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In regards to mapping ECG and BP vocabulary


(Jihoon Yoon) #1

Hello everyone!

We, partner hospitals and our hospital, have decided it would be a great idea to start including ECG (electrocardiogram) and BP (blood pressure) data into our database. While I was working the mapping portion of the vocabulary, I noticed that there aren’t great many options that were available for me to map. I was wondering if I required specific vocabulary set from ATHENA that I did not download? Or are they not available at this moment? If so, is it possible to create new concept ID so that we can map specific terms separately?

Thank you very much for reading this, and happy Friday!

Sincerely,
Ji


(Anna Ostropolets) #2

@jyoon can you provide me with the examples of the concepts you couldn’t map?


(Manlik Kwong) #3

Hi, I am currently mapping and loading ECG data into our staging OMOP implementation at Tufts Medical Center. I have mapping for both electrocardiograph interpretation statements and measurements for the top 3 electrocardiograph companies (Philips’ 0A/0B/0C, GE’s 12SL, and the GLASGOW criteria) as well as global (ex Heart rate, PR Interval, QTc, etc) and lead level measurements (ex V2 ST J).

The approach I’ve taken is to define a new ECG vocabulary/concepts for each of manufacturer criteria and measurements, then concept_relationship entries to link those ECG concepts where possible to SNOMED and LOINC concepts. The ETL then preferentially utilize the SNOMED/LOINC concepts where available to load observations and measurements, otherwise uses the ECG vocabulary concepts.

Confirmed ECG statements that are not matched to SNOMED concepts presently go into the note table and typed accordingly so it can be easily identified as ECG notes vs EHR or other clinician notes.

Using the above - each confirmed ECG generates about 500 measurements (490) and observations (~5-10) into our OMOP database.

Happy to share our mapping.

  • MK

(Jihoon Yoon) #4

I’m sorry for the late reply, of course I’ll be more than happy to provide examples.

Some of the examples where I will need to map are systolic and diastolic blood pressures at different mmHg, but I don’t believe I either did not download the proper vocabulary from ATHENA, or the specific mmHg of blood pressure is not supported yet. Other example is things such as blood pressure while sleeping and blood pressure while awake.

So if I put in couple examples:

We are currently still discussing and discuss possible solutions to mapping these problems, I’ll keep updating the solution/decision we have come up with

Sincerely,
Ji


(Jihoon Yoon) #5

@mkwong I would love to see your mapping and thank you so much for your reply.

Sincerely,
Ji


(Manlik Kwong) #6

Please shoot me an E-mail at mkwong@tuftsmedicalcenter.org and let me know what electrocardiograph you are using as there are several ECG criteria and measurements.

Note that while most if not all commercial electrocardiograph products only support the standard 12-lead, the mapping I have created supports the full 16-lead system plus vectorcardiograms (XYZ) in terms of measurements. These would fall under a custom vocabulary since SNOMED does not support 16 lead nor XYZ concepts.


(Christian Reich) #7

Friends:

Did you end up with a good EKG standard? Should we ratify it?


(Manlik Kwong) #8

Hi Christian - I have not gotten any feedback from industry regarding my proposed ECG mapping to SNOMED, LOINC, and custom mappings for those ECG observation statements and measurements not already in the standard vocabularies. I’ve been rather busy lately and have not come back to this. Would you suggest making a proposal to OHDSI and not wait for industry input? Thanks for the advice.


(Christian Reich) #9

We can always get to the industry later. So, yes, I’d do that.


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