Unspecified Codes and the OMOP Vocabulary

CDM Builders
1

@Christian_Reich or @Dymshyts,

The top ICD9s that go unmapped for one of my large claims databases using Vocabulary 20160817 are

CODE	ROW_COUNT	DESCRIPTION
585.9	1,759,514	Chronic kidney disease, unspecified
V58.11	1,385,843	Encounter for antineoplastic chemotherapy
V15.82	888,951		Personal history of tobacco use
571.5	391,793		Cirrhosis of liver without mention of alcohol
707.12	282,690		Ulcer of calf
V58.1	207,269		Encounter for antineoplastic chemotherapy and immunotherapy
995.20	177656		Unspecified adverse effect of unspecified drug, medicinal and biological substance
V58.12	114804		Encounter for antineoplastic immunotherapy

The theme I’m seeing here is when things are “unspecified” or not really specific like “antineoplastic immunotherapy” don’t get any mapping. Anything thoughts brewing about how to tackle these less than specific situations? For example previous exposure to a chemotherapy agent, regardless of what it is, is a common ask but right now this just gets a CONCEPT_ID = 0 in the CDM.

Thank you,
Erica

Tagging @rmakadia, @clairblacketer, and @Ajit_Londhe as they are interested in this topic as well.

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2

@Christian_Reich & @Dymshyts,

Another code just came up recently for me in this space of “unspecified” or specifically in this case “other” - 696.1-Other psoriasis is associated with a whole bunch of psoriasis conditions but the Vocabulary only associates it to 75614 - Acrodermatitis continua. In this case I would either map it to nothing or what would be better is mapping it to all of its conditions.

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3

@Christian_Reich or @Dymshyts,

This is still an interesting topic for me. Just wondering if there are any thoughts on it.

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4

The general rule of these “other” and “unspecified” is to map to a parent condition, such as:
“Schizophrenia, unspecified” Maps to “Schizophrenia”
and
“Schizophrenia, other” Maps to “Schizophrenia”
so the same thing we did with a 696.1-Other psoriasis, mapped it to Psoriasis
if when try to find what Other psoriasis means

“Applies To
Acrodermatitis continua
Dermatitis repens
Psoriasis: NOS any type, except arthropathic”
so we can find these concepts:
83839005 acrodermatitis continua of Hallopeau
200976008 acrodermatitis continua (SNOMED concept_codes here)
but how can we determine “Psoriasis: NOS any type, except arthropathic”?
Thus me and @Christian_Reich decide to map to a general concept in such a cases.

These concepts weren’t mapped because target concepts were outdated and haven’t replaced with a new concepts properly.

5

For ICD9 585.9-Chronic kidney disease, unspecified why can’t you use 46271022-Chronic kidney disease? I think that follows the logic you apply above.

For V58.11-Encounter for antineoplastic chemotherapy, could you use ‘716872004-Antineoplastic chemotherapy regimen’?

Maybe there is some part of the process I’m still not understanding?

FYI, I’m still in Vocab 20161218 if this makes a difference.

6

Yeah, you are right, we use them.
Next release we are going to fix that.
We already have all these mappings done locally.

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