This document was added or updated on 20/03/2015.

BIOMEDICAL COMORBIDITY

In order to facilitate research into the presence of more than one condition, several comorbidity data items have been created.  These data items cover a range of conditions and have been calculated for a range of files and for both self reported conditions and conditions based on biomedical data. For information on Self Report Comorbidity data items, refer to the Self report comorbidity page of this Users' Guide.

Biomedical comorbidity data items cover Diabetes, Chronic Kidney Disease (CKD) and Cardiovascular Disease (CVD).

Diabetes (HbA1c, FPG) and Chronic Kidney disease (CKD) were determined using biomedical test results. Cardiovascular Disease (CVD) was determined using self report data from the ICD10-Classification (NATSIHS) or ICD10-Mini Classification (AATSIHS/NATSINPAS).

The data items available are:

• Comorbidity (Biomedical) - HBA1C (incl. Diabetes HbA1c, CKD, CVD)
• Comorbidity (Biomedical) - FPG (incl. Diabetes FPG, CKD, CVD)

The following section outlines for each biomedical comorbidity data item available the:

• definitions used to derive the data items
• population applicable to the data items
• methodology used to produce the data items

COMORBIDITY (BIOMEDICAL) - HBA1C

Definition

This data item is produced from the following self report and biomedical data for combinations of the following conditions:

• Cardiovascular diseases (Self-report)
• Diabetes - HbA1c (Biomedical)
• Chronic Kidney disease (Biomedical)

For the purposes of deriving this item the following definitions were used:

Cardiovascular disease

To be classified as having cardiovascular disease, the following criteria were required to be met for one or more cardiovascular conditions.

The following conditions were required to have been diagnosed and also be current and long-term (condition status 1):

• Hypertensive diseases
• Tachycardia
• Oedema
• Diseases of arteries arterioles & capillaries
• Diseases of veins lymphatic vessels etc
• Other diseases of circulatory system
• Symptoms signs involving circulatory system.

The following conditions only required diagnosis (condition status 1,2,3):

• Ischaemic heart diseases
• Other heart diseases
• Cerebrovascular diseases.

For further information on the collection of self report cardiovascular disease, refer to the Heart and circulatory conditions page of this Users' Guide.

For information on the ICD10 classifications or Condition status item used for CVD, refer to the Health Conditions page of this Users' Guide.

Diabetes - HbA1c

To be classified as having Diabetes (HbA1c), respondents needed to have known or newly diagnosed diabetes. This was determined based on the Diabetes prevalence - HbA1c (%) data item.

For information on the Diabetes prevalence derivation, refer to the Diabetes Biomarkers page of this Users' Guide.

Chronic Kidney Disease

To be classified as having Chronic Kidney Disease, respondents needed to be in stages 1 to 5. This was determined based on the Chronic Kidney Disease (CKD) stages (mL/min/1.73m2) data item.

For information on the stages of Chronic Kidney Disease, refer to the Chronic Kidney Disease (CKD) Biomarkers page of this Users' Guide.

Population

The population for this data data item are respondents aged 18 years and over who participated in the Biomedical component. This data item is available on the NATSIHS, NATSINPAS and AATSIHS files and is located on the biomedical level.

Methodology

Using the defined conditions, the following output categories were produced:

0. Not applicable
1. Diabetes (HBA1C) only
2. CKD only
3. CVD (self-report) only
4. Diabetes (HBA1C) and CKD only
5. Diabetes (HBA1C) and CVD (self-report) only
6. CKD and CVD (self-report) only
7. Diabetes (HBA1C) and CKD and CVD (self-report)
8. Does not have Diabetes (HBA1C) or CKD or CVD (self-report).

In this item each respondent is allocated to only one category. Where people had a not known status for a test result, they were treated as not having the condition.

In order to create some flexibility with the use of this item, categories 1 to 3 were produced, which contain persons with only one condition and also category 8 which contain persons with none of the conditions.

To produce frequencies based on different combinations of these conditions, users can collapse categories as required. For example, to determine those people with either Diabetes or CKD, combine categories 1,2,4,5,6 and 7. To determine those people who don't have CVD, combine categories 1,2,4 and 8.


COMORBIDITY (BIOMEDICAL) - FPG

Definition

This data item is produced from the following self report and biomedical data for combinations of the following conditions:

• Cardiovascular diseases (Self-report)
• Diabetes - FPG (Biomedical)
• Chronic Kidney disease (Biomedical)

For the purposes of deriving this item the following definitions were used:

Cardiovascular disease

To be classified as having cardiovascular disease, the following criteria was required to be met for one or more cardiovascular condition.

The following conditions were required to have been diagnosed and also be current and long-term (condition status 1):

• Hypertensive diseases
• Tachycardia
• Oedema
• Diseases of arteries arterioles & capillaries
• Diseases of veins lymphatic vessels etc
• Other diseases of circulatory system
• Symptoms signs involving circulatory system

The following conditions only required diagnosis (condition status 1,2,3):

• Ischaemic heart diseases
• Other heart diseases
• Cerebrovascular diseases

For further information on the collection of self report cardiovascular disease, refer to the Heart and circulatory conditions page of this Users' Guide.

For information on the self report ICD10 classifications or Condition status item used for CVD, refer to the Health Conditions page of this Users' Guide.

Diabetes - FPG

To be classified as having Diabetes (FPG), respondents needed to have known or newly diagnosed diabetes. This was determined based on categories 1 and 2 of the Diabetes prevalence - fasting plasma glucose (mmol/L) data item.

For information on the Diabetes prevalence derivation, refer to the Diabetes Biomarkers page of this Users' Guide.

Chronic Kidney Disease

To be classified as having Chronic Kidney Disease, respondents needed to be in stages 1 to 5. This was determined based on the Chronic Kidney Disease (CKD) stages (mL/min/1.73m2) data item.

For information on the stages of Chronic Kidney Disease, refer to the Chronic Kidney Disease (CKD) Biomarkers page of this Users' Guide.


Population

The population for this data item are respondents aged 18 years and over who participated in the Biomedical component and fasted for 8 hours or more. This data item is available on the NATSIHS, NATSINPAS and AATSIHS files and is located on the biomedical level.

Methodology

Using the defined conditions, the following output categories were produced:

0. Not applicable
1. Diabetes (FPG) only
2. CKD only
3. CVD (self-report) only
4. Diabetes (FPG) and CKD only
5. Diabetes (FPG) and CVD (self-report) only
6. CKD and CVD (self-report) only
7. Diabetes (FPG) and CKD and CVD (self-report)
8. Does not have Diabetes (FPG) or CKD or CVD (self-report)

In this item each respondent is allocated to only one category. Where people had a not known status for a test result, they were treated as not having the condition.

In order to create some flexibility with the use of this item, categories 1 to 3 were produced, which contain persons with only one condition and also category 8 which contain persons with none of the conditions.

To produce frequencies based on different combinations of these conditions, collapse categories as required. For example, to determine those people with CVD and CKD, combine categories 6 and 7. To determine those people who don't have Diabetes (FPG), combine categories 2,3,6 and 8.

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