DRUG_EXPOSURE

Link to CommonDataModel

• DRUG_EXPOSURE

Source Tables (mimic)

prescriptions

• omitted, rows which not have any enddate. They are only 5K on 4M. Since drug_exposure_end_date cannot be null.
• mapped to RxNorm done by Paul Church
• drug_type_concept_id = 38000177 ("Prescription written")
• sig contains informations of doses (workaround)
• visit_detail_id is not assigned; this is because there is no time information and therefore no sufficient precision

inputevents_cv

• drug_type_concept_id = 38000180 ("Inpatient administration")
• drug_exposure_start_datetime or drug_exposure_end_datetime are null (because there is no end charttime in inputevents_cv).

As provided on physionet "For amounts received (usually volumes), the CHARTTIME represents the time at which that volume was received. That is, it can be considered an “end time”, i.e. X millilitres of solution was administered to the patient by this CHARTTIME. For rates, the CHARTTIME represents the time at which that rate was set. That is, it can be considered a “start time”, i.e. the patient is now receiving X mcg/kg/min of a drug at this CHARTTIME".

We choose not to infer missing times. So amount have no starttime and rates have no endtime!

• visit_detail_id is assigned

inputevents_mv

• drug_type_concept_id = 38000180 ("Inpatient administration")
• row with cancelled have not been exported from mimic
• visit_detail_id is assigned

Mapping used

continue_unit_carevue

• add good format to units

inputevents_drug

• it maps common drugs from inputevents

route

• it maps common route of drugs from inputevents

Examples

explanation of drug_type_concept_id

SELECT concept_name, drug_type_concept_id, count(1)
FROM drug_exposure
JOIN concept ON drug_type_concept_id = concept_id
GROUP BY concept_name, drug_type_concept_id ORDER BY count(1) desc;

concept_name	drug_type_concept_id	count
Inpatient administration	38000180	53225
Prescription written	38000177	9715

explanation of the route_concept_id

SELECT distinct(concept_name) 
FROM drug_exposure 
JOIN concept ON route_concept_id = concept_id;

concept_name
Intraocular
Infusion, intravenous catheter, continuous
Subcutaneous
Injection, intravenous, rapid push
Nasal
No matching concept
Sublingual
Buccal
Oral
Intrathecal
Intraperitoneal
Rectal
Endotracheopulmonary
Intracerebroventricular
Genitourinary therapy
Auricular
Administration of substance via oral route
Intramuscular
Administration of substance via subcutaneous route
Intravenous injection
Regional perfusion
Intraarticular
Intravaginal
Inhalation
Haemodialysis
Intraventricular cardiac
Transdermal
Epidural
Topical
Intravenous
Intrapleural

repartition of drug, with non omop mimic labels

-- as used in prescriptions table (= prescribed medications)
SELECT drug_source_value, count(1)
FROM drug_exposure
WHERE drug_type_concept_id = 38000177                                  		-- concept.concept_name = 'Prescription written'
GROUP BY 1 ORDER BY count(1) desc limit 10;

drug_source_value	count
Potassium Chloride	477
0.9% Sodium Chloride	378
D5W	334
NS	297
Insulin	274
Furosemide	253
Iso-Osmotic Dextrose	238
Magnesium Sulfate	220
SW	198
Acetaminophen	183

repartition of drug, with omop concept = RxNorm mapping

-- as used in prescriptions table (= prescribed medications)
SELECT concept_id, concept_name, count(1)
FROM drug_exposure
JOIN CONCEPT  ON drug_concept_id = concept_id
WHERE drug_type_concept_id = 38000177 						-- concept.concept_name = 'Prescription written'
GROUP BY 1, 2 ORDER BY count(1) desc limit 10;

concept_id	concept_name	count
19096877	Anhydrous Dextrose	407
0	No matching concept	385
967823	Sodium Chloride	322
19010309	Water	260
40220357	1000 ML Sodium Chloride 9 MG/ML Injection	205
36249737	250 ML Glucose 50 MG/ML Injection	199
1718752	50 ML Potassium Chloride 0.4 MEQ/ML Injection	165
1596977	Regular Insulin, Human	164
40221385	100 ML Sodium Chloride 9 MG/ML Injection	152
35603227	4 ML Furosemide 10 MG/ML Injection	139

drugs are linked in fact_relationship table

-- two levels of links to represent linkorderid and orderid in mimic
-- Warning : fact_id_1 and fact_id_2 may be the solution or the main drug
SELECT drug_1.drug_source_value as drug_1, drug_2.drug_source_value as drug_2
FROM
(
        SELECT fact_id_1, fact_id_2
        FROM fact_relationship
        WHERE fact_id_1 IN
	(
                SELECT drug_exposure_id
                FROM drug_exposure
                WHERE drug_type_concept_id = 38000180                 -- concept.concept_name = 'Inpatient administration'
	)

) as couple
JOIN drug_exposure drug_1 ON drug_1.drug_exposure_id = fact_id_1
JOIN drug_exposure drug_2 ON drug_2.drug_exposure_id = fact_id_2
WHERE drug_1.drug_source_value != drug_2.drug_source_value
AND drug_1.drug_source_value is not null
AND drug_2.drug_source_value is not null
LIMIT 10;

drug_1	drug_2
Cefazolin	NaCl 0.9%
Norepinephrine	NaCl 0.9%
Potassium Chloride	KCL (Bolus)
Solution	Propofol
NaCl 0.9%	Pantoprazole (Protonix)
NaCl 0.9%	Norepinephrine
Solution	Famotidine (Pepcid)
Levofloxacin	Dextrose 5%
Calcium Gluconate (CRRT)	Dextrose 5%
NaCl 0.9%	Norepinephrine

to extract only the non omop mimic id from inputevents_cv

-- warning : when the drug is IV, with a rate record, drug_exposure_end_datetime is always null
-- warning : when the drug is IV, whis an amount recorded drug_exposure_start_datetime is always null
SELECT *
FROM drug_exposure
WHERE drug_source_concept_id IN 
(
	SELECT concept_id 
	FROM concept  
	WHERE concept_name ILIKE '%carevue%'
)
AND drug_type_concept_id = 38000180; 						-- concept.concept_name = 'Inpatient administration'

to extract only the non omop mimic id from inputevents_mv

SELECT *
FROM drug_exposure
WHERE drug_source_concept_id IN 
(
	SELECT concept_id 
	FROM concept  
	WHERE concept_name ILIKE '%metavision%'
)
AND drug_type_concept_id = 38000180; 						-- concept.concept_name = 'Inpatient administration'

to find IV continuous drugs recorded in rate

SELECT distinct on (drug_source_value) quantity, dose_unit_source_value, drug_source_value, drug_source_concept_id, drug_exposure_start_datetime, drug_exposure_end_datetime
FROM drug_exposure
WHERE route_concept_id = 45879918                                                 -- concept.concept_name = 'Infusion, intravenous catheter, continuous'
AND dose_unit_source_value ILIKE '%/%'
ORDER BY drug_source_value, drug_exposure_start_datetime
LIMIT 10;

quantity	dose_unit_source_value	drug_source_value	drug_source_concept_id	drug_exposure_start_datetime	drug_exposure_end_datetime
300	mL/hour	Albumin 25%	2001030521	2135-05-17 18:22:00	2135-05-17 17:22:00
499.99998	mL/hour	Albumin 5%	2001030523	2130-11-14 19:19:00	2130-11-14 18:49:00
1.0016694	mg/min	Amiodarone	2001027331	2101-06-06 23:44:00	2101-06-06 17:00:00
0.5	mg/hour	Ativan	2001024300	2110-06-18 11:00:00
0.1000033297	mg/kg/hour	Cisatracurium	2001027337	2181-05-20 22:06:00	2181-05-20 21:57:00
49.9999986	mL/hour	D5 1/2NS	2001028689	2130-08-13 09:00:00	2130-08-13 04:00:00
49.9999986	mL/hour	D5LR	2001028691	2181-05-23 19:56:00	2181-05-23 11:10:00
249.991524	mL/hour	D5NS	2001028690	2185-08-14 14:56:00	2185-08-14 11:00:00
0.2001280807	mcg/kg/hour	Dexmedetomidine (Precedex)	2001030569	2133-11-15 03:00:00	2133-11-14 20:25:00
150	mL/hour	Dextrose 5%	2001030526	2101-06-02 02:49:00	2101-06-01 20:10:00

to find IV continuous drugs recorded in amount

SELECT distinct on (drug_source_value) quantity, dose_unit_source_value, drug_source_value, drug_source_concept_id, drug_exposure_start_datetime, drug_exposure_end_datetime
FROM drug_exposure
WHERE route_concept_id = 45879918                                                 -- concept.concept_name = 'Infusion, intravenous catheter, continuous'
AND dose_unit_source_value NOT ILIKE '%/%'
ORDER BY drug_source_value, drug_exposure_start_datetime 
LIMIT 10;

quantity	dose_unit_source_value	drug_source_value	drug_source_concept_id	drug_exposure_start_datetime	drug_exposure_end_datetime
100	ml	.45% Normal Saline	2001024228		2193-02-08 22:00:00
125	ml	.9% Normal Saline	2001024227		2115-09-10 23:00:00
2.0000001	grams	Calcium Gluconate	2001027335	2101-06-02 02:30:00	2101-06-02 01:30:00
200	ml	D5/.45NS	2001024225		2160-12-23 20:00:00
10	ml	D5W	2001023343		2177-08-21 08:00:00
0.1	mg	Folate	2001024257		2132-07-17 02:00:00
1.00000004	mg	Folic Acid	2001028694	2130-08-14 17:36:00	2130-08-14 17:16:00
2.5	mEq	KCL	2001023347		2131-08-05 15:00:00
10.0000008	mmol	K Phos	2001028696	2119-05-27 16:00:00	2119-05-27 15:00:00
250	ml	Lactated Ringers	2001023345		2140-03-18 00:00:00