To answer @Christian_Reich's question:
These concept_ids specifically created for Janssen's Truven Marketscan ETL, authored by @ericaVoss. The concept_ids refer to specific tables (i.e. Inpatient Detail) and columns (i.e. "primary" vs. "dx1") for that specific database. The "inpatient detail - primary" comes from the ICD9 code that is stored in the "inpatient detail" table, column "primary". "inpatient detail - 1st position" comes from the ICD9 code that is stored in the "inpatient detail" table, column "dx1". These ICD9 codes can be different and it is important to know the difference. However, these type_concept_ids are not really representative of claims in general - hence the type_concept_ids are very specific to Truven Marketscan. Since these were one of the first type_concept_ids used, users have used these type_concept_ids for variety of things. But, basically, these type_concept_ids are very data source specific, and are not representative of standard claim fields.
I do need to disagree with my my pal @Gowtham_Rao on the following quote:
After reading the description of where these type_concept_ids come from, you will now know that you cannot turn "inpatient detail - 1st position" into a "secondary diagnosis". This is referring to how Marketscan organizes data. This is not referencing the UB04 fields.
Only claim information coming from facility claims (i.e. UB 04 forms) have "primary" diagnoses. Claim documentation shows that box 67 of the UB04 form is considered the "principle diagnosis" for both inpatient and outpatient facility billing (see sections 10.3 and 10.2 of the Medicare billing manual here) Facility claims can come from inpatient facilities (i.e. acute inpatient admissions from an ER encounter) and outpatient facilities (i.e. cataract surgery) and only these claims have "primary" diagnoses fields. HOWEVER, claim information coming from physician claims (i.e. HCFA 1500 forms) do not have a "primary" diagnosis. They DO have "line diagnoses" which refer to the specific diagnosis the procedure code was paid for. Some claim datasources provide line diagnoses for procedure codes.
So for claims data, I suggest the following condition_types, since these fields are standardized from claims data:
- secondary (or "supplemental" if we want to prevent users from thinking "secondary" = "dx2")
- line diagnosis
I could debate whether to include a "patient reason" type_condition_id since there is a field on the UB04 claim form to store the ICD9/ICD10 code associated with the patient's reason for visit. But I have never seen any claim dataset available to researchers that provide those codes.
Now there seems to be some confusion as to what is stored in the type_concept_id and what is stored in the status_concept_id.
@Gowtham_Rao suggests type_concept_id should contain information related to position (i.e. primary and secondary).
@MPhilofsky suggests type_concept_id should contain EHR, Claim, and other data source provenance information.
I'm not sure what the resolution to this is.
And I'm not sure what @aostropolets means when she says "precoordinated concepts".
Sounds like we need a meeting.