Open sebbacon opened 4 years ago
Code lists coming from Helen MacDonald for COPD and other chronic lung disease, excluding asthma. This may be better than cluster codes they think.
chronic_resp_no_asthma_Jul19.xlsx codes lists with no asthma: https://datacompass.lshtm.ac.uk/1663/
issues with asthma. From Helen M:
Validated 'specific' asthma codes published by Niseen et al. However this code list alone probably ascertains asthma when used "ever
Would likely need to be combined with use of asthma medications to avoid capturing childhood asthma or wheeze when had infection in the past.
Cystic Fibrosis: cystic_fibrosis_Jul18.xlsx
Some cystic fibrosis medicines are infrequently supplied from primary care. We could use a these medicines to hopefully pick up further exclusions in practices where the READ codes are not recorded comprehensively. Let me know and I can generate a list.
Agreed in phone call today to use asthma medicines to identify patients with asthma. @brianmackenna @hmcd @amirmehrkar
@brianmackenna Shall we split Asthma into it's own issue as it has a different methodology?
It's quite possible we'd want to measure it separately anyway right?
agreed
Draft sign off (COPD only)
DEFINITION: Patients who have any COPD Read 3 code ever on their medical records held by TPP. Absence of a code on the record is taken as no presence of COPD.
CODE LISTS: Read 3 code list (when available) - mapped by TPP from combined Read 2 LSHTM validated code lists (https://github.com/ebmdatalab/tpp-sql-notebook/files/4409910/chronic_resp_no_asthma_Jul19.xlsx; https://github.com/ebmdatalab/tpp-sql-notebook/files/4409917/cystic_fibrosis_Jul18.xlsx); and sense checked FLEXIBILITY NEEDED BETWEEN STUDIES: EFFECTS ON COHORT SELECTION: Patients must have been registered for at least 12 months before the index date, in order to allow for recording of disease codes.
POTENTIAL BIASES:
CLINICAL SIGN OFF & DATE:
EPIDEMIOLOGY SIGN OFF & DATE:
SHARED WITH WIDER TEAM: Yes/No
FINAL SIGN OFF DATE (and apply label)
Draft
DEFINITION: Patients who have any chronic respiratory disease Read 3 code ever on their medical records held by TPP. This includes chronic obstructive pulmonary disease (COPD); and such conditions as bronchiectasis, cystic fibrosis, and interstitial lung fibrosis. Absence of a code on the record is taken as no presence of disease.
CODE LISTS: Read 3 code list (when available). Created using this method by TPP:
Combined Read 2 LSHTM/PRIMIS code lists
Adding in key clusters from QOF and mapping to CTV3 (read code 3). qof-chronic-resp-disease.xlsx Inclusion and exclusion criteria.
Adding in high level snowmed codes and mapping to CTV3. Key Terms searched for in CT SNOWMED BROWSER:
snowmed-chronic-resp-disease.xlsx
NOTE: Some parents could not be used higher than the one in the document because starts to incorporate cancers, for example parent of bronchiectasis is disorder of bronchus which includes malignancy
Final list sense checked by clinician
FLEXIBILITY NEEDED BETWEEN STUDIES: We may want to add in at a later date, patients who are in receipt of active treatment.
EFFECTS ON COHORT SELECTION: Patients must have been registered for at least 12 months before the index date, in order to allow for recording of disease codes.
POTENTIAL BIASES: Excludes undiagnosed patients. Combines a range of different respiratory conditions, which may obscure associations of specific respiratory diseases.
CLINICAL SIGN OFF & DATE:
EPIDEMIOLOGY SIGN OFF & DATE:
SHARED WITH WIDER TEAM: Yes/No
FINAL SIGN OFF DATE (and apply label)
I have received the Read 3 code list from TPP (Thanks @chris-tpp). This is the code list with all the codes provided: Chronic_Resp_No_Asthma_CTV3_Raw-REVIEWED.xlsx
I have reviewed all the codes and marked all the ones that I think we should not include by putting a '1' in the not include column and a reason. The main reasons are:
I have included long term complications of TB such as bronchiectasis. I have also included chronic pulmonary oedema.
FINAL CODE LIST (i.e. these codes removed): Chronic_no_asthma-final.xlsx
One issue identified by TPP:
There is no longer a COPDEXC cluster. These would have been the exclusion codes and we may have to add any old codes manually to this list.
I don't think this makes much difference to our final code list but happy to discuss
We’ve got a solution to this remaining issue. If we remove the restriction on active QOF clusters then we pick up these codes and it doesn’t seem to expand the list too much for clinical review. All other lists have had - will have this applied; we’ll get a list of COPDEXC codes separately to you.
Ok great, and then would the idea be that I merge them into the file above.
@brianmackenna, to follow on from Slack chat. I am not sure that pulmonary TB should be included which is why I took it out as it is an infection and shouldn't be a chronic condition (although we know it can be if not treated). Agree with your point at chronic pulmonary heart disease - I can remove this.
Agree with rationale for exclusion for pulmonary TB. Other codes I propose for possibly excluding are related to pulmonary heart disease which will affect low numbers (so lets not spend a lot of time thinking about)
Discussed with @hmcd: agreed to remove chronic pulmonary heart disease and cor pulmonale for code list and make sure are in the chronic heart conditions list.
I will amend the definition and repaste here and then we can sign off
FINAL SIGN OFF
DEFINITION: Patients who have any chronic respiratory disease Read 3 code ever on their medical records held by TPP. This includes chronic obstructive pulmonary disease (COPD); and such conditions as bronchiectasis, cystic fibrosis, and interstitial lung fibrosis. Absence of a code on the record is taken as no presence of disease.
CODE LISTS: Final read 3 code list: Chronic_no_asthma-final (v1.1).xlsx )
Created using this method by TPP:
Combined Read 2 LSHTM/PRIMIS code lists
Adding in key clusters from QOF and mapping to CTV3 (read code 3). qof-chronic-resp-disease.xlsx Inclusion and exclusion criteria.
Adding in high level snowmed codes and mapping to CTV3. Key Terms searched for in CT SNOWMED BROWSER:
snowmed-chronic-resp-disease.xlsx
NOTE: Some parents could not be used higher than the one in the document because starts to incorporate cancers, for example parent of bronchiectasis is disorder of bronchus which includes malignancy
Final list sense checked by clinician. I have received the Read 3 code list from TPP. This is the code list with all the codes provided. Chronic_Resp_No_Asthma_CTV3_Raw-REVIEWED.xlsx
I have reviewed all the codes and marked all the ones that I think we should not include by putting a '1' in the not include column and a reason. The main reasons are:
FLEXIBILITY NEEDED BETWEEN STUDIES: We may want to add in at a later date, patients who are in receipt of active treatment.
EFFECTS ON COHORT SELECTION: Patients must have been registered for at least 12 months before the index date, in order to allow for recording of disease codes.
POTENTIAL BIASES: Excludes undiagnosed patients. Combines a range of different respiratory conditions, which may obscure associations of specific respiratory diseases.
CLINICAL SIGN OFF & DATE: Caroline Morton (@CarolineMorton) 8.4.2020 20:12
EPIDEMIOLOGY SIGN OFF & DATE: Brian MacKenna (@brianmackenna ) 10.4.20 15:23 (note we may wish to rename the checks)
SHARED WITH WIDER TEAM: Yes
FINAL SIGN OFF DATE (and apply label)
@annaschultze has had a look at the code while reviewing ebmdatalab/tpp-sql-notebook#81 and spotted occupational does. You can view the code list on OpenCodelist @CarolineMorton I remember we discussed occupational codes one day but don't think it was related to this issue. Should we remove?
Think we agreed we should include any chronic nonreversible lung disease so it would include occupational pneumoconiosis etc. (Not asthma triggered by dust though).
Is there a reason we would want to exclude these?
On Sun, 26 Apr 2020 12:42 Brian, notifications@github.com wrote:
@annaschultze https://github.com/annaschultze has had a look at the code and spotted occupational does. You can view the code list on OpenCodelist http://smallweb1.ebmdatalab.net:8001/codelist/opensafely/chronic-respiratory-disease/ @CarolineMorton https://github.com/CarolineMorton I remember we discussed occupational codes one day but don't think it was related to this issue. Should we remove?
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While reviewing ebmdatalab/tpp-sql-notebook#81 @annaschultze has highlighted the inclusion of the four codes below for a double check to see if they should be removed. (see here on OpenCodelists)
ID | term description | source |
---|---|---|
X1025 | Occupational asthma | High_Level_SNOMED |
X1026 | Baker's asthma | High_Level_SNOMED |
X1027 | Colophony asthma | High_Level_SNOMED |
X1028 | Grain worker's asthma | High_Level_SNOMED |
I have updated the file and removed four occupational asthma codesaafter discussion with @CarolineMorton Chronic_no_asthma-final.1.2.xlsx
To be clear for other studies asthma was removed and defined elsewhere as it was not included here in Immunisation risk group - chronic respiratory disease without asthma , which is discussed at started of issue.
@hmcd @CarolineMorton I've removed the cystic fibrosis screening code from the chronic respiratory disease codelist and saved an amended copy here: opensafely-chronic-respiratory-disease-version2.xlsx
The original version remains unchanged.
@inglesp suggested the amended codelist could be uploaded with a different name (e.g chronic respiratory disease version 2) as an interim measure until there's a process in place for making multiple versions of the same codelist. So I can do that if useful - though I assume will need signing off @CarolineMorton?
One ticket as I understand the approach will be very similar
If the logic is exactly as above, this has been implemented here - but we still need to define the code lists for disease and medicines.