[PDF] Mapping’the’666Mpaent’French’Naonwide’Healthcare’Database



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Nicolas Thurin

1, 2 , Marine Pénichon 1 , Régis Lassalle 1 , Patrick Blin 1 , Cécile Droz䇳Perroteau 1 , Martijn Schuemie 3 , Nicholas Moore 1, 2

Ø SNDS (Système National des Données de Santé) is the French Nationwide Healthcare System Database • Covers about 99% of the French population (about 66.6 million persons) from birth (or immigration) to death (or emigration) • Merges information of reimbursed claims (SNIIRAM) linked to the national hospital-discharge summary (PMSI) and the national death registry (CépiDC) • Includes: demographics; physician or paramedical visits (without medical indication); dispensed drugs and medical devices; lab tests (without results); chronic medical conditions; hospitalization with ICD10 codes for primary, linked and associated diagnoses, date and duration; reimbursed procedures

Ø EGB (Echantillon Généraliste de Bénéficiaires) is the 1/97 th random

permanent representative sample of SNDS. • 810 000 persons • Planned 20-year longitudinal data • Same structure than SNDS

Ø EGB is an ideal candidate for assessing the possibility to apply the

OMOP CDM to the SNDS

2018 European OHDSI Symposium, March 23

th , Rotterdam, Netherlands

Background Conclusions

1 Bordeaux PharmacoEpi, INSERM CIC1401, Université de Bordeaux, Bordeaux, France; 2

INSERM U1219, France;

3

Janssen R&D, Titusville, New Jersey, USA Methods

1. Extraction of an EGB sample (extraction of all the myocardi al infarctions between 2009 and 2014)

2. Data management of the 74 resulting datasets to 14 transitional

ones

• Socio demographic data • Medical visits • Chronic medical conditions • Hospitalization diagnoses • Drug dispensings • Lab tests • Outpatient procedures • Inpatient procedures

3. ETL design

• Theoretical mapping of the variables from EGB to OMOP CDM v5 (Figure 1.) • Assessment of the mapping from source codes and thesauri to

OMOP standardized vocabulary (Table 1.)

4. Effective mapping of data

• Variables mapping • Generation of the treatment durat ion for t he drug_exposure table according to drug dispensings data • Codes mapping whenever present in OMOP vocabulary

Ø Most of the standardized clinical data tables can be generated following OHDSI Extract Transform and Load (ETL) process. However the mapping of the French terminologies for procedures, lab tests, drugs and devices to OMOP Standard Vocabularies is required to complete fully the transformation of the clinical part of EGB and SNDS and enable the use of the whole set of OHDSI

tools

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Results

Ø Most of the national nomenclatures used in France are not included in the OMOP vocabularies • CIP is used to identify drug boxes dispensed in community pharmacies • UCD is used to identify expensive drugs dispensed in the hospitals • LPP is mainly used to code reimbursed medical devices • CCAM is used to code outpatient and inpatient procedures • NABM is used to code inpatient and outpatient lab tests Effective mapping of data

nicolas.thurin@u-bordeaux.fr Figure 1. EGB data Mapping Approach to CDM v5 (clinical part only, without devices)

ETL design Ø To date, 4 data tables have been generated • person Ÿ drug_exposure • location Ÿ observation_period Ø Drug treatment duration for the drug_exposure table has been generated using medians of treatment duration and taking into account the 3-month drug boxes. Ø The theoretical mapping of the 14 transitional tables corresponding to the clinical part of the EGB has been realized through WhiteRabbit and RabbitInHat softwares (Figure 1.)

Table 1. Presence of EGB and SNDS vocabularies in the OMOP vocabularies Ø Other 5 data tables have not been created yet but do not seem to present technical difficulties • death Ÿ condition_occurence Ÿ care_site • provider Ÿ visit_occurence

Ø Generation of procedure_occurence and measurements tables requires the mapping of CCAM and NABM vocabularies to standard concepts EGB CDM V5

socio-demographics non-hosp. outpatient visits long term condition principal and related diagnosis of hosp. stays associated diagnosis of hosp. stays treatment dispensing private hosp. inpatient lab tests public hosp. outpatient lab tests non-hosp. outpatient lab tests non-hosp. outpatient procedures public hosp. outpatient procedures private hosp. inpatient procedures public hosp. inpatients procedures public hosp. inpatient lab tests

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