TY - JOUR
T1 - More than two-dozen prescription drug-based risk scores are available for risk adjustment
T2 - A systematic review
AU - Mehta, Hemalkumar B.
AU - Wang, Lin
AU - Malagaris, Ioannis
AU - Duan, Yanjun
AU - Rosman, Lori
AU - Alexander, G. Caleb
N1 - Funding Information:
Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2021/9
Y1 - 2021/9
N2 - Objective: While several prescription drug-based risk indices have been developed, their design, performance, and application has not previously been synthesized. Study design and setting: We searched Ovid MEDLINE, CINAHL and Embase from inception through March 3, 2020 and included studies that developed or updated a prescription drug-based risk index. Two reviewers independently performed screening and extracted information on data source, study population, cohort sizes, outcomes, study methodology and performance. Predictive performance was evaluated using C statistics for binary outcomes and R2 for continuous outcomes. The PROSPERO ID for this review is CRD42020165498. Results: Of 19,112 articles that were retrieved, 124 were full-text screened and 25 were included, each of which represented a de novo or updated drug-based index. The indices were customized to varied age groups and clinical populations and most commonly evaluated outcomes including mortality (36%), hospitalization (24%) and healthcare costs (24%). C statistics ranged from 0.62 to 0.92 for mortality and 0.59 to 0.72 for hospitalization, while adjusted R2 for healthcare costs ranged from 0.06 to 0.62. Seven of the 25 risk indices included used global drug classification algorithms. Conclusions: More than two-dozen prescription drug-based risk indices have been developed and they differ significantly in design, performance and application.
AB - Objective: While several prescription drug-based risk indices have been developed, their design, performance, and application has not previously been synthesized. Study design and setting: We searched Ovid MEDLINE, CINAHL and Embase from inception through March 3, 2020 and included studies that developed or updated a prescription drug-based risk index. Two reviewers independently performed screening and extracted information on data source, study population, cohort sizes, outcomes, study methodology and performance. Predictive performance was evaluated using C statistics for binary outcomes and R2 for continuous outcomes. The PROSPERO ID for this review is CRD42020165498. Results: Of 19,112 articles that were retrieved, 124 were full-text screened and 25 were included, each of which represented a de novo or updated drug-based index. The indices were customized to varied age groups and clinical populations and most commonly evaluated outcomes including mortality (36%), hospitalization (24%) and healthcare costs (24%). C statistics ranged from 0.62 to 0.92 for mortality and 0.59 to 0.72 for hospitalization, while adjusted R2 for healthcare costs ranged from 0.06 to 0.62. Seven of the 25 risk indices included used global drug classification algorithms. Conclusions: More than two-dozen prescription drug-based risk indices have been developed and they differ significantly in design, performance and application.
KW - Administrative healthcare data
KW - Comorbidity scores
KW - Pharmacy data
KW - Prescription drugs
KW - Risk index
KW - Systematic review
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U2 - 10.1016/j.jclinepi.2021.03.029
DO - 10.1016/j.jclinepi.2021.03.029
M3 - Review article
C2 - 33838274
AN - SCOPUS:85110409330
VL - 137
SP - 113
EP - 125
JO - Journal of Chronic Diseases
JF - Journal of Chronic Diseases
SN - 0895-4356
ER -