Right now some standard concept_ids in the Visit domain are combined with Care Sites, such as 38004307, Adult Care Home or 8782, Urgent Care Facility. Other standard concept_ids in the Visit domain are combined with clinical events, such as 38004443, Child Mental Retardation and / or Developmental Disability Respite Care or 44777691, Well babies (care given by the mother / substitute, with nursing advice if needed). And this is confusing for people building their CDMs. Why are some combos allowed and others are not? And I’m going to put it out there, and would like for others to chime in, but I think we made a mistake when we expanded the Visit domain. Years ago we had a handful of high level standard concepts in the visit domain. These included OP, IP, ER, ER to IP, and LTC. And those five fit Christian’s definition perfectly. Then the standard concepts in the domain were expanded and now it is confusing because some encounter types are a perfect match to a standard concept_id and other encounter types aren’t present. As a community, we need to:
- Define the use case for Visits. What questions do we need to answer with these data?
- Define what a Visit represents.
- Review the structure of the Visit Occurrence table to ensure it fits our use cases.
- Review the current list of standard concept_ids in the Visit domain and add or subtract as necessary with remapping on non-standard concepts to standard concepts.
- Document, document and more documentation on the use cases, decisions made, rationale behind the decision, changes to the CDM (if needed), changes to the Vocabs (if needed), ETL guidance, and end user (analyst/researcher) guidance.
I’m tagging this as a Themis issue, but I would like the discussion kicked off here.