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VA Drug Class and Product identifiers

Hi OHDSI,
My understanding is VA drug class and/or product codes were made non standard… I see someone else asked about the reason for this but I didn’t see a response. Why is this vocabulary no longer supported or in our vocabulary updates?. I work with VA’s OMOP drug mapping team and any new VUIDs are no longer mapping.

Thanks,
Liz Hanchrow RN

@Liz_Hanchrow:

Because they are no longer updated. It’s a pity. We liked them a lot. But they are now overtaken by MED-RT. Let me know if that is incorrect.

Hi Christian,
I spoke with John Kilbourne, MD who is the VA federal owner of NDF and MED-RT. You might check with your vocabulary contact for updates. NDF and VUIDs persist and updates are being sent to NLM by VA PBM.

Thanks,

Liz Hanchrow
Elizabeth.Hanchrow@va.gov

@Liz_Hanchrow:

You are correct. The VA NDF and Class still exist in the world, and can be downloaded. I don’t quite remember what happened, but in 2017 the NLM stopped distributing them with the RxNorm delivery, and declared that they are no longer maintained. Instead, MED-RT is the new classification system.

But the latter didn’t happen that way. NDF and VA Class are still going strong. At the time, we decided to focus on ATC as the main drug class, because of its much wider adoption internationally. The VA Classes only collect US drugs. Phenotype definitions based on it notoriously won’t work outside the country. We therefore decided not to bring it back, but happy to change our minds if there is a good use case. Is there? Do you guys need it for OHDSI-type research? We could re-integrate them into RxNorm, this time through the UMLS.

We never adopted MED-RT. Problem is a structure that doesn’t dwell well in our hierarchical world. For example, the class of vitamin agonists are descendents of the actual vitamin. We don’t work that way. Ingredients (whether the orginal or an agonist) have the same level below a class. We were thinking to do some surgery on MED-RT and revert those oddities, but then decided it would be too much work for a questionable purpose, and threw all efforts on ATC.

Thoughts?

Hi @Christian_Reich ,

Sorry, I tried to add my response to your question in the earlier post, but the system blocked it.

I wanted to circle back with you on the VA Drug Class and Product Codes after Drs. Michael Matheny and John Kilbourne discussed. Dr. Matheny would like to bring NDF with VUIDs back and he offered to help coordinate updating the vocabulary and fix any of the hierarchy issues should you like assistance. He explained we really need those to come back into the OMOP CDM because the user community who are using OMOP has really expanded based on the number of VA access requests for both research and national operational users. We are also getting requests for small data additions for particular use cases. To help coordinate this, I checked VA PBM’s website for the latest pharmacist curated formulary. We can send you this if it would be helpful. PBM’s Excel does include the latest identifiers for all the new drugs and vaccines I checked. Dr. Matheny has also asked Julie Ducom (Julie.Ducom@va.gov) to assist.

Thanks,

Liz Hanchrow RN, MSN

VA OMOP Help Desk Concierge

Liz.Hanchrow@vumc.org or Elizabeth.Hanchrow@va.gov

Liz

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@JulieDucom, @Liz_Hanchrow

Not a problem.

I’ll respond on email for the details.

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Hi @Christian_Reich and @Liz_Hanchrow,
(and tagging also @Dymshyts & @Alexdavv )
we analyzed that a bit, as you know and I have a bold suggestion to make that is a little outside normal conventions. I think it is a good idea to make this public so that we can collect more input.
We might have made changes in the past under wrong assumptions, have deprecated the VA VUIDs for the VA products vocabulary and instead added concepts from the NDFRT terminology source. However, maintenance of the NDFRT has been suspended. The NDFRT concepts that made it into the VA products vocabulary superseding the VUIDs are somewhat out of place and not useful there. More so, we stopped delivering new VUIDs to the vocabulary.

I propose to surgically cut the misplaced NDFRT concepts loose and move them over to the NDFRT vocabulary, without changing their concept ID but simply by switching the vocabulary ID for the concepts. At the same time we would reactivate the previously deprecated VUIDs and add the ones that meanwhile are missing.

Please, let us know, if you think this is too risky or if you believe the side effects are a calculated risk, we can take.

  • Mik
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Here’s what we are going to do:
We create the vocabulary_id =‘VANDF’ with vocabulary_name = ‘National Drug File’. Exactly as it’s named in UMLS.
In reality, VA product is not a separate vocabulary, but a level of NDFRT, that’s why we actually deprecated it. But by mistake we put VANDF concepts under the VA product vocabualary, so they were deprecated as well. So instead of ‘VA product’ we’ll have the correct vocabulary id and name: ‘VANDF’ and ‘National Drug File’.
So the concepts that belong to the VANDF, but currently in VA Product in OMOP, will get the proper vocabulary_id and validity as defined by VANDF, and other concepts from VA Product will go to the NDFRT vocabulary and remain deprecated.

Also we build the mappings to RxNorm and investigate the relational structure within VANDF.

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