@Christian_Reich has a very good proposal linked above. It covers smokeless tobacco consumption and nicotine smoking, not marijuana or other substances. Since we don’t have a lot of time during our Themis workshop, we need to be focused on a solution for nicotine.
The proposal:
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Creates a hierarchy with smoking at the top
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Covers e-cigarettes/vape pens, pipe, passive/2nd hand smoke, smokeless, etc.
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Records intensity of smoking into trivial to very heavy categories.
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Previous or ex-smoker gets relegated to “History of” category like all history of concepts
One item not covered is the “pack years” concept. There is not a standard concept_id for this idea. UK Biobank has a non-standard concept_id = 35811050. Do we make this concept standard since there isn’t a standard concept_id for this idea? Then have the observation.value_as_number contain the # of pack years? We will need to keep it outside the hierarchy because pack years can’t be determined to be trivial versus heavy because the age of a person matters. Example: 20 packyear record is a very different category for a 30yo person versus an 80 yo person. And as Christian and Oleg point out, pack years is a measure of cumulative damage versus cigarettes per day which is current usage.
This proposal also does not cover:
Survey data. Survey data has a working group and should continue to be modeled and debated there.
Tobacco and nicotine data are not easy for a number of reasons. It’s not always recorded, it’s patient reported, it’s not always reported accurately, it can begin years or decades before our Observation Period starts, there’s lots of free text out there, etc. Our goal is solid conventions covering the majority of use cases. And as our data, vocabularies, recording methods, and use cases evolve, so will the conventions and the CDM.
Thoughts?