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Reducing complexity: a visualisation of multimorbidity by combining disease clusters and triads.
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- معلومة اضافية
- المصدر:
Publisher: BioMed Central Country of Publication: England NLM ID: 100968562 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2458 (Electronic) Linking ISSN: 14712458 NLM ISO Abbreviation: BMC Public Health Subsets: MEDLINE
- بيانات النشر:
Original Publication: London : BioMed Central, [2001-
- الموضوع:
- نبذة مختصرة :
Background: Multimorbidity is highly prevalent in the elderly and relates to many adverse outcomes, such as higher mortality, increased disability and functional decline. Many studies tried to reduce the heterogeneity of multimorbidity by identifying multimorbidity clusters or disease combinations, however, the internal structure of multimorbidity clusters and the linking between disease combinations and clusters are still unknown. The aim of this study was to depict which diseases were associated with each other on person-level within the clusters and which ones were responsible for overlapping multimorbidity clusters.
Methods: The study analyses insurance claims data of the Gmünder ErsatzKasse from 2006 with 43,632 female and 54,987 male patients who were 65 years and older. The analyses are based on multimorbidity clusters from a previous study and combinations of three diseases ("triads") identified by observed/expected ratios ≥ 2 and prevalence rates ≥ 1%. In order to visualise a "disease network", an edgelist was extracted from these triads, which was analysed by network analysis and graphically linked to multimorbidity clusters.
Results: We found 57 relevant triads consisting of 31 chronic conditions with 200 disease associations ("edges") in females and 51 triads of 29 diseases with 174 edges in males. In the disease network, the cluster of cardiovascular and metabolic disorders comprised 12 of these conditions in females and 14 in males. The cluster of anxiety, depression, somatoform disorders, and pain consisted of 15 conditions in females and 12 in males.
Conclusions: We were able to show which diseases were associated with each other in our data set, to which clusters the diseases were assigned, and which diseases were responsible for overlapping clusters. The disease with the highest number of associations, and the most important mediator between diseases, was chronic low back pain. In females, depression was also associated with many other diseases. We found a multitude of associations between disorders of the metabolic syndrome of which hypertension was the most central disease. The most prominent bridges were between the metabolic syndrome and musculoskeletal disorders. Guideline developers might find our approach useful as a basis for discussing which comorbidity should be addressed.
- References:
Schmerz. 2003 Oct;17(5):359-66. (PMID: 14513343)
Diabet Med. 2006 May;23(5):469-80. (PMID: 16681555)
Spine (Phila Pa 1976). 2006 Jun 1;31(13):1491-5. (PMID: 16741460)
J Am Geriatr Soc. 2009 Feb;57(2):225-30. (PMID: 19207138)
Rheumatology (Oxford). 2008 Oct;47(10):1567-70. (PMID: 18710901)
BMJ. 1998 Dec 5;317(7172):1564-7. (PMID: 9836660)
J Clin Epidemiol. 2001 Jul;54(7):661-74. (PMID: 11438406)
BMC Public Health. 2011;11:101. (PMID: 21320345)
PLoS One. 2012;7(9):e45390. (PMID: 23028979)
Ann Fam Med. 2005 May-Jun;3(3):223-8. (PMID: 15928225)
J Clin Epidemiol. 2014 Mar;67(3):254-66. (PMID: 24472295)
J Manipulative Physiol Ther. 2003 May;26(4):243-52. (PMID: 12750659)
Gesundheitswesen. 2009 Dec;71(12):823-31. (PMID: 19387933)
Am J Epidemiol. 2010 Jan 15;171(2):135-54. (PMID: 20007994)
PLoS One. 2010;5(12):e15941. (PMID: 21209965)
Popul Health Metr. 2011 Jun 02;9(1):15. (PMID: 21635787)
J Clin Epidemiol. 2013 Feb;66(2):209-17. (PMID: 23257152)
Am J Epidemiol. 1994 Jan 15;139(2):119-29. (PMID: 8296779)
Ageing Res Rev. 2011 Sep;10(4):430-9. (PMID: 21402176)
Eur J Gen Pract. 2008;14 Suppl 1:28-32. (PMID: 18949641)
Scand J Rheumatol. 2001;30(3):169-71. (PMID: 11469529)
Eur Respir J. 2008 Oct;32(4):962-9. (PMID: 18579551)
Phys Ther. 2008 Nov;88(11):1254-64. (PMID: 18801858)
Arch Fam Med. 1997 Jan-Feb;6(1):43-9. (PMID: 9003169)
Br J Psychiatry. 2000 Dec;177:486-92. (PMID: 11102321)
Pain Physician. 2000 Apr;3(2):167-92. (PMID: 16906196)
Circulation. 2002 May 7;105(18):e132-7. (PMID: 11994263)
- الموضوع:
Date Created: 20141218 Date Completed: 20150914 Latest Revision: 20220408
- الموضوع:
20240628
- الرقم المعرف:
PMC4301832
- الرقم المعرف:
10.1186/1471-2458-14-1285
- الرقم المعرف:
25516155
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