1 List of Abbreviations

AESI adverse events of special interest
CCAE IBM MarketScan(R) Commercial Claims and Encounters
CDM Common Data Model
COVID-19 COronaVIrus Disease 2019
CPRD Clinical Practice Research Datalink
CUIMC Columbia University Irving Medical Center
DA Disease Analyzer
EHR Electronic Health Record
EHDEN European Health Data & Evidence Network
FDA U.S. Food and Drug Administration
JMDC Japan Medical Data Center
MDCD IBM MarketScan(R) Multi-State Medicaid Database
MDCR IBM MarketScan(R) Medicare Supplemental Database
OHDSI Observational Health Data Science and Informatics
OMOP Observational Medical Outcomes Partnership
OPTUM_DOD Optum(R) de-identified Clinformatics<U+00AE> Data Mart Database <U+0096> Date of Death
OPTUM_EHR Optum(R) de-identified Electronic Health Record Dataset
TAR time-at-risk
TTS thrombosis with thrombocytopenia syndrome

2 Responsible Parties

2.1 Investigators

Investigator Institution/Affiliation
Erica A Voss * Observational Health Data Analytics, Janssen Research and Development, Titusville, NJ, USA
Azza Shoaibi Observational Health Data Analytics, Janssen Research and Development, Titusville, NJ, USA
Anna Ostropolets Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, NY, USA
Fredrik Nyberg School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Thamer Alshammary Medication Safety Research Chair, King Saud University, Riyadh, Saudi Arabia
Marc A. Suchard Department of Biostatistics, University of California, Los Angeles, Los Angeles, CA, USA
Martijn J. Schuemie Observational Health Data Analytics, Janssen Research and Development, Titusville, NJ, USA
Dani Prieto-Alhambra Centre for Statistics in Medicine, NDORMS, University of Oxford, Oxford, UK
Peter R Rijnbeek Erasmus University Medical Center, Rotterdam, The Netherlands
Patrick B Ryan Observational Health Data Analytics, Janssen Research and Development, Titusville, NJ, USA
* Principal Investigator

2.2 Disclosures

This study is undertaken within Observational Health Data Sciences and Informatics (OHDSI), an open collaboration.

Data sources associated with the EHDEN network received funding from the Innovative Medicines Initiative 2 Joint Undertaking (JU) under grant agreement No 806968. The JU receives support from the European Union’s Horizon 2020 research and innovation programme and EFPIA.

EAV, AS, MJS, and PBR are employees Janssen Research & Development, LLC and are Johnson & Johnson shareholders.

MAS receives grant funding from the US National Institutes of Health and the US Food & Drug Administration and contracts from the US Department of Veterans Affairs and Janssen Research and Development.

3 Amendments and Updates

Table 3.1 lists any protocol amendments made over time.

Table 3.1: Protocol amendments
Number Date Section of study protocol Amendment or update Reason
1.0.0 2021.11.02
1.0.1 2022.02.20 Milestones / Outcome Cohort Definitions (in text and Appendix) Improved milestones based on current state and added additional anaphylaxis definition In working with IPCI, we learned there were anaphylaxis concepts not included in our original definition (because they did not have source codes associated to them [e.g., 42536383-anaphlaxis shock]). However, IPCI had a source to standard mapping to these missing anaphylaxis concepts. Updated cohort is Cohort 567 - Anaphylaxis V2.0. Since the protocol is being updated, took the opportunity to improve the milestone dates.

4 Milestones

Table 4.1 lists the study milestones.

Table 4.1: Study milestones
Milestone Planned / actual date
Start of analysis 2021-11-29
End data collection 2022-02-28
End of analysis 2022-03-31
Results presentation 2022-04-30

5 Rationale and Background

Background rates of adverse events are important in monitoring the safety of vaccines as this baseline information can serve as a comparator to the rates of the adverse events in those that are vaccinated ( [1] , [2] ). Previously, the Observational Health Data Sciences and Informatics (OHDSI) community conducted a population-based network retrospective cohort study to characterize the background rates of adverse events of special interest (AESI) for the COVID-19 vaccine, using observational data from 13 databases in 8 countries [3]. This work extends this prior OHDSI study by characterizing the background rates of these AESIs in subjects after their COVID-19 disease. In addition to pre-pandemic rates in the general population, it is relevant to know how often these AESIs occur amongst patients who suffer the condition vaccines aim to prevent to provide a counterfactual for risk evaluation.

6 Study Objectives

We aim to quantify how often AESIs occur in subjects post COVID-19 disease overall and across specific age and sex groups.

Our aim is purely descriptive. The hope with this work is the evidence we provide can be used to contextualize safety signals among the vaccinated and also inform risk benefit analysis

7 Research Methods

7.1 Data Sources

We intend to study data with different data source provenance (e.g., electronic medical records, insurance claims) as well data representing different populations (privately insured employees or patients with limited income) and data with different origins (US and non-US). This study will be run on datasets that have been converted to the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM) [4] [5].

These data sources include but are not limited to:

  • Columbia University Irving Medical Center (CUIMC) Electronic Health Record (EHR)
  • Stanford
  • IBM MarketScan® Commercial Claims and Encounters (CCAE)
  • IBM MarketScan® Medicare Supplemental Beneficiaries (MDCR)
  • IBM MarketScan® Multi-state Medicaid (MDCD)
  • IQVIA® Disease Analyzer (DA) Germany (IQVIA_GERMANY_DA)
  • IQVIA® Disease Analyzer (DA) France (IQVIA_FRANCE_DA)
  • IQVIA® Australia Longitudinal Patient Data (IQVIA_AUSTRALIA_LPD)
  • Japan Medical Data Center (JMDC)
  • Optum® de-identified Electronic Health Record Dataset (OPTUM_EHR)
  • Optum® de-identified Clinformatics® Data Mart Database – Date of Death (OPTUM_DOD)
  • Clinical Practice Research Datalink (CPRD) – GOLD / Aurum
  • Various European Health Data & Evidence Network (EHDEN) Data Partners
  • Other data sources from prospective data partners

7.2 Study Populations

We will define all target and outcome cohorts in the Atlas environment (https://atlas.ohdsi.org/). Detailed definitions can be found in the Appendix.

7.2.1 Target Cohort Definitions

The target population is subjects who had COVID-19 disease. We will identify this in three ways:

  • Cohort 562 - Earliest COVID-19 Event (positive test)
  • Cohort 563 - Earliest COVID-19 Event (positive test OR diagnosis)
  • Cohort 565 - Earliest COVID-19 Event (positive test OR diagnosis) (pre 2021)

An additional cohort will be added to run background incidence rates for the AESIs within a general population. This will allow us to more easily compare this work to the previously generated background rates [3].

  • Cohort 566 - Persons at Risk at Start of Year 2017-2019

7.2.2 Outcome Cohort Definitions

For the purposes of this research, we use the outcomes outlined in the U.S. Food and Drug Administration (FDA) “Background Rates of Adverse Events of Special Interest for COVID-19 Vaccine Safety Monitoring” protocol [6]. This protocol includes Guillain-Barré syndrome, facial nerve (Bell’s) palsy, anaphylaxis, encephalomyelitis, narcolepsy, appendicitis, non-hemorrhagic stroke, hemorrhagic stroke, acute myocardial infarction, myocarditis and pericarditis, deep vein thrombosis, pulmonary embolism, disseminated intravascular coagulation, immune thrombocytopenia, febrile seizure, and transverse myelitis. We will also include additional safety outcomes/concerns that emerged such as thrombosis with thrombocytopenia syndrome (TTS), seizure, and narcolepsy. All phenotype definitions were based on the FDA protocol (when possible) with minor clinical context broadening (and minor code broadening as needed for example to accommodate SNOMED) to allow them to run on our wide range of data sources.

We consider the effect of clean windows to define the incidence of outcomes. A clean window is the prespecified time prior to the vaccination (reference master protocol [6]). We will use an outcome-specific clean window, within which an outcome is not considered incident. The clean window (as also defined in the FDA protocol), is 365 days for all outcomes except 30 days for anaphylaxis and 183 days for facial nerve palsy and encephalomyelitis.

  • Cohort 411 - Pulmonary Embolism
  • Cohort 405 - Hemorrhagic Stroke
  • Cohort 406 - Non-Hemorrhagic Stroke
  • Cohort 402 - Deep Vein Thrombosis (DVT)
  • Cohort 386 - Appendicitis
  • Cohort 385 - Disseminated Intravascular Coagulation
  • Cohort 381 - Transverse Myelitis
  • Cohort 349 - Anaphylaxis V1.0
  • Cohort 568 - Anaphylaxis V2.0
  • Cohort 347 - Bell’s Palsy
  • Cohort 346 - Encephalomyelitis
  • Cohort 345 - Narcolepsy
  • Cohort 343 - Guillain Barre syndrome
  • Cohort 340 - Acute Myocardial Infarction
  • Cohort 339 - Myocarditis Pericarditis
  • Cohort 335 - Immune Thrombocytopenia (ITP)
  • Cohort 547 - Thrombosis with Thrombocytopenia (TWT)

7.3 Population Subgroups

In order to appropriately use incidence characterization among a target population (e.g., COVID-19 subjects) as context for interpreting an observed rate of adverse events in a given population (e.g., a population exposed to COVID-19 vaccines), it is important to consider the extent to which the target population is comparable to the exposed individuals.

One aspect of the target population is the population subgroup. We will consider the following age and sex subgroups independently and jointly. This work will not perform subgroup analysis on patients who have conditions that make them high risk for severe COVID-19 disease.

  • Age groups
    • Pediatric Age Groups:
      • 0-4
      • 5-11
      • 12-17
    • General:
      • 0–5
      • 6–17
      • 18–34
      • 35–54
      • 55–64
      • 65–74
      • 75–84
      • Greater Than 85 (>=)
    • Sex
      • Male
      • Female

7.4 Time-at-risk (TAR)

For AESI rates estimated for a general population, TAR is not possible to consider, since there is no obvious index point from which TAR would be counted. Consequently, AESI rates estimated over moderately long-time intervals are for statistical stability is generally an appropriate approach to give background rates. When trying to understand AESI in COVID-19 patients, in contrast, the onset of COVID-19 provides a natural index point, which may be directly relevant if the AESI is associated with COVID-19. For some outcomes, there is a known pathophysiological relationship between them and COVID-19 that can justify a choice of time at risk. For other outcomes, less is known. In estimating baseline incidence rates, there is a tension between using long time-at-risk windows to maximize the sample size and provide rate stability and using windows that match the planned windows in the vaccinated patients. Using windows that match the planned windows in vaccinated individuals would be relevant mainly for conditions where it may be possible that both COVID-19 and vaccination affect the outcome with similar TAR, which may be assumed to be the case mainly if they act through related or similar mechanisms. In other situations, the more relevant comparison or context may be stable long-term rates. AESI rates on COVID-19 individuals, for different TARs, will be particularly important to understand especially when AESIs are assessed in vaccinated individuals, where information on prior COVID-19 and its timing are available.

We will include seven TARs, relative to the COVID-19 index date, for this work.

  • Days 0 – 2 (to capture accute events)
  • Days 1 – 7 days (One Week)
  • Days 1 – 14 days (Two Weeks - to align with COVID-19 symptoms appearing [7])
  • Days 1 – 21 days (Three Weeks - this will likely be the target TAR post vaccines)
  • Days 1 – 28 days (Four Weeks)
  • Days 1 – 90 days
  • Days 1 – 365 days

For this work we are focused on the acute events of COVID-19, we are not estimating the post acute COVID-19 effects.

7.5 Incidence rate estimation outputs

The following will performed for every subgroup and TAR combination:

  • Absolute number of outcomes
  • Absolute number of outcomes prior to TAR start date
  • Absolute number of patients at risk
  • Absolute number of patients with outcomes prior to TAR start date
  • Absolute number of patients with outcomes within TAR interval
  • Incidence proportion of outcomes within TAR interval
  • Incidence rate of outcomes within TAR interval

In the above outcome counts, multiple data elements (e.g., multiple diagnosis codes) within a clean window count as one outcome. Patients will contribute time-at-risk from the index date (date of COVID-19 diagnosis or positive results) until the earliest of 365 days after the index, their observation period end date, or the start date of the outcome event. Persons with prior outcome events will not begin to contribute time-at-risk until the clean window requirement is satisfied.

We will generate descriptive statistics for all these cohorts using the OHDSI R tool called Cohort Diagnostics. Additionally, incidence rates will be calculated via an R package.

8 Strengths and Limitations

8.1 Strengths

  • Cohort studies allow direct estimation of incidence rates following exposure of interest, and the new-user design can capture early events following treatment exposures while avoiding confounding from previous treatment effects; new use allows for a clear exposure index date.
  • The fully specified study protocol is being published before analysis begins.
  • Dissemination of the results will not depend on estimated effects, avoiding publication bias.
  • All analytic methods have previously been verified on real data.
  • All software is freely available as open source.
  • Use of a common data model allows extension of the experiment to future databases and allows replication of these results on licensable databases that were used in this experiment, while still maintaining patient privacy on patient-level data.
  • Use of multiple databases allows estimating consistency to add credibility and supports generalizability.

8.2 Limitations

  • Misclassification of study variables is unavoidable in secondary use of health data, so it is possible to misclassify treatments, covariates, and outcomes; we do not expect differential misclassification, so bias will most likely be towards the null.
  • The electronic health record databases may be missing care episodes for patients due to care outside the respective health systems; bias will most likely be towards the null.
  • Causality between drug exposure and any given event cannot be drawn for individual cases.

9 Protection of Human Subjects

This work does not involve human subjects research. The project does, however, use de-identified human data collected during routine healthcare provision. Confidentiality of subject records will be maintained always. All study reports will contain aggregate data only and will not identify individual subjects or physicians. At no time during the study will the sponsor receive subject identifying information except when it is required by regulations in case of reporting adverse events.

All data partners executing this study within their data sources will have received institutional review board (IRB) approval or waiver for participation in accordance to their institutional governance prior to execution. This study will be executed across a federated and distributed data network, where analysis code is sent to participating data partners and only aggregate summary statistics are returned, with no sharing of patient-level data between organizations.

10 Management and Reporting of Adverse Events and Adverse Reactions

This study uses coded data that already exist in electronic databases. In these types of databases, it is not possible to link (i.e., identify a potential causal association between) a particular product and medical event for any specific individual. Thus, the minimum criteria for reporting an adverse event (i.e., identifiable patient, identifiable reporter, a suspect product and event) are not available and adverse events are not reportable as individual adverse event reports. The study results will be assessed for medically important findings.

11 Plans for Disseminating and Communicating Study Results

Open science aims to make scientific research, including its data process and software, and its dissemination, through publication and presentation, accessible to all levels of an inquiring society, amateur or professional [8]. Open science delivers reproducible, transparent and reliable evidence. All aspects of study (except private patient data) will be open, and we will actively encourage other interested researchers, clinicians and patients to participate.

11.1 Transparent and re-usable research tools

The protocol and all source code will be available here prior to execution across the federated and distributed network. https://github.com/ohdsi-studies/Covid19SubjectsAesiIncidenceRate

11.2 Continuous sharing of results

We will store and openly communicate all of these results as they become available using a user-friendly web-based app.

11.3 Scientific meetings and publications

We will deliver multiple presentations at scientific venues and will also prepare multiple scientific publications for clinical, informatics, and statistical journals.

11.4 General public

We believe in sharing our findings that will guide clinical care with the general public. This study will use social-media (Twitter-OHDSI) to facilitate this.

References

1
Black S, Eskola J, Siegrist CA, et al. Importance of background rates of disease in assessment of vaccine safety during mass immunisation with pandemic H1N1 influenza vaccines. Lancet 2009;374:2115–22. doi:10.1016/s0140-6736(09)61877-8
2
Wijnans L, Lecomte C, Vries C de, et al. The incidence of narcolepsy in europe: Before, during, and after the influenza a(H1N1)pdm09 pandemic and vaccination campaigns. Vaccine 2013;31:1246–54. doi:10.1016/j.vaccine.2012.12.015
3
Li X, Ostropolets A, Makadia R, et al. Characterizing the incidence of adverse events of special interest for COVID-19 vaccines across eight countries: A multinational network cohort study. medRxiv Published Online First: 2021. doi:10.1101/2021.03.25.21254315
4
Observational medical outcomes partnership common data model (OMOP CDM). https://github.com/OHDSI/CommonDataModel
5
Hripcsak G, Duke JD, Shah NH, et al. Observational health data sciences and informatics (OHDSI): Opportunities for observational researchers. Studies in Health Technology and Informatics 2015;216:574–8.
6
Background rates of adverse events of special interest for COVID-19 vaccine safety monitoring protocol. 2021.https://www.bestinitiative.org/wp-content/uploads/2021/02/C19-Vaccine-Safety-AESI-Background-Rate-Protocol-FINAL-2020.pdf
7
Symptoms of COVID-19. https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html
8
Woelfle M, Olliaro P, Todd MH. Open science is a research accelerator. Nature Chemistry 2011;3:745–8.

Appendix

A Target Cohort Definitions

A.1 Cohort 562 - Earliest COVID-19 Event (postive test)

A.1.1 Cohort Entry Events

People may enter the cohort when observing any of the following:

  1. measurements of ‘SARS-CoV-2 test’, starting after December 1, 2019; with value as concept: “detected”, “detected”, “positive”, “positive”, “present” or “present”.

  2. condition occurrences of ‘COVID-19’, starting after December 1, 2019.

Limit cohort entry events to the earliest event per person.

A.1.2 Additional Inclusion Criteria

  • Continuous Observation of at least 365d

Entry events having at least 1 observation period, starting anytime up to 365 days before cohort entry start date and ending between 0 days after and all days after cohort entry start date.

  • No COVID-19/SARS-CoV-2 Tests Prior to Index

Entry events with all of the following criteria:

  1. having no measurements of ‘SARS-CoV-2 test’, starting anytime prior to cohort entry start date; allow events outside observation period; with value as concept: “detected”, “detected”, “positive”, “positive”, “present” or “present”.
  2. having no condition occurrences of ‘COVID-19’, starting anytime prior to cohort entry start date; allow events outside observation period; having no measurements of ‘SARS-CoV-2 test’, with value as concept: “negative”, “not detected”, “not detected in pooled specimen”, “absent”, “negative”, “not detected” or “absent”.

  • =1 positive test on day 0 to day 3

Entry events having at least 1 measurement of ‘SARS-CoV-2 test’, starting between 0 days before and 3 days after cohort entry start date; with value as concept: “detected”, “detected”, “positive”, “positive”, “present” or “present”.

A.1.3 Cohort Exit

The cohort end date will be offset from index event’s start date plus 3 days.

A.1.4 Cohort Eras

Entry events will be combined into cohort eras if they are within 0 days of each other.

A.1.5 Concept: COVID-19

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
37311061 COVID-19 840539006 SNOMED NO YES NO

A.1.6 Concept: SARS-CoV-2 test

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
756055 Measurement of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) OMOP4873969 OMOP Extension NO YES NO
37310258 Measurement of Severe acute respiratory syndrome coronavirus 2 antibody 1240461000000109 SNOMED YES YES NO
704059 Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique, making use of high throughput technologies as described by CMS-2020-01-R U0003 HCPCS NO YES NO
704058 2019-nCoV Coronavirus, SARS-CoV-2/2019-nCoV (COVID-19), any technique, multiple types or subtypes (includes all targets), non-CDC, making use of high throughput technologies as described by CMS-2020-01-R U0004 HCPCS NO YES NO

A.2 Cohort 563 - Earliest COVID-19 Event (postive test OR diagnosis)

A.2.1 Cohort Entry Events

People may enter the cohort when observing any of the following:

  1. measurements of ‘SARS-CoV-2 test’, starting after December 1, 2019; with value as concept: “detected”, “detected”, “positive”, “positive”, “present” or “present”.

  2. condition occurrences of ‘COVID-19’, starting after December 1, 2019; having no measurements of ‘SARS-CoV-2 test’, starting between 0 days before and 3 days after ‘COVID-19’ start date; with value as concept: “negative”, “not detected”, “not detected in pooled specimen”, “absent”, “negative”, “not detected” or “absent”.

Limit cohort entry events to the earliest event per person.

A.2.2 Additional Inclusion Criteria

  • Continuous Observation of at least 365d

Entry events having at least 1 observation period, starting anytime up to 365 days before cohort entry start date and ending between 0 days after and all days after cohort entry start date.

  • No COVID-19/SARS-CoV-2 Tests Prior to Index

Entry events with all of the following criteria:

  1. having no measurements of ‘SARS-CoV-2 test’, starting anytime prior to cohort entry start date; allow events outside observation period; with value as concept: “detected”, “detected”, “positive”, “positive”, “present” or “present”.
  2. having no condition occurrences of ‘COVID-19’, starting anytime prior to cohort entry start date; having no measurements of ‘SARS-CoV-2 test’, starting anytime up to 3 days after ‘COVID-19’ start date; allow events outside observation period; with value as concept: “negative”, “not detected”, “not detected in pooled specimen”, “absent”, “negative”, “not detected” or “absent”.

A.2.3 Cohort Exit

The cohort end date will be offset from index event’s start date plus 3 days.

A.2.4 Cohort Eras

Entry events will be combined into cohort eras if they are within 0 days of each other.

A.2.5 Concept: COVID-19

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
37311061 COVID-19 840539006 SNOMED NO YES NO

A.2.6 Concept: SARS-CoV-2 test

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
756055 Measurement of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) OMOP4873969 OMOP Extension NO YES NO
37310258 Measurement of Severe acute respiratory syndrome coronavirus 2 antibody 1240461000000109 SNOMED YES YES NO
704059 Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique, making use of high throughput technologies as described by CMS-2020-01-R U0003 HCPCS NO YES NO
704058 2019-nCoV Coronavirus, SARS-CoV-2/2019-nCoV (COVID-19), any technique, multiple types or subtypes (includes all targets), non-CDC, making use of high throughput technologies as described by CMS-2020-01-R U0004 HCPCS NO YES NO

A.3 Cohort 565 - Earliest COVID-19 Event (postive test OR diagnosis) (pre 2021)

A.3.1 Cohort Entry Events

People may enter the cohort when observing any of the following:

  1. measurements of ‘SARS-CoV-2 test’, starting between December 1, 2019 and December 1, 2020; with value as concept: “detected”, “detected”, “positive”, “positive”, “present” or “present”.

  2. condition occurrences of ‘COVID-19’, starting between December 1, 2019 and December 1, 2020; having no measurements of ‘SARS-CoV-2 test’, starting between 0 days before and 3 days after ‘COVID-19’ start date; with value as concept: “negative”, “not detected”, “not detected in pooled specimen”, “absent”, “negative”, “not detected” or “absent”.

Limit cohort entry events to the earliest event per person.

A.3.2 Additional Inclusion Criteria

  • Continuous Observation of at least 365d

Entry events having at least 1 observation period, starting anytime up to 365 days before cohort entry start date and ending between 0 days after and all days after cohort entry start date.

  • No COVID-19/SARS-CoV-2 Tests Prior to Index

Entry events with all of the following criteria:

  1. having no measurements of ‘SARS-CoV-2 test’, starting anytime prior to cohort entry start date; allow events outside observation period; with value as concept: “detected”, “detected”, “positive”, “positive”, “present” or “present”.
  2. having no condition occurrences of ‘COVID-19’, starting anytime prior to cohort entry start date; having no measurements of ‘SARS-CoV-2 test’, starting anytime up to 3 days after ‘COVID-19’ start date; allow events outside observation period; with value as concept: “negative”, “not detected”, “not detected in pooled specimen”, “absent”, “negative”, “not detected” or “absent”.

A.3.3 Cohort Exit

The cohort end date will be offset from index event’s start date plus 3 days.

A.3.4 Cohort Eras

Entry events will be combined into cohort eras if they are within 0 days of each other.

A.3.5 Concept: COVID-19

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
37311061 COVID-19 840539006 SNOMED NO YES NO

A.3.6 Concept: SARS-CoV-2 test

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
756055 Measurement of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) OMOP4873969 OMOP Extension NO YES NO
37310258 Measurement of Severe acute respiratory syndrome coronavirus 2 antibody 1240461000000109 SNOMED YES YES NO
704059 Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique, making use of high throughput technologies as described by CMS-2020-01-R U0003 HCPCS NO YES NO
704058 2019-nCoV Coronavirus, SARS-CoV-2/2019-nCoV (COVID-19), any technique, multiple types or subtypes (includes all targets), non-CDC, making use of high throughput technologies as described by CMS-2020-01-R U0004 HCPCS NO YES NO

A.4 Cohort 566 - Persons at Risk at Start of Year 2017-2019

A.4.1 Cohort Entry Events

People with continuous observation of 365 days before event enter the cohort when observing any of the following:

  1. observation periods, a user defiend start date of January 1, 2017 and end date of January 1, 2017.

  2. observation periods, a user defiend start date of January 1, 2018 and end date of January 1, 2018.

  3. observation periods, a user defiend start date of January 1, 2019 and end date of January 1, 2019.

A.4.2 Cohort Exit

The cohort end date will be offset from index event’s start date plus 0 days.

A.4.3 Cohort Eras

Entry events will be combined into cohort eras if they are within 0 days of each other.

B Outcome Cohort Definitions

B.1 Cohort 411 - Pulmonary Embolism

B.1.1 Cohort Entry Events

People may enter the cohort when observing any of the following:

  1. condition occurrences of ‘Pulmonary Embolism FDA concept proxy’.

B.1.2 Additional Inclusion Criteria

  • has no events in prior ‘clean window’ - 365 days

Entry events having no condition occurrences of ‘Pulmonary Embolism FDA concept proxy’, starting in the 365 days prior to cohort entry start date; allow events outside observation period.

B.1.3 Cohort Exit

The cohort end date will be offset from index event’s start date plus 1 day.

B.1.4 Cohort Eras

Entry events will be combined into cohort eras if they are within 0 days of each other.

B.1.5 Concept: Pulmonary Embolism FDA concept proxy

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
254662 Pulmonary infarction 64662007 SNOMED NO YES NO
36713113 Saddle embolus of pulmonary artery 328511000119109 SNOMED NO YES NO
440417 Pulmonary embolism 59282003 SNOMED NO YES NO
435616 Amniotic fluid embolism 17263003 SNOMED YES YES NO
435887 Antepartum deep vein thrombosis 49956009 SNOMED YES YES NO
196715 Budd-Chiari syndrome 82385007 SNOMED YES YES NO
4062269 Cerebral venous thrombosis in pregnancy 200259003 SNOMED YES YES NO
442055 Obstetric air pulmonary embolism 200286003 SNOMED YES YES NO
433832 Obstetric blood-clot pulmonary embolism 200299000 SNOMED YES YES NO
435026 Obstetric pulmonary embolism 200284000 SNOMED YES YES NO
440477 Obstetric pyemic and septic pulmonary embolism 267284008 SNOMED YES YES NO
318137 Phlebitis and thrombophlebitis of intracranial sinuses 192753009 SNOMED YES YES NO
199837 Portal vein thrombosis 17920008 SNOMED YES YES NO
438820 Postpartum deep phlebothrombosis 56272000 SNOMED YES YES NO
4235812 Septic thrombophlebitis 439731006 SNOMED YES YES NO
195294 Thrombosed hemorrhoids 75955007 SNOMED YES YES NO
4187790 Thrombosis of retinal vein 46085004 SNOMED YES YES NO
444247 Venous thrombosis 111293003 SNOMED YES YES NO
44782732 Chronic pulmonary embolism 133971000119108 SNOMED YES YES NO
40479606 Septic pulmonary embolism 441557008 SNOMED YES YES NO

B.2 Cohort 405 - Hemorrhagic stroke

B.2.1 Cohort Entry Events

People may enter the cohort when observing any of the following:

  1. condition occurrences of ‘Hemorrhagic stroke subarachnoid intracerebral subdural’.

Restrict entry events to having at least 1 visit occurrence of ‘Inpatient or Inpatient/ER visit’, starting anytime on or before cohort entry start date and ending between 0 days before and all days after cohort entry start date.

B.2.2 Additional Inclusion Criteria

  • has no events in prior ‘clean window’ - 365 days

Entry events having no condition occurrences of ‘Hemorrhagic stroke subarachnoid intracerebral subdural’, starting in the 365 days prior to cohort entry start date; allow events outside observation period; having at least 1 visit occurrence of ‘Inpatient or Inpatient/ER visit’, starting anytime on or before ‘Hemorrhagic stroke subarachnoid intracerebral subdural’ start date and ending between 0 days before and all days after ‘Hemorrhagic stroke subarachnoid intracerebral subdural’ start date.

B.2.3 Cohort Exit

The cohort end date will be offset from index event’s start date plus 1 day.

B.2.4 Cohort Eras

Entry events will be combined into cohort eras if they are within 0 days of each other.

B.2.5 Concept: Inpatient or Inpatient/ER visit

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
262 Emergency Room and Inpatient Visit ERIP Visit NO YES NO
9201 Inpatient Visit IP Visit NO YES NO

B.2.6 Concept: Hemorrhagic stroke subarachnoid intracerebral subdural

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
439847 Intracranial hemorrhage 1386000 SNOMED NO NO NO
432923 Subarachnoid hemorrhage 21454007 SNOMED NO NO NO
376713 Cerebral hemorrhage 274100004 SNOMED YES NO NO
4148906 Spontaneous subarachnoid hemorrhage 270907008 SNOMED NO NO NO
4144154 Non-traumatic intracerebral ventricular hemorrhage 425957003 SNOMED NO NO NO
4111709 Non-traumatic subdural hemorrhage 195176009 SNOMED NO NO NO
42535426 Acute nontraumatic subdural hemorrhage 291581000119109 SNOMED NO NO NO
43530728 Subacute non-traumatic intracranial subdural hemorrhage 291591000119107 SNOMED NO NO NO
4174299 Perinatal intracranial hemorrhage 276647007 SNOMED YES YES NO
36716544 Fetal or neonatal non-traumatic intraventricular hemorrhage 722581000 SNOMED YES YES NO
4345688 Intracerebral hemorrhage in fetus or newborn 240313004 SNOMED YES YES NO
43530727 Spontaneous cerebral hemorrhage 291571000119106 SNOMED NO NO NO

B.3 Cohort 406 - Non-Hemorrhagic Stroke

B.3.1 Cohort Entry Events

People may enter the cohort when observing any of the following:

  1. condition occurrences of ‘cerebral infarction FDA conceptset proxy’.

Restrict entry events to having at least 1 visit occurrence of ‘Inpatient or Inpatient/ER visit’, starting anytime on or before cohort entry start date and ending between 0 days before and all days after cohort entry start date.

B.3.2 Additional Inclusion Criteria

  • has no events in prior ‘clean window’ - 365 days

Entry events having no condition occurrences of ‘cerebral infarction FDA conceptset proxy’, starting in the 365 days prior to cohort entry start date; allow events outside observation period; having at least 1 visit occurrence of ‘Inpatient or Inpatient/ER visit’, starting anytime on or before ‘cerebral infarction FDA conceptset proxy’ start date and ending between 0 days before and all days after ‘cerebral infarction FDA conceptset proxy’ start date.

B.3.3 Cohort Exit

The cohort end date will be offset from index event’s start date plus 1 day.

B.3.4 Cohort Eras

Entry events will be combined into cohort eras if they are within 0 days of each other.

B.3.5 Concept: Inpatient or Inpatient/ER visit

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
262 Emergency Room and Inpatient Visit ERIP Visit NO YES NO
9201 Inpatient Visit IP Visit NO YES NO

B.3.6 Concept: cerebral infarction FDA conceptset proxy

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
443454 Cerebral infarction 432504007 SNOMED NO YES NO
40479572 Infarct of cerebrum due to iatrogenic cerebrovascular accident 441526008 SNOMED YES YES NO
4046360 Lacunar infarction 230698000 SNOMED YES YES NO

B.4 Cohort 402 - Deep Vein Thrombosis (DVT)

B.4.1 Cohort Entry Events

People may enter the cohort when observing any of the following:

  1. condition occurrences of ‘Deep Vein Thrombosis broad’.

B.4.2 Additional Inclusion Criteria

  • has no events in prior ‘clean window’ - 365 days

Entry events having no condition occurrences of ‘Deep Vein Thrombosis broad’, starting in the 365 days prior to cohort entry start date; allow events outside observation period.

B.4.3 Cohort Exit

The cohort end date will be offset from index event’s start date plus 1 day.

B.4.4 Cohort Eras

Entry events will be combined into cohort eras if they are within 0 days of each other.

B.4.5 Concept: Deep Vein Thrombosis broad

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
4133004 Deep venous thrombosis 128053003 SNOMED NO YES NO
4149782 Thrombosis of vein of lower limb 309735004 SNOMED NO NO NO
444247 Venous thrombosis 111293003 SNOMED NO NO NO
77310 Deep vein phlebitis and thrombophlebitis of the leg 266267005 SNOMED YES YES NO
40481089 Embolism from thrombosis of vein of lower extremity 444816006 SNOMED NO YES NO
435565 Embolism and thrombosis of the vena cava 195437003 SNOMED NO YES NO
193512 Embolism and thrombosis of the renal vein 195438008 SNOMED NO YES NO
36712971 Chronic deep venous thrombosis 15760351000119105 SNOMED YES YES NO
435887 Antepartum deep vein thrombosis 49956009 SNOMED YES YES NO
438820 Postpartum deep phlebothrombosis 56272000 SNOMED YES YES NO
44782752 Acute deep venous thrombosis of internal jugular vein 135001000119100 SNOMED NO YES NO
44782751 Acute deep venous thrombosis of axillary vein 134961000119104 SNOMED NO YES NO
4179911 Axillary vein thrombosis 297156001 SNOMED YES NO NO

B.5 Cohort 386 - Appendicitis

B.5.1 Cohort Entry Events

People may enter the cohort when observing any of the following:

  1. condition occurrences of ‘Appendicitis’.

B.5.2 Additional Inclusion Criteria

  • has no events in prior ‘clean window’ - 365 days

Entry events having no condition occurrences of ‘Appendicitis’, starting in the 365 days prior to cohort entry start date; allow events outside observation period.

B.5.3 Cohort Exit

The cohort end date will be offset from index event’s start date plus 1 day.

B.5.4 Cohort Eras

Entry events will be combined into cohort eras if they are within 0 days of each other.

B.5.5 Concept: Inpatient or Inpatient/ER visit

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
262 Emergency Room and Inpatient Visit ERIP Visit NO YES NO
9201 Inpatient Visit IP Visit NO YES NO

B.5.6 Concept: Appendicitis

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
440448 Appendicitis 74400008 SNOMED NO YES NO

B.6 Cohort 385 - Disseminated Intravascular Coagulation

B.6.1 Cohort Entry Events

People may enter the cohort when observing any of the following:

  1. condition occurrences of ‘Disseminated intravascular coagulation’.

B.6.2 Additional Inclusion Criteria

  • has no events in prior ‘clean window’ - 365 days

Entry events having no condition occurrences of ‘Disseminated intravascular coagulation’, starting in the 365 days prior to cohort entry start date; allow events outside observation period.

B.6.3 Cohort Exit

The cohort end date will be offset from index event’s start date plus 1 day.

B.6.4 Cohort Eras

Entry events will be combined into cohort eras if they are within 0 days of each other.

B.6.5 Concept: Inpatient or Inpatient/ER visit

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
262 Emergency Room and Inpatient Visit ERIP Visit NO YES NO
9201 Inpatient Visit IP Visit NO YES NO

B.6.6 Concept: Disseminated intravascular coagulation

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
436093 Disseminated intravascular coagulation 67406007 SNOMED NO YES NO

B.7 Cohort 381 - Transverse Myelitis

B.7.1 Cohort Entry Events

People may enter the cohort when observing any of the following:

  1. condition occurrences of ‘Transverse Myelitis’.

B.7.2 Additional Inclusion Criteria

  • has no events in prior ‘clean window’ - 365 days

Entry events having no condition occurrences of ‘Transverse Myelitis’, starting in the 365 days prior to cohort entry start date; allow events outside observation period.

B.7.3 Cohort Exit

The cohort end date will be offset from index event’s start date plus 1 day.

B.7.4 Cohort Eras

Entry events will be combined into cohort eras if they are within 0 days of each other.

B.7.5 Concept: Transverse Myelitis

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
443904 Transverse myelopathy syndrome 16631009 SNOMED NO YES NO

B.8 Cohort 349 - Anaphylaxis v1.0

B.8.1 Cohort Entry Events

People may enter the cohort when observing any of the following:

  1. condition occurrences of ‘Anaphylaxis or Anaphylactic shock due to serum’.

B.8.2 Additional Inclusion Criteria

  • has no events in prior ‘clean window’ - 30 days

Entry events having no condition occurrences of ‘Anaphylaxis or Anaphylactic shock due to serum’, starting in the 30 days prior to cohort entry start date; allow events outside observation period.

B.8.3 Cohort Exit

The cohort end date will be offset from index event’s start date plus 1 day.

B.8.4 Cohort Eras

Entry events will be combined into cohort eras if they are within 0 days of each other.

B.8.5 Concept: Anaphylaxis or Anaphylactic shock due to serum

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
441202 Anaphylaxis 39579001 SNOMED NO NO NO
442038 Anaphylactic shock due to serum 213320003 SNOMED NO YES NO

B.9 Cohort 568 - Anaphylaxis v2.0

B.9.1 Cohort Entry Events

People may enter the cohort when observing any of the following:

  1. condition occurrences of ‘Anaphylaxis broad’.

B.9.2 Additional Inclusion Criteria

  • has no events in prior ‘clean window’ - 30 days

Entry events having no condition occurrences of ‘Anaphylaxis broad’, starting in the 30 days prior to cohort entry start date; allow events outside observation period.

B.9.3 Cohort Exit

The cohort end date will be offset from index event’s start date plus 1 day.

B.9.4 Cohort Eras

Entry events will be combined into cohort eras if they are within 0 days of each other.

B.9.5 Concept: Anaphylaxis broad

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
4032658 Localized anaphylaxis 14654002 SNOMED NO YES NO
4084639 Idiopathic anaphylaxis 241954008 SNOMED NO YES NO
4221182 Anaphylaxis due to substance 417516000 SNOMED NO NO NO
4193788 Anaphylactic transfusion reaction 79337003 SNOMED NO YES NO
441202 Anaphylaxis 39579001 SNOMED NO NO NO
42536383 Anaphylactic shock 735173007 SNOMED NO YES NO

B.9.6 Concept: Inpatient or Emergency Room visit

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
262 Emergency Room and Inpatient Visit ERIP Visit NO YES NO
9201 Inpatient Visit IP Visit NO YES NO
9203 Emergency Room Visit ER Visit NO YES NO

B.10 Cohort 347 - Bell’s Palsy Events

B.10.1 Cohort Entry Events

People may enter the cohort when observing any of the following:

  1. condition occurrences of ‘Bell’s palsy’.

B.10.2 Additional Inclusion Criteria

  • has no events in prior ‘clean window’ 183 days

Entry events having no condition occurrences of ‘Bell’s palsy’, starting in the 183 days prior to cohort entry start date; allow events outside observation period.

B.10.3 Cohort Exit

The cohort end date will be offset from index event’s start date plus 1 day.

B.10.4 Cohort Eras

Entry events will be combined into cohort eras if they are within 0 days of each other.

B.10.5 Concept: Bell’s palsy

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
4091559 Facial palsy 280816001 SNOMED NO YES NO
4048018 Congenital facial nerve palsy 230542008 SNOMED YES YES NO
36716396 Congenital hereditary facial paralysis with variable hearing loss syndrome 722389002 SNOMED YES YES NO

B.11 Cohort 346 - Encephalomyelitis

B.11.1 Cohort Entry Events

People may enter the cohort when observing any of the following:

  1. condition occurrences of ‘Encephalomyelitis’.

Restrict entry events to having at least 1 visit occurrence of ‘Inpatient or Inpatient/ER visit’, starting anytime on or before cohort entry start date and ending between 0 days before and all days after cohort entry start date.

B.11.2 Additional Inclusion Criteria

  • has no events in prior ‘clean window’ 183 days

Entry events having no condition occurrences of ‘Encephalomyelitis’, starting in the 183 days prior to cohort entry start date; allow events outside observation period; having at least 1 visit occurrence of ‘Inpatient or Inpatient/ER visit’, starting anytime on or before ‘Encephalomyelitis’ start date and ending between 0 days before and all days after ‘Encephalomyelitis’ start date.

B.11.3 Cohort Exit

The cohort end date will be offset from index event’s start date plus 1 day.

B.11.4 Cohort Eras

Entry events will be combined into cohort eras if they are within 0 days of each other.

B.11.5 Concept: Inpatient or Inpatient/ER visit

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
262 Emergency Room and Inpatient Visit ERIP Visit NO YES NO
9201 Inpatient Visit IP Visit NO YES NO

B.11.6 Concept: Encephalomyelitis

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
372615 Post-infectious encephalitis 192727001 SNOMED NO YES NO
378143 Encephalitis 45170000 SNOMED NO NO NO
4147498 Encephalitis, myelitis and encephalomyelitis 267576008 SNOMED NO YES NO
373189 Encephalomyelitis 62950007 SNOMED NO YES NO
4190307 Inflammatory disease of the central nervous system 39367000 SNOMED NO NO NO
379792 Post-immunization encephalitis 192704009 SNOMED NO YES NO
4330496 Inflammation of spinal cord due to toxin 431520004 SNOMED NO YES NO
138965 Myelitis 41370002 SNOMED NO NO NO

B.12 Cohort 345 - Narcolepsy

B.12.1 Cohort Entry Events

People may enter the cohort when observing any of the following:

  1. condition occurrences of ‘Narcolepsy’.

B.12.2 Additional Inclusion Criteria

  • has no events in prior ‘clean window’ - 365 days

Entry events having no condition occurrences of ‘Narcolepsy’, starting in the 365 days prior to cohort entry start date; allow events outside observation period.

B.12.3 Cohort Exit

The cohort end date will be offset from index event’s start date plus 1 day.

B.12.4 Cohort Eras

Entry events will be combined into cohort eras if they are within 0 days of each other.

B.12.5 Concept: Narcolepsy

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
437854 Cataplexy and narcolepsy 193042000 SNOMED NO YES NO
436100 Narcolepsy 60380001 SNOMED NO YES NO

B.13 Cohort 343 - Guillain Barre Syndrome

B.13.1 Cohort Entry Events

People may enter the cohort when observing any of the following:

  1. condition occurrences of ‘Guillian-Barre syndrome’.

Restrict entry events to having at least 1 visit occurrence of ‘Inpatient or Inpatient/ER visit’, starting anytime on or before cohort entry start date and ending between 0 days before and all days after cohort entry start date.

B.13.2 Additional Inclusion Criteria

  • has no events in prior ‘clean window’

Entry events having no condition occurrences of ‘Guillian-Barre syndrome’, starting in the 365 days prior to cohort entry start date; allow events outside observation period; having at least 1 visit occurrence of ‘Inpatient or Inpatient/ER visit’, starting anytime on or before ‘Guillian-Barre syndrome’ start date and ending between 0 days before and all days after ‘Guillian-Barre syndrome’ start date.

B.13.3 Cohort Exit

The cohort end date will be offset from index event’s start date plus 1 day.

B.13.4 Cohort Eras

Entry events will be combined into cohort eras if they are within 0 days of each other.

B.13.5 Concept: Guillian-Barre syndrome

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
374925 Acute infective polyneuritis 129131007 SNOMED NO YES NO
4164770 Guillain-Barre syndrome 40956001 SNOMED NO YES NO
4070552 Fisher’s syndrome 1767005 SNOMED NO YES NO

B.13.6 Concept: Inpatient or Inpatient/ER visit

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
262 Emergency Room and Inpatient Visit ERIP Visit NO YES NO
9201 Inpatient Visit IP Visit NO YES NO

B.14 Cohort 340 - Acute Myocardial Infarction

B.14.1 Cohort Entry Events

People may enter the cohort when observing any of the following:

  1. condition occurrences of ‘Myocardial Infarction and complication’.

Restrict entry events to having at least 1 visit occurrence of ‘Inpatient or Inpatient/ER visit’, starting anytime on or before cohort entry start date and ending between 0 days before and all days after cohort entry start date.

B.14.2 Additional Inclusion Criteria

  • has no events in prior ‘clean window’ - 365 days

Entry events having no condition occurrences of ‘Myocardial Infarction and complication’, starting in the 365 days prior to cohort entry start date; allow events outside observation period; having at least 1 visit occurrence of ‘Inpatient or Inpatient/ER visit’, starting anytime on or before ‘Myocardial Infarction and complication’ start date and ending between 0 days before and all days after ‘Myocardial Infarction and complication’ start date.

B.14.3 Cohort Exit

The cohort end date will be offset from index event’s start date plus 1 day.

B.14.4 Cohort Eras

Entry events will be combined into cohort eras if they are within 0 days of each other.

B.14.5 Concept: Inpatient or Inpatient/ER visit

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
262 Emergency Room and Inpatient Visit ERIP Visit NO YES NO
9201 Inpatient Visit IP Visit NO YES NO

B.14.6 Concept: Myocardial Infarction and complication

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
4329847 Myocardial infarction 22298006 SNOMED NO YES NO
314666 Old myocardial infarction 1755008 SNOMED YES YES NO
4108680 Thrombosis of atrium, auricular appendage, and ventricle due to and following acute myocardial infarction 194868001 SNOMED NO YES NO
4108678 Hemopericardium due to and following acute myocardial infarction 194862000 SNOMED NO YES NO
438172 Atrial septal defect due to and following acute myocardial infarction 194863005 SNOMED NO YES NO
4124687 Cardiac rupture due to and following acute myocardial infarction 233847009 SNOMED NO YES NO
45766212 Mitral valve regurgitation due to and following acute myocardial infarction 703326006 SNOMED NO YES NO
37109910 Ventricular aneurysm due to and following acute myocardial infarction 723858002 SNOMED NO YES NO
37109911 Pulmonary embolism due to and following acute myocardial infarction 723859005 SNOMED NO YES NO
37109912 Arrhythmia due to and following acute myocardial infarction 723860000 SNOMED NO YES NO

B.15 Cohort 339 - Myocarditis Pericarditis

B.15.1 Cohort Entry Events

People may enter the cohort when observing any of the following:

  1. condition occurrences of ‘Myocarditis Pericarditis’.

B.15.2 Additional Inclusion Criteria

  • has no events in prior ‘clean window’ - 365 days

Entry events having no condition occurrences of ‘Myocarditis Pericarditis’, starting in the 365 days prior to cohort entry start date; allow events outside observation period.

B.15.3 Cohort Exit

The cohort end date will be offset from index event’s start date plus 1 day.

B.15.4 Cohort Eras

Entry events will be combined into cohort eras if they are within 0 days of each other.

B.15.5 Concept: Myocarditis Pericarditis

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
4289908 Viral pericarditis 70189005 SNOMED NO YES NO
4138837 Pericarditis 3238004 SNOMED NO YES NO
314383 Myocarditis 50920009 SNOMED NO YES NO
4149913 Systemic lupus erythematosus with pericarditis 309762007 SNOMED NO YES NO
318072 Histoplasmosis with pericarditis 187059008 SNOMED NO YES NO
44782774 Chest pain due to pericarditis 34791000119103 SNOMED NO YES NO

B.16 Cohort 335 - Immune thrombocytopenia (ITP)

B.16.1 Cohort Entry Events

People may enter the cohort when observing any of the following:

  1. condition occurrences of ‘Idiopathic and Immune Thrombocytopenia’.

B.16.2 Additional Inclusion Criteria

  • has no events in prior ‘clean window’ - 365 days

Entry events having no condition occurrences of ‘Idiopathic and Immune Thrombocytopenia’, starting in the 365 days prior to cohort entry start date; allow events outside observation period.

B.16.3 Cohort Exit

The cohort end date will be offset from index event’s start date plus 1 day.

B.16.4 Cohort Eras

Entry events will be combined into cohort eras if they are within 0 days of each other.

B.16.5 Concept: Idiopathic and Immune Thrombocytopenia

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
4159749 Idiopathic maternal thrombocytopenia 371106008 SNOMED NO YES NO
4103532 Immune thrombocytopenia 2897005 SNOMED NO YES NO
4119134 Thrombocytopenic purpura 302873008 SNOMED NO YES NO

B.17 Cohort 547 - Thrombosis with Thrombocytopenia (TWT)

B.17.1 Cohort Entry Events

People may enter the cohort when observing any of the following:

  1. condition occurrences of ‘cerebral venous sinus thrombosis (CVST narrow)’.

  2. condition occurrences of ‘Deep Vein Thrombosis (narrow)’.

  3. condition occurrences of ‘Pulmonary Embolism’.

  4. condition occurrences of ‘Intraabdominal thrombosis - hepatic thrombosis’.

  5. condition occurrences of ‘Intraabdominal- splenic infacrtion and thrombosis’.

  6. condition occurrences of ‘Portal Vein thrombosis (include visceral, mesenteric)’.

  7. condition occurrences of ‘other Intraabdominal thrombosis’.

  8. condition occurrences of ‘Intestinal infarction’.

  9. condition occurrences of ‘Cerebral infarction’.

  10. condition occurrences of ‘Hemorrhagic stroke’.

  11. condition occurrences of ‘Myocardial Infarction and complication’.

B.17.2 Additional Inclusion Criteria

  • Thrombocytopenia within 7 days of thrombosis with no such event in the past 90 days (clean window)

Entry events with all of the following criteria:

  1. with any of the following criteria:

    1. having at least 1 measurement of ‘Platelet measurement’, starting between 7 days before and 7 days after cohort entry start date; numeric value between 10 and 150; unit: “cubic millimeter”, “per cubic millimeter”, “thousand per microliter”, “thousand per cubic millimeter”, “billion per liter”, “per liter” or “million per milliliter”.
    2. having at least 1 measurement of ‘Platelet measurement’, starting between 7 days before and 7 days after cohort entry start date; numeric value between 10 and 150; low range between 130 and 170.
    3. having at least 1 condition occurrence of ‘Thrombocytopenia (narrow)’, starting between 7 days before and 7 days after cohort entry start date.

  2. with all of the following criteria:

    1. having no measurements of ‘Platelet measurement’, starting between 90 days before and 7 days before cohort entry start date; numeric value between 10 and 150; unit: “cubic millimeter”, “per cubic millimeter”, “thousand per microliter”, “thousand per cubic millimeter”, “billion per liter”, “per liter” or “million unit per milliliter”.
    2. having no measurements of ‘Platelet measurement’, starting between 90 days before and 7 days before cohort entry start date; numeric value between 10 and 150; low range between 130 and 170.
    3. having no condition occurrences of ‘Thrombocytopenia (broad)’, starting between 90 days before and 7 days before cohort entry start date.
  • Thrombosis clean window period (-365 days)

Entry events with all of the following criteria:

  1. having no condition occurrences of ‘cerebral venous sinus thrombosis (CVST broad)’, starting in the 365 days prior to cohort entry start date.
  2. having no condition occurrences of ‘Deep Vein Thrombosis (broad)’, starting in the 365 days prior to cohort entry start date.
  3. having no condition occurrences of ‘Pulmonary Embolism’, starting in the 365 days prior to cohort entry start date.
  4. having no condition occurrences of ‘Intraabdominal thrombosis - hepatic thrombosis’, starting in the 365 days prior to cohort entry start date.
  5. having no condition occurrences of ‘Intraabdominal- splenic infacrtion and thrombosis’, starting in the 365 days prior to cohort entry start date.
  6. having no condition occurrences of ‘Portal Vein thrombosis (include visceral, mesenteric)’, starting in the 365 days prior to cohort entry start date.
  7. having no condition occurrences of ‘other Intraabdominal thrombosis’, starting in the 365 days prior to cohort entry start date.
  8. having no condition occurrences of ‘Intestinal infarction’, starting in the 365 days prior to cohort entry start date.
  9. having no condition occurrences of ‘Cerebral infarction’, starting in the 365 days prior to cohort entry start date.
  10. having no condition occurrences of ‘Hemorrhagic stroke’, starting in the 365 days prior to cohort entry start date.
  11. having no condition occurrences of ‘Myocardial Infarction and complication’, starting in the 365 days prior to cohort entry start date.

B.17.3 Cohort Exit

The cohort end date will be offset from index event’s start date plus 1 day.

B.17.4 Cohort Eras

Entry events will be combined into cohort eras if they are within 0 days of each other.

B.17.5 Concept: Thrombocytopenia (broad)

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
37397537 Beta thalassemia X-linked thrombocytopenia syndrome 718196002 SNOMED NO YES NO
432870 Thrombocytopenic disorder 302215000 SNOMED NO YES NO

B.17.6 Concept: Platelet measurement

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
3007461 Platelets [#/volume] in Blood 26515-7 LOINC NO YES NO
3031586 Platelets [#/volume] in Blood by Estimate 49497-1 LOINC NO YES NO
3024929 Platelets [#/volume] in Blood by Automated count 777-3 LOINC NO YES NO
3039827 Platelets [#/volume] in Body fluid by Automated count 40574-6 LOINC NO YES NO
3024386 Platelet mean volume [Entitic volume] in Blood by Rees-Ecker 776-5 LOINC NO YES NO
4267147 Platelet count 61928009 SNOMED NO YES NO
37393863 Platelet count 1022651000000100 SNOMED NO YES NO

B.17.7 Concept: Deep Vein Thrombosis (narrow)

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
44782752 Acute deep venous thrombosis of internal jugular vein 135001000119100 SNOMED NO YES NO
435565 Embolism and thrombosis of the vena cava 195437003 SNOMED NO NO NO
40481089 Embolism from thrombosis of vein of lower extremity 444816006 SNOMED NO YES NO
193512 Embolism and thrombosis of the renal vein 195438008 SNOMED NO NO NO
4133004 Deep venous thrombosis 128053003 SNOMED NO YES NO
4149782 Thrombosis of vein of lower limb 309735004 SNOMED NO NO NO
36712971 Chronic deep venous thrombosis 15760351000119105 SNOMED YES YES NO
435887 Antepartum deep vein thrombosis 49956009 SNOMED YES YES NO
4179911 Axillary vein thrombosis 297156001 SNOMED YES NO NO
435031 Postnatal deep vein thrombosis - delivered with postnatal complication 200237000 SNOMED YES YES NO
4062264 Postnatal deep vein thrombosis with postnatal complication 200238005 SNOMED YES YES NO
438820 Postpartum deep phlebothrombosis 56272000 SNOMED YES YES NO
44782762 Acute thrombosis of subclavian vein 132611000119104 SNOMED NO NO NO
762049 Acute thrombosis of right subclavian vein 286431000119103 SNOMED NO NO NO
762048 Acute thrombosis of left subclavian vein 286421000119101 SNOMED NO NO NO
46271900 Recurrent deep vein thrombosis 710167004 SNOMED NO NO NO
4317289 Thrombosis of mesenteric vein 95446005 SNOMED NO NO NO
4124856 Inferior mesenteric vein thrombosis 234041004 SNOMED NO NO NO
4318407 Thrombophlebitis of mesenteric vein 95447001 SNOMED NO NO NO
4055089 Superior mesenteric vein thrombosis 197001004 SNOMED NO NO NO
45757410 Acute thrombosis of mesenteric vein 133421000119101 SNOMED NO NO NO
45757409 Chronic thrombosis of mesenteric vein 133411000119108 SNOMED NO NO NO
4203836 Thrombosis of subclavian vein 438647008 SNOMED NO NO NO
44782759 Chronic thrombosis of subclavian vein 132551000119104 SNOMED NO NO NO
4205652 Thrombophlebitis of subclavian vein 438483005 SNOMED NO NO NO
762046 Chronic thrombosis of right subclavian vein 286381000119105 SNOMED NO NO NO
762051 Chronic thrombosis of left subclavian vein 286451000119109 SNOMED NO NO NO
44811347 Thrombosis of internal jugular vein 864191000000104 SNOMED NO NO NO
4033521 Splenic vein thrombosis 14534009 SNOMED NO NO NO
4089917 Phlegmasia alba dolens - obstetric 280966008 SNOMED YES NO NO
45773536 Deep venous thrombosis of femoropopliteal vein 703277001 SNOMED NO NO NO
4203618 Thrombophlebitis of femoropopliteal vein 52496006 SNOMED NO NO NO
762047 Acute bilateral thrombosis of subclavian veins 286411000119108 SNOMED NO NO NO
36712892 Acute thrombosis of splenic vein 143561000119108 SNOMED NO NO NO
4269051 Puerperal phlegmasia alba dolens 62583006 SNOMED YES NO NO
4096099 Phlebitis of deep veins of lower extremity 25114006 SNOMED NO NO NO

B.17.8 Concept: Deep Vein Thrombosis (broad)

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
320741 Thrombophlebitis 64156001 SNOMED NO NO NO
4096099 Phlebitis of deep veins of lower extremity 25114006 SNOMED NO NO NO
44782752 Acute deep venous thrombosis of internal jugular vein 135001000119100 SNOMED NO YES NO
44811347 Thrombosis of internal jugular vein 864191000000104 SNOMED NO NO NO
45757409 Chronic thrombosis of mesenteric vein 133411000119108 SNOMED NO NO NO
4203836 Thrombosis of subclavian vein 438647008 SNOMED NO NO NO
4205652 Thrombophlebitis of subclavian vein 438483005 SNOMED NO NO NO
4124856 Inferior mesenteric vein thrombosis 234041004 SNOMED NO NO NO
4203618 Thrombophlebitis of femoropopliteal vein 52496006 SNOMED NO NO NO
4318407 Thrombophlebitis of mesenteric vein 95447001 SNOMED NO NO NO
762047 Acute bilateral thrombosis of subclavian veins 286411000119108 SNOMED NO NO NO
44782762 Acute thrombosis of subclavian vein 132611000119104 SNOMED NO NO NO
435565 Embolism and thrombosis of the vena cava 195437003 SNOMED NO NO NO
45757410 Acute thrombosis of mesenteric vein 133421000119101 SNOMED NO NO NO
4033521 Splenic vein thrombosis 14534009 SNOMED NO NO NO
762049 Acute thrombosis of right subclavian vein 286431000119103 SNOMED NO NO NO
4055089 Superior mesenteric vein thrombosis 197001004 SNOMED NO NO NO
440738 Phlebitis of the femoral vein 195404000 SNOMED NO NO NO
444247 Venous thrombosis 111293003 SNOMED NO NO NO
40481089 Embolism from thrombosis of vein of lower extremity 444816006 SNOMED NO YES NO
193512 Embolism and thrombosis of the renal vein 195438008 SNOMED NO NO NO
45773536 Deep venous thrombosis of femoropopliteal vein 703277001 SNOMED NO NO NO
36712892 Acute thrombosis of splenic vein 143561000119108 SNOMED NO NO NO
4234997 Disorder of vein 90507008 SNOMED NO NO NO
439838 Thrombophlebitis migrans 31268005 SNOMED NO NO NO
4133004 Deep venous thrombosis 128053003 SNOMED NO YES NO
44782759 Chronic thrombosis of subclavian vein 132551000119104 SNOMED NO NO NO
444097 Thrombophlebitis of lower extremities 46253008 SNOMED NO NO NO
4327889 Thromboembolism of vein 429098002 SNOMED NO NO NO
4149782 Thrombosis of vein of lower limb 309735004 SNOMED NO NO NO
762048 Acute thrombosis of left subclavian vein 286421000119101 SNOMED NO NO NO
4317289 Thrombosis of mesenteric vein 95446005 SNOMED NO NO NO
36712971 Chronic deep venous thrombosis 15760351000119105 SNOMED YES YES NO
435887 Antepartum deep vein thrombosis 49956009 SNOMED YES YES NO
438820 Postpartum deep phlebothrombosis 56272000 SNOMED YES YES NO
4179911 Axillary vein thrombosis 297156001 SNOMED YES NO NO
4089917 Phlegmasia alba dolens - obstetric 280966008 SNOMED YES YES NO

B.17.9 Concept: Pulmonary Embolism

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
254662 Pulmonary infarction 64662007 SNOMED NO YES NO
36713113 Saddle embolus of pulmonary artery 328511000119109 SNOMED NO YES NO
440417 Pulmonary embolism 59282003 SNOMED NO YES NO
435616 Amniotic fluid embolism 17263003 SNOMED YES YES NO
435887 Antepartum deep vein thrombosis 49956009 SNOMED YES YES NO
196715 Budd-Chiari syndrome 82385007 SNOMED YES YES NO
4062269 Cerebral venous thrombosis in pregnancy 200259003 SNOMED YES YES NO
442055 Obstetric air pulmonary embolism 200286003 SNOMED YES YES NO
433832 Obstetric blood-clot pulmonary embolism 200299000 SNOMED YES YES NO
435026 Obstetric pulmonary embolism 200284000 SNOMED YES YES NO
440477 Obstetric pyemic and septic pulmonary embolism 267284008 SNOMED YES YES NO
318137 Phlebitis and thrombophlebitis of intracranial sinuses 192753009 SNOMED YES YES NO
199837 Portal vein thrombosis 17920008 SNOMED YES YES NO
438820 Postpartum deep phlebothrombosis 56272000 SNOMED YES YES NO
4235812 Septic thrombophlebitis 439731006 SNOMED YES YES NO
195294 Thrombosed hemorrhoids 75955007 SNOMED YES YES NO
4187790 Thrombosis of retinal vein 46085004 SNOMED YES YES NO
444247 Venous thrombosis 111293003 SNOMED YES YES NO
44782732 Chronic pulmonary embolism 133971000119108 SNOMED YES YES NO
40479606 Septic pulmonary embolism 441557008 SNOMED YES YES NO
4240832 Failed attempted termination of pregnancy with pulmonary embolism 58123006 SNOMED YES NO NO
4236271 Recurrent pulmonary embolism 438773007 SNOMED NO NO NO

B.17.10 Concept: Cerebral infarction

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
443454 Cerebral infarction 432504007 SNOMED NO YES NO
40479572 Infarct of cerebrum due to iatrogenic cerebrovascular accident 441526008 SNOMED YES YES NO
4046360 Lacunar infarction 230698000 SNOMED YES YES NO
372435 Periventricular leukomalacia 230769007 SNOMED YES NO NO
377254 Multi-infarct dementia, uncomplicated 70936005 SNOMED YES NO NO
379778 Multi-infarct dementia 56267009 SNOMED YES NO NO
443790 Multi-infarct dementia with delusions 25772007 SNOMED YES NO NO
443864 Multi-infarct dementia with depression 14070001 SNOMED YES NO NO
444091 Multi-infarct dementia with delirium 10349009 SNOMED YES NO NO
4046089 Vascular dementia of acute onset 230285003 SNOMED YES NO NO
4046090 Mixed cortical and subcortical vascular dementia 230287006 SNOMED YES NO NO
4129534 Pituitary apoplexy 237701005 SNOMED YES NO NO

B.17.11 Concept: Hemorrhagic stroke

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
439847 Intracranial hemorrhage 1386000 SNOMED NO NO NO
432923 Subarachnoid hemorrhage 21454007 SNOMED NO NO NO
376713 Cerebral hemorrhage 274100004 SNOMED YES NO NO
4148906 Spontaneous subarachnoid hemorrhage 270907008 SNOMED NO NO NO
4144154 Non-traumatic intracerebral ventricular hemorrhage 425957003 SNOMED NO NO NO
4111709 Non-traumatic subdural hemorrhage 195176009 SNOMED NO NO NO
42535426 Acute nontraumatic subdural hemorrhage 291581000119109 SNOMED NO NO NO
43530728 Subacute non-traumatic intracranial subdural hemorrhage 291591000119107 SNOMED NO NO NO
4174299 Perinatal intracranial hemorrhage 276647007 SNOMED YES YES NO
36716544 Fetal or neonatal non-traumatic intraventricular hemorrhage 722581000 SNOMED YES YES NO
4345688 Intracerebral hemorrhage in fetus or newborn 240313004 SNOMED YES YES NO
43530727 Spontaneous cerebral hemorrhage 291571000119106 SNOMED NO NO NO
4108952 Subarachnoid hemorrhage from carotid siphon and bifurcation 195155004 SNOMED NO NO NO
4111708 Subarachnoid hemorrhage from vertebral artery 195160000 SNOMED NO NO NO
35609033 Haemorrhagic stroke 1078001000000105 SNOMED NO NO NO

B.17.12 Concept: Myocardial Infarction and complication

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
4329847 Myocardial infarction 22298006 SNOMED NO YES NO
4108680 Thrombosis of atrium, auricular appendage, and ventricle due to and following acute myocardial infarction 194868001 SNOMED NO YES NO
4108678 Hemopericardium due to and following acute myocardial infarction 194862000 SNOMED NO YES NO
438172 Atrial septal defect due to and following acute myocardial infarction 194863005 SNOMED NO YES NO
4124687 Cardiac rupture due to and following acute myocardial infarction 233847009 SNOMED NO YES NO
45766212 Mitral valve regurgitation due to and following acute myocardial infarction 703326006 SNOMED NO YES NO
37109910 Ventricular aneurysm due to and following acute myocardial infarction 723858002 SNOMED NO YES NO
37109911 Pulmonary embolism due to and following acute myocardial infarction 723859005 SNOMED NO YES NO
37109912 Arrhythmia due to and following acute myocardial infarction 723860000 SNOMED NO YES NO
314666 Old myocardial infarction 1755008 SNOMED YES YES NO

B.17.13 Concept: Intestinal infarction

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
4195665 Gastrointestinal tract vascular insufficiency 312607004 SNOMED NO NO NO
4148299 Ischemic colitis 30588004 SNOMED NO NO NO
4173167 Mesenteric embolus 276500007 SNOMED NO NO NO
4317289 Thrombosis of mesenteric vein 95446005 SNOMED NO NO NO
4319280 Acute bowel infarction 22323009 SNOMED NO NO NO
4144032 Mesenteric thrombus and/or embolus 307420006 SNOMED NO NO NO
45757410 Acute thrombosis of mesenteric vein 133421000119101 SNOMED NO NO NO
45757409 Chronic thrombosis of mesenteric vein 133411000119108 SNOMED NO NO NO
44811741 Acute ischaemia of large intestine 906201000000100 SNOMED NO NO NO
44811740 Acute ischaemia of small intestine 906191000000102 SNOMED NO NO NO
37117790 Insufficiency of mesenteric artery 734041006 SNOMED NO NO NO
37016198 Epiploic appendagitis 14720231000119109 SNOMED NO NO NO
35622081 Nongangrenous ischemic colitis 763398006 SNOMED NO NO NO
35622080 Gangrenous ischemic colitis 763397001 SNOMED NO NO NO
4345926 Abdominal angina 241154007 SNOMED NO NO NO
4342767 Transient ischemic colitis 235845003 SNOMED NO NO NO
4341648 Hemorrhagic infarction of intestine 235851008 SNOMED NO NO NO
4341646 Occlusive mesenteric ischemia 235842000 SNOMED NO NO NO
4340939 Non-occlusive mesenteric ischemia 235843005 SNOMED NO NO NO
4340378 Transmural infarction of intestine 235852001 SNOMED NO NO NO
4340375 Focal segmental ischemia of small intestine 235844004 SNOMED NO NO NO
4318537 Large bowel gangrene 95538007 SNOMED NO NO NO
4318407 Thrombophlebitis of mesenteric vein 95447001 SNOMED NO NO NO
4240850 Acute ischemic enterocolitis 5820008 SNOMED NO NO NO
4239942 Embolic mesenteric infarction 57658009 SNOMED NO NO NO
4237654 Ischemic enterocolitis 90891007 SNOMED NO NO NO
4215949 Nonocclusive intestinal infarction 72150009 SNOMED NO NO NO
4214720 Thrombotic mesenteric infarction 80475003 SNOMED NO NO NO
4192856 Acute ischemic colitis 75700000 SNOMED NO NO NO
4188336 Chronic ischemic enterocolitis 46882000 SNOMED NO NO NO
4174014 Inferior mesenteric artery embolus 297140006 SNOMED NO NO NO
4149013 Mesenteric infarction 3558002 SNOMED NO NO NO
4148257 Chronic gastrointestinal tract vascular insufficiency 266520007 SNOMED NO NO NO
4148256 Acute GIT vascular insufficiency 266519001 SNOMED NO NO NO
4124856 Inferior mesenteric vein thrombosis 234041004 SNOMED NO NO NO
4055089 Superior mesenteric vein thrombosis 197001004 SNOMED NO NO NO
4055025 Superior mesenteric artery embolus 196999001 SNOMED NO NO NO
4045408 Ischemic stricture of intestine 13026000 SNOMED NO NO NO
201894 Acute vascular insufficiency of intestine 91489000 SNOMED NO NO NO
192673 Vascular insufficiency of intestine 82196007 SNOMED NO NO NO

B.17.14 Concept: Thrombocytopenia (narrow)

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
432870 Thrombocytopenic disorder 302215000 SNOMED NO YES NO
37397537 Beta thalassemia X-linked thrombocytopenia syndrome 718196002 SNOMED YES YES NO
36713112 Pancytopenia due to antineoplastic chemotherapy 328301000119102 SNOMED YES YES NO
40321716 Secondary thrombocytopenia 154826009 SNOMED YES NO NO
435076 Transient neonatal thrombocytopenia 23205009 SNOMED YES YES NO
4239484 Acquired pancytopenia 5876000 SNOMED YES YES NO
137829 Aplastic anemia 306058006 SNOMED YES YES NO
4133981 Benign gestational thrombocytopenia 128090002 SNOMED YES YES NO
436956 Evans syndrome 75331009 SNOMED YES YES NO
4316372 HELLP syndrome 95605009 SNOMED YES YES NO
42536958 Pancytopenia caused by medication 736024007 SNOMED YES YES NO
4247776 Posttransfusion purpura 73162004 SNOMED YES YES NO
440982 Wiskott-Aldrich syndrome 36070007 SNOMED YES YES NO
42537688 Congenital thrombocytopenia 737221003 SNOMED YES YES NO
437242 Congenital thrombocytopenic purpura 267535004 SNOMED YES YES NO
4221109 Neonatal thrombocytopenia 82835005 SNOMED YES YES NO
432881 Pancytopenia 127034005 SNOMED YES YES NO
4119134 Thrombocytopenic purpura 302873008 SNOMED YES NO NO

B.17.15 Concept: Intraabdominal thrombosis - hepatic thrombosis

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
4223098 Hepatic artery thrombosis 83940008 SNOMED NO YES NO
4301208 Hepatic vein thrombosis 38739001 SNOMED NO YES NO
4111853 Embolism and thrombosis of hepatic artery 195343000 SNOMED NO YES NO
196715 Budd-Chiari syndrome 82385007 SNOMED NO NO NO
4277276 Veno-occlusive disease of the liver 65617004 SNOMED NO YES NO

B.17.16 Concept: Portal Vein thrombosis (include visceral, mesenteric)

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
199837 Portal vein thrombosis 17920008 SNOMED NO YES NO
37111372 Visceral venous thrombosis 726099002 SNOMED NO YES NO
4223670 Thrombosis of abdominal aorta 84272007 SNOMED NO YES NO
196715 Budd-Chiari syndrome 82385007 SNOMED NO NO NO
36717492 Acute occlusion of mesenteric vein 721663007 SNOMED NO NO NO
45757410 Acute thrombosis of mesenteric vein 133421000119101 SNOMED NO NO NO
45757409 Chronic thrombosis of mesenteric vein 133411000119108 SNOMED NO NO NO
4124856 Inferior mesenteric vein thrombosis 234041004 SNOMED NO NO NO
4173167 Mesenteric embolus 276500007 SNOMED NO NO NO
4144032 Mesenteric thrombus and/or embolus 307420006 SNOMED NO NO NO
4055089 Superior mesenteric vein thrombosis 197001004 SNOMED NO NO NO
4318407 Thrombophlebitis of mesenteric vein 95447001 SNOMED NO NO NO
4317289 Thrombosis of mesenteric vein 95446005 SNOMED NO NO NO

B.17.17 Concept: Intraabdominal- splenic infacrtion and thrombosis

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
36712891 Chronic thrombosis of splenic vein 143551000119106 SNOMED NO YES NO
4033521 Splenic vein thrombosis 14534009 SNOMED NO YES NO
35615064 Thrombosis of splenic artery 15972701000119106 SNOMED NO YES NO
36712892 Acute thrombosis of splenic vein 143561000119108 SNOMED NO YES NO
4044745 Splenic infarction 22996003 SNOMED NO YES NO
4048527 Fleckmilz 123617004 SNOMED NO NO NO

B.17.18 Concept: cerebral venous sinus thrombosis (CVST narrow)

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
4111714 Cerebral infarction due to cerebral venous thrombosis, non-pyogenic 195230003 SNOMED NO YES NO
4179912 Intracranial venous thrombosis 297157005 SNOMED NO YES NO
4061473 Obstetric cerebral venous thrombosis 200258006 SNOMED YES YES NO
4273550 Thrombosis of intracranial venous sinus of pregnancy AND/OR puerperium 63795001 SNOMED YES YES NO
45765438 Neonatal noninfectious cerebral venous sinus thrombosis 702374000 SNOMED YES YES NO
36717594 Neonatal thrombosis of cerebral venous sinus 722930000 SNOMED YES YES NO
4223544 Cerebral venous thrombosis of pregnancy AND/OR puerperium 84216001 SNOMED YES YES NO

B.17.19 Concept: cerebral venous sinus thrombosis (CVST broad)

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
318137 Phlebitis and thrombophlebitis of intracranial sinuses 192753009 SNOMED NO YES NO
4111714 Cerebral infarction due to cerebral venous thrombosis, non-pyogenic 195230003 SNOMED NO YES NO
4045733 Cerebrovascular and spinal vascular disorders 230689003 SNOMED NO NO NO
4179912 Intracranial venous thrombosis 297157005 SNOMED NO YES NO
4061473 Obstetric cerebral venous thrombosis 200258006 SNOMED YES YES NO
4273550 Thrombosis of intracranial venous sinus of pregnancy AND/OR puerperium 63795001 SNOMED YES YES NO
45765438 Neonatal noninfectious cerebral venous sinus thrombosis 702374000 SNOMED YES YES NO
36717594 Neonatal thrombosis of cerebral venous sinus 722930000 SNOMED YES YES NO
4223544 Cerebral venous thrombosis of pregnancy AND/OR puerperium 84216001 SNOMED YES YES NO

B.17.20 Concept: other Intraabdominal thrombosis

Concept ID Concept Name Code Vocabulary Excluded Descendants Mapped
4049318 Thrombosis of renal vein 15842009 SNOMED NO YES NO
4223670 Thrombosis of abdominal aorta 84272007 SNOMED NO YES NO
444264 Thrombosis of iliac artery 82453008 SNOMED NO YES NO
4207615 Thrombosis of vein of trunk 312584000 SNOMED NO YES NO
4273526 Vertebral artery thrombosis 64775002 SNOMED NO YES NO
196715 Budd-Chiari syndrome 82385007 SNOMED YES YES NO
199837 Portal vein thrombosis 17920008 SNOMED YES YES NO
4317289 Thrombosis of mesenteric vein 95446005 SNOMED YES YES NO
195294 Thrombosed hemorrhoids 75955007 SNOMED YES YES NO
4033521 Splenic vein thrombosis 14534009 SNOMED YES YES NO
4301208 Hepatic vein thrombosis 38739001 SNOMED YES YES NO
4092406 Portal thrombophlebitis 24805007 SNOMED YES YES NO