We want to develop a codelist to identify patients near death. This is likely to be associated with a reduced likelihood of being offered / receiving a COVID-19 vaccine.
Ideally, we'd target those very close to death, < 1 month, say. But this is harder to define. An alternative codelsits based on "death expected < 1 year" is more feasible and will at least usefully include many of the "< 1 month" cohort. We can then exclude people if they're on this list, to provide more clinical homogeneity when studying vaccine effectiveness.
Currently it covers "end of life" care pathways, "DNR" decisions, "terminal" illnesses, and "palliative" search terms.
I wonder if palliative codes are too non-specific? There are a group of Palliative Care Diagnoses Y-codes but they include many diagnoses that don't necessarily imply end-of-life, eg some cancers, multiple sclerosis, which makes me think involvement in palliative care services is not necessarily a "death < 1 year" situation.
I've not included any search terms relating to specific terminal diagnoses (pancreatic cancer the classic example) but we could add.
wjchulme
commented
3 years ago
We want to develop a codelist to identify patients near death. This is likely to be associated with a reduced likelihood of being offered / receiving a COVID-19 vaccine.
Ideally, we'd target those very close to death, < 1 month, say. But this is harder to define. An alternative codelsits based on "death expected < 1 year" is more feasible and will at least usefully include many of the "< 1 month" cohort. We can then exclude people if they're on this list, to provide more clinical homogeneity when studying vaccine effectiveness.
A draft codelist exists here: https://codelists.opensafely.org/builder/07191665/
Currently it covers "end of life" care pathways, "DNR" decisions, "terminal" illnesses, and "palliative" search terms.
I wonder if palliative codes are too non-specific? There are a group of
Palliative Care DiagnosesY-codes but they include many diagnoses that don't necessarily imply end-of-life, eg some cancers, multiple sclerosis, which makes me think involvement in palliative care services is not necessarily a "death < 1 year" situation.I've not included any search terms relating to specific terminal diagnoses (pancreatic cancer the classic example) but we could add.