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--- documentation:next_cdm:denominator_units [2015/12/30 11:08] – klaus_bonadt
+++ documentation:next_cdm:denominator_units [2017/07/07 15:20] (current) – clairblacketer
@@ Line 1: / Line 1: @@
 ===== Denominator Units for liquid drugs and quantity field in DRUG_EXPOSURE =====
+=== Proposals are now tracked as github issues ===
+[[https://github.com/OHDSI/CommonDataModel/issues/72|link to github issue]]
   * Requester: Klaus Bonadt
@@ Line 44: / Line 46: @@
 === Use Cases ===
-^  1     ^ Tablets^
+^  1     ^ Solid preparations, preparations where dose cannot be split^
-^ :::|//Example: In Europe packs with a fixed pack size are dispensed, for example Paracetamol 500 mg, 20 tablets.//|
+^ :::|Example: 20 tablets of 19020053 "Acetaminophen 500 MG Oral Tablet"|
-^ DRUG_STRENGTH  | The denominator_unit is empty |
+^ DRUG_STRENGTH  | The denominator_unit is empty. Amount_value and amount_unit_concept_id contain the effective dose. //Note that in non-US databases the quantity could be retrieved from the box_size field, however, the ETL should copy that to the DRUG_EXPOSURE.quantity field.//|
-^ DRUG_EXPOSURE  | Quantity refers to number of pieces, e.g. tablets    |
+^ DRUG_EXPOSURE  | Quantity refers to number of pieces, e.g. 20 tablets    |
-^ :::|//In the example: 20//|
+^ :::||
-^ ''Ingredient dose=''|''quantity x amount_value [amount_unit_concept_id]''|
+^ ''Total dose=''|''quantity x amount_value [amount_unit_concept_id]''|
-^ :::|''//Paracetamol dose = 20 x 500mg = 10,000mg//''|
+^ :::|''Acetaminophen dose = 20 x 500 mg = 10,000 mg''|
 | | |
 ^  2     ^ Puffs of an inhaler ^
-^ :::|Note: There is no difference to use case 1 besides that the DRUG_STRENGTH table may put {actuat} in the denominator. In this case the strength is provided in the numerator.|
+^ :::|Example: 150 puffs of 21174430 "Nicotine 0.5 MG/ACTUAT [Nicorette]". Note: There is no difference to use case 1 besides that the DRUG_STRENGTH table has {actuat} in the denominator_unit. In this case the strength is provided in the numerator.|
-^ DRUG_STRENGTH  | The denominator_unit is {actuat}|
+^ DRUG_STRENGTH  | The denominator_unit is {actuat}. The numerator value and numerator unit contain the dose per actuation (puff) |
-^ DRUG_EXPOSURE  | Quantity refers to the number of pieces, e.g. puffs |
+^ DRUG_EXPOSURE  | Quantity refers to the number puffs, e.g. 150 |
-^ ''Ingredient dose=''|''quantity x numerator_value [numerator_unit_concept_id]''|
+^ ''Total dose=''|''quantity x numerator_value [numerator_unit_concept_id]''|
+^ :::|''Nicotin dose = 150 x 0.5 mg = 75 mg''|
 | | |
 ^  3     ^ Quantified Drugs^
-^ :::|//Example: The Clinical Drug is Paracetamol 250 mg/mL in a 5mL oral suspension. The Quantified Clinical Drug would have 1250 mg / 5 ml in the DRUG_STRENGTH table. Two suspensions are dispensed.//|
+^ :::|Example: 43275770 "60 ML Acetaminophen 50 MG/ML Oral Solution", meaning, there are 60 mL of Acetaminophe (Paracetamol) of a concentration of 50 mg/mL. Two such bottles are prescribed. |
-^ DRUG_STRENGTH  | The denominator_unit is either mg or mL. The denominator_value might be different from 1. |
+^ DRUG_STRENGTH  | The concentration is given in the numerator/denominator fields, with the denominator unit either mg or mL, and the denominator value typically not 1. E.g. 3000 mg in 60 mL. |
-^ DRUG_EXPOSURE  | Quantity refers to a fraction or multiple of the pack. |
+^ DRUG_EXPOSURE  | Quantity refers to a fraction or multiple of the container. E.g. 2|
-^ :::|// Example: 2// |
+^ ''Total dose=''|''quantity x numerator_value [numerator_unit_concept_id]''|
-^ ''Ingredient dose=''|''quantity x numerator_value [numerator_unit_concept_id]''|
+^ :::|''// Acetaminophen dose = 2 x 3000 mg = 6000 mg//''|
-^ :::|''// Paracetamol dose = 2 x 1250mg = 2500mg//''|
 | | |
-^  4     ^Drugs with the total amount in quantity^
+^  4     ^Liquid drugs, or drugs where the amount can be split randomly. The total amount in given in quantity^
-^ :::|//Example: 42799258 "Benzyl Alcohol 0.1 ML/ML / Pramoxine hydrochloride 0.01 MG/MG Topical Gel" dispensed in a 1.25oz pack.//|
+^ :::|Example: 42799258 "Benzyl Alcohol 0.1 ML/ML / Pramoxine hydrochloride 0.01 MG/MG Topical Gel" dispensed in a 1.25 oz pack.|
-^ DRUG_STRENGTH  | The denominator_unit is either mg or mL.|
+^ DRUG_STRENGTH  | The concentration is given in the numerator/denominator fields, with the denominator unit either mg or mL, and the denominator value as null. E.g. Benzyl Alcohol in mL and Pramoxine hydrochloride in mg |
-^ :::|// Example: Benzyl Alcohol in mL and Pramoxine hydrochloride in mg// |
+^ DRUG_EXPOSURE  | Quantity refers to the unit provided in DRUG_STRENGTH. Since both mL and mg are found mg is preferred. E.g. 1.25 x 30 (conversion factor oz -> mL) x 1000 (conversion mL -> mg) = 37,000 |
-^ DRUG_EXPOSURE  | Quantity refers to mL or g.|
+^ ''Total dose=''|''quantity x numerator_value [numerator_unit_concept_id]''|
-^ :::|// Example: 1.25 x 30 (conversion factor oz -> mL) = 37// |
+^ :::|''Benzyl Alcohol dose = 37,000 x 0.1 mL x 0.001 = 3.7 mL''|
-^ ''Ingredient dose=''|''quantity x numerator_value [numerator_unit_concept_id]''|
+^ :::|''Pramoxine hydrochloride dose = 37,000 x 0.01 mg = 370 mg''|
-^ :::|''// Benzyl Alcohol dose = 37 x 0.1mL = 3.7mL//''|
+^ :::|//Note: At analysis time, the denominator should be checked in the DRUG_STRENGTH table. As mg is used for the second ingredient the factor 1000 should be applied to convert between g and mg.//|
-^ :::|//''Pramoxine hydrochloride dose = 37 x 0.01mg x 1000 = 370mg''//|
-^ :::|//Note: The analytical side checks the denominator in the DRUG_STRENGTH table. As mg is used for the second ingredient the factor 1000 will be applied to convert between g and mg.//|
 | | |
-^  5     ^Compounding^
+^  5     ^Compounded drugs^
-^ :::|//Example: Ibuprofen 20%/Piroxicam 1% Cream, 30ml in 5ml tubes.//|
+^ :::|Example: 30 mL Ibuprofen 20% / Piroxicam 1% Cream.|
-^ DRUG_STRENGTH  | We need entries for the ingredients of Ibuprofen and  Piroxicam, probably with an amount_value of 1 and a unit of mg.|
+^ DRUG_STRENGTH  | Two separate entries for the ingredients of Ibuprofen and  Piroxicam are required, with an amount value of null and a amount unit of mg. |
-^ DRUG_EXPOSURE  | Quantity refers to the total amount of the compound. Use one record in the DRUG_EXPOSURE table for each compound.|
+^ DRUG_EXPOSURE  | Quantity refers to the total weight amount of the compounded ingredient. Use one record in the DRUG_EXPOSURE table for each compound. Eg.g 20% Ibuprofen in 30 mL = 6 mL, 1% Piroxicam in 30 mL = 0.3 mL |
-^ :::|// Example: 20% Ibuprofen of 30ml = 6mL, 1% Piroxicam of 30ml = 0.3mL// |
+^ ''Total dose=''|Depends on the drugs involved: One of the use cases above.|
-^ ''Ingredient dose=''|Depends on the drugs involved: One of the use cases above.|
+^ :::|''Ibuprofen dose = 6 x 1000 = 6000 mg''|
-^ :::|''// Ibuprofen dose = 6 x 1mg x 1000 = 6000mg//''|
+^ :::|''Piroxicam dose = 0.3 x 1000 = 300 mg''|
-^ :::|//''Piroxicam dose = 0.3 x 1mg x 1000 = 300mg''//|
+^ :::|//Note: At analysis time, the denominator should be checked for both ingredients in the DRUG_STRENGTH table. If it is not mg a conversion factor of 1000 should be applied to convert between mL/g and mg.//|
-^ :::|//Note: The analytical side determines that the denominator for both ingredients in the DRUG_STRENGTH table is mg and applies the factor 1000 to convert between mL/g and mg.//|
 | | |
-^  6     ^Dose release over time, e.g. Patches^
+^  6     ^Drugs with delayed release over time, e.g. Patches^
-^ :::|//Example: Ethinyl Estradiol 0.000833 MG/HR / norelgestromin 0.00625 MG/HR Weekly Transdermal Patch//|
+^ :::|Example: 1518199 "Ethinyl Estradiol 0.000833 MG/HR / norelgestromin 0.00625 MG/HR Weekly Transdermal Patch|
-^ DRUG_STRENGTH  | The denominator units refer to hour.|
+^ DRUG_STRENGTH  | The release is provided as numerator/denominator pair, with the denominator value as null and the denominator unit hour. E.g. Ethinyl Estradiol 0.000833 mg/h / norelgestromin 0.00625 mg/h|
-^ :::|//Example: Ethinyl Estradiol 0.000833 mg/h / norelgestromin 0.00625 mg/h//|
+^ DRUG_EXPOSURE  | Quantity refers to the number of pieces. E.g. 1 patch. |
-^ DRUG_EXPOSURE  | Quantity refers to the number of pieces.|
+^ ''Release rate=''|''numerator_value [numerator_unit_concept_id]''|
-^ :::|// Example: 1 patch// |
+^ :::|''Ethinyl Estradiol rate = 0.000833 mg/h''|
-^ ''Ingredient rate=''|''numerator_value [numerator_unit_concept_id]''|
+^ :::|''norelgestromin rate 0.00625 mg/h''|
-^ :::|''// Ethinyl Estradiol rate = 0.000833 mg/h//''|
-^ :::|//''norelgestromin rate 0.00625 mg/h''//|
 ^ :::|//Note: This can be converted to a daily dosage by multiplying it with 24. (Assuming 1 patch at a time for at least 24 hours)//|