PDF(Pubmed)
Abstract：
UNASSIGNED: Identifying clusters of co-occurring diseases may help characterise distinct phenotypes of Multiple Long-Term Conditions (MLTC). Understanding the associations of disease clusters with health-related outcomes requires a strategy to assign clusters to people, but it is unclear how the performance of strategies compare.
UNASSIGNED: First, to compare the performance of methods of assigning disease clusters to people at explaining mortality, emergency department attendances and hospital admissions over one year. Second, to identify the extent of variation in the associations with each outcome between and within clusters.
UNASSIGNED: We conducted a cohort study of primary care electronic health records in England, including adults with MLTC. Seven strategies were tested to assign patients to fifteen disease clusters representing 212 LTCs, identified from our previous work. We tested the performance of each strategy at explaining associations with the three outcomes over 1 year using logistic regression and compared to a strategy using the individual LTCs.
UNASSIGNED: 6,286,233 patients with MLTC were included. Of the seven strategies tested, a strategy assigning the count of conditions within each cluster performed best at explaining all three outcomes but was inferior to using information on the individual LTCs. There was a larger range of effect sizes for the individual LTCs within the same cluster than there was between the clusters.
UNASSIGNED: Strategies of assigning clusters of co-occurring diseases to people were less effective at explaining health-related outcomes than a person\'s individual diseases. Furthermore, clusters did not represent consistent relationships of the LTCs within them, which might limit their application in clinical research.
UNASSIGNED: First, to compare the performance of methods of assigning disease clusters to people at explaining mortality, emergency department attendances and hospital admissions over one year. Second, to identify the extent of variation in the associations with each outcome between and within clusters.
UNASSIGNED: We conducted a cohort study of primary care electronic health records in England, including adults with MLTC. Seven strategies were tested to assign patients to fifteen disease clusters representing 212 LTCs, identified from our previous work. We tested the performance of each strategy at explaining associations with the three outcomes over 1 year using logistic regression and compared to a strategy using the individual LTCs.
UNASSIGNED: 6,286,233 patients with MLTC were included. Of the seven strategies tested, a strategy assigning the count of conditions within each cluster performed best at explaining all three outcomes but was inferior to using information on the individual LTCs. There was a larger range of effect sizes for the individual LTCs within the same cluster than there was between the clusters.
UNASSIGNED: Strategies of assigning clusters of co-occurring diseases to people were less effective at explaining health-related outcomes than a person\'s individual diseases. Furthermore, clusters did not represent consistent relationships of the LTCs within them, which might limit their application in clinical research.
摘要：
■确定共同发生的疾病簇可能有助于表征多种长期疾病（MLTC）的不同表型。了解疾病集群与健康相关结果的关联需要一种策略来将集群分配给人们。但目前还不清楚策略的表现如何比较。
■首先，为了比较在解释死亡率时将疾病集群分配给人们的方法的性能，急诊科就诊人数和住院人数超过一年。第二,以确定集群之间和集群内与每个结果的关联差异程度。
■我们对英格兰的初级保健电子健康记录进行了一项队列研究，包括患有MLTC的成年人。测试了七种策略，将患者分配到代表212个LTC的15个疾病集群，从我们以前的工作中确定。我们使用逻辑回归测试了每种策略在1年内解释与三个结果的关联的性能，并与使用单个LTC的策略进行了比较。
■纳入6,286,233例MLTC患者。在测试的七个策略中，在每个集群内分配条件计数的策略在解释所有三个结局方面表现最好,但不如使用关于单个LTC的信息.与簇之间相比,在同一簇内的个体LTC存在更大范围的效应大小。
将共同发生的疾病集群分配给人们的策略在解释与健康相关的结果方面不如一个人的个体疾病有效。此外，集群不代表其中LTC的一致关系，这可能会限制它们在临床研究中的应用。
■首先，为了比较在解释死亡率时将疾病集群分配给人们的方法的性能，急诊科就诊人数和住院人数超过一年。第二,以确定集群之间和集群内与每个结果的关联差异程度。
■我们对英格兰的初级保健电子健康记录进行了一项队列研究，包括患有MLTC的成年人。测试了七种策略，将患者分配到代表212个LTC的15个疾病集群，从我们以前的工作中确定。我们使用逻辑回归测试了每种策略在1年内解释与三个结果的关联的性能，并与使用单个LTC的策略进行了比较。
■纳入6,286,233例MLTC患者。在测试的七个策略中，在每个集群内分配条件计数的策略在解释所有三个结局方面表现最好,但不如使用关于单个LTC的信息.与簇之间相比,在同一簇内的个体LTC存在更大范围的效应大小。
将共同发生的疾病集群分配给人们的策略在解释与健康相关的结果方面不如一个人的个体疾病有效。此外，集群不代表其中LTC的一致关系，这可能会限制它们在临床研究中的应用。
