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Oncology Treatment Proposal

I am asking for feedback on the Oncology Treatment Proposal. See here:

Please provide feedback here in this Google document:

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Why is this not called “treatment_concept_id” like everywhere else?

[quote=“mgurley, post:91, topic:704”]
The Treatment Modality defines a high-level classification of the oncology treatment. The Treatment Modality domain is partially based on the NCI CRN ‘Cancer Therapy Look-up Tables’.
The Treatment Submodality defines a more fine-grained classification of the oncology treatment. The Treatment Submodality is partially based on the NCI CRN ‘Cancer Therapy Look-up Tables’. The Cancer Therapy lookup tables contain lists of NDCs, CPT, and HCPC codes classified by the Treatment Submodality that encode low-level clinical events representing receipt of oncology drug therapy or radiation therapy.[/quote]

Is this not something the Vocabulary does? In the other tables, the concept_id refers to the most detailed concept. The roll-up is done through the hierarchy. Wouldn’t we do the same thing here?

Do we really need this stacking? I am thinking. For surgeries, there are no cycles. For radiotherapies, there are, but there is no standardization. It is very specific to the disease and the anatomical situation. Only drug therapies are there regimented chemo cycles. But why wouldn’t it be enough to just indicate a cycle. The analytical application could count them, if necessary.

Why do we need a specific therapy notion for drugs? I thought we keep them all alike? Why would this not be the same as the treatment_concept_id above?

Thinking out loud again: Currently, we don’t really have these cross-links between the clinical tables. Reason is that this is usually not provided. And if it is, it often is low quality, because medical practice often doesn’t work linearly, that there is a treatment for a single condition. Life would be easier if we left it out for the time being until we know more.

However, @Gowtham_Rao is thinking about something similar: Episode of Care. There, you could combine everything: Diagnoses, diagnostics and treatment. Without having to create all these individual cross-links. We should think about this.

Same thing. Looks to me like the TREATMENT, TREATMENT_CYCLE and TREATMENT_EVENT tables are redundant. Only provide the lowest treatment level, which in case of surgery is the thing itself and in case of drug is the cycle. Radiotherapy - not sure, but not sure how the three tables above would help.

What properties or modifiers do you have in mind?

That could be the Episode of Care idea.