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Issue of metformin

Vocabulary Users
#1

Hi there,
I am exploring CDM now, tried to find the ancestor of metformin.
However, I realized that Biguanide was marked as the same level of the metformin.
Can anyone either explain to me what was going on or maybe fix the issue?

Thanks.
Tianze
Below is the code.

SELECT max_levels_of_separation, concept.*
FROM concept_ancestor
JOIN concept ON ancestor_concept_id = concept_id
WHERE descendant_concept_id = 1503297
ORDER BY max_levels_of_separation, concept_name

#2

Thanks! It’s a really good feedback, when you ask good questions just after the tutorial.

to make the life easier I would recommend to use ATC concepts as a drug classes idetifier.
Others sources have pretty messy structure, and we don’t have use cases where people need that, so we put them in OHDSI vocabulary as they are.

SELECT max_levels_of_separation, concept.*
FROM devv5.concept_ancestor
JOIN concept ON ancestor_concept_id = concept_id
WHERE descendant_concept_id = 1503297
and vocabulary_id in (‘ATC’)
ORDER BY max_levels_of_separation, concept_name

#3

Great! It works.
The follow-up question is why there are inconsistencies between the ATC and the level of separation.
I guess the level of separation is based on the SNOMED. Alternatively, can we conclude that sometimes the level of separation doesn’t work according to the question, especially on the treatment classes?

Thanks.

0 21600747 metformin Drug ATC ATC 5th
2 21600745 Biguanides Drug ATC ATC 4th
2 21600744 BLOOD GLUCOSE LOWERING DRUGS, EXCL. INSULINS Drug ATC ATC 3rd
3 21600712 DRUGS USED IN DIABETES Drug ATC ATC 2nd
4 21600001 ALIMENTARY TRACT AND METABOLISM Drug ATC ATC 1st

#4

It’s based on the number of jumps between the ancestor and descendant concept whatewher vocabulary gives us the relationships usually, here we use ATC original relationships
So
A10BA02 Is a A10BA
A10BA Is a A10B
A10B Is a A10 , means levels of separations defined in this way:
A10BA02 - A10BA - 1
A10BA02 - A10B - 2
A10BA02 - A10B - 3

But, Yes, here is something weird with these levels, Biguanides should have levels of separation =1, will take a look why it happens

t