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External validity of the cardiovascular health study: a comparison with the Medicare population.
Tuesday,2012-11-06 12:18 America/Los_Angeles — eenright
| Title | External validity of the cardiovascular health study: a comparison with the Medicare population. |
| Publication Type | Journal Article |
| Year of Publication | 2009 |
| Authors | DiMartino, LD, Hammill, BG, Curtis, LH, Gottdiener, JS, Manolio, TA, Powe, NR, Schulman, KA |
| Journal | Med Care |
| Volume | 47 |
| Issue | 8 |
| Pagination | 916-23 |
| Date Published | 2009 Aug |
| ISSN | 1537-1948 |
| Keywords | Aged, Cardiovascular Diseases, Cohort Studies, Comorbidity, Female, Humans, Male, Medicare, Randomized Controlled Trials as Topic, Reproducibility of Results, Socioeconomic Factors, United States |
| Abstract | <p><b>BACKGROUND: </b>The Cardiovascular Health Study (CHS), a population-based prospective cohort study, has been used to identify major risk factors associated with cardiovascular disease and stroke in the elderly.</p><p><b>OBJECTIVE: </b>To assess the external validity of the CHS.</p><p><b>RESEARCH DESIGN: </b>Comparison of the CHS cohort to a national cohort of Medicare beneficiaries and to Medicare beneficiaries residing in the CHS geographic regions.</p><p><b>SUBJECTS: </b>CHS participants and a 5% sample of Medicare beneficiaries.</p><p><b>MEASURES: </b>Demographic and administrative characteristics, comorbid conditions, resource use, and mortality.</p><p><b>RESULTS: </b>Compared with both Medicare cohorts, the CHS cohort was older and included more men and African American participants. CHS participants were more likely to be enrolled in Medicare managed care than beneficiaries in the national Medicare cohort. Compared with the Medicare cohorts, mortality in the CHS was more than 40% lower at 1 year, approximately 25% lower at 5 years, and approximately 15% lower at 10 years. There were minimal differences in comorbid conditions and health care resource use.</p><p><b>CONCLUSION: </b>The CHS cohort is comparable with the Medicare population, particularly with regard to comorbid conditions and resource use, but had lower mortality. The difference in mortality may reflect the CHS recruitment strategy or volunteer bias. These findings suggest it may not be appropriate to project absolute rates of disease and outcomes based on CHS data to the entire Medicare population. However, there is no reason to expect that the relative risks associated with physiologic processes identified by CHS data would differ for nonparticipants.</p> |
| DOI | 10.1097/MLR.0b013e318197b104 |
| Alternate Journal | Med Care |
| PubMed ID | 19597373 |
| PubMed Central ID | PMC2716425 |
| Grant List | N01HC55222 / HC / NHLBI NIH HHS / United States N01 HC085086 / HC / NHLBI NIH HHS / United States N01HC85084 / HC / NHLBI NIH HHS / United States N01 HC085081 / HC / NHLBI NIH HHS / United States U01 HL080295-04 / HL / NHLBI NIH HHS / United States N01HC85080 / HC / NHLBI NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States N01 HC075150 / HC / NHLBI NIH HHS / United States N01 HC015103 / HC / NHLBI NIH HHS / United States N01 HC085083 / HC / NHLBI NIH HHS / United States N01HC85085 / HC / NHLBI NIH HHS / United States N01 HC085085 / HC / NHLBI NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States N01HC45133 / HC / NHLBI NIH HHS / United States N01 HC085082 / HC / NHLBI NIH HHS / United States N01HC85081 / HC / NHLBI NIH HHS / United States N01 HC085080 / HC / NHLBI NIH HHS / United States N01HC85079 / HC / NHLBI NIH HHS / United States N01 HC055222 / HC / NHLBI NIH HHS / United States N01HC85086 / HC / NHLBI NIH HHS / United States N01HC85082 / HC / NHLBI NIH HHS / United States N01 HC085084 / HC / NHLBI NIH HHS / United States N01HC75150 / HL / NHLBI NIH HHS / United States N01HC75150 / HC / NHLBI NIH HHS / United States N01HC15103 / HC / NHLBI NIH HHS / United States N01HC85083 / HC / NHLBI NIH HHS / United States U01HL080295 / HL / NHLBI NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States N01 HC085079 / HC / NHLBI NIH HHS / United States N01HC35129 / HC / NHLBI NIH HHS / United States N01 HC045133 / HC / NHLBI NIH HHS / United States N01 HC035129 / HC / NHLBI NIH HHS / United States |