• Tony Antoniou, Ryan Ng, Richard H Glazier, Alexander Kopp, and Peter C Austin.
• Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Ontario, Canada; The Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. Electronic address: tantoniou@smh.ca.
• Ann Epidemiol. 2014 Jul 1; 24 (7): 532-7.

PurposeWe compared the John's Hopkins' Aggregated Diagnosis Groups (ADGs), which are derived using inpatient and outpatient records, with the hospital record-derived Charlson and Elixhauser comorbidity indices for predicting outcomes in human immunodeficiency virus (HIV)-infected patients.MethodsWe used a validated algorithm to identify HIV-infected adults (n = 14,313) in Ontario, Canada, and randomly divided the sample into derivation and validation samples 100 times. The primary outcome was all-cause mortality within 1 year, and secondary outcomes included hospital admission and all-cause mortality within 1-2 years.ResultsThe ADG, Elixhauser, and Charlson methods had comparable discriminative performance for predicting 1-year mortality, with median c-statistics of 0.785, 0.767, and 0.788, respectively, across the 100 validation samples. All methods had lower predictive accuracy for all-cause mortality within 1-2 years. For hospital admission, the ADG method had greater discriminative performance than either the Elixhauser or Charlson methods, with median c-statistics of 0.727, 0.678, and 0.668, respectively. All models displayed poor calibration for each outcome.ConclusionsIn patients with HIV, the ADG, Charlson, and Elixhauser methods are comparable for predicting 1-year mortality. However, poor calibration limits the use of these methods for provider profiling and clinical application.Copyright © 2014 Elsevier Inc. All rights reserved.

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