While working on Condition Status consolidation, we realized that Suspected stuff handling is still to be discussed and agreed within the community. We already faced this in COVID where we tried two controversial approaches:
Store the suspected diagnoses in the Condition Domain as general Condition concepts, but mark them with condition_status_concept_id = ‘Suspected diagnosis’. Then we realized that no analytical methods were able to deal with condition_status_concept_id so you basically can’t distinguish between confirmed and suspected diagnoses. Another issue is that events in the Condition_occurence table are positive facts by the definition and suspected diagnoses don’t look convincing enough to be stored in the same bucket because in every study when you query the Condition_occurance table, you should keep it in mind (and exclude suspected stuff if needed).
Store the suspected diagnoses in the Observation Domain using the mapping to SNOMED concepts in the ‘Disease suspected’ hierarchy or post-coordination (if some more specific nosologies are needed).
We finished up with the 2nd approach in COVID, but it will not effectively work in some countries/datasets, where the diagnostic process and its representation in EHR have some peculiarities. @Christian_Reich Can you please explain how every single diagnosis is being treated as preliminary/suspected at some point and being represented in the electronic records.