Measuring disease burden with individual cumulative incidence in patients with cirrhosis

Objective:

Introduce a new method for evaluating the health history of a patient through the use of multi-type recurrent events data that can aid in the assessment of disease progression and quality of life in a healthcare setting.

Methods:

The Disease Burden Score (DBS) is characterized as the area under the Disease Burden Curve (DBC), a monotone, increasing stepwise graph, that measures the weighted or unweighted number of health events that occur during a patient’s follow-up period (i.e. cardiovascular events or decompensation events).

Results:

The performance of our method, evaluated in simulation studies, demonstrated that our modeling method produces unbiased results and can improve power over alternatives in common biomedical research settings. The method was also applied to real data from a collection of Electronic Health Records.

Conclusion:

A DBS can be computed for all patients present in the data and thus can be used as a means of comparing subgroups and as the outcome variable in regression. This measure is not only a valuable tool in cases where death data is not available or reliable but also as an interim measurement when death is infrequent.