Is diagnostic system equipments (CT, MRI, etc.) exposure data also included in device_exposure?

[solmazeradat]

Is diagnostic system equipments (CT, MRI, etc.) exposure data also included in in device_exposure?

CDM or THEMIS convention?

THEMIS

Table or Field level?

Field

Is this a general convention?

No

Summary of issues

• Can we can transform EMR diagnostic device applied data to device_exposure itself?

• According to the device_exposure definition within the CDM, it seems that the diagnostic equipment can also be converted

The Device domain captures information about a person’s exposure to a foreign physical object or instrument which is used for diagnostic or therapeutic purposes through a mechanism beyond chemical action. Devices include implantable objects (e.g. pacemakers, stents, artificial joints), medical equipment and supplies (e.g. bandages, crutches, syringes), other instruments used in medical procedures (e.g. sutures, defibrillators) and material used in clinical care (e.g. adhesives, body material, dental material, surgical material).

Summary of answer

• suggestion:

Author 1:
device_exposure should be populated with those devices that have influence on a person and/or are used in her treatment (like prosthesis or cardiac implant). In other words, with the objects a patient can be exposed to (that’s why it’s called device_exposure not device_used or something). That’s why I’m not sure if we should put MRI into device_exposure (and MRI system gantry has a different meaning from the whole MRI).
For those that are relevant, you can follow the links ‘Has dir device’, ‘Has proc device’, ‘Using acc device’, ‘Using device’ from SNOMED procedure to it’s device. For example, Implantation of joint prosthesis into knee joint has relation to Knee joint prosthesis.

Author 2
Providing example for ECGs taken during patient care:

Procedure are for those actions that are done to a patient so an ECG (and other diagnostic “procedures”) be captured in the device_exposure only. This is the direction we are taking for all ECG data - device_exposure captures when the 12-lead ECG was done, measurements captures global and lead level measurement values (ex ST J-point uV), observations for mapped SNOMED cardiologist findings, note to capture all other cardiologist notes not mapped to standard concepts.

The author also provide the following ETL approach for mapping device_concept_id = 12 lead ECG

• The EHR ETL sets up the person.person_id and person.visit_occurrence_id - derived from the known EHR medical record number. When I receive a confirmed ECG from our heartstation (ECG was reviewed by a cardiologist), it contains the medical record associated with the patient visit - thus now I have when the ECG was done (measurement.measurement_datetime), the person.person_id, and the person.visit_occurrence_id.

• I can then enter a device_exposure entry using the above information (person_id, visit_occurrence_id, device_exposure_start_datetime, . The device_exposure.device_concept_type_id is “EHR Detail” (“Device Type”). The device_exposure.device_concept_id is “12 lead ECG”.

• The measurements would be linked via person_id, visit_occurrence_id, measurement_datetime (same as device_exposure_start_datetime), and measurement.measurement_type_concept_id -> new type concept “Derived from ECG”.

• This makes it fairly straight forward to finding all patients with ST elevation in the inferior leads by querying the measurements table only. I suspect this would work as well for CT and other diagnostic procedures.

Related links

• Forum post - https://forums.ohdsi.org/t/exposure-to-diagnostic-system-equipments-ct-mri-etc-can-be-included-in-device-exposure/4767

Other comments/notes

• Please use this section to add any other relevant notes or comments. (i.e. if links are not working, something is out of date or deprecated)

[MelaniePhilofsky]

This issue should be moved to the Medical Imaging WG. They are creating an extension for these data.