{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T21:12:52Z","timestamp":1788469972164,"version":"build-2803163510"},"reference-count":31,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Med Inform"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The 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\u2013based mappings. The commonly used mapping does not reflect current German coding standards.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>For 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Agreement 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 (\u201cperipheral vascular disease,\u201d \u201cmild liver disease,\u201d and \u201csevere liver disease\u201d) 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 \u201cperipheral vascular disease\u201d category, suggesting significant discrepancies for specific research questions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/93923","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T14:10:06Z","timestamp":1786630206000},"page":"e93923","source":"Crossref","is-referenced-by-count":0,"title":["Developing Country-Specific Charlson Comorbidity Index Mappings for Use With German Administrative Data: Methodological Comparative Study"],"prefix":"10.2196","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-1625-9419","authenticated-orcid":false,"given":"Piotr Pawe\u0142","family":"Soko\u0142owski","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6861-7961","authenticated-orcid":false,"given":"Michael","family":"Hagmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1589-8699","authenticated-orcid":false,"given":"M\u00e1t\u00e9 E","family":"Maros","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1053-6162","authenticated-orcid":false,"given":"Gaetan","family":"Kamdje Wabo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6238-6758","authenticated-orcid":false,"given":"Josefine Maria","family":"Meerjanssen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9673-5030","authenticated-orcid":false,"given":"Fabian","family":"Siegel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"ref1","unstructured":"Real-world evidence provided by EMA: support for regulatory decision-makingEuropean Medicines Agency202404102026-01-02https:\/\/www.ema.europa.eu\/en\/documents\/other\/guide-real-world-evidence-provided-ema-support-regulatory -decision-making_en.pdf"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1007\/s40290-022-00456-6"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1159\/000521288"},{"key":"ref5","unstructured":"Prostate cancerEuropean Association of 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