Effects of Longitudinal Changes in Charlson Comorbidity on Prognostic Survival Model Performance Among Newly Diagnosed Patients with Hypertension

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atmire.migration.oldid3203
dc.contributor.advisorQuan, Hude
dc.contributor.authorRymkiewicz, Peter
dc.date.accessioned2015-05-01T16:10:54Z
dc.date.available2015-06-22T07:00:49Z
dc.date.issued2015-05-01
dc.date.submitted2015en
dc.description.abstractObjectives: To assess methods of defining comorbidities by comparing risk adjusted mortality predictive model fit and performance among newly diagnosed hypertensive population. Methods: We included nearly all patients 18 year and older with an incident diagnosis of hypertension from one Canadian Province. We compared prognostic model performance for Cox regression models using Charlson comorbidities as time-invariant covariates (TIC) at baseline and time-varying covariates (TVC). Cox regression was used to calculate hazard ratios. Model fit and performance was based on the comparison of the AIC and Likelihood Ratio. Results: All Cox regression time-varying covariate models (TVCMs) outperformed time-invariant covariate (TIVMs) baseline models, based on a comparison of AIC and Likelihood Ratio, regardless of the method used to adjust for individual risk using the Charlson Comorbidities. TVCMs included all 17 Charlson comorbidities as individual independent variables showed the best fit and performance compared with similar baseline models, AIC (1,670,491 to 1,720,126) and Likelihood Ratio (112,941.72 to 63,239.78) respectively. Conclusion: Accounting for changes in patient comorbidity status over time more accurately capture a patient’s health risk and improves predictive model fit and performance over longer follow-up periods than traditional baseline method.en_US
dc.identifier.citationRymkiewicz, P. (2015). Effects of Longitudinal Changes in Charlson Comorbidity on Prognostic Survival Model Performance Among Newly Diagnosed Patients with Hypertension (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca. doi:10.11575/PRISM/25827en_US
dc.identifier.doihttp://dx.doi.org/10.11575/PRISM/25827
dc.identifier.urihttp://hdl.handle.net/11023/2209
dc.language.isoeng
dc.publisher.facultyGraduate Studies
dc.publisher.institutionUniversity of Calgaryen
dc.publisher.placeCalgaryen
dc.rightsUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.
dc.subjectEpidemiology
dc.subjectHealth Care Management
dc.subjectMedicine and Surgery
dc.subject.classificationcomorbidityen_US
dc.subject.classificationCharlson Comorbidity Indexen_US
dc.subject.classificationCCIen_US
dc.subject.classificationLongitudinalen_US
dc.subject.classificationhypertensionen_US
dc.subject.classificationSurvival Analysisen_US
dc.subject.classificationtime to eventen_US
dc.subject.classificationchange in comorbidityen_US
dc.subject.classificationlongitudinal comorbidityen_US
dc.subject.classificationtime varying covariate modelen_US
dc.subject.classificationTVCMen_US
dc.titleEffects of Longitudinal Changes in Charlson Comorbidity on Prognostic Survival Model Performance Among Newly Diagnosed Patients with Hypertension
dc.typemaster thesis
thesis.degree.disciplineCommunity Health Sciences
thesis.degree.grantorUniversity of Calgary
thesis.degree.nameMaster of Science (MSc)
ucalgary.item.requestcopytrue
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