Defining Relative Time Criteria in ATLAS for Cohort Creation

[thejas (Thejas Bharadwaj)]

Hi OHDSI Community,

I am currently working on creating a cohort in ATLAS with the following criteria:

1. Patients with a Non-Small Cell Lung Cancer (NSCLC) diagnosis (this serves as the cohort entry criteria and index date).
2. Patients who received targeted therapy.
3. Patients who received immune checkpoint inhibitors (ICI) at most 1 year before the targeted therapy.
4. Patients who had a liver toxicity test after the start of targeted therapy.

I am facing a challenge with defining the relative time criteria for the ICI checkpoint inhibitors. In ATLAS, I can only set time filters relative to the index date (which is the NSCLC diagnosis date). However, I need to specify that the ICI checkpoint inhibitors should occur at most 1 year before the targeted therapy date, not relative to the index date.

My Questions:

1. Is there a way to define time criteria in ATLAS relative to another event (e.g., targeted therapy) instead of the index date?
2. If not, are there any workarounds or best practices for handling this type of relative time logic in ATLAS?
3. Would this require custom SQL or modifications outside of ATLAS?

I’ve tried exploring the cohort definition interface but haven’t found a straightforward way to implement this. Any guidance or suggestions would be greatly appreciated!

Thank you in advance for your help!

[agolozar (Asieh Golozar)]

@thejas In your example, ICI use should be nested within targeted therapy. In ATLAS, you can do this by selecting “Add Attribute” for targeted therapy drug exposure, then choosing “Nested Criteria.” By doing so, index date for ICI use is anchored to the date of targeted therapy as you can see in the screenshot below: