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Discharge Diagnosis

I am constructing a cohort of patients in Calypso and want to be able to create an inclusion rule based upon a condition being a discharge diagnosis. How can I do this?

Hi @mmckillop

So, it sounds like you want to limit the CONDITION_OCCURRENCE records by
using the CONDITION_TYPE_CONCEPT_ID, which tells you where the data came
from. There’s many type concepts available, but none specifically are
‘discharge diagnosis’. I know some groups, like at CUMC, delineate
diagnoses based on what they come in with (EHR chief complaint,
http://www.ohdsi.org/web/atlas/#/concept/42894222) and what they leave with
(Primary condition http://www.ohdsi.org/web/atlas/#/concept/44786627).
Within the claims database I work with, we identify conditions based on if
the clams was inpatient or outpatient service, as well as its position
(primary vs. secondary) on the claim. For example, here’s the condition
type concept I use to find the ‘discharge diagnosis’, which would be the
primary diagnosis from an inpatient visit (
http://www.ohdsi.org/web/atlas/#/concept/38000183).

Hello @mmmckillop and @Patrick_Ryan,

We have recently vetted a proposal of a new field, CONDITION_STATUS_CONCEPT_ID, in the CONDITION_OCCURRENCE table. This field would indicate the status/stage of diagnosis: Admitting, Preliminary, Discharge/Final. The difference between this proposed field and CONDITION_TYPE_CONCEPT_ID is that the former identifies the status/stage of diagnosis and the latter its source. For example, both Admitting and Discharge diagnoses can come from claims or problem list, can be primary or secondary. The proposal is here: http://www.ohdsi.org/web/wiki/doku.php?id=documentation:next_cdm:conditionstatus. I hope that we’ll ratify it at our next CDM Workgroup meeting in June.

@rimma and @Patrick_Ryan thank you. I will be interested to know what happens. In the meantime I will use the two concepts Patrick mentioned to represent discharge diagnosis.

@rimma and @Christian_Reich,

What about adding a present on admission (POA) concept ID?

We have researchers here who are interested in capturing POA and we didn’t know where to put it. We think CONDITION_STATUS_CONCEPT_ID might be a good home however we just need a new CONCEPT_ID for it.

Thanks,
@Ajit_Londhe, @jweave17, & @ericaVoss

Like this concept_id that already exists and is already standard?
http://www.ohdsi.org/web/atlas/#/concept/46236988

@Patrick_Ryan - it is weird it is in the OBSERVATION domain but I see the other ones are in that domain too. Look like this would be okay.

@Christian_Reich & @rimma - so what version of the CDM is this in? I’m getting confused on how to handle the versions. According to GitHub we are on 5.0.1.

@ericaVoss:

We will roll out the version control with @karthik at the next WG meeting on Tuesday.

t