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    Investigation of the international comparability of population-based routine hospital data set derived comorbidity scores for patients with lung cancer

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    Author
    Luchtenborg, M; Morris, EJA; Tataru, D; Coupland, VH; Smith, A; Milne, RL; te Marvelde, L; Baker, D; Young, J; Turner, D; ...
    Date
    2018-04-01
    Source Title
    Thorax
    Publisher
    BMJ PUBLISHING GROUP
    University of Melbourne Author/s
    Milne, Roger
    Affiliation
    Melbourne School of Population and Global Health
    Metadata
    Show full item record
    Document Type
    Journal Article
    Citations
    Luchtenborg, M., Morris, E. J. A., Tataru, D., Coupland, V. H., Smith, A., Milne, R. L., te Marvelde, L., Baker, D., Young, J., Turner, D., Nishri, D., Earle, C., Shack, L., Gavin, A., Fitzpatrick, D., Donnelly, C., Lin, Y., Moller, B., Brewster, D. H. ,... Peake, M. D. (2018). Investigation of the international comparability of population-based routine hospital data set derived comorbidity scores for patients with lung cancer. THORAX, 73 (4), pp.339-349. https://doi.org/10.1136/thoraxjnl-2017-210362.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/257416
    DOI
    10.1136/thoraxjnl-2017-210362
    Abstract
    INTRODUCTION: The International Cancer Benchmarking Partnership (ICBP) identified significant international differences in lung cancer survival. Differing levels of comorbid disease across ICBP countries has been suggested as a potential explanation of this variation but, to date, no studies have quantified its impact. This study investigated whether comparable, robust comorbidity scores can be derived from the different routine population-based cancer data sets available in the ICBP jurisdictions and, if so, use them to quantify international variation in comorbidity and determine its influence on outcome. METHODS: Linked population-based lung cancer registry and hospital discharge data sets were acquired from nine ICBP jurisdictions in Australia, Canada, Norway and the UK providing a study population of 233 981 individuals. For each person in this cohort Charlson, Elixhauser and inpatient bed day Comorbidity Scores were derived relating to the 4-36 months prior to their lung cancer diagnosis. The scores were then compared to assess their validity and feasibility of use in international survival comparisons. RESULTS: It was feasible to generate the three comorbidity scores for each jurisdiction, which were found to have good content, face and concurrent validity. Predictive validity was limited and there was evidence that the reliability was questionable. CONCLUSION: The results presented here indicate that interjurisdictional comparability of recorded comorbidity was limited due to probable differences in coding and hospital admission practices in each area. Before the contribution of comorbidity on international differences in cancer survival can be investigated an internationally harmonised comorbidity index is required.

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