In your case, you care about specific routes that can’t be inferred from dose forms at all (RxNorm doesn’t have nasogastric tubes). So you need to keep that in your route_concept_id and use route_concept_id for research. In Theresa’s proposal your nasogastric route is standard and is a kid of enteral route and then systemic. Is it going to work for you?
Hey @benskov
In the proposal at least two routes are missing, which are inside the bladder, intraperitoneal, therefore I doubt it fits your use case perfectly. If we add these two routes, why not add more? And one day we will end up in SNOMED - exactly where we are now.
Besides, for local route, you need to use some proxy route Local, which is a hierarchical ancestor of topical, intrathecal, etc. Currently, all the routes you are looking for are available in SNOMED in a high-resolution with the correct hierarchy and no assumptions / data loss / data gain. Even the nice Surgical drain for Abscess management.
Makes sense?
Also could you please describe your experience (read wrestle) with weight-based medications here? This discussion takes its route in 2018, but to this day there is still no standard way how to do it (or am I missing something)?
I agree with @zhuk! Let’s not ruin the current use cases to met the needs of a new use case when there is an alternate solution which will satisfy both!
Has there been any progress on this work?
I opened a PR Add NCIt "route of administration" codes as concepts, add standard maps to SNOMED terms · Issue #1056 · OHDSI/Vocabulary-v5.0 · GitHub to add NCI route terms as non-standard with maps to SNOMED (we see NCI route codes in our source data).
@Scott_Favre
I’ve seen that you closed the issue already as completed because the Routes community contribution has been chosen for the February 2025 release. Just transferring the message here.
Also tagging @tburkard since it is her contribution and area of expertise
By the way, there is a potential for Route intersection with a CDISC vocabulary. Have you checked your routes against the current version of vocabs?
Thanks for the link to CDISC.
It looks like the route codes I find the NCIThesaurus file are actually CDISC codes? Athena shows C38288 for oral from.
Hello, @Scott_Favre
In short:
These codes are both NCIt codes/SCUIs and CDISC SCUIs, therefore, the intersection is possible.
However, SCUIs used as concept_codes in CDISC are only a subset of NCIt codes/SCUIs, therefore some codes may be missing.
As @zhuk mentioned, CDISC wiki may bring some light on how the Vocabulary ETL was done (e.g., concept_code definition, names assignment).
@zhuk @aostropolets @MPhilofsky @Christian_Reich here is the proposal discussed during the call we had on July 10th 2024 : only creating routes that do not exist yet (implant and injectable) and creating many (broad) relationships between dose forms and routes (including the newly created “Implant” and “Injectable”).
The idea is that we do not change the existing route vocabulary but allow those who do not have route readily available to infer it from dose form through the relationship.
Moreover, implant and injectable were created because they do not exist yet in the existing snomed route vocabulary but are useful routes (the existing snomed vocabulary lists around 100 ways of different injections which is way too detailed, but has no overall term such as “injectable”). However, the conclusion was to not create relationships between existing routes and the two new routes.
The github post where you can find the “new” route suggestion is still the same but the title has been changed to reflect the new suggestion " suggest to add two new routes and link dose form to route": suggest new tidier route hierarchy through linkage to dose form · Issue #860 · OHDSI/Vocabulary-v5.0
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