Multicentric validation of a Multimorbidity Adjusted Disability Score to stratify depression-related risks using temporal disease maps

Abstract

ABSTRACTIn the EU project TRAJECTOME, we used a novel methodology to identify temporal disease maps of depression and highly prevalent co-occurring disease conditions. This information was combined with disability weights established by the Global Burden of Disease Study 2019 to create a depression-related health risk assessment tool, the Multimorbidity Adjusted Disability Score (MADS). MADS was used to stratify over one million cases from three different cohorts and evaluate the impact on utilisation of healthcare resources, mortality, pharmacological burden, healthcare expenditure and multimorbidity progression. Results indicate statistically significant associations between MADS and increased mortality rate (P <.001), heightened healthcare utilization (i.e. emergency room visits P <.001; hospitalizations P <.001; pharmaceutical prescriptions P <.001; total healthcare expenditure P <.001), and a higher risk of disease progression and incidence of new depression-related comorbidities. MADS seems to be a promising approach to predict depression-related health risk and depression’s impact on individuals and healthcare systems, which can be tested in other diseases; nevertheless, clinical validation is still necessary.