How to map surgical case level?

Vocabulary Users
1

I am working on a conversion with a surgical case level table that contains following values:

Average
Complex
Emergency
Endoscopy
High risk
Major
Minimal
Minor
Moderate
Neurologic
Open heart
Orthopedic/Neurologic
Orthopedics
Procedural
Routine
Special procedure
Trauma
Ultra-radical (extensive)
Vascular
da Vinci

I checked the concept table but have not found similar classification. Can someone help?

2

@QI_omop
It seems combination of specialty, indication, scope and method of surgery. Are they exclusive, mutually?

For example, surgey with da Vinci (robotic surgery) can be major surgery or high risk surgery.

3

@SCYou They are mutually exclusive.

4

@QI_omop
I think modifier_concept_id in the procedure_occurrence table might be the right place for this information, though I’m not sure this information can be inter-operable across databases.

5

@QI_omop:

Are they stand-alone? Or are they coming with real procedures?

6

@Christian_Reich. They are not stand_alone. They all come with real procedures and have hundred to thousands of surgical cases. Below are some examples:

surgical_case_level_desc surgical_procedure_desc
Minor Tendon repair
Major Hip hemiarthroplasty
Major Laparoscopic cholecystectomy
Procedural Lithotripsy extracorporeal shock wave
Orthopedic/Neurologic Hip total replacement (arthroplasty)
Open heart Coronary artery bypass graft (CABG)
Complex Hip total replacement (arthroplasty)
Endoscopy Laparoscopic colon resection
7

@QI_omop
Because of @Christian_Reich 's brilliant question, I can see the situation, now.
If so, I would use fact_relationship to describe surgical case level for each unique concpet_id of surgical procedure. It would be more simpler and much smaller.

8

Are surgical_case_level_desc expected to be modifiers to distinguish between kinds of the same procedure (e.g. major/minor intervention or open vs. endoscopic surgery)?

From what I can see now, values can be split into several categories:

  1. Possibly meaningless, like ‘Procedural’ or ‘Special procedure’
  2. True modifiers that have distinct clinical meanings like ‘Minor’, ‘Major’ or ‘da Vinci’
  3. Classification values, that rely more to circumstance and provider (and also are preserved in meaning of the procedure itself), like ‘Orthopedics’ or ‘Vascular’

It would be easier to suggest the best course of action if we had seen the entire list of possible combinations of fields.

9

@Eduard_Korchmar:

You are the procedure man. So, the question goes back to you, really. 1) I agree, let’s throw it out. 2) should be part of your hierarchy. And 3) - agreed, is not a function of the procedure. We can get that through the provider.