the functional limitations of Mexican-American elderly
Markides, K. S., Stroup‐Benham, C. A., Goodwin, J. S., Perkowski, L. C., Lichtenstein, M. J., & Ray, L. A. (1996) · Annals of Epidemiology · doi:10.1016/s1047-2797(96)00061-0 · Cited by 134
A Comprehensive Prognostic Index to Predict Survival Based on Multiple Comorbidities
Fleming, S. T., Rastogi, A., Dmitrienko, A. A., & Johnson, K. D. (1999) · Medical Care · doi:10.1097/00005650-199906000-00009 · Cited by 118
Incalzi, R. A., Capparella, O., Gemma, A., Landi, F., BRUNO, E., MEO, F. D., & Carbonin, P. (1997) · Journal of Internal Medicine · doi:10.1046/j.1365-2796.1997.00132.x · Cited by 112
Fuchs, Z., Blumstein, T., Novikov, I., Walter‐Ginzburg, A., Lyanders, M., Gindin, J., Habot, B., & Modan, B. (1998) · The Journals of Gerontology Series A · doi:10.1093/gerona/53a.6.m447 · Cited by 108
Survival in Patients With End-Stage Renal Disease
Wright, L. F. (1991) · American Journal of Kidney Diseases · doi:10.1016/s0272-6386(12)80245-9 · Cited by 104
Incidence of Functional Decline and Improvement in a Community-dwelling, Very Elderly Population
Hébert, R., Brayne, C., & Spiegelhalter, D. J. (1997) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a009053 · Cited by 102
[Comorbidity indexes: review of the literature and application to studies of elderly population].
Harboun, M., & Ankri, J. (2001) · PubMed · Cited by 85
Desai, M. M., Bogardus, S. T., Williams, C. S., Vitagliano, G., & Inouye, S. K. (2002) · Journal of the American Geriatrics Society · doi:10.1046/j.1532-5415.2002.50113.x · Cited by 75
A New Casemix Adjustment Index for Hospital Mortality Among Patients With Congestive Heart Failure
Polanczyk, C. A., Rohde, L. E. P., Philbin, E. A., & Salvo, T. G. D. (1998) · Medical Care · doi:10.1097/00005650-199810000-00007 · Cited by 71
Changes in Functional Ability from Ages 70 to 75
Avlund, K., Davidsen, M., & Schultz‐Larsen, K. (1995) · Journal of Aging and Health · doi:10.1177/089826439500700205 · Cited by 65
Comorbidity-Adjusted Complication Risk
Brailer, D. J., Kroch, E. A., Pauly, M. V., & Huang, J. (1996) · Medical Care · doi:10.1097/00005650-199605000-00010 · Cited by 60
The Comorbidity Symptom Scale: A Combined Disease Inventory and Assessment of Symptom Severity
Crabtree, H. L., Gray, C., Hildreth, A. J., O’Connell, J., & Brown, J. (2000) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2000.tb03882.x · Cited by 56
Predictors of disability in elderly finnish men—A longitudinal study
Lammi, U., Kivelä, S., Nissinen, A. M., Punsar, S., Puska, P., & Karvonen, M. (1989) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(89)90120-0 · Cited by 55
COMORBIDITIES IN STROKE PATIENTS AS ASSESSED WITH A NEWLY DEVELOPED COMORBIDITY SCALE1
Liu, M., Tsuji, T., 辻内, 和., & Chino, N. (1999) · American Journal of Physical Medicine & Rehabilitation · doi:10.1097/00002060-199909000-00004 · Cited by 53
Normand, S. T., Morris, C. N., Fung, K., McNeil, B. J., & Epstein, A. M. (1995) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(94)00126-b · Cited by 51
Morbidity and Comorbidity Among Great Lakes American Indians: Predictors of Functional Ability
Chapleski, E. E., Lichtenberg, P. A., Dwyer, J. W., Youngblade, L., & Tsai, P.-H. (1997) · The Gerontologist · doi:10.1093/geront/37.5.588 · Cited by 34
Kishimoto, M., Ojima, T., Nakamura, Y., Yanagawa, H., Fujita, Y., Kasagi, F., Kodama, K., Ueda, K., Suzuki, S., & Kagamimori, S. (1998) · Journal of Epidemiology · doi:10.2188/jea.8.272 · Cited by 25
Cited by
Sorted by citations
Risk of Cardiovascular Disease in Patients with Nonalcoholic Fatty Liver Disease
Targher, G., Day, C. P., & Bonora, E. (2010) · New England Journal of Medicine · doi:10.1056/nejmra0912063 · Cited by 1,907
Nagamatsu, L. S., Chan, A., Davis, J. C., Beattie, B. L., Graf, P., Voss, M. W., Sharma, D., & Liu-Ambrose, T. Y. L. (2013) · Journal of Aging Research · doi:10.1155/2013/861893 · Cited by 1,090
Diederichs, C., Berger, K., & Bartels, D. B. (2011) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/glq208 · Cited by 693
Huntley, A. L., Johnson, R., Purdy, S., Valderas, J. M., & Salisbury, C. (2012) · The Annals of Family Medicine · doi:10.1370/afm.1363 · Cited by 619
Physical Complications in Acute Lung Injury Survivors: A Two-Year Longitudinal Prospective Study
Fan, E., Dowdy, D. W., Colantuoni, E., Mendez-Tellez, P. A., Sevransky, J. E., Shanholtz, C., Dennison Himmelfarb, C. R., Desai, S. V., Ciesla, N., Herridge, M. S., et al. (2014) · Critical Care Medicine · doi:10.1097/ccm.0000000000000040 · Cited by 615
Metadata
- 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 › 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review