2019-08-28 15:02:47 +00:00
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<!DOCTYPE html>
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2020-04-27 20:35:41 +00:00
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<html>
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2019-08-28 15:02:47 +00:00
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<head>
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<meta charset="utf-8" />
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<meta name="generator" content="pandoc" />
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2020-04-27 20:35:41 +00:00
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2019-08-28 15:02:47 +00:00
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2020-10-06 15:11:13 +00:00
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<meta name="author" content="Clair Blacketer" />
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2019-08-28 15:02:47 +00:00
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2020-10-06 15:11:13 +00:00
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<meta name="date" content="2020-10-06" />
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2019-08-28 15:02:47 +00:00
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2022-01-13 18:59:03 +00:00
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<title>drug_dose.knit</title>
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2019-08-28 15:02:47 +00:00
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2023-10-26 18:13:30 +00:00
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<script src="site_libs/header-attrs-2.25/header-attrs.js"></script>
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2022-01-13 18:59:03 +00:00
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2019-08-28 15:02:47 +00:00
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<meta name="viewport" content="width=device-width, initial-scale=1" />
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2022-01-13 18:59:03 +00:00
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<style>h1 {font-size: 34px;}
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h1.title {font-size: 38px;}
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h2 {font-size: 30px;}
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h4 {font-size: 18px;}
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h5 {font-size: 16px;}
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h6 {font-size: 12px;}
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code {color: inherit; background-color: rgba(0, 0, 0, 0.04);}
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pre:not([class]) { background-color: white }</style>
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2019-08-28 15:02:47 +00:00
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2023-10-26 18:13:30 +00:00
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<link href="site_libs/font-awesome-6.4.2/css/all.min.css" rel="stylesheet" />
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<link href="site_libs/font-awesome-6.4.2/css/v4-shims.min.css" rel="stylesheet" />
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2019-08-28 15:02:47 +00:00
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2021-01-06 15:52:57 +00:00
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<style type="text/css">
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code{white-space: pre-wrap;}
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ul.task-list{list-style: none;}
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2019-08-28 15:02:47 +00:00
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<style type="text/css">code{white-space: pre;}</style>
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2021-01-06 15:52:57 +00:00
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2022-07-27 01:48:28 +00:00
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2019-08-28 15:02:47 +00:00
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<link rel="stylesheet" href="style.css" type="text/css" />
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<style type = "text/css">
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.main-container {
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max-width: 940px;
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margin-left: auto;
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margin-right: auto;
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}
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img {
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max-width:100%;
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}
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.tabbed-pane {
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padding-top: 12px;
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}
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.html-widget {
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margin-bottom: 20px;
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}
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button.code-folding-btn:focus {
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outline: none;
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}
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summary {
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display: list-item;
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}
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2022-07-27 01:48:28 +00:00
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details > summary > p:only-child {
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display: inline;
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}
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2022-01-13 18:59:03 +00:00
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pre code {
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padding: 0;
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}
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2019-08-28 15:02:47 +00:00
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</style>
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<style type="text/css">
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.dropdown-submenu {
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position: relative;
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}
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.dropdown-submenu>.dropdown-menu {
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top: 0;
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left: 100%;
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margin-top: -6px;
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margin-left: -1px;
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border-radius: 0 6px 6px 6px;
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}
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.dropdown-submenu:hover>.dropdown-menu {
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display: block;
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}
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.dropdown-submenu>a:after {
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display: block;
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content: " ";
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float: right;
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width: 0;
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height: 0;
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border-color: transparent;
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border-style: solid;
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border-width: 5px 0 5px 5px;
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border-left-color: #cccccc;
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margin-top: 5px;
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margin-right: -10px;
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}
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.dropdown-submenu:hover>a:after {
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2022-01-13 18:59:03 +00:00
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border-left-color: #adb5bd;
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2019-08-28 15:02:47 +00:00
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}
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.dropdown-submenu.pull-left {
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float: none;
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}
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.dropdown-submenu.pull-left>.dropdown-menu {
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left: -100%;
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margin-left: 10px;
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border-radius: 6px 0 6px 6px;
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}
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</style>
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2022-01-13 18:59:03 +00:00
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<script type="text/javascript">
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2019-08-28 15:02:47 +00:00
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// manage active state of menu based on current page
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$(document).ready(function () {
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// active menu anchor
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href = window.location.pathname
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href = href.substr(href.lastIndexOf('/') + 1)
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if (href === "")
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href = "index.html";
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var menuAnchor = $('a[href="' + href + '"]');
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2023-02-08 20:04:22 +00:00
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// mark the anchor link active (and if it's in a dropdown, also mark that active)
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var dropdown = menuAnchor.closest('li.dropdown');
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if (window.bootstrap) { // Bootstrap 4+
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menuAnchor.addClass('active');
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dropdown.find('> .dropdown-toggle').addClass('active');
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} else { // Bootstrap 3
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menuAnchor.parent().addClass('active');
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dropdown.addClass('active');
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}
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2022-01-13 18:59:03 +00:00
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// Navbar adjustments
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var navHeight = $(".navbar").first().height() + 15;
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var style = document.createElement('style');
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var pt = "padding-top: " + navHeight + "px; ";
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var mt = "margin-top: -" + navHeight + "px; ";
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var css = "";
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// offset scroll position for anchor links (for fixed navbar)
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for (var i = 1; i <= 6; i++) {
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css += ".section h" + i + "{ " + pt + mt + "}\n";
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}
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style.innerHTML = "body {" + pt + "padding-bottom: 40px; }\n" + css;
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document.head.appendChild(style);
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2019-08-28 15:02:47 +00:00
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});
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</script>
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<!-- tabsets -->
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<style type="text/css">
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.tabset-dropdown > .nav-tabs {
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display: inline-table;
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max-height: 500px;
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min-height: 44px;
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overflow-y: auto;
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border: 1px solid #ddd;
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border-radius: 4px;
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}
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2023-10-26 18:13:30 +00:00
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.tabset-dropdown > .nav-tabs > li.active:before, .tabset-dropdown > .nav-tabs.nav-tabs-open:before {
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content: "\e259";
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2019-08-28 15:02:47 +00:00
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font-family: 'Glyphicons Halflings';
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display: inline-block;
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padding: 10px;
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border-right: 1px solid #ddd;
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}
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.tabset-dropdown > .nav-tabs.nav-tabs-open > li.active:before {
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2023-10-26 18:13:30 +00:00
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content: "\e258";
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2019-08-28 15:02:47 +00:00
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font-family: 'Glyphicons Halflings';
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2023-10-26 18:13:30 +00:00
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border: none;
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2019-08-28 15:02:47 +00:00
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}
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.tabset-dropdown > .nav-tabs > li.active {
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display: block;
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}
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.tabset-dropdown > .nav-tabs > li > a,
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.tabset-dropdown > .nav-tabs > li > a:focus,
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.tabset-dropdown > .nav-tabs > li > a:hover {
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border: none;
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display: inline-block;
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border-radius: 4px;
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2020-04-27 20:35:41 +00:00
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background-color: transparent;
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2019-08-28 15:02:47 +00:00
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}
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.tabset-dropdown > .nav-tabs.nav-tabs-open > li {
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display: block;
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float: none;
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}
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.tabset-dropdown > .nav-tabs > li {
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display: none;
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}
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</style>
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<!-- code folding -->
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2020-04-27 20:35:41 +00:00
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</head>
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<body>
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<div class="container-fluid main-container">
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2019-08-28 15:02:47 +00:00
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<div class="navbar navbar-default navbar-fixed-top" role="navigation">
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<div class="container">
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<div class="navbar-header">
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2022-07-27 01:48:28 +00:00
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<button type="button" class="navbar-toggle collapsed" data-toggle="collapse" data-bs-toggle="collapse" data-target="#navbar" data-bs-target="#navbar">
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2019-08-28 15:02:47 +00:00
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<span class="icon-bar"></span>
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<span class="icon-bar"></span>
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<span class="icon-bar"></span>
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</button>
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<a class="navbar-brand" href="index.html"><div><img src="ohdsi16x16.png"></img> OMOP Common Data Model </div></a>
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</div>
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<div id="navbar" class="navbar-collapse collapse">
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<ul class="nav navbar-nav">
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<li>
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<a href="index.html">
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2023-02-08 20:04:22 +00:00
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<span class="fa fa-house"></span>
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2019-08-28 15:02:47 +00:00
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</a>
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</li>
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2021-02-19 02:37:32 +00:00
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<li class="dropdown">
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2022-07-27 01:48:28 +00:00
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<a href="#" class="dropdown-toggle" data-toggle="dropdown" role="button" data-bs-toggle="dropdown" aria-expanded="false">
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2022-01-13 18:59:03 +00:00
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<span class="fa fa-landmark"></span>
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2019-10-31 19:06:09 +00:00
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Background
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2021-02-19 02:37:32 +00:00
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<span class="caret"></span>
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2019-10-31 19:06:09 +00:00
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</a>
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2021-02-19 02:37:32 +00:00
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<ul class="dropdown-menu" role="menu">
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<li>
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<a href="background.html">Model Background</a>
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</li>
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2021-09-22 19:39:44 +00:00
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<li>
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<a href="cdmRefreshProcess.html">CDM Refresh Process</a>
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</li>
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2021-02-19 02:37:32 +00:00
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<li>
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<a href="vocabulary.html">How the Vocabulary is Built</a>
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</li>
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</ul>
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2019-10-31 19:06:09 +00:00
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</li>
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2021-09-22 19:39:44 +00:00
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<li class="dropdown">
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2022-07-27 01:48:28 +00:00
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<a href="#" class="dropdown-toggle" data-toggle="dropdown" role="button" data-bs-toggle="dropdown" aria-expanded="false">
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2022-01-13 18:59:03 +00:00
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<span class="fa fa-list-alt"></span>
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2019-08-28 15:02:47 +00:00
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Conventions
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2021-09-22 19:39:44 +00:00
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<span class="caret"></span>
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2019-08-28 15:02:47 +00:00
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</a>
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2021-09-22 19:39:44 +00:00
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<ul class="dropdown-menu" role="menu">
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<li>
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<a href="dataModelConventions.html">General Conventions</a>
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</li>
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<li>
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<a href="ehrObsPeriods.html">Observation Periods for EHR Data</a>
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2020-10-06 15:11:13 +00:00
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<div id="how-to-calculate-drug-dose" class="section level1">
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<h1><strong>How to Calculate Drug Dose</strong></h1>
|
2023-02-08 20:04:22 +00:00
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<p>These conventions have been curated to show how to consider
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calculating cumulative and daily drug dose for a given exposure record.
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These are high-level examples meant to demonstrate how one might use the
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DRUG_STRENGTH table and they do not take into account switching or
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stockpiling.</p>
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<p><strong>1. Tablets and other fixed amount
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formulations</strong><br><br> <strong>Example</strong>: Acetaminophen
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(Paracetamol) 500 mg, 20 tablets.<br> <strong>DRUG_STRENGTH</strong> The
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denominator_unit is empty<br> <strong>DRUG_EXPOSURE</strong> The
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quantity refers to number of pieces, e.g. tablets.<br> <em>In the
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example</em>: 20<br>
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<code>Ingredient dose= quantity x amount_value [amount_unit_concept_id]</code><br>
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Acetaminophen dose = 20 x 500mg = 10,000mg<br> Daily dose =
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Acetaminophen dose/drug duration<br><br></p>
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<p><strong>2. Puffs of an inhaler</strong><br><br>
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<strong>Note</strong>: There is no difference to use case 1 above
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besides that the DRUG_STRENGTH table may put {actuat} in the denominator
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unit. In this case the strength is provided in the numerator.<br>
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<strong>DRUG_STRENGTH</strong> The denominator_unit is {actuat}<br>
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<strong>DRUG_EXPOSURE</strong> The quantity refers to the number of
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pieces, e.g. puffs<br>
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<code>Ingredient dose= quantity x numerator_value [numerator_unit_concept_id]</code><br>
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Daily dose = Ingredient dose/drug duration<br><br> <strong>3. Quantified
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Drugs which are formulated as a concentration</strong><br><br>
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<strong>Example</strong>: The Clinical Drug is Acetaminophen 250 mg/mL
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in a 5mL oral suspension. The Quantified Clinical Drug would have 1250
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mg / 5 ml in the DRUG_STRENGTH table. Two suspensions are dispensed.<br>
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<strong>DRUG_STRENGTH</strong> The denominator_unit is either mg or mL.
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The denominator_value might be different from 1.<br>
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<strong>DRUG_EXPOSURE</strong> The quantity refers to a fraction or
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multiple of the pack.<br> <em>In the example</em>: 2<br>
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<code>Ingredient dose= quantity x numerator_value [numerator_unit_concept_id]</code><br>
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<em>Acetaminophen dose</em> = 2 x 1250mg = 2500mg<br> Daily dose =
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Acetaminophen dose/drug duration<br><br> <strong>4. Drugs with the total
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amount provided in quantity, e.g. chemotherapeutics</strong><br><br>
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<strong>Example</strong>: 42799258 “Benzyl Alcohol 0.1 ML/ML / Pramoxine
|
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hydrochloride 0.01 MG/MG Topical Gel” dispensed in a 1.25oz pack.<br>
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<strong>DRUG_STRENGTH</strong> The denominator_unit is either mg or
|
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mL.<br> <strong>Example</strong>: Benzyl Alcohol in mL and Pramoxine
|
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hydrochloride in mg<br> <strong>DRUG_EXPOSURE</strong> The quantity
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refers to mL or g.<br> <strong>Example</strong>: 1.25 x 30
|
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|
<em>(conversion factor oz -> mL)</em> = 37<br>
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|
<code>Ingredient dose= quantity x numerator_value [numerator_unit_concept_id]</code><br>
|
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|
<em>Benzyl Alcohol dose</em> = 37 x 0.1mL = 3.7mL<br> Daily dose =
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Benzyl Alcohol dose/drug duration<br> <em>Pramoxine hydrochloride
|
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|
dose</em> = 37 x 0.01mg x 1000 = 370mg<br> Daily dose = Pramoxine
|
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hydrochloride dose/drug duration<br><br> <strong>Note</strong>: The
|
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analytical side should check the denominator in the DRUG_STRENGTH table.
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As mg is used for the second ingredient the factor 1000 will be applied
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to convert between g and mg.<br><br> <strong>5. Compounded
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drugs</strong><br><br> <strong>Example</strong>: Ibuprofen 20%/Piroxicam
|
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1% Cream, 30ml in 5ml tubes.<br> <strong>DRUG_STRENGTH</strong> We need
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entries for the ingredients of Ibuprofen and Piroxicam, probably with an
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amount_value of 1 and a unit of mg.<br> <strong>DRUG_EXPOSURE</strong>
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The quantity refers to the total amount of the compound. Use one record
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in the DRUG_EXPOSURE table for each compound.<br>
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|
<strong>Example</strong>: 20% Ibuprofen of 30ml = 6mL, 1% Piroxicam of
|
|
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|
30ml = 0.3mL<br>
|
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|
|
<code>Ingredient dose= Depends on the drugs involved: One of the use cases above.</code>
|
|
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|
|
<em>Ibuprofen dose</em> = 6 x 1mg x 1000 = 6000mg<br> Daily dose =
|
|
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|
|
Ibuprofen dose/drug duration<br> <em>Piroxicam dose</em> = 0.3 x 1mg x
|
|
|
|
|
1000 = 300mg<br> Daily dose = Piroxicam dose/drug duration<br>
|
|
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|
|
<strong>Note</strong>: The analytical side determines that the
|
|
|
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|
denominator for both ingredients in the DRUG_STRENGTH table is mg and
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|
|
applies the factor 1000 to convert between mL/g and mg.<br><br>
|
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|
|
<strong>6. Drugs with the active ingredient released over time,
|
|
|
|
|
e.g. patches</strong><br><br> <strong>Example</strong>: Ethinyl
|
|
|
|
|
Estradiol 0.000833 MG/HR / norelgestromin 0.00625 MG/HR Weekly
|
|
|
|
|
Transdermal Patch<br> <strong>DRUG_STRENGTH</strong> The denominator
|
|
|
|
|
units refer to hour.<br> <strong>Example</strong>: Ethinyl Estradiol
|
|
|
|
|
0.000833 mg/h / norelgestromin 0.00625 mg/h<br>
|
|
|
|
|
<strong>DRUG_EXPOSURE</strong> The quantity refers to the number of
|
|
|
|
|
pieces.<br> <strong>Example</strong>: 1 patch<br>
|
|
|
|
|
<code>Ingredient rate= numerator_value [numerator_unit_concept_id]</code><br>
|
|
|
|
|
<em>Ethinyl Estradiol rate</em> = 0.000833 mg/h<br> <em>norelgestromin
|
|
|
|
|
rate</em> 0.00625 mg/h<br> <strong>Note</strong>: This can be converted
|
|
|
|
|
to a daily dosage by multiplying it with 24. (Assuming 1 patch at a time
|
|
|
|
|
for at least 24 hours)</p>
|
2019-08-28 15:02:47 +00:00
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</div>
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</div>
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<script>
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// add bootstrap table styles to pandoc tables
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function bootstrapStylePandocTables() {
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2021-01-06 15:52:57 +00:00
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|
|
$('tr.odd').parent('tbody').parent('table').addClass('table table-condensed');
|
2019-08-28 15:02:47 +00:00
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}
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$(document).ready(function () {
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bootstrapStylePandocTables();
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});
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</script>
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|
2020-04-27 20:35:41 +00:00
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<!-- tabsets -->
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<script>
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$(document).ready(function () {
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window.buildTabsets("TOC");
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});
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$(document).ready(function () {
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$('.tabset-dropdown > .nav-tabs > li').click(function () {
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$(this).parent().toggleClass('nav-tabs-open');
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});
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});
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</script>
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<!-- code folding -->
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2019-08-28 15:02:47 +00:00
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var script = document.createElement("script");
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script.type = "text/javascript";
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script.src = "https://mathjax.rstudio.com/latest/MathJax.js?config=TeX-AMS-MML_HTMLorMML";
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