The impact table (Figure 1, page 2126) consists of 35 comorbid conditions based on the conditions listed in the National Institute on Aging (NIA) and the National Cancer Institute (NCI) Collaborative Study on Comorbidity and Early Diagnosis of Cancer in the Elderly.
A condition may be absent, active or in the past medical history.
Impacts for a condition may be high, moderate, low or negligible
where:
• Active: "under active management" in the figure caption; I assume includes any ongoing process
• History only: "no current management/history only" in caption; I assume somewhat inactive
• If a person has multiple comorbidities affecting one organ, then only one of the conditions is counted (page 2124). This would affect (a) asthma and COPD, (b) mental health and depression, (c) all of the cardiac conditions, (d) Alzheimer's and Parkinson's disease. (e) possibly thyroid/endocrine disorders and diabetes.
number of high impact conditions =
= SUM(high impact conditions present)
number of moderate impact conditions =
= SUM(moderate impact conditions present)
number of low impact conditions =
= SUM(low impact conditions present)
number of negligible impact conditions =
= SUM(negligible impact conditions present)
total number of comorbidities =
= SUM(all conditions present)
On page 2126 (second column), mention is made of a point system (high = 4, moderate =3, low =2, negligible =1, none = 0). It might be possible to multiply these factors by the number of each impact category and then sum the values into a total score.
Limitation:
• I can think of a lot of exceptions to the classification weightings. For example, (a) severe acute pancreatitis would be gastrointestinal problem with a ranking of moderate impact, (b) cirrhosis with liver failure would be a moderate condition, and (c) there is little mention for infectious diseases.
