I would like to open a discussion on whether we should make a proposal for Atlas to make the type_concept_ids a more prevalent choice in Atlas, so end users don’t mistake a Person’s chief complaint of stroke with an actual diagnosis of stroke or a Person’s claim for reason of visit to be a Procedure versus a Person actually receiving a Procedure. Or maybe move this data into the Observation domain and use concept_id = 3019237, chief complaint - reported.
Last time I looked, which has been a while, Atlas didn’t force the user to pick a type_concept_id. The default is to pull data from all type_concept_ids. If you’re doing a study which is looking at an initial event of “myocardial infarction” and the condition_type_concept_id is not specified, then you could be including folks with a chief complaint or reason for visit = “heart attack”, but after examination and testing by a Provider it is determined the Person has a different Condition. Or if you’re doing an inpatient study, it doesn’t matter which drug was ordered, it matters which drug was administered because the administered drug is an actual drug exposure. Every inpatient visit includes at least a handful of various ordered, prn drugs to alleviate sleeplessness, pain, constipation, fever, cough, etc. Most of which are not given.
I know that small quality issues in data are washed out by our very large datasets, but EHRs have a large amount of these data. In the datasets I have seen, this is recorded almost every time a Person has a Visit.
From my experience, there is a lack of knowledge around this field and EHR data in general. Colorado has participated in research which didn’t specify the type_concept_id. Causing study leads to think we had duplicated data in our CDM, when in reality we have ordered, administered and dispensed drug data which amounts to multiple records for the same drug and dose on the same day. Maybe I’m worrying about something that doesn’t really have an affect on results. Thoughts?