Hello,
In the last Psychiatry Working Group meeting, we ran into the issue of how to store radiology diagnostic report in OMOP CDM. Examples of such report are below:
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Bilateral basal ganglia lacunar infarction
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Mild cerebral atrophy in bilateral medial prefrontal lobes
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White matter demyelinating
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Bilateral frontal fissure widened slightly
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Intracranial aneurysm of the left vertebral artery
Please note: these are not original CT scan finding but the diagnosis report based on CT examination. If we parse these reports, some commonality of the attributes can be seen and are listed below:
Radiology diagnostic report | Laterality | Body site | Severity | Condition/Diagnosis |
---|---|---|---|---|
Bilateral basal ganglia lacunar infarction | bilateral | basal ganglia | lacunar infarction | |
Mild cerebral atrophy in bilateral medial prefrontal lobes | bilateral | medial prefrontal lobes | mild | cerebral atrophy |
White matter demyelinating | white matter | demyelinating | ||
Bilateral frontal fissure widened slightly | bilateral | frontal fissure | slightly | widened |
Intracranial aneurysm of the left vertebral artery | left | vertebral artery | Intracranial aneurysm |
As you can see, these diagnostic reports have more granularity than what SNOMED can currently handle. Besides the condition/diagnosis, they may also include other attributes such as severity, laterality, size as well as more detail anatomy/topology. As this is similar to tumor diagnosis that has modifiers of the diagnosis, we propose to use the same mechanism (measurement table) to handle these radiology diagnostic reports just as how it is done for tumor. Specifically, load diagnosis into CONDITION_OCCURRENCE table and put other attributes (laterality, severity, size and body site etc.) into MEASUREMENT table and link them via the two modifier columns (modifier_of_event_id and modifier_of_field_concept_id)
Below displays the result of this proposal using “Mild cerebral atrophy in bilateral medial prefrontal lobes” as an example:
The idea is probably not new. Some relevant discussion can be found here and here.
Please feel free to shed any insight on this.