CONDITION_OCCURRENCE

Erica Voss edited this page Oct 11, 2018 · 9 revisions

Conditions are records of a Person suggesting the presence of a disease or medical condition stated as a diagnosis, a sign, or a symptom, which is either observed by a Provider or reported by the patient. Conditions are recorded in different sources and levels of standardization, for example:

  • Medical claims data include diagnoses coded in Source Vocabularies such as ICD-9-CM that are submitted as part of a reimbursement claim for health services
  • EHRs may capture Person conditions in the form of diagnosis codes or symptoms
Field Required Type Description
condition_occurrence_id Yes bigint A unique identifier for each Condition Occurrence event.
person_id Yes bigint A foreign key identifier to the Person who is experiencing the condition. The demographic details of that Person are stored in the PERSON table.
condition_concept_id Yes integer A foreign key that refers to a Standard Concept identifier in the Standardized Vocabularies belonging to the 'Condition' domain.
condition_start_date No date The date when the instance of the Condition is recorded.
condition_start_datetime Yes datetime The date and time when the instance of the Condition is recorded.
condition_end_date No date The date when the instance of the Condition is considered to have ended.
condition_end_datetime No datetime The date when the instance of the Condition is considered to have ended.
condition_type_concept_id Yes integer A foreign key to the predefined Concept identifier in the Standardized Vocabularies reflecting the source data from which the Condition was recorded, the level of standardization, and the type of occurrence. These belong to the 'Condition Type' vocabulary
condition_status_concept_id Yes integer A foreign key that refers to a Standard Concept identifier in the Standardized Vocabularies reflecting the point of care at which the Condition was diagnosed.
stop_reason No varchar(20) The reason that the Condition was no longer present, as indicated in the source data.
provider_id No integer A foreign key to the Provider in the PROVIDER table who was responsible for capturing (diagnosing) the Condition.
visit_occurrence_id No integer A foreign key to the visit in the VISIT_OCCURRENCE table during which the Condition was determined (diagnosed).
visit_detail_id No integer A foreign key to the visit in the VISIT_DETAIL table during which the Condition was determined (diagnosed).
condition_source_value No varchar(50) The source code for the Condition as it appears in the source data. This code is mapped to a Standard Condition Concept in the Standardized Vocabularies and the original code is stored here for reference.
condition_source_concept_id Yes integer A foreign key to a Condition Concept that refers to the code used in the source.
condition_status_source_value No varchar(50) The source code for the condition status as it appears in the source data. This code is mapped to a Standard Concept in the Standardized Vocabularies and the original code is stored here for reference.

Conventions

No. Convention Description
1 Valid Condition Concepts belong to the 'Condition' domain.
2 Condition records are typically inferred from diagnostic codes recorded in the source data. Such code systems, like ICD-9-CM, ICD-10-CM, Read etc., provide a comprehensive coverage of conditions. However, if the diagnostic code in the source does not define a condition, but rather an observation or a procedure, then such information is not stored in the CONDITION_OCCURRENCE table, but in the respective tables indicated by the domain.
3 Source Condition identifiers are mapped to Standard Concepts for Conditions in the Standardized Vocabularies. When the source code cannot be translated into a Standard Concept, a CONDITION_OCCURRENCE entry is stored with only the corresponding SOURCE_CONCEPT_ID and SOURCE_VALUE, while the CONDITION_CONCEPT_ID is set to 0.
4 Family history and past diagnoses ('history of') are not recorded in the CONDITION_OCCURRENCE table. Instead, they are listed in the OBSERVATION table.
5 Codes written in the process of establishing the diagnosis, such as 'question of' of and 'rule out', are not represented here. Instead, they are listed in the OBSERVATION table, if they are used for analyses.
6 A Condition Occurrence Type is assigned based on the data source and type of condition attribute, for example:
  • ICD-9-CM Primary Diagnosis from inpatient and outpatient claims
  • ICD-9-CM Secondary Diagnoses from inpatient and outpatient claims
  • Diagnoses or problems recorded in an EHR.
7 Valid Condition Occurrence Type Concepts belong to the 'Condition Type' vocabulary in the 'Type Concept' domain.
8 The Stop Reason indicates why a Condition is no longer valid with respect to the purpose within the source data. Typical values include 'Discharged', 'Resolved', etc. Note that a Stop Reason does not necessarily imply that the condition is no longer occurring.
9 Condition source codes are typically ICD-9-CM, Read or ICD-10-CM diagnosis codes from medical claims or discharge status/visit diagnosis codes from EHRs.
10 Presently, there is no designated vocabulary, domain, or class that represents condition status. The following concepts from SNOMED are recommended:
  • Admitting diagnosis: 4203942
  • Final diagnosis: 4230359 (should also be used for discharge diagnosis
  • Preliminary diagnosis: 4033240
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