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documentation:cdm:dose_era [2016/07/26 17:55]
cgreich [Conventions]
documentation:cdm:dose_era [2016/08/16 17:00]
cgreich
Line 11: Line 11:
 ==== Conventions ==== ==== Conventions ====
   * Dose Eras will be derived from records in the DRUG_EXPOSURE table and the Dose information from the DRUG_STRENGTH table using a standardized algorithm.   * Dose Eras will be derived from records in the DRUG_EXPOSURE table and the Dose information from the DRUG_STRENGTH table using a standardized algorithm.
-  * Each Dose Era corresponds to one or many Drug Exposures that form a continuous interval and contain the same Drug Ingredient (active compound) at the same effective dose. +  * Each Dose Era corresponds to one or many Drug Exposures that form a continuous interval and contain the same Drug Ingredient (active compound) at the same effective ​daily dose. 
-  * Dose Form information is not taken into account. So, if the patient changes between different formuations,​ or different manufacturers with the same formuation, the Dose Era is still spanning the entire time of exposure to the Ingredient.+  * Dose Form information is not taken into account. So, if the patient changes between different formuations,​ or different manufacturers with the same formulation, the Dose Era is still spanning the entire time of exposure to the Ingredient. 
 +  * The daily dose is calculated for each DRUG_EXPOSURE record by calculating the total dose of the record and dividing by the duration. 
 +  * The total dose of a DRUG_EXPOSURE record is calculated with the help of the DRUG_STRENGTH table containing the dosage information for each drug as following:​ 
 + 
 +^  1     ^ Tablets and other fixed amount formulations ^  
 +^ :::​|//​Example:​ Acetaminophen (Paracetamol) 500 mg, 20 tablets.//​| 
 +^ DRUG_STRENGTH ​ | The denominator_unit is empty | 
 +^ DRUG_EXPOSURE ​ | The quantity refers to number of pieces, e.g. tablets ​   | 
 +^ :::|//In the example: 20//| 
 +^ ''​Ingredient dose=''​|''​quantity x amount_value [amount_unit_concept_id]''​| 
 +^ :::​|''//​Acetaminophen dose = 20 x 500mg = 10,​000mg//''​| 
 +| | | 
 +^  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 unit. In this case the strength is provided in the numerator.| 
 +^ DRUG_STRENGTH ​ | The denominator_unit is {actuat}| 
 +^ DRUG_EXPOSURE ​ | The quantity refers to the number of pieces, e.g. puffs | 
 +^ ''​Ingredient dose=''​|''​quantity x numerator_value [numerator_unit_concept_id]''​| 
 +| | | 
 +^  3     ^ Quantified Drugs which are formulated as a concentration ^  
 +^ :::​|//​Example:​ The Clinical Drug is Acetaminophen 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.//​| 
 +^ DRUG_STRENGTH ​ | The denominator_unit is either mg or mL. The denominator_value might be different from 1. | 
 +^ DRUG_EXPOSURE ​ | The quantity refers to a fraction or, multiple of the pack. | 
 +^ :::|// Example: 2// | 
 +^ ''​Ingredient dose=''​|''​quantity x numerator_value [numerator_unit_concept_id]''​| 
 +^ :::​|''//​ Acetaminophen dose = 2 x 1250mg = 2500mg//''​| 
 +| | | 
 +^  4     ^ Drugs with the total amount provided in quantity, e.g. chemotherapeutics ^  
 +^ :::​|//​Example:​ 42799258 "​Benzyl Alcohol 0.1 ML/ML / Pramoxine hydrochloride 0.01 MG/MG Topical Gel" dispensed in a 1.25oz pack.//| 
 +^ DRUG_STRENGTH ​ | The denominator_unit is either mg or mL.| 
 +^ :::|// Example: Benzyl Alcohol in mL and Pramoxine hydrochloride in mg// | 
 +^ DRUG_EXPOSURE ​ | The quantity refers to mL or g.| 
 +^ :::|// Example: 1.25 x 30 (conversion factor oz -> mL) = 37// | 
 +^ ''​Ingredient dose=''​|''​quantity x numerator_value [numerator_unit_concept_id]''​| 
 +^ :::​|''//​ Benzyl Alcohol dose = 37 x 0.1mL = 3.7mL//''​| 
 +^ :::​|//''​Pramoxine hydrochloride dose = 37 x 0.01mg x 1000 = 370mg''//​| 
 +^ :::|//Note: The analytical side should check 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     ^ Compounded drugs ^  
 +^ :::​|//​Example:​ Ibuprofen 20%/​Piroxicam 1% Cream, 30ml in 5ml tubes.//| 
 +^ 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_EXPOSURE ​ | The quantity refers to the total amount of the compound. Use one record in the DRUG_EXPOSURE table for each compound.| 
 +^ :::|// Example: 20% Ibuprofen of 30ml = 6mL, 1% Piroxicam of 30ml = 0.3mL// | 
 +^ ''​Ingredient dose=''​|Depends on the drugs involved: One of the use cases above.| 
 +^ :::​|''//​ Ibuprofen dose = 6 x 1mg x 1000 = 6000mg//''​| 
 +^ :::​|//''​Piroxicam dose = 0.3 x 1mg x 1000 = 300mg''//​| 
 +^ :::|//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     ^ Drugs with the active ingredient released over time, e.g. patches ^  
 +^ :::​|//​Example:​ Ethinyl Estradiol 0.000833 MG/HR / norelgestromin 0.00625 MG/HR Weekly Transdermal Patch//| 
 +^ DRUG_STRENGTH ​ | The denominator units refer to hour.| 
 +^ :::​|//​Example:​ Ethinyl Estradiol 0.000833 mg/h / norelgestromin 0.00625 mg/h//| 
 +^ DRUG_EXPOSURE ​ | The quantity refers to the number of pieces.| 
 +^ :::|// Example: 1 patch// | 
 +^ ''​Ingredient rate=''​|''​numerator_value [numerator_unit_concept_id]''​| 
 +^ :::​|''//​ 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)//| 
  
documentation/cdm/dose_era.txt · Last modified: 2017/09/25 15:09 by clairblacketer