Multifetal pregnancy after implementation of a publicly funded fertility program
Velez MP, Soule A, Gaudet L, Pudwell J, Nguyen P, Ray JG. JAMA Netw Open. 2024; 7(4):e248496. Epub 2024 Apr 25.
Purpose — We compared the John’s Hopkins’ Aggregated Diagnosis Groups (ADGs), which are derived using inpatient and outpatient records, with the hospital-record derived Charlson and Elixhauser co-morbidity indices for predicting outcomes in HIV-infected patients.
Methods — We used a validated algorithm to identify HIV-infected adults (n=14,313) in Ontario, Canada, and randomly divided the sample into derivation and validation samples 100 times. The primary outcome was all-cause mortality within one year, and secondary outcomes included hospital admission and all-cause mortality within one to two years.
Results — The ADG, Elixhauser and Charlson methods had comparable discriminative performance for predicting one-year mortality, with median c-statistics of 0.785, 0.767 and 0.788, respectively, across the 100 validation samples. All methods had lower predictive accuracy for all-cause mortality within one to two years. For hospital admission, the ADG method had greater discriminative performance than either the Elixhauser or Charlson methods, with median c-statistics of 0.727, 0.678 and 0.668, respectively. All models displayed poor calibration for each outcome.
Conclusions — In patients with HIV, the ADG, Charlson and Elixhauser methods are comparable for predicting one-year mortality. However, poor calibration limits the use of these methods for provider profiling and clinical application.
Antoniou T, Ng R, Glazier RH, Kopp A, Austin PC. Ann Epidemiol. 2014; 24(7):532-7. Epub 2014 Apr 18.
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