Allow users to filter by dose form group

[jrlegrand]

Problem Statement

Users need to be able to filter by dose form group (DFG). DFG is a grouping of dose form (DF).

Criteria for Success

Pulling in DFG does not make the granularity of the rxcui_ndc.sql query change and I should be able to specify DFGs and only see results with those DFGs. Maybe I am also notified of which DFGs are filtered out?

Additional Information

Dose form group (TTY=DFG) is a term type that serves as a grouping of dose forms (TTY=DF) related by route of administration (i.e., Topical) or dose form (i.e., Pill). DFG, along with SCDG and SBDG term types, are meant to be used in medication application interfaces. Instead of users scrolling through a long list of drugs with many different dose forms, the DFG/SCDG/SBDG group dose forms for shorter, more manageable drug lists.

See these links:

• DFG: https://www.nlm.nih.gov/research/umls/rxnorm/docs/appendix3.html
• DF: https://www.nlm.nih.gov/research/umls/rxnorm/docs/appendix2.html

[kristentaytok]

I wonder if we instead consider adding another filter on the back-end to an RxClass column that specifies route based on system?

idk all the edge cases for this and if all the classification systems actually map every drug, but say for asthma: disease is under "respiratory tract diseases" ATC is under "respiratory system" and VA_Class is under "respiratory tract medications"

So could we say if the user picks something under of these "respiratory" categories, then filter for DFG IN (inhalant product, injectable product, oral product, etc) Or if user picks something under "ophthalmic" or "eye", then filter for DFG IN (ophthalmic product) Or under "otic" or "ear", then DFG IN (otic product, ophthalmic product) etc.

I may be wrong or have a big gap in my understanding of the RxNav/RxClass tables, but it feels like there aren't that many dosage-form specific classes and not too many DFGs that get affected by this, and therefore perhaps we can create some rules/filters like this?

[jrlegrand]

That sounds cool and might be possible but probably would file that under optimization because I think doing this type of thing in settings would be palatable enough for end users and we know it covers all RxNorm meds. There's other cooler things I would personally rather try to do before we try to do this. Also I have found sometimes when I try to get too fancy, I build things that don't behave the way users would expect them to.

[jrlegrand]

Example issue (note 3 dose_form_group_name fields):

medication_ingredient_rxcui	medication_ingredient_name	medication_ingredient_tty	medication_product_rxcui	medication_product_name	medication_product_tty	dose_form_rxcui	dose_form_name	dose_form_tty	dose_form_group_rxcui	dose_form_group_name	dose_form_group_tty	medication_ndc
26225	ondansetron	IN	104894	ondansetron 4 MG Disintegrating Oral Tablet	SCD	316942	Disintegrating Oral Tablet	DF	1151133	Pill	DFG	63187037910
26225	ondansetron	IN	104894	ondansetron 4 MG Disintegrating Oral Tablet	SCD	316942	Disintegrating Oral Tablet	DF	1294713	Disintegrating Oral Product	DFG	63187037910
26225	ondansetron	IN	104894	ondansetron 4 MG Disintegrating Oral Tablet	SCD	316942	Disintegrating Oral Tablet	DF	1151131	Oral Product	DFG	63187037910

How do we maintain granularity with this? Or do we handle this with a different table?

[jrlegrand]

42 distinct DFGs 118 distinct DFs

Therefore, it will be easier for user to filter by DFG.

Maybe we create a second table called dfg_df which just has the mappings from DFG to DF or something and just use that to allow the user to filter the results of the main query?

[jrlegrand]

Link to DFG granularity export: https://drive.google.com/file/d/1Ae7NroHP7nBgoWxLQkLVp4M3OCbQZB8M/view?usp=sharing

[jrlegrand]

select distinct df_rxnconso.str as df, dfg_rxnconso.str as dfg

-- dose form
from rxnconso df_rxnconso 

-- dose form group
left join rxnrel dfg_rxnrel on dfg_rxnrel.rxcui2 = df_rxnconso.rxcui and dfg_rxnrel.rela = 'isa'
left join rxnconso dfg_rxnconso on dfg_rxnconso.rxcui = dfg_rxnrel.rxcui1 and dfg_rxnconso.sab = 'RXNORM' and dfg_rxnconso.tty = 'DFG'

where df_rxnconso.sab = 'RXNORM' and df_rxnconso.tty = 'DF'

[jrlegrand]

df	dfg
Mouthwash	Dental Product
Mouthwash	Oral Liquid Product
Mouthwash	Mouthwash Product
Ophthalmic Solution	Ophthalmic Product
Delayed Release Oral Tablet	Oral Product
Delayed Release Oral Tablet	Pill
Toothpaste	Dental Product
Toothpaste	Paste Product
Toothpaste	Toothpaste Product
Toothpaste	Oral Paste Product
Vaginal Cream	Vaginal Product
Vaginal Foam	Vaginal Product
Vaginal Gel	Vaginal Product
Chewable Tablet	Oral Product
Chewable Tablet	Pill
Chewable Tablet	Chewable Product
Ophthalmic Ointment	Ophthalmic Product
Medicated Shampoo	Shampoo Product
Nasal Spray	Inhalant Product
Nasal Spray	Nasal Product
Irrigation Solution	Irrigation Product
Ophthalmic Irrigation Solution	Ophthalmic Product
Disintegrating Oral Tablet	Oral Product
Disintegrating Oral Tablet	Pill
Disintegrating Oral Tablet	Disintegrating Oral Product
Extended Release Oral Capsule	Oral Product
Extended Release Oral Capsule	Pill
Extended Release Oral Tablet	Oral Product
Extended Release Oral Tablet	Pill
Extended Release Suspension	Oral Product
Extended Release Suspension	Oral Liquid Product
Injectable Solution	Injectable Product
Injectable Suspension	Injectable Product
Intraperitoneal Solution	Intraperitoneal Product
Medicated Bar Soap	Soap Product
Medicated Liquid Soap	Soap Product
Mucous Membrane Topical Solution	Mucosal Product
Nasal Inhalant	Inhalant Product
Nasal Inhalant	Nasal Product
Nasal Gel	Nasal Product
Nasal Ointment	Nasal Product
Nasal Solution	Nasal Product
Ophthalmic Gel	Ophthalmic Product
Ophthalmic Suspension	Ophthalmic Product
Oral Capsule	Oral Product
Oral Capsule	Pill
Oral Cream	Oral Product
Oral Cream	Oral Cream Product
Oral Solution	Oral Product
Oral Solution	Oral Liquid Product
Oral Suspension	Oral Product
Oral Suspension	Oral Liquid Product
Otic Solution	Otic Product
Otic Suspension	Otic Product
Rectal Cream	Rectal Product
Rectal Spray	Rectal Product
Rectal Suppository	Rectal Product
Topical Cream	Topical Product
Topical Lotion	Topical Product
Topical Oil	Topical Product
Topical Ointment	Topical Product
Topical Solution	Topical Product
Transdermal System	Topical Product
Transdermal System	Transdermal Product
Oral Wafer	Oral Product
Oral Wafer	Wafer Product
Oral Lozenge	Oral Product
Oral Lozenge	Lozenge Product
Delayed Release Oral Capsule	Oral Product
Delayed Release Oral Capsule	Pill
Gas for Inhalation	Inhalant Product
Inhalation Powder	Inhalant Product
Powder Spray	Topical Product
Rectal Ointment	Rectal Product
Rectal Solution	Rectal Product
Sublingual Tablet	Oral Product
Sublingual Tablet	Pill
Sublingual Tablet	Sublingual Product
Topical Powder	Topical Product
Vaginal Ointment	Vaginal Product
Oral Tablet	Oral Product
Oral Tablet	Pill
Rectal Foam	Rectal Product
Urethral Suppository	Urethral Product
Enema	Rectal Product
Oral Granules	Oral Product
Oral Granules	Granule Product
Oral Pellet	Oral Product
Oral Pellet	Pellet Product
Inhalation Solution	Inhalant Product
Mucosal Spray	Mucosal Product
Oral Spray	Oral Product
Oral Spray	Oral Liquid Product
Oral Spray	Oral Spray Product
Topical Spray	Topical Product
Oral Gel	Oral Product
Oral Gel	Oral Gel Product
Rectal Gel	Rectal Product
Oral Paste	Oral Product
Oral Paste	Paste Product
Oral Paste	Oral Paste Product
Oral Foam	Oral Product
Oral Foam	Oral Foam Product
Topical Foam	Topical Product
Topical Gel	Topical Product
Oral Ointment	Oral Product
Oral Ointment	Oral Ointment Product
Oral Powder	Oral Product
Oral Powder	Oral Powder Product
Paste	Paste Product
Chewing Gum	Oral Product
Chewing Gum	Chewable Product
Douche	Vaginal Product
Drug Implant	Drug Implant Product
Metered Dose Inhaler	Inhalant Product
Prefilled Syringe	Injectable Product
Dry Powder Inhaler	Inhalant Product
Pack
Medicated Pad	Topical Product
Medicated Pad	Medicated Pad or Tape
Medicated Tape	Topical Product
Medicated Tape	Medicated Pad or Tape
Buccal Film	Oral Product
Buccal Film	Buccal Product
Buccal Tablet	Oral Product
Buccal Tablet	Pill
Buccal Tablet	Buccal Product
Injectable Foam	Injectable Product
Effervescent Oral Tablet	Oral Product
Powder for Nasal Solution	Nasal Product
Granules for Oral Solution	Oral Product
Granules for Oral Solution	Granule Product
Granules for Oral Suspension	Oral Product
Granules for Oral Suspension	Granule Product
Powder for Oral Solution	Oral Product
Powder for Oral Solution	Oral Powder Product
Powder for Oral Suspension	Oral Product
Powder for Oral Suspension	Oral Powder Product
Topical Suspension	Topical Product
Auto-Injector	Injectable Product
Pen Injector	Injectable Product
Cartridge	Injectable Product
Jet Injector	Injectable Product
Injection	Injectable Product
Intratracheal Suspension	Intratracheal Product
Nasal Powder	Nasal Product
Vaginal Film	Vaginal Product
Topical Liquefied Gas	Topical Product
Medicated Patch	Topical Product
Metered Dose Nasal Spray	Inhalant Product
Metered Dose Nasal Spray	Nasal Product
Sublingual Powder	Oral Product
Sublingual Powder	Sublingual Product
Sublingual Powder	Oral Powder Product
Intrauterine System	Drug Implant Product
Tablet for Oral Suspension	Oral Product
Tablet for Oral Suspension	Oral Liquid Product
Inhalation Suspension	Inhalant Product
Vaginal Insert	Vaginal Product
Vaginal Sponge	Vaginal Product
Vaginal System	Vaginal Product
Chewable Extended Release Oral Tablet	Oral Product
Chewable Extended Release Oral Tablet	Pill
Chewable Extended Release Oral Tablet	Chewable Product
Oral Film	Oral Product
Oral Film	Oral Film Product
Sublingual Film	Oral Product
Sublingual Film	Sublingual Product
Sublingual Film	Oral Film Product
Inhalation Spray	Inhalant Product
Delayed Release Oral Granules	Oral Product
Delayed Release Oral Granules	Granule Product
Powder for Pyelocalyceal Solution	Pyelocalyceal Product

[kristentaytok]

@jrlegrand @yevgenybulochnik @Bridg109 apologies if I missed this in the code or our call, but curious about where the MDT user would input the selected dfg's; namely, the config seems more like population-based params vs. the drug class/cui params are entered in the command line run_mdt step.

[jrlegrand]

See https://github.com/coderxio/medication-diversification/issues/21 if you have any - pardon the pun - input.

[kristentaytok]

Lol thank you! I knew we were talking about it in the context of other tickets or related topics but couldn't find it. Yea I think depending on how we want the user to use the config file, it may make sense to either put all the inputs in the config file or keep drug-related params in the command line step vs. the population params in the config file. Just my opinion though.