We noticed concept 4172372 Remission phase [Measure Value] {Qualifier Value} Snomed has a “Maps to” relationship to concepts but is in the “Meas Value” domain. The conditions and disorders are a “Maps to”.
This affects multiple condition concepts that were updated and split into two.
Now Non-Standard:
alcohol use, unspecified, in remission
cocaine use, unspecified, in remission
cannabis use, unspecified, in remission
other stimulant use, unspecified, in remission
opioid use, unspecified, in remission
Standard:
987891000000105/46286594 Problem related to lifestyle (finding) Observation Snomed
4172372 Remission phase [Measure Value] {Qualifier Value} Snomed
Thank you for your question.
Yes, this requires fixing. Meas Value concepts should be moved back to the Observation domain.
Provided mappings also should be fixed as Qualifier Value concepts don’t carry the semantics of clinical events and we should not use them to map conditions.
Unless these fixes are implemented I would propose you use concepts from the hierarchy of Disorders in remission to map these non-standard concepts.
Hi @m-khitrun,
Thank you for responding so promptly. I wanted to clarify, the mappings you see at the bottom of my message are the new standard concepts for these conditions after the last vocab update. When you say “they need to be fixed”- is this something OHDSI will do? Our ETL expert, Katherine Simon, created a chart that outlines the issue very well- I have attached it. Please let me know if I need to provide additional information. Thanks again, Tina Copy of Maps to Value Vocabulary Issue.xlsx (47.7 KB)
Yes, our Vocabulary Team should deprecate these erroneous mappings and remap the mentioned ICD10CM concepts to the proper targets. We expect these fixes to be implemented during the nearest release.
Hi @m-khitrun, You mentioned that Qualifier Value concepts should not be used to map conditions. Is there OHDSI documentation explaining more about how/when to use Qualifier Value concepts?
Qualifier Value concepts do not carry the semantics of clinical events. Thus, if a source concept represents a clinical event (condition, procedure, etc.) it should not be mapped to a Qualifier Value.
Qualifier Values provide values for ‘Measurement/Value’ or ‘Observation/Value’ pairs and are used to fill the value_as_concept_id fields in the Measurement and Observation CDM tables, respectively.
Or, if you perform a mapping job, you may use them as targets to create ‘Maps to value’ relationships, not ‘Maps to’.
Also, you may find additional information about Qualifier Values in the SNOMED documentation.
I have come across a similar example and wanted to run it past you before I create a change in my ETL.
I have patients with an ICD10 code of Y76.1 (Functional Endoscopic Sinus Surgery) has a non standard concept_id of 44517083, and sits under a domain of ‘Observation’ and is a Qualifier Value.
When I map to a standard concept (Snomed) of 4127485 - Functional Endoscopic Sinus Surgery, this concept sits under a domain of ‘Meas Value’.
Am I correct in thinking the following:
Flow record into the Observation table
Observation_Concept_ID = 4127485
Observation_Source_Concept_ID = 44517083
Value_ As_Source_Concept_ID = 4127485
As I see in the coding guidelines, this Y76.1 code is used supplementary to a primary OPSC-4 A-X procedure code. To my mind, this modification data may be stored in the modifier_concept_id field. In this case, it will be definitely connected to the primary procedure.
Now, according to the CDM 5.4 specification, this field is populated with the modifiers from US-specific vocabs (CPT4 and HCPCS). However, I believe that we can consider expanding the list of accepted values.
You should also consider, that in the procedure_occurence there can be only one modifier per procedure, so if you have, e.g. records with Y and Z codes at once, you will have to choose only one of them.
