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How to store patient’s character before onset of illness


#21

got it.thanks for your follow up


(Dmytry Dymshyts) #22

@Christian_Reich we can use
History of clinical finding in subject
as OBSERVATION.observation_concept_id and exact character trait as OBSERVATION.value_as_concept_id.

@Andrea have you met other characteristics of a person, which fall under the following criteria?

I’m asking, because if we only have “patient’s character before onset of illness” case we can solve it using History of clinical finding in subject , but if we have more such characteristics, we need to think about a brand new approach to store these person’s characteristics.


(Chris Knoll) #23

Friends,
Let’s not introduce another way to store temporal information in the CDM. The mechanism of the CDM is to store observations on the dates that you find them. If there’s something in the note saying ‘the person had clinical finding X a week prior to this encounter’ then put an condition_occurrence/observation of X at time dateadd(d, -7,visit_start_date) into the patient’s record.

What may be required here is a Themis recommendation about how to handle observations that describe events that occur at a different time index: recent history vs. distant history, and how that can be coded into dates in the CDM. But as far as storing observations that happened relative to some other observations, the date_time fields (and to some extent the order of the visit_detail chain in visit_details) is the standard way to handle this.


(Christian Reich) #24

@Chris_Knoll: I think the “before onset” is a red herring. What’s really meant is “character trait per se”, before the onset. So, say, Christian Reich always has been relaxed and calm. And then on Dec 2nd he read a Forum post and flipped out. Now, when was “calm, relaxed”? The day before the onset? Or the weekend before that? Or last year?

The Psych WG needs to figure out which findings they want to be able to declare generically for a person, with no time stamp. I think.


#25

what criteria?


(Dmytry Dymshyts) #26

So, it is more a person characteristic (like Race or Gender) rather a clinical event.


#27

yes it is.When this patient came to Hospital A, I wasn’t sure if he was the very first time and most of the time, it was not the first time


(Christian Reich) #28

@Andrea: Ok, so which one is it?

  1. You know when the patient was calm - put it in with that date (even if the date is an approximation of “before the onset”
  2. You don’t know when the last time the patient was calm, but you know generally the patient had a calm character. In that case you need to figure out in the Psych WG how to handle this and come to us with a proposal.

@Dymshyts: Can you take that on in your WG?


#29

number two is my situation


(Dmytry Dymshyts) #30

Sure, We’ll take it into the agenda of the next meeting.
The workgroup information and meeting information here:
https://www.ohdsi.org/web/wiki/doku.php?id=projects:workgroups:psychiatry


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