Evidence map›Paper›PMID 42593349›Full record

ArticleJMIR medical informatics2026

Developing Country-Specific Charlson Comorbidity Index Mappings for Use With German Administrative Data: Methodological Comparative Study.

Piotr Paweł Sokołowski, Michael Hagmann, Máté E Maros, Gaetan Kamdje Wabo, Josefine Maria Meerjanssen, Fabian Siegel

Abstract readComparative Study
In one paragraph

Article in JMIR medical informatics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

6 authors.

Piotr Paweł SokołowskiDepartment of Biomedical Informatics, Mannheim Institute for Intelligent Systems in Medicine (MIISM), Medical Faculty Mannheim, Heidelberg University, Mannheim, Baden-Wuerttemberg, Germany.ORCID 0009-0008-1625-9419
Michael HagmannDepartment of Medical Statistics, Biomathematics and Information Processing, Medical Faculty Mannheim, Heidelberg University, Mannheim, Baden-Wuerttemberg, Germany.ORCID 0000-0001-6861-7961
Máté E MarosDepartment of Biomedical Informatics, Mannheim Institute for Intelligent Systems in Medicine (MIISM), Medical Faculty Mannheim, Heidelberg University, Mannheim, Baden-Wuerttemberg, Germany.ORCID 0000-0002-1589-8699
Gaetan Kamdje WaboDepartment of Biomedical Informatics, Mannheim Institute for Intelligent Systems in Medicine (MIISM), Medical Faculty Mannheim, Heidelberg University, Mannheim, Baden-Wuerttemberg, Germany.ORCID 0000-0002-1053-6162
Josefine Maria MeerjanssenDepartment of Biomedical Informatics, Mannheim Institute for Intelligent Systems in Medicine (MIISM), Medical Faculty Mannheim, Heidelberg University, Mannheim, Baden-Wuerttemberg, Germany.ORCID 0009-0009-6238-6758
Fabian SiegelDepartment of Biomedical Informatics, Mannheim Institute for Intelligent Systems in Medicine (MIISM), Medical Faculty Mannheim, Heidelberg University, Mannheim, Baden-Wuerttemberg, Germany.ORCID 0000-0002-9673-5030

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe Charlson Comorbidity Index (CCI) is widely used to quantify comorbidity burden in observational research. Applying it to real-world data requires accurate International Classification of Diseases-based mappings. The commonly used mapping does not reflect current German coding standards.

objectiveThis study aimed to develop year-specific mappings (2004 to 2026) based on the German modification of the International Classification of Diseases, 10th Revision (ICD-10-GM), for the CCI with an open-source implementation and compare them with the commonly used mapping.

methodsFor each year, mappings were curated via independent dual review with consensus. In 515,827 inpatient cases from a German tertiary center (2010-2024), year-appropriate mappings and the commonly used mapping were applied, and the results were pooled into 2 corresponding datasets that were subsequently compared. Agreement was assessed using the intraclass correlation coefficient (2-way mixed-effects model for absolute agreement based on single measurement), and the significance of the discordances was measured using the McNemar test.

resultsAgreement was very high; 3.1% (16,136/515,827) of cases differed. A single code was present in 48.9% (7896/16,136) of the discordant cases and was intentionally excluded in the new mappings as it was not diagnostic for the category it was assigned to. Discordant results were found in 58.8% (10/17) of the categories ("peripheral vascular disease," "mild liver disease," and "severe liver disease") being present in, respectively, 51.7% (8339/16,136), 17.4% (2813/16,136), and 16.4% (2657/16,136) of the discordant cases. After filtering the dataset to only include observations with any diagnosis of a malignant disease, 6.9% (9377/136,607) of cases differed, and 79.3% (7434/9377) of those differences were caused by the "peripheral vascular disease" category, suggesting significant discrepancies for specific research questions.

conclusionsWe provide transparent, year-specific ICD-10-GM (2004-2026) mappings and an open-source tool for CCI calculation. The mappings align with current German coding practice and enable reproducible, year-appropriate comorbidity adjustment using administrative data.

Indexed as

ComorbidityInternational Classification of DiseasesFemaleGermanyHumansMaleautomated scoringCharlson Comorbidity Indexcomorbidity mappingDeyo adaptationelectronic health recordsGermanyICD-10-GMInternational Classification of Diseases, 10th Revision, German ModificationQuan mappingreal-world datarisk adjustment

Identifiers

PMID42593349
PMCPMC13586706

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.