R Package for Pediatric Complex Chronic Condition Classification

R Package for Pediatric Complex Chronic Condition Classification

Gordon LB; Shappell H; Massaro J; D'Agostino Sr RB; Brazier J; Campbell SE; Kleinman ME; Kieran MW

JAMA.

2018

Identification of children with complex chronic conditions (CCCs) is necessary to improve health care delivery and perform clinical research, because this patient population uses significant inpatient and outpatient medical resources.1 The original CCC classification was published in 2000.2 A second version was published in 2014 to reflect additions to the International Classification of Diseases system and the US adoption of the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision.3 The CCC classification is widely used in research (currently cited in more than 100 peer-reviewed journal publications). However, the current approach to assigning the CCC categories in health care–related data sets is limited by proprietary software and computational inefficiency. SAS and Stata software to assign CCC categories were published as appendices to the 2014 update,3 but not all investigators have access to these statistical packages. In addition, increasingly large data sets are available to investigators. Although the data processing capability of individual computers continues to improve, the SAS and Stata software can take significant time to run on data sets with millions of observations. The objective of this project was to develop computationally efficient software to generate the CCC categories using R, a free, open-source statistical environment.4 We then compared the SAS, Stata, and R software with respect to accuracy and speed of classification on a typical desktop system.

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July 2018 List