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- Improving the Performance of Risk-adjusted Mortality Modeling for Colorectal Cancer Surgery by Combining Claims Data and Clinical Data
- Won Mo Jang, Jae-Hyun Park, Jong-Hyock Park, Jae Hwan Oh, Yoon Kim
- J Prev Med Public Health. 2013;46(2):74-81. Published online March 28, 2013
- DOI: https://doi.org/10.3961/jpmph.2013.46.2.74
- 9,377 View
- 75 Download
- 6 Crossref
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Abstract
PDF Objectives The objective of this study was to evaluate the performance of risk-adjusted mortality models for colorectal cancer surgery.
Methods We investigated patients (n=652) who had undergone colorectal cancer surgery (colectomy, colectomy of the rectum and sigmoid colon, total colectomy, total proctectomy) at five teaching hospitals during 2008. Mortality was defined as 30-day or in-hospital surgical mortality. Risk-adjusted mortality models were constructed using claims data (basic model) with the addition of TNM staging (TNM model), physiological data (physiological model), surgical data (surgical model), or all clinical data (composite model). Multiple logistic regression analysis was performed to develop the risk-adjustment models. To compare the performance of the models, both
c -statistics using Hanley-McNeil pair-wise testing and the ratio of the observed to the expected mortality within quartiles of mortality risk were evaluated to assess the abilities of discrimination and calibration.Results The physiological model (
c =0.92), surgical model (c =0.92), and composite model (c =0.93) displayed a similar improvement in discrimination, whereas the TNM model (c =0.87) displayed little improvement over the basic model (c =0.86). The discriminatory power of the models did not differ by the Hanley-McNeil test (p >0.05). Within each quartile of mortality, the composite and surgical models displayed an expected mortality ratio close to 1.Conclusions The addition of clinical data to claims data efficiently enhances the performance of the risk-adjusted postoperative mortality models in colorectal cancer surgery. We recommended that the performance of models should be evaluated through both discrimination and calibration.
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Summary
Citations
Citations to this article as recorded by
- Estimating postoperative mortality in colorectal surgery- a systematic review of risk prediction models
Alexios Dosis, Jack Helliwell, Aron Syversen, Jim Tiernan, Zhiqiang Zhang, David Jayne
International Journal of Colorectal Disease.2023;[Epub] CrossRef - Modified Tumor Budding as a Better Predictor of Lymph Node Metastasis in Early Gastric Cancer: Possible Real-World Applications
Kwangil Yim, Won Mo Jang, Sung Hak Lee
Cancers.2021; 13(14): 3405. CrossRef - Investigación epidemiológica en cáncer colorrectal: perspectiva, prospectiva y retos bajo la óptica de explotación del Big-Data
J.M. García Torrecillas, M. Ferrer Márquez, Á. Reina Duarte, F. Rubio-Gil
SEMERGEN - Medicina de Familia.2016; 42(8): 509. CrossRef - Variation between Hospitals with Regard to Diagnostic Practice, Coding Accuracy, and Case-Mix. A Retrospective Validation Study of Administrative Data versus Medical Records for Estimating 30-Day Mortality after Hip Fracture
Jon Helgeland, Doris Tove Kristoffersen, Katrine Damgaard Skyrud, Anja Schou Lindman, Alanna M Chamberlain
PLOS ONE.2016; 11(5): e0156075. CrossRef - Model for risk adjustment of postoperative mortality in patients with colorectal cancer
K Walker, P J Finan, J H van der Meulen
British Journal of Surgery.2015; 102(3): 269. CrossRef - Problems With Public Reporting of Cancer Quality Outcomes Data
Paul Goldberg, Rena M. Conti
Journal of Oncology Practice.2014; 10(3): 215. CrossRef
- Prevalence of Musculoskeletal Symptoms Related With Activities of Daily Living and Contributing Factors in Korean Adults
- Kyusik Choi, Jae-Hyun Park, Hae-Kwan Cheong
- J Prev Med Public Health. 2013;46(1):39-49. Published online January 31, 2013
- DOI: https://doi.org/10.3961/jpmph.2013.46.1.39
- 10,619 View
- 101 Download
- 17 Crossref
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Abstract
PDF
Objectives This study aims to investigate the prevalence of musculoskeletal symptoms and factors related to daily activities in a representative Korean population.
Methods This study was based on the questions about musculoskeletal symptoms in the Korean General Social Survey 2010. The questionnaire about musculoskeletal symptoms was adopted from Korean Occupational Safety and Health Agency guide, and it includes general characteristics, characteristics of pain, work type, work intensity and a 12-item Short Form Health Survey (SF-12). We utilized the criteria of the National Institute for Occupational Safety and Health to define the prevalence of musculoskeletal symptoms. Demographic, behavioral and socioeconomic factors were analyzed using logistic regression.
Results The prevalence of musculoskeletal symptoms was 38.3%. The prevalence was higher in females, the elderly, those without health insurance, and those with a low income, low education, and occupations with a heavy workload. The prevalence by body part was highest in the back, shoulder, and knee, in that order. The physical component summary and mental component summary of the SF-12 decreased with increasing musculoskeletal symptoms.
Conclusions Musculoskeletal symptoms are very common in the general population, and related to various socio-demographic factors. These results suggest that active prevention and management of musculoskeletal symptoms is needed at a national level.
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Summary
Citations
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Journal of Bone and Joint Surgery.2020; 102(24): 2129. CrossRef - Prevalence of Musculoskeletal Pain Among Academic Staff of Mekelle University, Ethiopia
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