Cancer_Modifier. Metastasis - OHDSI/Vocabulary-v5.0 GitHub Wiki
Being a part of the Cancer Modifier Vocabulary, the Metastasis Concept Class is developed to capture facts of distant metastatic spread.
The concepts in the Class are organized in internal hierarchical relationships to ease phenotyping and querying.
Root Concept | Metastasis |
↓Subsumes | |
Concept-1 | Metastasis to bone |
↓Subsumes | |
Concept-2 | Metastasis to bone of skull |
↓Subsumes | |
Concept-3 | Metastasis to ethmoid bone |
The concepts are also linked to special anatomical sites according to the metastasis location. These links are built to be used to provide access to the major Standard OMOP terminology - SNOMED.
The concept class is designed to be used as a trigger for Metastatic Disease Episode and in some cases as a trigger of Progression Episode from Disease Extent and Disease Dynamic Episode classes respectively.
- The first time a Metastasis occurs - the Metastatic Disease Episode has to be initiated. Once metastatic - always metastatic.
- Every new distinct concept_id from the class could trigger the Progression Episode as the majority of widely used clinical protocols interpret new cancerous lesions as Progression.
- The concepts are designed as comprehensive and self-sufficient facts, thus there is NO need to use value_as_concept_id.
- If tracking of Metastatic disease dynamics is desired, then the facts may be stored as postcoordinated pairs (event and value). In this case, we suggest storing the distinct value_as_concept_id for the same Metastasis concept (measurement_concept_id) to reflect the time course of the metastasis development. For value examples see the table below.
value_concept_id | value_concept_name | value_concept_class_id | value_vocabulary_id |
4181412 | Present | Meas Value | SNOMED |
4132135 | Absent | Meas Value | SNOMED |
4128639 | Decrease | Meas Value | SNOMED |
4123515 | Increase | Meas Value | SNOMED |
… etc |
- To denote the Lymph Node involvement, please use the Nodes concept class concept irrespective of pattern of lymphonodular spread(regional=local and metastatic=distant). The potential target for (distant) ‘Metastasis to lymph nodes’ is Distant Lymph Nodes concept. Potential structure of Nodes concept class and it’s interaction with Metastasis class is discussed in Issue.