Cohort Definition Name : Earliest event of Depressive and Sleep Disorder
Contributor name : Joel Swerdel’,‘Azza Shoaibi’
Contributor OrcId :
Logic Description : Earliest occurrence of either 1) a depressive disorder diagnosis that is preceded by a sleep disorder diagnosis in the prior year 2) a sleep disorder diagnosis that is preceded by a depressive disorder diagnosis in the prior year cohort exit is the end of continuous observation.
Recommended study application : target
Assertion statement : This cohort definition was executed on at least one real person-level observational health data source and resulted in a cohort with at least 1 person.
Target Clinical Description : Major depressive disorder (MDD) with sleep disorder is defined as clinical depression with the presence of impaired sleep patterns. Alterations in sleep are 1 of 2 cardinal symptoms of MDD[1]. Sleep disturbance is one of the most consistent symptoms associated with major depressive disorder, and often disturbances persist even when a subject is in remission[2]. 44-88% of those with MDD report experiencing insomnia[2]. Risk factors for MDD with sleep disorder include a family history of schizophrenia, bipolar disorder, or major depression, age, marital status, family history, history of other mental health disorders, chronic illness, social class, and social conditions.
"Evaluation conclusion : MDD with sleep disorder using a concept set of 99 concepts including inclusions and exclusions which incorporated all those found from the literature review and from the analysis of PHOEBE and orphan concepts in cohort diagnostics. The algorithm retrieves subjects from all 8 databases tested. We developed a more specific cohort requiring a second diagnosis code for sleep disorder in the time period 31-365 days after index. This cohort may improve the specificity of the algorithm albeit at the expense of sensitivity from the PheValuator analysis. The significant loss in sensitivity, however, precludes its use in our analysis.
PheValuator cannot assess two conditions simultaneously. In this analysis, however we report on the performance chratritics of each deffinition, sepretly. For sleep disorder; we may view the differences in performance between a broad (single required code) and a narrow (2 required codes 31-365 days apart). We were able to assess the performance characteristics in 7 of the 8 databases; there were too few subjects in Australia for an accurate assessment. We found that the broad definition had very good sensitivity ranging from 56% in Germany to 94% in JMDC. PPV was also very good, ranging from 94% in MDCD to 99% in JMDC. Adding the requirement of a second code raised the PPV, nearly 100% in all databases but at the expense of a large decrease in sensitivity (range: 12-65%).
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Imported to the OHDSI Phenotype Library. It may be expected to be found with id = 1022 in the next release. Thank you