We are ETL’ing blood products to the Device table for the FDA BEST project. The quantity field holds the number of units being transfused. However, infants don’t receive “units” of blood products, they receive mL based on their weight. How would I correctly represent the unit of quantity since it is an integer field?
Oh!!! We didn’t think about that. Do you want to propose an amendment to the CDM? Should we make it a drug? Either one makes me cringe.
I don’t like the options
I welcome all ideas! Hopefully, someone has an even better solution.
@burrowse Has PEDSnet tackled blood product ETL? If yes, do you want to share the conventions?
@MPhilofsky We’re just getting started with our Device Exposure ETL and haven’t tackled blood products yet!
We used USAGI to map Epic blood products to SNOMED, but I just mapped the PEDs and adult to the same concept. I didn’t realize the difference, and looking back at USAGI, there aren’t any separate codes for peds. Not really a problem with the All of Us program right now. Might be in the future.
If SNOMED doesn’t have Peds concept codes, seems like you’ll have to add a “unit” field to the CDM (or maybe a “modifier” field).
My 2 cents:
- it seem that whenever we have “quantity” as a field we need “unit” to complement it. I know it doesn’t seem necessary for device b/c the device_concept often has an implied or actual unit - e.g., I got 4 bandaids, so device is ‘bandaid’ and quantity is ‘4’ so there is no need for ‘unit’ as a field, b/c the information is inferred in the device concept. This doesn’t work well for blood for children because the quantity may be ‘100’ but the ‘unit’ may be milliliters. In this case the device should be ‘RBC ml’ not ‘RBC Unit’. In adults, we think of the device as ‘RBC Unit’ and quantity as X and a field for ‘units’ is not necessary. If there is a device-concept_ID for ‘RBC mls’-- we could use this when needed with quantity w/o a unit field, and use a device_concept_ID that is specific to ‘RBC Unit’ when that fits best. If the unit is not conveyed clearly in the device_concept (RBC-ml, RBC unit) then we need quantity and unit fields. I did NOT find a device-concept for RBC-ml but maybe someone else can verify.
Are there any other ‘devices’ with units-- for example I got 1 liter of cement in my head- where units are important? If not, maybe drug is best. I did find an example of another device with units–Generic Floseal Hemostatic Matrix 5,000units/10ml kit – so a person may not get all 5,000 units (or maybe they always do, I don’t use this product-but you get my point)
- If not device- then maybe drug (procedure has quantity but not unit, so same issue)
Actually, this proposal is growing on me. You could have other measurements attached to exposure to a device, like voltage of a CPR treatment. It could work. Do you want to create a proper proposal?
Just as a FYI - Many Epic sites have ISBT codes in their blood product data. The ISBT codes have a much finer granularity than the text strings.