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Proposal to add type_concepts for lab Measurements

Vocabulary Users
#1

@aostropolets and I propose to add 4 values to the Measurement Type concepts where vocabulary_id and concept_class_id = “Meas Type”

We would like to represent:

collected: collected, but no result yet
completed: test completed, but not “final” could be waiting on verification
Final/read/verified: I’m open to naming conventions here, but the representation of the concept would be a final reading of a test

The current values: From physical examination, Derived value, Test ordered through EHR, Lab result, Pathology finding, and Patient reported value.

Use cases:

  1. [quote=“aostropolets, post:3, topic:4083”]
    we put all tests into Measurement table. If a record has no result we thereby know that those tests were either ordered or collected but the result never came back to the clinic.
    [/quote]

  2. We do daily, incremental data loads from our EHR. Our tests are in every stage: ordered, collected, completed, and final/verified. We need to distinguish between the different stages.

We would like community feedback before bringing this to the Themis WG on Thursday

1 Like
CPT4 Observations
#2

@MPhilofsky I’m late to the party and I’m not sure where this proposal is at but…

I think this highlights an issue within the CDM where additional details are squeezed into the type concepts which, as I understand it, are meant only to specify “what source the information was drawn or inferred from”. Most of the domains have a set of type concepts that fit this mold but a few exceptions (i.e. condition and death) make this confusing:

  • current death type : source type + underlying/immediate/contributory
  • current condition type : source type + inpatient/outpatient + header/detail + position + primary/secondary (yikes)

I believe it’s on the THEMIS agenda to clean these up?

My vote would be to follow a similar approach to how conditions were further qualified using condition_status_concept_id (admitting vs. discharge vs. preliminary diagnosis) and that we add a new column, let’s say measurement_status_concept_id, to store the status information. Adding the status of the measurement to the meas_type concept class would not allow us to retain both the source (e.g. ‘test ordered through EHR’) and the status (e.g. ‘collected’) in a single measurement record unless we adopted the approach used in condition types and created a concept for every combination.

#3

@rtmill,

Great ideas are never too late! Yes, this was on the Themis agenda, but didn’t get a conclusion because it wasn’t ready with a good proposal.

I like your idea. Adding these values to a “status” column would satisfy our use cases. We get a few utilization of care, improved care models, etc. requests for our data. The Provider “ordered” the lab, the person had the lab “drawn/collected”, the lab test was “completed”, the lab test was “verified/read/final” result (blood cultures).

#4

@MPhilofsky, @aostropolets, @rtmill:

Make a proposal and hand to @clairblacketer, please please.

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