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Ventilator-associated pneumonia - Custom mapping - Phenotyping Initiative

Hi all,

My name is Ankur Krishnan and I am the data and project manager for ECRAID-Base ([About ECRAID-Base | Ecraid] and in October last year we joined the EHDEN initiative to transform the data from an observational study on ventilator-associated pneumonia (VAP) in ICU settings, to OMOP-CDM.

  • The onset/diagnosis of pneumonia (ventilator-associated, hospital-acquired and others) is commonly determined using the FDA criteria (please see - https://www.cdc.gov/nhsn/pdfs/pscmanual/6pscvapcurrent.pdf). And, so is the case in our study.

  • We are approaching this by mapping the concepts within each criteria. For example –

    • for, “New onset or acute worsening cough, or dyspnea, or tachypnea” – “new
      onset”, “worsening”, “cough”, “dyspnea” and “tachypnea” can mostly be mapped to
      SNOMED CT. Additionally, we are also developing custom mappings for the
      criteria, as a whole.*
    • Similarly, for ‘Worsening (increased volume or purulence) of expectorated sputum
      or suctioned respiratory secretions’*
  • Additionally, criteria such as ‘Clinically relevant worsening of the PaO2/FiO2 ratio’ is based on clinician judgement and therefore, harder to map to a concept quantitatively.*

  • We were wondering how other studies and researchers who have worked with or are working on pneumonia (@SCYou), within the OHDSI community, have approached this.

  • We think, if other researchers have at some point developed custom mappings or perhaps some other innovative solution to mapping pneumonia FDA criteria while maintaining granularity, it would help enable standardization and harmonization across studies within the OHDSI community.

@Gowtham_Rao: We were also wondering if ventilator-associated pneumonia (and hospital-acquired pneumonia) and other infectious diseases such as complicated urinary tract infections and acute (lower and upper) respiratory tract infections would be good candidates for the Phenotyping Initiative. We think that infectious diseases research would greatly benefit from the OHDSI federated data network but we could not find much representation for this research domain (and also Antimicrobial Resistance research) within the OHDSI community. We would be happy to get our study team/clinical experts involved to initiate this discussion.

Yes. I think they are Phenotypes that the community would be interested in. The phenotype development and evaluation workgroup and ohdsi phenotype library are resources that may be able to help further the idea.

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Great! Many thanks for the suggestions. We will look into these.