TY - JOUR
T1 - Updating and Validating the Rheumatic Disease Comorbidity Index to Incorporate ICD-10-CM Diagnostic Codes
AU - Dolomisiewicz, Anthony
AU - Ali, Hanifah
AU - Roul, Punyasha
AU - Yang, Yangyuna
AU - Cannon, Grant W.
AU - Sauer, Brian
AU - Baker, Joshua F.
AU - Mikuls, Ted R.
AU - Michaud, Kaleb
AU - England, Bryant R.
N1 - Funding Information:
Dr. Baker's work was supported by VA Clinical Science Research & Development and Rehabilitation Research & Development (merit grants CX‐001703 and RX‐003644, respectively). Dr. Mikuls's work was supported by VA Biomedical Laboratory Research & Development (grant I01‐BX‐004660), the Department of Defense (grant PR‐200793), the Rheumatology Research Foundation, and the NIH/National Institute of General Medical Sciences (grant U54‐GM‐115458). Dr. Michaud's work was supported by the Rheumatology Research Foundation and the NIH/National Institute of General Medical Sciences (grant U54‐GM‐115458). Dr. England's work was supported by VA Clinical Science Research & Development (grant IK2‐CX‐002203).
Publisher Copyright:
© 2023 The Authors. Arthritis Care & Research published by Wiley Periodicals LLC on behalf of American College of Rheumatology. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.
PY - 2023/10
Y1 - 2023/10
N2 - Objective: To update and validate the Rheumatic Disease Comorbidity Index (RDCI) utilizing International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes. Methods: We defined ICD-9-CM (n = 1,068) and ICD-10-CM (n = 1,425) era cohorts (n = 862 in both) spanning the ICD-9-CM to ICD-10-CM transition in a multicenter, prospective rheumatoid arthritis registry. Information regarding comorbidities was collected from linked administrative data over 2-year assessment periods. An ICD-10-CM code list was generated from crosswalks and clinical expertise. ICD-9– and ICD-10–derived RDCI scores were compared using intraclass correlation coefficients (ICC). The predictive ability of the RDCI for functional status and death during follow-up was assessed using multivariable regression models and goodness-of-fit statistics (Akaike's information criterion [AIC] and quasi information criterion [QIC]) in both cohorts. Results: Mean ± SD RDCI scores were 2.93 ± 1.72 in the ICD-9-CM cohort and 2.92 ± 1.74 in the ICD-10-CM cohort. RDCI scores had substantial agreement in individuals who were in both cohorts (ICC 0.71 [95% confidence interval 0.68–0.74]). Prevalence of comorbidities was similar between cohorts with absolute differences <6%. Higher RDCI scores were associated with a greater risk of death and poorer functional status during follow-up in both cohorts. Similarly, in both cohorts, models including the RDCI score had the lowest QIC (functional status) and AIC (death) values, indicating better model performance. Conclusion: The newly proposed ICD-10-CM codes for the RDCI-generated comparable RDCI scores to those derived from ICD-9-CM codes and are highly predictive of functional status and death. The proposed ICD-10-CM codes for the RDCI can be used in rheumatic disease outcomes research spanning the ICD-10-CM era.
AB - Objective: To update and validate the Rheumatic Disease Comorbidity Index (RDCI) utilizing International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes. Methods: We defined ICD-9-CM (n = 1,068) and ICD-10-CM (n = 1,425) era cohorts (n = 862 in both) spanning the ICD-9-CM to ICD-10-CM transition in a multicenter, prospective rheumatoid arthritis registry. Information regarding comorbidities was collected from linked administrative data over 2-year assessment periods. An ICD-10-CM code list was generated from crosswalks and clinical expertise. ICD-9– and ICD-10–derived RDCI scores were compared using intraclass correlation coefficients (ICC). The predictive ability of the RDCI for functional status and death during follow-up was assessed using multivariable regression models and goodness-of-fit statistics (Akaike's information criterion [AIC] and quasi information criterion [QIC]) in both cohorts. Results: Mean ± SD RDCI scores were 2.93 ± 1.72 in the ICD-9-CM cohort and 2.92 ± 1.74 in the ICD-10-CM cohort. RDCI scores had substantial agreement in individuals who were in both cohorts (ICC 0.71 [95% confidence interval 0.68–0.74]). Prevalence of comorbidities was similar between cohorts with absolute differences <6%. Higher RDCI scores were associated with a greater risk of death and poorer functional status during follow-up in both cohorts. Similarly, in both cohorts, models including the RDCI score had the lowest QIC (functional status) and AIC (death) values, indicating better model performance. Conclusion: The newly proposed ICD-10-CM codes for the RDCI-generated comparable RDCI scores to those derived from ICD-9-CM codes and are highly predictive of functional status and death. The proposed ICD-10-CM codes for the RDCI can be used in rheumatic disease outcomes research spanning the ICD-10-CM era.
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U2 - 10.1002/acr.25116
DO - 10.1002/acr.25116
M3 - Article
C2 - 36951260
AN - SCOPUS:85153259214
SN - 2151-464X
VL - 75
SP - 2199
EP - 2206
JO - Arthritis care & research
JF - Arthritis care & research
IS - 10
ER -