Development and validation of the Anticholinergic Medication Index (ACMI), CY P03 20 02

To Develop a validated ACMI, including algorithm for wider implementation. Our initial model will include equally weighted candidate AC medications, based on our literature reviews. The regression model will be flexible parametric survival to produce outcome risks by 12 months, accounting for competing events (e.g. mortality). We will adjust for potential overfitting using a global shrinkage factor estimated by bootstrapping, and will use penalisation via elastic net if variable selection is considered important for parsimony. Internal validation will use bootstrapping of the entire development dataset, and optimism-adjusted estimates of predictive performance produced for calibration (e.g. calibration-in-the-large, calibration slope, Observed/Expected), discrimination (e.g. C-statistic) and overall (e.g. Nagelkerke R2) performance of predicted risks. We will evaluate performance of the model in subgroups of patients stratified by frailty level (mild, moderate, severe frailty) using the electronic frailty index (eFI).

01/05/2020

5 years