Mei:  As I have suggested earlier in this thread, we need *some* date, and it 
doesn’t matter much which date.
If, as now appears, what date that is varies across sites, it is *not* in my 
judgment worth the effort to use a date that is consistent across sites.

The larger issue, which we are still gathering information on, is general date 
shifting.
I am hoping that we will be able to converge on a plan, adapted from a 
suggestion earlier today by Philip Reader at UT Southwestern, in which we get 
from each GPC site *non-shifted dates, which are partly de-identified [turned 
from identifiable to “limited” or “research-identifiable”] by providing only 
year and month.  That works for UT Southwestern, and from separate discussion, 
I believe that it should work for Indiana and Iowa.  We may handle MCW 
separately since they only date shift by +/- 10 days to begin with.

We will still have to confirm that this works for us on the receiving end (I’m 
checking on that).  But that will be easier if we can tell our IRB that we’ve 
already worked this out with y’all.


Bernie

*************************************************************
Bernard S. Black
Chabraja Professor, Northwestern University
Pritzker Law School and Kellogg School of Management
375 East Chicago Ave., Chicago IL 60611
bbl...@northwestern.edu<mailto:bbl...@northwestern.edu>
tel:  law:  312-503-2784<tel:312-503-2784>; Kellogg 
847-491-5049<tel:847-491-5049>; cell: 847-807-9599<tel:847-807-9599>
papers on SSRN at:  http://ssrn.com/author=16042
************************************************************

From: Mei Liu [mailto:mei...@kumc.edu]
Sent: Wednesday, January 25, 2017 2:20 PM
To: Al'ona Furmanchuk <alona.furmanc...@northwestern.edu>; Dan Connolly 
<dconno...@kumc.edu>
Cc: Bernard Black <bbl...@kellogg.northwestern.edu>; gpc-dev@listserv.kumc.edu; 
Stoddard, Alexander <astodd...@mcw.edu>
Subject: RE: [gpc-informatics] #551: next-D labs for cohort selection
Importance: High

So far based on the site replies, Nebraska and UTSW are using specimen_date as 
the start_date and KUMC and MCW are using result_date. I suggest that we first 
figure out the variability of this information at each site (simple question) 
before asking them to calculate the max difference (more complicated).

If the max difference is calculated across all labs, the result won’t be 
representative for the labs required for Next-D, maybe even nonsensical due to 
work flow differences as Alex Stoddard mentioned. Based on my understanding, 
difference between lab order date and specimen taken date can be large in the 
outpatient setting because a patient may wait for quite a while before going to 
the lab. On the other hand, I suspect that the difference between specimen 
taken date and the result date won’t vary too much among patients because same 
facilities are used for result generation (if it takes 2 days to get a lab 
result, the same is likely to apply for all patients).

With this said, if all the participating GPC sites uses either specimen or 
result date as the start date, would it significantly affect the Next-D cohort 
selection and analysis if no change is made?

--
Mei

From: Gpc-dev [mailto:gpc-dev-boun...@listserv.kumc.edu] On Behalf Of Al'ona 
Furmanchuk
Sent: Wednesday, January 25, 2017 1:00 PM
To: Dan Connolly
Cc: Bernard Black; gpc-dev@listserv.kumc.edu<mailto:gpc-dev@listserv.kumc.edu>; 
Stoddard, Alexander
Subject: Re: [gpc-informatics] #551: next-D labs for cohort selection

When I asked for date difference I was asking about any lab type.
Glucose labs are not in PCORNET model and have to be pull out from i2b2 
separately. For A1c(which is in PCORNET model)  I was assuming all sites have 
all 3 dates available.
I was not aware situation is so bad. Lets discuss it in the next CAPRICORN/GPC 
meeting.


On Wed, Jan 25, 2017 at 12:45 PM, Dan Connolly 
<dconno...@kumc.edu<mailto:dconno...@kumc.edu>> wrote:
I started looking at date differences... for similar reasons to the ones Alex 
gave, I thought a histogram was in order... I had assumed the specimen date and 
order date were in the same table as the result date. But I don't see them. I 
don't know where they are.

My earlier 1 to 2 month estimate for revising HERON ETL was based on this 
assumption. I no longer have a clear design in my head, so multiply my estimate 
by 2x to 3x until I know more.

--
Dan

________________________________________
From: Gpc-dev 
[gpc-dev-boun...@listserv.kumc.edu<mailto:gpc-dev-boun...@listserv.kumc.edu>] 
on behalf of Stoddard, Alexander [astodd...@mcw.edu<mailto:astodd...@mcw.edu>]
Sent: Wednesday, January 25, 2017 11:41 AM
To: gpc-dev@listserv.kumc.edu<mailto:gpc-dev@listserv.kumc.edu>
Subject: Re: [gpc-informatics] #551: next-D labs for cohort selection

I’ll return the Excel spreadsheet survey with info for MCW outside of the dev 
list.

MCW uses RESULT_DATE for the i2b2 “START_DATE” for lab facts.  START_DATE being 
a very poor name imposed by the i2b2 schema, it’s really just “some date” for a 
fact without any explicit context – hence the difference choices we will find 
between sites. It is also the “only date” that can be used to ask time relative 
questions of any given set of  facts in i2b2 unless we start creating related 
concepts or being inventive with modifier codes. I know of no example of i2b2 
modifier codes modifying the _date_ of a fact as opposed to the _value_. I 
think the schema would support it in principle but I have no idea if the client 
and generated queries would. This would also be a long term major ETL 
development task.

We do have all three of order_date, specimen_date and result_date from our Epic 
source data. But specimen date is only partially available, we are at the mercy 
of manual data entry and data validation upstream of us in the system. That is, 
at least in part, why MCW made the expedient choice of making RESULT_DATE our 
anchor for lab facts, it was the “best” one that was consistently available in 
the large.

Are the max difference questions for the different date types to be answered in 
the limited context of only to A1C values, or all lab results in our source 
system (or some broader subset)?

I fear a simple max difference is going to be non-robust, uninformative, and 
look very bad (or even nonsensical) for us. Some work flows upstream (at least 
at MCW) for entering lab results into the EHR use manual data abstraction, and 
others use (at times broken) automated abstraction with poorly mapped date 
field semantics. There is going to be some percentage of completely bogus date 
values. To truly assess the lag between the different lab date semantics will 
probably take calculating percentiles of the differences for individual lab 
tests – this is obviously more effort and we will need guidance on how soon an 
answer is needed for it to be useful and if it is worth the effort and/or worth 
the wait.

Thank you,

 Alex Stoddard
Biomedical Informatics Software Engineer
CTSI
Medical College of Wisconsin



Date: Wed, 25 Jan 2017 08:29:17 -0600
    From: "Al'ona Furmanchuk" 
<furmanc...@icnanotox.org<mailto:furmanc...@icnanotox.org>>
    To: Dan Connolly <dconno...@kumc.edu<mailto:dconno...@kumc.edu>>
    Cc: Bernard Black 
<bbl...@kellogg.northwestern.edu<mailto:bbl...@kellogg.northwestern.edu>>,
        "<gpc-dev@listserv.kumc.edu<mailto:gpc-dev@listserv.kumc.edu>>" 
<gpc-dev@listserv.kumc.edu<mailto:gpc-dev@listserv.kumc.edu>>
    Subject: Re: [gpc-informatics] #551: next-D labs for cohort selection:
        fasting glucose, HbA1c
    Message-ID:
        
<cadevuy6gxhn009napqyucrnjukds1zodzpw6fwyovrk7cy9...@mail.gmail.com<mailto:cadevuy6gxhn009napqyucrnjukds1zodzpw6fwyovrk7cy9...@mail.gmail.com>>
    Content-Type: text/plain; charset="utf-8"

    Before we go toward changes, lets just see if we need to. I would
    appreciate if each site could fill up attached form and send back to me. I
    filled some sites based on this discussion. Please, check and correct if I
    got it wrong.
    Alona.



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--
Al’ona Furmanchuk, Ph.D.
Research Associate

Department of Electrical Engineering and Computer Science
Northwestern University
2145 Sheridan Road, Tech L359
Evanston, IL 60208
Web: 
http://furmanchuk.com/<https://urldefense.proofpoint.com/v2/url?u=http-3A__furmanchuk.com_&d=CwMGaQ&c=yHlS04HhBraes5BQ9ueu5zKhE7rtNXt_d012z2PA6ws&r=UogPJ7VYoAeiC8NNwyY5AxLx8QgaRiMcicgAv7oi3tc&m=vwlur8tl2Bo6IylrHsoPoEJPCGHMYkOQTQb-4KcwwpI&s=bMpFb1a4Wsc4ZLoa0NaOBL_XHMTPqkLXzRfaQw3vFrE&e=>
E-mail: alona.furmanc...@northwestern.edu<mailto:furmanc...@icnanotox.org>
Phone: 847-467-2299
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