Closed NickKramer87 closed 7 months ago
Dr. Franks is on board. We discussed a bunch of options, but to start with, let's try adding in LARC. She gave me these specifications:
In the pregnancy module, after Normal_Pregnancy_Completion
, if there was no pregnancy complication, place LARC with this probability distribution:
SNOMED Code | Probability | Description |
---|---|---|
65200003 | 8.236% | Insertion of intrauterine contraceptive device |
169553002 | 3.364% | Insertion of subcutaneous contraceptive |
blank | 88.4% | None |
More details for the record: This comes from a 2021 publication that found that in a state with mandated inpatient access to LARC, it is done 11.6% of the time. Of those, hormonal LNG (levonorgestrel) IUDs are 56.5%, copper IUDs are 14.5%, and nexplanon (subcutaneous implants) are 29.1%. We translated this to say that of the 11.6% of patients where IPP LARC is placed, 71% are IUDs, and 29% are subcutaneous contraceptives.
Brant AR, Kollikonda S, Yao M, Mei L, Emery J. Use of Immediate Postpartum Long-Acting Reversible Contraception Before and After a State Policy Mandated Inpatient Access. Obstet Gynecol. 2021 Nov 1;138(5):732-737. doi: 10.1097/AOG.0000000000004560. PMID: 34619694.
A couple other notes from Dr. Franks:
As an organization that will be working with the Synthea patient generator, it would be useful to be able to develop clinical modules to add to the Synthea patient probability workflow that better represent the issues we are analyzing.
Action Items: