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Repository for discussion of OpenSAFELY codelists
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Mechanical Valves #91

Open brianmackenna opened 3 years ago

brianmackenna commented 3 years ago

We want to develop a codelist for "mechanical valves".

One example use case of where it is needed is there is a concern that anticoagulant switching activity at the height of the pandemic may have led to people with mechanical/prosthetic valves getting a DOAC (see OpenSAFELY paper for more information, in whom it is generally cautioned/contraindicated.

brianmackenna commented 3 years ago

I have started a SNOMED-CT list to support ascertainment for those with a mechanical valve. This is available here

https://codelists.opensafely.org/builder/54ae5cab/

Some bullet points to help with checking and iterating

brianmackenna commented 3 years ago

@laurietomlinson and @angelwong121 have already developed a ctv3 codelist for valvular AF which we can use.

brianmackenna commented 3 years ago

Points from discussion with @speed-vm.

brianmackenna commented 3 years ago

Discussion with @speed-vm and me

Comments welcome on this decision!

speed-vm commented 3 years ago

@brianmackenna I've had a look into this

Think my reservation is the replacement or repair. The important part is the replacement, and the type of valve for the replacement is not specified here and repair procedures are not an indication for anticoagulation.

Therefore in view of that ambiguity would prefer to omit:

Mitral valve: [plastic repair] or [replacement] Pulmonary valve: [plastic repair] or [replacement] Aortic valve: [plastic repair] or [replacement] Tricuspid valve: [plastic repair] or [replacement]

Perhaps these could be included for that second piece of work you mentioned earlier for clarification of code?

brianmackenna commented 3 years ago

Ok so the ambiguity is that the replacement may have been with a tissue valve?

speed-vm commented 3 years ago

Yes, that is not specific

From: Brian @.> Sent: 28 June 2021 10:08 To: opensafely/codelist-development @.> Cc: SPEED, Victoria (KING'S COLLEGE HOSPITAL NHS FOUNDATION TRUST) @.>; Mention @.> Subject: Re: [opensafely/codelist-development] Mechanical Valves (#91)

Ok so the ambiguity is that the replacement may have been with a tissue valve?

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brianmackenna commented 3 years ago

Published version https://www.opencodelists.org/codelist/opensafely/mechanical-or-artificial-valves/72fdabd8/

brianmackenna commented 3 years ago

Upon further review by collaborators three further physical object codes have been identified for inclusion

705991002 |Mechanical cardiac valve prosthesis (physical object)| 310819002 |Ball and cage cardiac valve prosthesis (physical object)| 310820008 |Tilting disc cardiac valve prosthesis (physical object)|

https://www.opencodelists.org/codelist/opensafely/mechanical-or-artificial-valves/18c42b4d/