Protocol: RCRI Validation Study

Info

• Research Area: Methods research
• Protocol Version: 1.0.0

Lay Summary

The Revised Cardiac Risk Index for Pre-Operative Risk (RCRI) model informs a patient of their risk of having cardiac complications before they have an optional non-cardiac surgery. The model has been incorporated into guidelines (https://pubmed.ncbi.nlm.nih.gov/27865641/) to help identify which patients would benefit from further risk assessment.

The original RCRI model was developed decades ago and an revised version was proposed more recently. It it known that model accuracy can decrease over time due to changes in medical care and patient comorbidities. Therefore, it is of interest to see how the original and revised models perform over time.

In this study we will apply the two versions of the model across a network of observational databases. We will evaluate the performances when applied to all patients with non-cardiac surgery dates across all time and also per year (when possible). This will enable us to see how much a model performance is impacted by time.

Technical Summary

The RCRI model was developed to predict cardiac complications in patients ≥45 years old (or 18-44 years old with significant cardiovascular disease) undergoing elective non-cardiac surgery or urgent/semi-urgent (non-emergent) non-cardiac surgery. The prediction index is the date of the surgery.

The RCRI is a simple model with six predictors (high risk surgery, history of ischemic heart disease, history of congestive heart failure, history of cerebrovascular disease, pre-operative treatment with insulin and pre-operative creatinine > 2mg/dL). The model simply assigned a patient 1 point per predictor that the patient has and these points are summed to the patient’s total score (e.g., a patient with a history of congestive heart failure only, creatinine < 2 mg/dL and no insulin pre-operatively would have a score of +1 ).

The original model then assigned risk percentages to the total score, however, this mapping was recalibrated for the revised model, so the scores mean different risks. It is unclear whether the revised model’s recalibration actually improved the model performance. Therefore, we will apply both versions of the model and calculate the discrimiantion via AUROC and AUPRC in addition to calibration via calibration-in-the-large and Estatistic. We will also plot decision curves.

As the RCRI model was developed many years ago. We will also evaluate the model stratfying by prediction index, so we can see whether the model performance changes over time. We will evaluate the model overall and by prediction index year.

Specific Aims, Objectives and Rationale

Specific aims:

• To implement the RCRI original and recalibrated models across a network of observational healthcare databases and evaluate the model’s discrimiantion and calibration.
• To compare the calibration and decision curves for the orginal vs recalibrated models.
• To compare the discrimination of the RCRI model over time (every year from 2010-2024).
• The compare the calibration over time (every year from 2010-2024) between the original and recalibrated models.

Objectives:

• To investigate whether the recalibrated model is better calibrated than the original across a network of databases.
• To investigate how the original and recalibrated RCRI model performances have changed over time.

Rationale:

• It is known that model performance can deteriorate over time, but it is unclear how much the performance deteriorates. We are interested in seeing how model updating via recalibration can impact the model deterioration. This will provide insight into how best to update models to keep them performing satisfactorily. We want to investigate this via a model that has been clinically implemented.

Study Design

We will implement a retrospective cohort design to evaluate the RCRI models across a number of observational healthcare databases mapped to the OMOP common data model.

For each database in this study we extract patients in the target population (Non-cardiac surgery during an inpatient visit, aged 45+ and no recent ER visit), who have >=365 days prior observation in the database. We then classify these patients as having the outcome (MI, CA and death) if they had the outcome within N days of the surgery date. Otherwise they are classed as non-outcome.

We then apply the RCRI model (original and recalibrated) to the patients using surgery date as index. This generates an original model predicted risk and revised model predicted risk per patient.

To evaluate the models, we compare the predicted risks with the truth (outcome = 1 and non-outcome = 0) to calculate the discrimination (AUROC and AUPRC), calibration (calibration-in-the-large and Estatistic). We also calculate 95% confidence intervals for the discrimination and ROC/calibration plots.

For the index-stratified evaluation, when possible (if there are >=25 patients with the outcome in the population and >=100 patients in the population), we will also repeat the evaluation for populations restricted to a specific index year (for years 2010,2011, …, 2023).

Phenotypes

The definitions via human readable descriptions in addition to SQL and JSON representations are available below.

Target Cohort

Revised Cardiac Risk Index - Target - Non-cardiac surgery

Friendly Definition

Cohort Entry Events

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

1. procedure occurrences of ‘Cerebrovascular Surgery’.

2. procedure occurrences of ‘Peripheral Vascular - Lower limb arterial bypass’.

3. procedure occurrences of ‘Colon and Rectal Resection (includes appendicetomy)’.

4. procedure occurrences of ‘Celiac Artery Revascularization’.

5. procedure occurrences of ‘Superior Mesenteric Artery Revascularization’.

6. procedure occurrences of ‘Thoracic Vascular Surgery’.

7. procedure occurrences of ‘Iliac-Femoral Bypass’.

8. procedure occurrences of ‘Complex Visceral Resection 1 - Liver’.

9. procedure occurrences of ‘Abdominal Aortic Aneurysm Repair’.

10. procedure occurrences of ‘Head and neck resection’.

11. procedure occurrences of ‘Cytoreductive surgery’.

12. procedure occurrences of ‘Thoracic resection’.

13. procedure occurrences of ‘Stomach Surgery’.

14. procedure occurrences of ‘Complex Visceral Resection 3 - Pancreas’.

15. procedure occurrences of ‘Complex Visceral Resection 2 - Oesophagus’.

16. procedure occurrences of ‘Renal Artery Revascularization’.

17. procedure occurrences of ‘Lymph node dissection (includes surgeries that are radical tissue removal)’.

18. procedure occurrences of ‘Pneumonectomy’.

19. procedure occurrences of ‘Major Hip or Pelvic Surgery’.

20. procedure occurrences of ‘Internal Fixation of Femur’.

21. procedure occurrences of ‘Below Knee Amputation’.

22. procedure occurrences of ‘Above Knee Amputation’.

23. procedure occurrences of ‘Radical hysterectomy’.

24. procedure occurrences of ‘Hysterectomy’.

25. procedure occurrences of ‘Radical prostatectomy’.

26. procedure occurrences of ‘Transurethral prostatectomy’.

27. procedure occurrences of ‘Knee arthroplasty’.

28. procedure occurrences of ‘Lobectomy’.

29. procedure occurrences of ‘Appendectomy’.

30. procedure occurrences of ‘Splenectomy’.

31. procedure occurrences of ‘Adrenalectomy’.

32. procedure occurrences of ‘Craniotomy’.

33. procedure occurrences of ‘Cholecystectomy’.

34. procedure occurrences of ‘Extra surgery list’.

35. procedure occurrences of ‘Breast reconstruction’.

Limit cohort entry events to the earliest event per person.

Inclusion Criteria

1. Age above 45 years

Entry events with the following event criteria: who are >= 45 years old.

2. Inpatient visit on day of surgery without ER visit immediately on or prior

Entry events having at least 1 visit occurrence of ‘Inpatient visit’, starting between 1 days before and 0 days before cohort entry start date and ending 1 days after cohort entry start date; having no visit occurrences of ‘Emergency or ER / Inpatient’, starting between 2 days before and 0 days after ‘Inpatient visit’ start date.

3. Observation period of 365 days

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

Cohort Exit

The person exits the cohort at the end of continuous observation.

Cohort Eras

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

JSON

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32, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 33, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 34, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 48, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 72, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 38, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 73, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 74, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 46, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 75, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 44, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 76, “ProcedureTypeExclude” : false } } ], “ObservationWindow” : { “PriorDays” : 0, “PostDays” : 0 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true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4311405, “CONCEPT_NAME” : “Biopsy”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “86273004”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Procedure” }, “isExcluded” : true, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4249893, “CONCEPT_NAME” : “Colonoscopy”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “73761001”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Procedure” }, “isExcluded” : true, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4304358, “CONCEPT_NAME” : “Diagnostic procedure”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, 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: “SNOMED”, “CONCEPT_CLASS_ID” : “Procedure” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4311405, “CONCEPT_NAME” : “Biopsy”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “86273004”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Procedure” }, “isExcluded” : true, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4249893, “CONCEPT_NAME” : “Colonoscopy”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “73761001”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Procedure” }, “isExcluded” : true, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4304358, “CONCEPT_NAME” : “Diagnostic procedure”, 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“INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “418”, “DOMAIN_ID” : “Observation”, “VOCABULARY_ID” : “DRG”, “CONCEPT_CLASS_ID” : “MS-DRG” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 38001218, “CONCEPT_NAME” : “Laparoscopic cholecystectomy w/o c.d.e. w MCC”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “417”, “DOMAIN_ID” : “Observation”, “VOCABULARY_ID” : “DRG”, “CONCEPT_CLASS_ID” : “MS-DRG” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 38001220, “CONCEPT_NAME” : “Laparoscopic cholecystectomy w/o c.d.e. w/o CC/MCC”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “419”, “DOMAIN_ID” : “Observation”, “VOCABULARY_ID” : “DRG”, “CONCEPT_CLASS_ID” : “MS-DRG” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 2722214, “CONCEPT_NAME” : “Laparoscopy, surgical; cholecystectomy (any method).”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “56340”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “CPT4”, “CONCEPT_CLASS_ID” : “CPT4” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 2722215, “CONCEPT_NAME” : “Laparoscopy, surgical; cholecystectomy with cholangiography.”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “56341”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “CPT4”, “CONCEPT_CLASS_ID” : “CPT4” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 2722216, “CONCEPT_NAME” : “Laparoscopy, surgical; cholecystectomy with exploration of common duct.”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “56342”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “CPT4”, “CONCEPT_CLASS_ID” : “CPT4” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4059308, “CONCEPT_NAME” : “Operation on gallbladder”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “19744006”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Procedure” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4042673, “CONCEPT_NAME” : “Procedure on heart”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “118797008”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Procedure” }, “isExcluded” : true, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4272324, “CONCEPT_NAME” : “Cardiopulmonary bypass operation”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “63697000”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Procedure” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4300528, “CONCEPT_NAME” : “Endoscopic excision of lesion of large intestine”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “78133002”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Procedure” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 2108020, “CONCEPT_NAME” : “Exploration for postoperative hemorrhage, thrombosis or infection; chest”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “35820”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “CPT4”, “CONCEPT_CLASS_ID” : “CPT4” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 46273729, “CONCEPT_NAME” : “Local excision of lesion of duodenum”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “709192002”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Procedure” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4230535, “CONCEPT_NAME” : “Repair of current obstetric laceration of rectum and sphincter ani”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “359946000”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Procedure” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 42872508, “CONCEPT_NAME” : “Laparoscopic subtotal cholecystectomy”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “450499007”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Procedure” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4163971, “CONCEPT_NAME” : “Laparoscopic cholecystectomy”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “45595009”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Procedure” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false } ] } }, { “id” : 76, “name” : “Breast reconstruction”, “expression” : { “items” : [ { “concept” : { “CONCEPT_ID” : 4216472, “CONCEPT_NAME” : “Breast reconstruction with deep inferior epigastric perforator skin flap”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “395167000”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Procedure” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 44809456, “CONCEPT_NAME” : “Breast reconstruction with extended latissimus dorsi flap”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “853311000000104”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Procedure” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 44809457, “CONCEPT_NAME” : “Breast reconstruction with extended latissimus dorsi flap and insertion of prosthesis”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “853321000000105”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Procedure” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4264332, “CONCEPT_NAME” : “Breast reconstruction with free flap”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “61938004”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Procedure” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 2102759, “CONCEPT_NAME” : “Breast reconstruction with free flap”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “19364”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “CPT4”, “CONCEPT_CLASS_ID” : “CPT4” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4032640, “CONCEPT_NAME” : “Breast reconstruction with latissimus dorsi flap with implant”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “14561009”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Procedure” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4216471, “CONCEPT_NAME” : “Breast reconstruction with latissimus dorsi mini-flap”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “395166009”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Procedure” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4064295, “CONCEPT_NAME” : “Breast reconstruction with muscle or myocutaneous flap”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “199649004”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Procedure” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 2102773, “CONCEPT_NAME” : “Breast reconstruction with transverse rectus abdominis myocutaneous flap (TRAM), double pedicle, including closure of donor site”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “19369”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “CPT4”, “CONCEPT_CLASS_ID” : “CPT4” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 2102761, “CONCEPT_NAME” : “Breast reconstruction with transverse rectus abdominis myocutaneous flap (TRAM), single pedicle, including closure of donor site”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “19367”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “CPT4”, “CONCEPT_CLASS_ID” : “CPT4” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false } ] } } ], “QualifiedLimit” : { “Type” : “First” }, “ExpressionLimit” : { “Type” : “First” }, “InclusionRules” : [ { “name” : “Age above 45 years”, “expression” : { “Type” : “ALL”, “CriteriaList” : [], “DemographicCriteriaList” : [ { “Age” : { “Value” : 45, “Op” : “gte” } } ], “Groups” : [] } }, { “name” : “Inpatient visit on day of surgery without ER visit immediately on or prior”, “expression” : { “Type” : “ALL”, “CriteriaList” : [ { “Criteria” : { “VisitOccurrence” : { “CorrelatedCriteria” : { “Type” : “ALL”, “CriteriaList” : [ { “Criteria” : { “VisitOccurrence” : { “CodesetId” : 43, “VisitTypeExclude” : false } }, “StartWindow” : { “Start” : { “Days” : 2, “Coeff” : -1 }, “End” : { “Days” : 0, “Coeff” : 1 }, “UseIndexEnd” : false, “UseEventEnd” : false }, “RestrictVisit” : false, “IgnoreObservationPeriod” : false, “Occurrence” : { “Type” : 0, “Count” : 0, “IsDistinct” : false } } ], “DemographicCriteriaList” : [], “Groups” : [] }, “CodesetId” : 0, “VisitTypeExclude” : false } }, “StartWindow” : { “Start” : { “Days” : 1, “Coeff” : -1 }, “End” : { “Days” : 0, “Coeff” : -1 }, “UseIndexEnd” : false, “UseEventEnd” : false }, “EndWindow” : { “Start” : { “Days” : 1, “Coeff” : 1 }, “End” : { “Coeff” : 1 }, “UseIndexEnd” : false, “UseEventEnd” : true }, “RestrictVisit” : false, “IgnoreObservationPeriod” : false, “Occurrence” : { “Type” : 2, “Count” : 1, “IsDistinct” : false } } ], “DemographicCriteriaList” : [], “Groups” : [] } }, { “name” : “Observation period of 365 days”, “expression” : { “Type” : “ALL”, “CriteriaList” : [ { “Criteria” : { “ObservationPeriod” : {} }, “StartWindow” : { “Start” : { “Coeff” : -1 }, “End” : { “Days” : 365, “Coeff” : -1 }, “UseIndexEnd” : false, “UseEventEnd” : false }, “EndWindow” : { “Start” : { “Days” : 1, “Coeff” : 1 }, “End” : { “Coeff” : 1 }, “UseIndexEnd” : false, “UseEventEnd” : true }, “RestrictVisit” : false, “IgnoreObservationPeriod” : false, “Occurrence” : { “Type” : 2, “Count” : 1, “IsDistinct” : false } } ], “DemographicCriteriaList” : [], “Groups” : [] } } ], “CensoringCriteria” : [], “CollapseSettings” : { “CollapseType” : “ERA”, “EraPad” : 0 }, “CensorWindow” : {} }

SQL

CREATE TABLE #Codesets ( codeset_id int NOT NULL, concept_id bigint NOT NULL ) ;

INSERT INTO #Codesets (codeset_id, concept_id) SELECT 0 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (9201)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (9201))

) I ) C UNION ALL SELECT 1 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4135199,2107924,2107949,2107837,4283095,4240486,4142641,4234989)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4135199,2107924,2107949,2107837,4283095,4240486,4142641,4234989))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673,1531956,2853855,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673,1531956,2853855))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 2 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4236706)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4236706))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 30 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4195136)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4195136))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673,4225223,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673,4225223))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 31 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4021530)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4021530))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 32 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4127886)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4127886))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 33 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4096783)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4096783))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 34 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4234536)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4234536))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 38 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4312749)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4312749))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4323208,4311405,4249893,4304358,4250892,4300528,4138127,4042673,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4323208,4311405,4249893,4304358,4250892,4300528,4138127,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 43 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (262,9203)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (262,9203))

) I ) C UNION ALL SELECT 44 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4141110,4103760,4139935,2003225,4128868,4231866,4267594,4052252,4236706,4294254,4066293,40487075,40483096,4110488,4144714,4205489,4194238,4295138,4314436,4187533,4203442,4204677,4127886,4199270,4306298,4141456,4098879,4322818,4022014,4338954,4287324,4251929)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4141110,4103760,4139935,2003225,4128868,4231866,4267594,4052252,4236706,4294254,4066293,40487075,40483096,4110488,4144714,4205489,4194238,4295138,4314436,4187533,4203442,4204677,4127886,4199270,4306298,4141456,4098879,4322818,4022014,4338954,4287324,4251929))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 45 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4013040,4196081,38001162,40482705)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4013040,4196081,38001162,40482705))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4144721,4035031,4195115,4311405,4170609,4249893,4304358,4250892,4300528,4138127,4179713,4126235,4194372,4062763,4127886,44809616,4179797,4030387,2002949,4144723,4042673,4166761,4199870,4200964,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4144721,4035031,4195115,4311405,4170609,4249893,4304358,4250892,4300528,4138127,4179713,4126235,4194372,4062763,4127886,44809616,4179797,4030387,2002949,4144723,4042673,4166761,4199870,4200964))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 46 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4101626)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4101626))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4232401,4250892,4300528,4138127,40490839,4343795,4243985,4080349,4296539,4069383,4182228,4284392,4121136,4042673,45887543,2103134,2103133,4265725,4136234,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4232401,4250892,4300528,4138127,40490839,4343795,4243985,4080349,4296539,4069383,4182228,4284392,4121136,4042673,45887543,2103134,2103133,4265725,4136234))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 47 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (2108643,2108645,2768119,2830031,4077122,2103867,2740455,2756407,2760818,2740654,2756413,2756411)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (2108643,2108645,2768119,2830031,4077122,2103867,2740455,2756407,2760818,2740654,2756413,2756411))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,42872673,4003042,4030715,4042673,4124209,4272324,2108020,46273729,4230535,2768119)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,42872673,4003042,4030715,4042673,4124209,2768119))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 48 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4078547)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4078547))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4239294,2824731,2005871,4042673,4180403,4343455,4343904,4106397,2000080,2000081,2000079,2105129,2000082,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4239294,2824731,2005871,4042673,4180403,4343455,4343904,4106397,2000080,2000081,2000079,2105129,2000082))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 51 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (2811735,2896830,2839189,4030150,4345349,46273729)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (2811735,2896830,2839189,4030150,4345349))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4314001,4147687,4076862,4311405,4272324,4249893,4304358,4250892,4300528,4138127,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4314001,4147687,4076862))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 55 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4180074)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4180074))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 56 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4049675,4244434)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4049675,4244434))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4267446,4311405,42736434,4249893,4304358,4250892,4300528,4138127,2211645,2211646,2107573,4042673,4181152,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4267446,4311405,42736434,4249893,4304358,4250892,4300528,4138127,2211645,2211646,2107573,4042673,4181152))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 57 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4050715,42872694)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4050715,42872694))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,2731751,2731749,42896667,2731750,4250892,4300528,4138127,4042673,4272324,2108020,46273729,4230535,43018848,2868194)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,2731751,2731749,42896667,2731750,4250892,4300528,4138127,4042673,43018848,2868194))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 58 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4050131,42872696)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4050131,42872696))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,2730933,4249893,4304358,4116625,4250892,4300528,4138127,4195806,4042673,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,2730933,4249893,4304358,4116625,4250892,4300528,4138127,4195806,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 59 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4188287,4022030)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4188287,4022030))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4168349,4042673,4229447,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4168349,4042673,4229447))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 61 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4049675,3188936,3186130,4259553,46271672,4000088,44793144,4181152,4199966,45887730,2107101,2107112)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (3188936,3186130,4259553,46271672,4000088,44793144,4181152,4199966,45887730,2107101,2107112))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,2107453,4272324,4249893,4304358,4250892,4300528,4138127,2211645,2211646,2107431,2107430,2211648,2107581,2107429,2107428,2211647,4042673,2107425,2107310,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,2107453,4272324,4249893,4304358,4250892,4300528,4138127,2211645,2211646,2107431,2107430,2211648,2107581,2107429,2107428,2211647,4042673,2107425,2107310))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 62 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4031312,4030825,4120657)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4031312,4030825,4120657))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 63 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4297155,4001562,709956,709957,4183741,42733287,2103375,42732580,2740664,2106890,2106891,2006433,2006421,4337034,4297155,43021873)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4297155,4001562,709956,709957,4183741,42733287,2103375,42732580,2740664,2106890,2106891,2006433,2006421,4337034,4297155,43021873))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 64 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4203442,4121242,4222325)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4203442,4121242,4222325))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4170280,4311405,4249893,4304358,4250892,4300528,4138127,4042673,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4170280,4311405,4249893,4304358,4250892,4300528,4138127,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 65 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4141456)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4141456))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 66 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4187533,725062,2108937)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4187533,725062,2108937))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 67 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (2108486,4120425,2108645,2108640,2108475,42735001,2102721,42733288,42732332,2110038,2108490,42742521,2110372,2006421)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (2108486,4120425,2108645,2108640,2108475,42735001,2102721,42733288,42732332,2110038,2108490,42742521,2110372,2006421))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 68 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4000882)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4000882))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 69 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4321450,4159841,4076334,2005415,2104897,2104896,2104912,2104919,2105149,4002375,2798725,2819144,2852443,2819622,2832272,2886663,2865770,2824740,2860039,2886683,2891748,2865764,4211987,2005457,2104900,2104899,2104943,2104914,2105166,2105165,2104920,2104934,2104898,4297365,2105163,2104913,2005882,4090926,2104839,2104840,4075926,4203771,2104918,2104917,2108020)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4321450,4159841,4076334,2005415,2104897,2104896,2104912,2104919,2105149,4002375,2798725,2819144,2852443,2819622,2832272,2886663,2865770,2824740,2860039,2886683,2891748,2865764,4211987,2005457,2104900,2104899,2104943,2104914,2105166,2105165,2104920,2104934,2104898,4297365,2105163,2104913,2005882,4090926,2104839,2104840,4075926,4203771,2104918,2104917))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4138127,4042673,4272324,4300528,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4138127,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 70 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4315036,4286744,43531416)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4315036,4286744,43531416))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 71 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4219032)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4219032))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 72 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4000882,42742510,4100718,4328240)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4000882,42742510,4100718,4328240))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 73 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (2722219,4241198)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (2722219,4241198))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 74 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (2109616,4047234)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (2109616,4047234))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,2752031,2752037,4042673,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,2752031,2752037,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 75 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (38001216,38001215,38001217,38001213,38001212,38001214,38001219,38001218,38001220,2722214,2722215,2722216,4059308,42872508,4163971)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (38001216,38001215,38001217,38001213,38001212,38001214,38001219,38001218,38001220,2722214,2722215,2722216,4059308,42872508,4163971))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4138127,4179071,4042673,4272324,4300528,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4138127,4179071,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 76 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4216472,44809456,44809457,4264332,2102759,4032640,4216471,4064295,2102773,2102761)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4216472,44809456,44809457,4264332,2102759,4032640,4216471,4064295,2102773,2102761))

) I ) C;

UPDATE STATISTICS #Codesets;

SELECT event_id, person_id, start_date, end_date, op_start_date, op_end_date, visit_occurrence_id INTO #qualified_events FROM ( select pe.event_id, pe.person_id, pe.start_date, pe.end_date, pe.op_start_date, pe.op_end_date, row_number() over (partition by pe.person_id order by pe.start_date ASC) as ordinal, cast(pe.visit_occurrence_id as bigint) as visit_occurrence_id FROM (– Begin Primary Events select P.ordinal as event_id, P.person_id, P.start_date, P.end_date, op_start_date, op_end_date, cast(P.visit_occurrence_id as bigint) as visit_occurrence_id FROM ( select E.person_id, E.start_date, E.end_date, row_number() OVER (PARTITION BY E.person_id ORDER BY E.sort_date ASC, E.event_id) ordinal, OP.observation_period_start_date as op_start_date, OP.observation_period_end_date as op_end_date, cast(E.visit_occurrence_id as bigint) as visit_occurrence_id FROM ( – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 1) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 2) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 45) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 57) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 58) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 61) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 55) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 51) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 56) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 47) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 62) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 63) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 64) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 65) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 66) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 59) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 67) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 68) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 69) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 70) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 71) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 30) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 31) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 32) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 33) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 34) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 48) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 72) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 38) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 73) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 74) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 46) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 75) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 44) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 76) ) C

– End Procedure Occurrence Criteria

) E JOIN @cdm_database_schema.observation_period OP on E.person_id = OP.person_id and E.start_date >= OP.observation_period_start_date and E.start_date <= op.observation_period_end_date WHERE DATEADD(day,0,OP.OBSERVATION_PERIOD_START_DATE) <= E.START_DATE AND DATEADD(day,0,E.START_DATE) <= OP.OBSERVATION_PERIOD_END_DATE ) P WHERE P.ordinal = 1 – End Primary Events ) pe

) QE

;

— Inclusion Rule Inserts

select 0 as inclusion_rule_id, person_id, event_id INTO #Inclusion_0 FROM ( select pe.person_id, pe.event_id FROM #qualified_events pe

JOIN ( – Begin Criteria Group select 0 as index_id, person_id, event_id FROM ( select E.person_id, E.event_id FROM #qualified_events E INNER JOIN ( – Begin Demographic Criteria SELECT 0 as index_id, e.person_id, e.event_id FROM #qualified_events E JOIN @cdm_database_schema.PERSON P ON P.PERSON_ID = E.PERSON_ID WHERE YEAR(E.start_date) - P.year_of_birth >= 45 GROUP BY e.person_id, e.event_id – End Demographic Criteria

) CQ on E.person_id = CQ.person_id and E.event_id = CQ.event_id GROUP BY E.person_id, E.event_id HAVING COUNT(index_id) = 1 ) G – End Criteria Group ) AC on AC.person_id = pe.person_id AND AC.event_id = pe.event_id ) Results ;

select 1 as inclusion_rule_id, person_id, event_id INTO #Inclusion_1 FROM ( select pe.person_id, pe.event_id FROM #qualified_events pe

JOIN ( – Begin Criteria Group select 0 as index_id, person_id, event_id FROM ( select E.person_id, E.event_id FROM #qualified_events E INNER JOIN ( – Begin Correlated Criteria select 0 as index_id, cc.person_id, cc.event_id from (SELECT p.person_id, p.event_id FROM #qualified_events P JOIN ( select PE.person_id, PE.event_id, PE.start_date, PE.end_date, PE.visit_occurrence_id, PE.sort_date FROM ( – Begin Visit Occurrence Criteria select C.person_id, C.visit_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select vo.person_id,vo.visit_occurrence_id,vo.visit_concept_id,vo.visit_start_date as start_date, vo.visit_end_date as end_date FROM @cdm_database_schema.VISIT_OCCURRENCE vo JOIN #Codesets cs on (vo.visit_concept_id = cs.concept_id and cs.codeset_id = 0) ) C

– End Visit Occurrence Criteria

) PE JOIN ( – Begin Criteria Group select 0 as index_id, person_id, event_id FROM ( select E.person_id, E.event_id FROM (SELECT Q.person_id, Q.event_id, Q.start_date, Q.end_date, Q.visit_occurrence_id, OP.observation_period_start_date as op_start_date, OP.observation_period_end_date as op_end_date FROM (– Begin Visit Occurrence Criteria select C.person_id, C.visit_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select vo.person_id,vo.visit_occurrence_id,vo.visit_concept_id,vo.visit_start_date as start_date, vo.visit_end_date as end_date FROM @cdm_database_schema.VISIT_OCCURRENCE vo JOIN #Codesets cs on (vo.visit_concept_id = cs.concept_id and cs.codeset_id = 0) ) C

– End Visit Occurrence Criteria ) Q JOIN @cdm_database_schema.OBSERVATION_PERIOD OP on Q.person_id = OP.person_id and OP.observation_period_start_date <= Q.start_date and OP.observation_period_end_date >= Q.start_date ) E INNER JOIN ( – Begin Correlated Criteria select 0 as index_id, p.person_id, p.event_id from (SELECT Q.person_id, Q.event_id, Q.start_date, Q.end_date, Q.visit_occurrence_id, OP.observation_period_start_date as op_start_date, OP.observation_period_end_date as op_end_date FROM (– Begin Visit Occurrence Criteria select C.person_id, C.visit_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select vo.person_id,vo.visit_occurrence_id,vo.visit_concept_id,vo.visit_start_date as start_date, vo.visit_end_date as end_date FROM @cdm_database_schema.VISIT_OCCURRENCE vo JOIN #Codesets cs on (vo.visit_concept_id = cs.concept_id and cs.codeset_id = 0) ) C

– End Visit Occurrence Criteria ) Q JOIN @cdm_database_schema.OBSERVATION_PERIOD OP on Q.person_id = OP.person_id and OP.observation_period_start_date <= Q.start_date and OP.observation_period_end_date >= Q.start_date ) p LEFT JOIN ( SELECT p.person_id, p.event_id FROM (SELECT Q.person_id, Q.event_id, Q.start_date, Q.end_date, Q.visit_occurrence_id, OP.observation_period_start_date as op_start_date, OP.observation_period_end_date as op_end_date FROM (– Begin Visit Occurrence Criteria select C.person_id, C.visit_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select vo.person_id,vo.visit_occurrence_id,vo.visit_concept_id,vo.visit_start_date as start_date, vo.visit_end_date as end_date FROM @cdm_database_schema.VISIT_OCCURRENCE vo JOIN #Codesets cs on (vo.visit_concept_id = cs.concept_id and cs.codeset_id = 0) ) C

– End Visit Occurrence Criteria ) Q JOIN @cdm_database_schema.OBSERVATION_PERIOD OP on Q.person_id = OP.person_id and OP.observation_period_start_date <= Q.start_date and OP.observation_period_end_date >= Q.start_date ) P JOIN ( – Begin Visit Occurrence Criteria select C.person_id, C.visit_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select vo.person_id,vo.visit_occurrence_id,vo.visit_concept_id,vo.visit_start_date as start_date, vo.visit_end_date as end_date FROM @cdm_database_schema.VISIT_OCCURRENCE vo JOIN #Codesets cs on (vo.visit_concept_id = cs.concept_id and cs.codeset_id = 43) ) C

– End Visit Occurrence Criteria

) A on A.person_id = P.person_id AND A.START_DATE >= P.OP_START_DATE AND A.START_DATE <= P.OP_END_DATE AND A.START_DATE >= DATEADD(day,-2,P.START_DATE) AND A.START_DATE <= DATEADD(day,0,P.START_DATE) ) cc on p.person_id = cc.person_id and p.event_id = cc.event_id GROUP BY p.person_id, p.event_id HAVING COUNT(cc.event_id) = 0 – End Correlated Criteria

) CQ on E.person_id = CQ.person_id and E.event_id = CQ.event_id GROUP BY E.person_id, E.event_id HAVING COUNT(index_id) = 1 ) G – End Criteria Group ) AC on AC.person_id = pe.person_id and AC.event_id = pe.event_id

) A on A.person_id = P.person_id AND A.START_DATE >= P.OP_START_DATE AND A.START_DATE <= P.OP_END_DATE AND A.START_DATE >= DATEADD(day,-1,P.START_DATE) AND A.START_DATE <= DATEADD(day,0,P.START_DATE) AND A.END_DATE >= DATEADD(day,1,P.START_DATE) AND A.END_DATE <= P.OP_END_DATE ) cc GROUP BY cc.person_id, cc.event_id HAVING COUNT(cc.event_id) >= 1 – End Correlated Criteria

) CQ on E.person_id = CQ.person_id and E.event_id = CQ.event_id GROUP BY E.person_id, E.event_id HAVING COUNT(index_id) = 1 ) G – End Criteria Group ) AC on AC.person_id = pe.person_id AND AC.event_id = pe.event_id ) Results ;

select 2 as inclusion_rule_id, person_id, event_id INTO #Inclusion_2 FROM ( select pe.person_id, pe.event_id FROM #qualified_events pe

JOIN ( – Begin Criteria Group select 0 as index_id, person_id, event_id FROM ( select E.person_id, E.event_id FROM #qualified_events E INNER JOIN ( – Begin Correlated Criteria select 0 as index_id, cc.person_id, cc.event_id from (SELECT p.person_id, p.event_id FROM #qualified_events P JOIN ( – Begin Observation Period Criteria select C.person_id, C.observation_period_id as event_id, C.start_date as start_date, C.end_date as end_date, CAST(NULL as bigint) as visit_occurrence_id, C.start_date as sort_date

from ( select op.person_id,op.observation_period_id,op.period_type_concept_id,op.observation_period_start_date as start_date, op.observation_period_end_date as end_date , row_number() over (PARTITION BY op.person_id ORDER BY op.observation_period_start_date) as ordinal FROM @cdm_database_schema.OBSERVATION_PERIOD op ) C

– End Observation Period Criteria

) A on A.person_id = P.person_id AND A.START_DATE >= P.OP_START_DATE AND A.START_DATE <= P.OP_END_DATE AND A.START_DATE >= P.OP_START_DATE AND A.START_DATE <= DATEADD(day,-365,P.START_DATE) AND A.END_DATE >= DATEADD(day,1,P.START_DATE) AND A.END_DATE <= P.OP_END_DATE ) cc GROUP BY cc.person_id, cc.event_id HAVING COUNT(cc.event_id) >= 1 – End Correlated Criteria

) CQ on E.person_id = CQ.person_id and E.event_id = CQ.event_id GROUP BY E.person_id, E.event_id HAVING COUNT(index_id) = 1 ) G – End Criteria Group ) AC on AC.person_id = pe.person_id AND AC.event_id = pe.event_id ) Results ;

SELECT inclusion_rule_id, person_id, event_id INTO #inclusion_events FROM (select inclusion_rule_id, person_id, event_id from #Inclusion_0 UNION ALL select inclusion_rule_id, person_id, event_id from #Inclusion_1 UNION ALL select inclusion_rule_id, person_id, event_id from #Inclusion_2) I; TRUNCATE TABLE #Inclusion_0; DROP TABLE #Inclusion_0;

TRUNCATE TABLE #Inclusion_1; DROP TABLE #Inclusion_1;

TRUNCATE TABLE #Inclusion_2; DROP TABLE #Inclusion_2;

select event_id, person_id, start_date, end_date, op_start_date, op_end_date into #included_events FROM ( SELECT event_id, person_id, start_date, end_date, op_start_date, op_end_date, row_number() over (partition by person_id order by start_date ASC) as ordinal from ( select Q.event_id, Q.person_id, Q.start_date, Q.end_date, Q.op_start_date, Q.op_end_date, SUM(coalesce(POWER(cast(2 as bigint), I.inclusion_rule_id), 0)) as inclusion_rule_mask from #qualified_events Q LEFT JOIN #inclusion_events I on I.person_id = Q.person_id and I.event_id = Q.event_id GROUP BY Q.event_id, Q.person_id, Q.start_date, Q.end_date, Q.op_start_date, Q.op_end_date ) MG – matching groups

– the matching group with all bits set ( POWER(2,# of inclusion rules) - 1 = inclusion_rule_mask WHERE (MG.inclusion_rule_mask = POWER(cast(2 as bigint),3)-1)

) Results WHERE Results.ordinal = 1 ;

– generate cohort periods into #final_cohort select person_id, start_date, end_date INTO #cohort_rows from ( – first_ends select F.person_id, F.start_date, F.end_date FROM ( select I.event_id, I.person_id, I.start_date, CE.end_date, row_number() over (partition by I.person_id, I.event_id order by CE.end_date) as ordinal from #included_events I join ( – cohort_ends – cohort exit dates – By default, cohort exit at the event’s op end date select event_id, person_id, op_end_date as end_date from #included_events ) CE on I.event_id = CE.event_id and I.person_id = CE.person_id and CE.end_date >= I.start_date ) F WHERE F.ordinal = 1 ) FE;

select person_id, min(start_date) as start_date, DATEADD(day,-1 * 0, max(end_date)) as end_date into #final_cohort from ( select person_id, start_date, end_date, sum(is_start) over (partition by person_id order by start_date, is_start desc rows unbounded preceding) group_idx from ( select person_id, start_date, end_date, case when max(end_date) over (partition by person_id order by start_date rows between unbounded preceding and 1 preceding) >= start_date then 0 else 1 end is_start from ( select person_id, start_date, DATEADD(day,0,end_date) as end_date from #cohort_rows ) CR ) ST ) GR group by person_id, group_idx;

DELETE FROM @target_database_schema.@target_cohort_table where cohort_definition_id = @target_cohort_id; INSERT INTO @target_database_schema.@target_cohort_table (cohort_definition_id, subject_id, cohort_start_date, cohort_end_date) select @target_cohort_id as cohort_definition_id, person_id, start_date, end_date FROM #final_cohort CO ;

TRUNCATE TABLE #cohort_rows; DROP TABLE #cohort_rows;

TRUNCATE TABLE #final_cohort; DROP TABLE #final_cohort;

TRUNCATE TABLE #inclusion_events; DROP TABLE #inclusion_events;

TRUNCATE TABLE #qualified_events; DROP TABLE #qualified_events;

TRUNCATE TABLE #included_events; DROP TABLE #included_events;

TRUNCATE TABLE #Codesets; DROP TABLE #Codesets;

Outcome Cohort

RCRI - Outcome - Myocardial infarction, CA and Death earliest event

Friendly Definition

Cohort Entry Events

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

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

2. condition occurrences of ‘Cardiac arrest’.

3. death of any form.

Inclusion Criteria

1. ER or inpatient hospital visit

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

Limit qualifying entry events to the earliest event per person.

Cohort Exit

The person exits the cohort at the end of continuous observation.

Cohort Eras

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

JSON

{ “cdmVersionRange” : “>=5.0.0”, “PrimaryCriteria” : { “CriteriaList” : [ { “ConditionOccurrence” : { “CodesetId” : 6 } }, { “ConditionOccurrence” : { “CodesetId” : 3 } }, { “Death” : { “DeathTypeExclude” : false } } ], “ObservationWindow” : { “PriorDays” : 0, “PostDays” : 0 }, “PrimaryCriteriaLimit” : { “Type” : “All” } }, “ConceptSets” : [ { “id” : 0, “name” : “Acute myocardial Infarction”, “expression” : { “items” : [ { “concept” : { “CONCEPT_ID” : 37109912, “CONCEPT_NAME” : “Arrhythmia due to and following acute myocardial infarction”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “723860000”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 438172, “CONCEPT_NAME” : “Atrial septal defect due to and following acute myocardial infarction”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “194863005”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4124687, “CONCEPT_NAME” : “Cardiac rupture due to and following acute myocardial infarction”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “233847009”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4108678, “CONCEPT_NAME” : “Hemopericardium due to and following acute myocardial infarction”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “194862000”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 45766212, “CONCEPT_NAME” : “Mitral valve regurgitation due to and following acute myocardial infarction”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “703326006”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4329847, “CONCEPT_NAME” : “Myocardial infarction”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “22298006”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 314666, “CONCEPT_NAME” : “Old myocardial infarction”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “1755008”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 37109911, “CONCEPT_NAME” : “Pulmonary embolism due to and following acute myocardial infarction”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “723859005”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4108680, “CONCEPT_NAME” : “Thrombosis of atrium, auricular appendage, and ventricle due to and following acute myocardial infarction”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “194868001”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 37109910, “CONCEPT_NAME” : “Ventricular aneurysm due to and following acute myocardial infarction”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “723858002”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false } ] } }, { “id” : 3, “name” : “Cardiac arrest”, “expression” : { “items” : [ { “concept” : { “CONCEPT_ID” : 321042, “CONCEPT_NAME” : “Cardiac arrest”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “410429000”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false } ] } }, { “id” : 4, “name” : “myocardial infarction”, “expression” : { “items” : [ { “concept” : { “CONCEPT_ID” : 37109912, “CONCEPT_NAME” : “Arrhythmia due to and following acute myocardial infarction”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “723860000”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 438172, “CONCEPT_NAME” : “Atrial septal defect due to and following acute myocardial infarction”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “194863005”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4124687, “CONCEPT_NAME” : “Cardiac rupture due to and following acute myocardial infarction”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “233847009”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4108678, “CONCEPT_NAME” : “Hemopericardium due to and following acute myocardial infarction”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “194862000”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4163874, “CONCEPT_NAME” : “History of myocardial infarction”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “399211009”, “DOMAIN_ID” : “Observation”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Context-dependent” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 45766212, “CONCEPT_NAME” : “Mitral valve regurgitation due to and following acute myocardial infarction”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “703326006”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4329847, “CONCEPT_NAME” : “Myocardial infarction”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “22298006”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 37109911, “CONCEPT_NAME” : “Pulmonary embolism due to and following acute myocardial infarction”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “723859005”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4108680, “CONCEPT_NAME” : “Thrombosis of atrium, auricular appendage, and ventricle due to and following acute myocardial infarction”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “194868001”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 37109910, “CONCEPT_NAME” : “Ventricular aneurysm due to and following acute myocardial infarction”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “723858002”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 45771327, “CONCEPT_NAME” : “Mitral valve regurgitation due to acute myocardial infarction with papillary muscle and chordal rupture”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “703330009”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 606159, “CONCEPT_NAME” : “Mitral valve regurgitation due to acute myocardial infarction”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “1142308000”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 45766214, “CONCEPT_NAME” : “Mitral valve regurgitation due to acute myocardial infarction without papillary muscle and chordal rupture”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “703328007”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false } ] } }, { “id” : 5, “name” : “inpatient or ER / Inpatient”, “expression” : { “items” : [ { “concept” : { “CONCEPT_ID” : 262, “CONCEPT_NAME” : “Emergency Room and Inpatient Visit”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “ERIP”, “DOMAIN_ID” : “Visit”, “VOCABULARY_ID” : “Visit”, “CONCEPT_CLASS_ID” : “Visit” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 9201, “CONCEPT_NAME” : “Inpatient Visit”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “IP”, “DOMAIN_ID” : “Visit”, “VOCABULARY_ID” : “Visit”, “CONCEPT_CLASS_ID” : “Visit” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false } ] } }, { “id” : 6, “name” : “myocardial Infarction and complication”, “expression” : { “items” : [ { “concept” : { “CONCEPT_ID” : 37109912, “CONCEPT_NAME” : “Arrhythmia due to and following acute myocardial infarction”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “723860000”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 438172, “CONCEPT_NAME” : “Atrial septal defect due to and following acute myocardial infarction”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “194863005”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4124687, “CONCEPT_NAME” : “Cardiac rupture due to and following acute myocardial infarction”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “233847009”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4108678, “CONCEPT_NAME” : “Hemopericardium due to and following acute myocardial infarction”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “194862000”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 45766212, “CONCEPT_NAME” : “Mitral valve regurgitation due to and following acute myocardial infarction”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “703326006”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4329847, “CONCEPT_NAME” : “Myocardial infarction”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “22298006”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 314666, “CONCEPT_NAME” : “Old myocardial infarction”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “1755008”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 37109911, “CONCEPT_NAME” : “Pulmonary embolism due to and following acute myocardial infarction”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “723859005”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4108680, “CONCEPT_NAME” : “Thrombosis of atrium, auricular appendage, and ventricle due to and following acute myocardial infarction”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “194868001”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 37109910, “CONCEPT_NAME” : “Ventricular aneurysm due to and following acute myocardial infarction”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “723858002”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 45771327, “CONCEPT_NAME” : “Mitral valve regurgitation due to acute myocardial infarction with papillary muscle and chordal rupture”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “703330009”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 606159, “CONCEPT_NAME” : “Mitral valve regurgitation due to acute myocardial infarction”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “1142308000”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 45766214, “CONCEPT_NAME” : “Mitral valve regurgitation due to acute myocardial infarction without papillary muscle and chordal rupture”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “703328007”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false } ] } } ], “QualifiedLimit” : { “Type” : “First” }, “ExpressionLimit” : { “Type” : “First” }, “InclusionRules” : [ { “name” : “ER or inpatient hospital visit”, “expression” : { “Type” : “ALL”, “CriteriaList” : [ { “Criteria” : { “VisitOccurrence” : { “CodesetId” : 5, “VisitTypeExclude” : false } }, “StartWindow” : { “Start” : { “Coeff” : -1 }, “End” : { “Days” : 0, “Coeff” : 1 }, “UseIndexEnd” : false, “UseEventEnd” : false }, “EndWindow” : { “Start” : { “Days” : 0, “Coeff” : -1 }, “End” : { “Coeff” : 1 }, “UseIndexEnd” : false, “UseEventEnd” : true }, “RestrictVisit” : false, “IgnoreObservationPeriod” : false, “Occurrence” : { “Type” : 2, “Count” : 1, “IsDistinct” : false } } ], “DemographicCriteriaList” : [], “Groups” : [] } } ], “CensoringCriteria” : [], “CollapseSettings” : { “CollapseType” : “ERA”, “EraPad” : 0 }, “CensorWindow” : {} }

SQL

CREATE TABLE #Codesets ( codeset_id int NOT NULL, concept_id bigint NOT NULL ) ;

INSERT INTO #Codesets (codeset_id, concept_id) SELECT 0 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (37109912,438172,4124687,4108678,45766212,4329847,37109911,4108680,37109910)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (37109912,438172,4124687,4108678,45766212,4329847,37109911,4108680,37109910))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (314666)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (314666))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 3 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (321042)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (321042))

) I ) C UNION ALL SELECT 4 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (37109912,438172,4124687,4108678,4163874,45766212,4329847,37109911,4108680,37109910,45771327,606159,45766214)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (37109912,438172,4124687,4108678,4163874,45766212,4329847,37109911,4108680,37109910,45771327,606159,45766214))

) I ) C UNION ALL SELECT 5 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (262,9201)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (262,9201))

) I ) C UNION ALL SELECT 6 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (37109912,438172,4124687,4108678,45766212,4329847,37109911,4108680,37109910,45771327,606159,45766214)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (37109912,438172,4124687,4108678,45766212,4329847,37109911,4108680,37109910,45771327,606159,45766214))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (314666)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (314666))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C;

UPDATE STATISTICS #Codesets;

SELECT event_id, person_id, start_date, end_date, op_start_date, op_end_date, visit_occurrence_id INTO #qualified_events FROM ( select pe.event_id, pe.person_id, pe.start_date, pe.end_date, pe.op_start_date, pe.op_end_date, row_number() over (partition by pe.person_id order by pe.start_date ASC) as ordinal, cast(pe.visit_occurrence_id as bigint) as visit_occurrence_id FROM (– Begin Primary Events select P.ordinal as event_id, P.person_id, P.start_date, P.end_date, op_start_date, op_end_date, cast(P.visit_occurrence_id as bigint) as visit_occurrence_id FROM ( select E.person_id, E.start_date, E.end_date, row_number() OVER (PARTITION BY E.person_id ORDER BY E.sort_date ASC, E.event_id) ordinal, OP.observation_period_start_date as op_start_date, OP.observation_period_end_date as op_end_date, cast(E.visit_occurrence_id as bigint) as visit_occurrence_id FROM ( – Begin Condition Occurrence Criteria SELECT C.person_id, C.condition_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date FROM ( SELECT co.person_id,co.condition_occurrence_id,co.condition_concept_id,co.visit_occurrence_id,co.condition_start_date as start_date, COALESCE(co.condition_end_date, DATEADD(day,1,co.condition_start_date)) as end_date FROM @cdm_database_schema.CONDITION_OCCURRENCE co JOIN #Codesets cs on (co.condition_concept_id = cs.concept_id and cs.codeset_id = 6) ) C

– End Condition Occurrence Criteria

UNION ALL – Begin Condition Occurrence Criteria SELECT C.person_id, C.condition_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date FROM ( SELECT co.person_id,co.condition_occurrence_id,co.condition_concept_id,co.visit_occurrence_id,co.condition_start_date as start_date, COALESCE(co.condition_end_date, DATEADD(day,1,co.condition_start_date)) as end_date FROM @cdm_database_schema.CONDITION_OCCURRENCE co JOIN #Codesets cs on (co.condition_concept_id = cs.concept_id and cs.codeset_id = 3) ) C

– End Condition Occurrence Criteria

UNION ALL – Begin Death Criteria select C.person_id, C.person_id as event_id, C.start_date, c.end_date, CAST(NULL as bigint) as visit_occurrence_id, C.start_date as sort_date from ( select d.person_id,d.cause_concept_id,d.death_date as start_date, DATEADD(day,1,d.death_date) as end_date FROM @cdm_database_schema.DEATH d

) C

– End Death Criteria

) E JOIN @cdm_database_schema.observation_period OP on E.person_id = OP.person_id and E.start_date >= OP.observation_period_start_date and E.start_date <= op.observation_period_end_date WHERE DATEADD(day,0,OP.OBSERVATION_PERIOD_START_DATE) <= E.START_DATE AND DATEADD(day,0,E.START_DATE) <= OP.OBSERVATION_PERIOD_END_DATE ) P

– End Primary Events ) pe

) QE

;

— Inclusion Rule Inserts

select 0 as inclusion_rule_id, person_id, event_id INTO #Inclusion_0 FROM ( select pe.person_id, pe.event_id FROM #qualified_events pe

JOIN ( – Begin Criteria Group select 0 as index_id, person_id, event_id FROM ( select E.person_id, E.event_id FROM #qualified_events E INNER JOIN ( – Begin Correlated Criteria select 0 as index_id, cc.person_id, cc.event_id from (SELECT p.person_id, p.event_id FROM #qualified_events P JOIN ( – Begin Visit Occurrence Criteria select C.person_id, C.visit_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select vo.person_id,vo.visit_occurrence_id,vo.visit_concept_id,vo.visit_start_date as start_date, vo.visit_end_date as end_date FROM @cdm_database_schema.VISIT_OCCURRENCE vo JOIN #Codesets cs on (vo.visit_concept_id = cs.concept_id and cs.codeset_id = 5) ) C

– End Visit Occurrence Criteria

) A on A.person_id = P.person_id AND A.START_DATE >= P.OP_START_DATE AND A.START_DATE <= P.OP_END_DATE AND A.START_DATE >= P.OP_START_DATE AND A.START_DATE <= DATEADD(day,0,P.START_DATE) AND A.END_DATE >= DATEADD(day,0,P.START_DATE) AND A.END_DATE <= P.OP_END_DATE ) cc GROUP BY cc.person_id, cc.event_id HAVING COUNT(cc.event_id) >= 1 – End Correlated Criteria

) CQ on E.person_id = CQ.person_id and E.event_id = CQ.event_id GROUP BY E.person_id, E.event_id HAVING COUNT(index_id) = 1 ) G – End Criteria Group ) AC on AC.person_id = pe.person_id AND AC.event_id = pe.event_id ) Results ;

SELECT inclusion_rule_id, person_id, event_id INTO #inclusion_events FROM (select inclusion_rule_id, person_id, event_id from #Inclusion_0) I; TRUNCATE TABLE #Inclusion_0; DROP TABLE #Inclusion_0;

select event_id, person_id, start_date, end_date, op_start_date, op_end_date into #included_events FROM ( SELECT event_id, person_id, start_date, end_date, op_start_date, op_end_date, row_number() over (partition by person_id order by start_date ASC) as ordinal from ( select Q.event_id, Q.person_id, Q.start_date, Q.end_date, Q.op_start_date, Q.op_end_date, SUM(coalesce(POWER(cast(2 as bigint), I.inclusion_rule_id), 0)) as inclusion_rule_mask from #qualified_events Q LEFT JOIN #inclusion_events I on I.person_id = Q.person_id and I.event_id = Q.event_id GROUP BY Q.event_id, Q.person_id, Q.start_date, Q.end_date, Q.op_start_date, Q.op_end_date ) MG – matching groups

– the matching group with all bits set ( POWER(2,# of inclusion rules) - 1 = inclusion_rule_mask WHERE (MG.inclusion_rule_mask = POWER(cast(2 as bigint),1)-1)

) Results WHERE Results.ordinal = 1 ;

– generate cohort periods into #final_cohort select person_id, start_date, end_date INTO #cohort_rows from ( – first_ends select F.person_id, F.start_date, F.end_date FROM ( select I.event_id, I.person_id, I.start_date, CE.end_date, row_number() over (partition by I.person_id, I.event_id order by CE.end_date) as ordinal from #included_events I join ( – cohort_ends – cohort exit dates – By default, cohort exit at the event’s op end date select event_id, person_id, op_end_date as end_date from #included_events ) CE on I.event_id = CE.event_id and I.person_id = CE.person_id and CE.end_date >= I.start_date ) F WHERE F.ordinal = 1 ) FE;

select person_id, min(start_date) as start_date, DATEADD(day,-1 * 0, max(end_date)) as end_date into #final_cohort from ( select person_id, start_date, end_date, sum(is_start) over (partition by person_id order by start_date, is_start desc rows unbounded preceding) group_idx from ( select person_id, start_date, end_date, case when max(end_date) over (partition by person_id order by start_date rows between unbounded preceding and 1 preceding) >= start_date then 0 else 1 end is_start from ( select person_id, start_date, DATEADD(day,0,end_date) as end_date from #cohort_rows ) CR ) ST ) GR group by person_id, group_idx;

DELETE FROM @target_database_schema.@target_cohort_table where cohort_definition_id = @target_cohort_id; INSERT INTO @target_database_schema.@target_cohort_table (cohort_definition_id, subject_id, cohort_start_date, cohort_end_date) select @target_cohort_id as cohort_definition_id, person_id, start_date, end_date FROM #final_cohort CO ;

TRUNCATE TABLE #cohort_rows; DROP TABLE #cohort_rows;

TRUNCATE TABLE #final_cohort; DROP TABLE #final_cohort;

TRUNCATE TABLE #inclusion_events; DROP TABLE #inclusion_events;

TRUNCATE TABLE #qualified_events; DROP TABLE #qualified_events;

TRUNCATE TABLE #included_events; DROP TABLE #included_events;

TRUNCATE TABLE #Codesets; DROP TABLE #Codesets;

Predictor Cohorts

Predictor: Revised Cardiac Risk Index - Covariate - Elevated risk surgery standard

Friendly Definition

Cohort Entry Events

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

1. procedure occurrences of ‘Cerebrovascular Surgery’.

2. procedure occurrences of ‘Peripheral Vascular - Lower limb arterial bypass’.

3. procedure occurrences of ‘Colon and Rectal Resection (includes appendicetomy)’.

4. procedure occurrences of ‘Celiac Artery Revascularization’.

5. procedure occurrences of ‘Superior Mesenteric Artery Revascularization’.

6. procedure occurrences of ‘Thoracic Vascular Surgery’.

7. procedure occurrences of ‘Iliac-Femoral Bypass’.

8. procedure occurrences of ‘Complex Visceral Resection 1 - Liver’.

9. procedure occurrences of ‘Abdominal Aortic Aneurysm Repair’.

10. procedure occurrences of ‘Head and neck resection’.

11. procedure occurrences of ‘Cytoreductive surgery’.

12. procedure occurrences of ‘Thoracic resection’.

13. procedure occurrences of ‘Stomach Surgery’.

14. procedure occurrences of ‘Complex Visceral Resection 3 - Pancreas’.

15. procedure occurrences of ‘Complex Visceral Resection 2 - Oesophagus’.

16. procedure occurrences of ‘Renal Artery Revascularization’.

17. procedure occurrences of ‘Lymph node dissection (includes surgeries that are radical tissue removal)’.

18. procedure occurrences of ‘Pneumonectomy’.

19. procedure occurrences of ‘Major Hip or Pelvic Surgery’.

20. procedure occurrences of ‘Internal Fixation of Femur’.

21. procedure occurrences of ‘Below Knee Amputation’.

22. procedure occurrences of ‘Above Knee Amputation’.

23. procedure occurrences of ‘Radical hysterectomy’.

24. procedure occurrences of ‘Hysterectomy’.

25. procedure occurrences of ‘Radical prostatectomy’.

26. procedure occurrences of ‘Transurethral prostatectomy’.

27. procedure occurrences of ‘Knee arthroplasty’.

28. procedure occurrences of ‘Lobectomy’.

29. procedure occurrences of ‘Appendectomy’.

30. procedure occurrences of ‘Splenectomy’.

31. procedure occurrences of ‘Adrenalectomy’.

32. procedure occurrences of ‘Craniotomy’.

33. procedure occurrences of ‘Cholecystectomy’.

34. procedure occurrences of ‘Extra surgery list’.

35. procedure occurrences of ‘Breast reconstruction’.

Limit cohort entry events to the earliest event per person.

Inclusion Criteria

1. Age above 45 years

Entry events with the following event criteria: who are >= 45 years old.

2. Inpatient visit on day of surgery without ER visit immediately on or prior

Entry events having at least 1 visit occurrence of ‘Inpatient visit’, starting between 1 days before and 0 days before cohort entry start date and ending 1 days after cohort entry start date; having no visit occurrences of ‘Emergency or ER / Inpatient’, starting between 2 days before and 0 days after ‘Inpatient visit’ start date.

3. Observation period of 365 days

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

4. Procedure Occurence of High Risk Surgery

Entry events having at least 1 procedure occurrence of ‘[RCRI] High risk Updated’, starting between 0 days before and 0 days after cohort entry start date; at same visit as cohort entry.

Cohort Exit

The person exits the cohort at the end of continuous observation.

Cohort Eras

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

JSON

{ “cdmVersionRange” : “>=5.0.0”, “PrimaryCriteria” : { “CriteriaList” : [ { “ProcedureOccurrence” : { “CodesetId” : 1, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 2, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 45, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 57, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 58, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 61, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 55, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 51, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 56, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 47, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 62, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 63, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 64, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 65, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 66, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 59, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 67, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 68, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 69, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 70, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 71, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 30, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 31, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 32, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 33, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 34, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 48, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 72, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 38, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 73, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 74, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 46, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 75, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 44, “ProcedureTypeExclude” : false } }, { “ProcedureOccurrence” : { “CodesetId” : 76, “ProcedureTypeExclude” : false } } ], “ObservationWindow” : { “PriorDays” : 0, “PostDays” : 0 }, “PrimaryCriteriaLimit” : { “Type” : “First” } }, “ConceptSets” : [ { “id” : 0, “name” : “Inpatient visit”, “expression” : { “items” : [ { “concept” : { “CONCEPT_ID” : 9201, “CONCEPT_NAME” : “Inpatient Visit”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “IP”, “DOMAIN_ID” : “Visit”, “VOCABULARY_ID” : “Visit”, “CONCEPT_CLASS_ID” : “Visit” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false } ] } }, { “id” : 1, “name” : “Cerebrovascular Surgery”, “expression” : { “items” : [ { “concept” : { “CONCEPT_ID” : 4135199, “CONCEPT_NAME” : “Anastomosis of carotid-subclavian artery”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “31573003”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Procedure” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 2107924, “CONCEPT_NAME” : “Bypass graft, with other than vein; carotid-subclavian”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “35606”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “CPT4”, “CONCEPT_CLASS_ID” : “CPT4” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 2107949, “CONCEPT_NAME” : “Bypass graft, with other than vein; subclavian-vertebral”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “35645”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “CPT4”, “CONCEPT_CLASS_ID” : “CPT4” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 2107837, “CONCEPT_NAME” : “Bypass graft, with vein; carotid-subclavian or subclavian-carotid”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “35506”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “CPT4”, “CONCEPT_CLASS_ID” : “CPT4” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4283095, “CONCEPT_NAME” : “Carotid endarterectomy”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “66951008”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Procedure” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4240486, “CONCEPT_NAME” : “Carotid-subclavian artery bypass graft with vein”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “59012002”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Procedure” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4142641, “CONCEPT_NAME” : “Creation of carotid-subclavian shunt”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “33349003”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Procedure” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4234989, “CONCEPT_NAME” : “Creation of subclavian-vertebral artery shunt”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “90476000”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Procedure” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4311405, “CONCEPT_NAME” : “Biopsy”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “86273004”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Procedure” }, “isExcluded” : true, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4249893, “CONCEPT_NAME” : “Colonoscopy”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “73761001”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Procedure” }, “isExcluded” : true, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4304358, “CONCEPT_NAME” : “Diagnostic procedure”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “103693007”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Procedure” }, “isExcluded” : true, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4250892, “CONCEPT_NAME” : “Emergency operation”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “73994005”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Procedure” }, “isExcluded” : true, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4300528, “CONCEPT_NAME” : “Endoscopic excision of lesion of large intestine”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “78133002”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Procedure” }, 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2002188, “CONCEPT_NAME” : “Other intra-abdominal vascular shunt or bypass”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “39.26”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “ICD9Proc”, “CONCEPT_CLASS_ID” : “4-dig billing code” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 2002124, “CONCEPT_NAME” : “Other excision of vessels, thoracic vessels”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “38.65”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “ICD9Proc”, “CONCEPT_CLASS_ID” : “4-dig billing code” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 2002127, “CONCEPT_NAME” : “Other excision of vessels, lower limb arteries”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “38.68”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “ICD9Proc”, “CONCEPT_CLASS_ID” : “4-dig billing code” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 2002123, “CONCEPT_NAME” : “Other excision of vessels, aorta, abdominal”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “38.64”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “ICD9Proc”, “CONCEPT_CLASS_ID” : “4-dig billing code” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 2002126, “CONCEPT_NAME” : “Other excision of vessels, abdominal veins”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “38.67”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “ICD9Proc”, “CONCEPT_CLASS_ID” : “4-dig billing code” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 2002125, “CONCEPT_NAME” : “Other excision of vessels, abdominal arteries”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “38.66”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “ICD9Proc”, “CONCEPT_CLASS_ID” : “4-dig billing code” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 2002191, “CONCEPT_NAME” : “Other (peripheral) vascular shunt or bypass”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “39.29”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “ICD9Proc”, “CONCEPT_CLASS_ID” : “4-dig billing code” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false } ] } } ], “QualifiedLimit” : { “Type” : “First” }, “ExpressionLimit” : { “Type” : “First” }, “InclusionRules” : [ { “name” : “Age above 45 years”, “expression” : { “Type” : “ALL”, “CriteriaList” : [], “DemographicCriteriaList” : [ { “Age” : { “Value” : 45, “Op” : “gte” } } ], “Groups” : [] } }, { “name” : “Inpatient visit on day of surgery without ER visit immediately on or prior”, “expression” : { “Type” : “ALL”, “CriteriaList” : [ { “Criteria” : { “VisitOccurrence” : { “CorrelatedCriteria” : { “Type” : “ALL”, “CriteriaList” : [ { “Criteria” : { “VisitOccurrence” : { “CodesetId” : 43, “VisitTypeExclude” : false } }, “StartWindow” : { “Start” : { “Days” : 2, “Coeff” : -1 }, “End” : { “Days” : 0, “Coeff” : 1 }, “UseIndexEnd” : false, “UseEventEnd” : false }, “RestrictVisit” : false, “IgnoreObservationPeriod” : false, “Occurrence” : { “Type” : 0, “Count” : 0, “IsDistinct” : false } } ], “DemographicCriteriaList” : [], “Groups” : [] }, “CodesetId” : 0, “VisitTypeExclude” : false } }, “StartWindow” : { “Start” : { “Days” : 1, “Coeff” : -1 }, “End” : { “Days” : 0, “Coeff” : -1 }, “UseIndexEnd” : false, “UseEventEnd” : false }, “EndWindow” : { “Start” : { “Days” : 1, “Coeff” : 1 }, “End” : { “Coeff” : 1 }, “UseIndexEnd” : false, “UseEventEnd” : true }, “RestrictVisit” : false, “IgnoreObservationPeriod” : false, “Occurrence” : { “Type” : 2, “Count” : 1, “IsDistinct” : false } } ], “DemographicCriteriaList” : [], “Groups” : [] } }, { “name” : “Observation period of 365 days”, “expression” : { “Type” : “ALL”, “CriteriaList” : [ { “Criteria” : { “ObservationPeriod” : {} }, “StartWindow” : { “Start” : { “Coeff” : -1 }, “End” : { “Days” : 365, “Coeff” : -1 }, “UseIndexEnd” : false, “UseEventEnd” : false }, “EndWindow” : { “Start” : { “Days” : 1, “Coeff” : 1 }, “End” : { “Coeff” : 1 }, “UseIndexEnd” : false, “UseEventEnd” : true }, “RestrictVisit” : false, “IgnoreObservationPeriod” : false, “Occurrence” : { “Type” : 2, “Count” : 1, “IsDistinct” : false } } ], “DemographicCriteriaList” : [], “Groups” : [] } }, { “name” : “Procedure Occurence of High Risk Surgery”, “expression” : { “Type” : “ANY”, “CriteriaList” : [ { “Criteria” : { “ProcedureOccurrence” : { “CodesetId” : 78, “ProcedureTypeExclude” : false } }, “StartWindow” : { “Start” : { “Days” : 0, “Coeff” : -1 }, “End” : { “Days” : 0, “Coeff” : 1 }, “UseIndexEnd” : false, “UseEventEnd” : false }, “RestrictVisit” : true, “IgnoreObservationPeriod” : false, “Occurrence” : { “Type” : 2, “Count” : 1, “IsDistinct” : false } } ], “DemographicCriteriaList” : [], “Groups” : [] } } ], “CensoringCriteria” : [], “CollapseSettings” : { “CollapseType” : “ERA”, “EraPad” : 0 }, “CensorWindow” : {} }

SQL

CREATE TABLE #Codesets ( codeset_id int NOT NULL, concept_id bigint NOT NULL ) ;

INSERT INTO #Codesets (codeset_id, concept_id) SELECT 0 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (9201)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (9201))

) I ) C UNION ALL SELECT 1 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4135199,2107924,2107949,2107837,4283095,4240486,4142641,4234989,4135199)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4135199,2107924,2107949,2107837,4283095,4240486,4142641,4234989,4135199))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673,1531956,2853855,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673,1531956,2853855))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 2 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4236706)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4236706))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 30 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4195136)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4195136))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673,4225223,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673,4225223))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 31 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4021530)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4021530))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 32 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4127886)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4127886))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 33 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4096783)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4096783))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 34 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4234536)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4234536))

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) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 38 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4312749)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4312749))

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) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 43 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (262,9203)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (262,9203))

) I ) C UNION ALL SELECT 44 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4141110,4103760,4139935,2003225,4128868,4231866,4267594,4052252,4236706,4294254,4066293,40487075,40483096,4110488,4144714,4205489,4194238,4295138,4314436,4187533,4203442,4204677,4127886,4306298,4141456,4098879,4322818,4022014,4338954,4287324,4251929,4199270)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4141110,4103760,4139935,2003225,4128868,4231866,4267594,4052252,4236706,4294254,4066293,40487075,40483096,4110488,4144714,4205489,4194238,4295138,4314436,4187533,4203442,4204677,4127886,4306298,4141456,4098879,4322818,4022014,4338954,4287324,4251929,4199270))

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) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 45 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4013040,4196081,38001162,40482705)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4013040,4196081,38001162,40482705))

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) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 46 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4101626)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4101626))

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) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 47 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (2108643,2108645,2768119,2830031,4077122,2103867,2740455,2756407,2760818,2740654,2756413,2756411)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (2108643,2108645,2768119,2830031,4077122,2103867,2740455,2756407,2760818,2740654,2756413,2756411))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,42872673,4003042,4030715,4042673,4124209,4272324,2108020,46273729,4230535,2768119,2768119,2768119)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,42872673,4003042,4030715,4042673,4124209,2768119,2768119,2768119))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 48 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4078547)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4078547))

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) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 51 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (2811735,2896830,2839189,4030150,4345349,46273729)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (2811735,2896830,2839189,4030150,4345349))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4314001,4147687,4076862,4311405,4272324,4249893,4304358,4250892,4300528,4138127,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4314001,4147687,4076862))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 55 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4180074)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4180074))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 56 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4049675,4244434)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4049675,4244434))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4267446,4311405,42736434,4249893,4304358,4250892,4300528,4138127,2211645,2211646,2107573,4042673,4181152,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4267446,4311405,42736434,4249893,4304358,4250892,4300528,4138127,2211645,2211646,2107573,4042673,4181152))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 57 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4050715,42872694)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4050715,42872694))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,2731751,2731749,42896667,2731750,4250892,4300528,4138127,4042673,4272324,2108020,46273729,4230535,43018848,2796119,2827243,2868194,2868194)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,2731751,2731749,42896667,2731750,4250892,4300528,4138127,4042673,43018848,2796119,2827243,2868194,2868194))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 58 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4050131,42872696)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4050131,42872696))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,2730933,4249893,4304358,4116625,4250892,4300528,4138127,4195806,4042673,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,2730933,4249893,4304358,4116625,4250892,4300528,4138127,4195806,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 59 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4188287,4022030)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4188287,4022030))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4168349,4042673,4229447,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4168349,4042673,4229447))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 61 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4049675,3188936,3186130,4259553,46271672,4000088,44793144,4181152,4199966,45887730,2107101,2107112)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (3188936,3186130,4259553,46271672,4000088,44793144,4181152,4199966,45887730,2107101,2107112))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,2107453,4272324,4249893,4304358,4250892,4300528,4138127,2211645,2211646,2107431,2107430,2211648,2107581,2107429,2107428,2211647,4042673,2107425,2107310,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,2107453,4272324,4249893,4304358,4250892,4300528,4138127,2211645,2211646,2107431,2107430,2211648,2107581,2107429,2107428,2211647,4042673,2107425,2107310))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 62 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4031312,4030825,4120657)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4031312,4030825,4120657))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 63 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4297155,4001562,709956,709957,4183741,42733287,2103375,42732580,2740664,2106890,2106891,2006433,2006421,4337034,4297155,43021873)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4297155,4001562,709956,709957,4183741,42733287,2103375,42732580,2740664,2106890,2106891,2006433,2006421,4337034,4297155,43021873))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 64 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4203442,4121242,4222325)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4203442,4121242,4222325))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4170280,4311405,4249893,4304358,4250892,4300528,4138127,4042673,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4170280,4311405,4249893,4304358,4250892,4300528,4138127,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 65 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4141456)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4141456))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 66 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4187533,725062,2108937)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4187533,725062,2108937))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 67 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (2108486,4120425,2108645,2108640,2108475,42735001,2102721,42733288,42732332,2110038,2108490,42742521,2110372,2006421)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (2108486,4120425,2108645,2108640,2108475,42735001,2102721,42733288,42732332,2110038,2108490,42742521,2110372,2006421))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 68 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4000882)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4000882))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 69 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4321450,4159841,4076334,2005415,2104897,2104896,2104912,2104919,2105149,4002375,2798725,2819144,2852443,2819622,2832272,2886663,2865770,2824740,2860039,2886683,2891748,2865764,4211987,2005457,2104900,2104899,2104943,2104914,2105166,2105165,2104920,2104934,2104898,4297365,2105163,2104913,2005882,4090926,2104839,2104840,4075926,4203771,2104918,2104917,2108020)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4321450,4159841,4076334,2005415,2104897,2104896,2104912,2104919,2105149,4002375,2798725,2819144,2852443,2819622,2832272,2886663,2865770,2824740,2860039,2886683,2891748,2865764,4211987,2005457,2104900,2104899,2104943,2104914,2105166,2105165,2104920,2104934,2104898,4297365,2105163,2104913,2005882,4090926,2104839,2104840,4075926,4203771,2104918,2104917))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4138127,4042673,4272324,4300528,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4138127,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 70 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4315036,4286744,43531416)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4315036,4286744,43531416))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 71 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4219032,4219032,4219032)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4219032,4219032,4219032))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 72 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4000882,42742510,4100718,4328240)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4000882,42742510,4100718,4328240))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 73 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (2722219,4241198)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (2722219,4241198))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 74 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (2109616,4047234)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (2109616,4047234))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,2752031,2752037,4042673,4272324,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4300528,4138127,2752031,2752037,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 75 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (38001216,38001215,38001217,38001213,38001212,38001214,38001219,38001218,38001220,2722214,2722215,2722216,4059308,42872508,4163971)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (38001216,38001215,38001217,38001213,38001212,38001214,38001219,38001218,38001220,2722214,2722215,2722216,4059308,42872508,4163971))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4311405,4249893,4304358,4250892,4138127,4179071,4042673,4272324,4300528,2108020,46273729,4230535)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4311405,4249893,4304358,4250892,4138127,4179071,4042673))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 76 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4216472,44809456,44809457,4264332,2102759,4032640,4216471,4064295,2102773,2102761)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4216472,44809456,44809457,4264332,2102759,4032640,4216471,4064295,2102773,2102761))

) I ) C UNION ALL SELECT 78 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4231866,4168166,4074687,4242396,4187533,4128700,4119403,4141126,4013041,4041980,4221381,4195076,4078220,4148793,4244411,4144800,4196958,4025993,4000882,4185246,4022807,4097064,4275564,4010266,4079730,42872878,4273866,4327488,4280567,4253207,4218137,4296622,4202994,4029416,4295965,4168926,4030148,4174035,4124310,4220195,4131021,4280225,4316068,4043100,4148948,2002085,2002082,4054342,4054342,4054342,2002071,4196199,4196199,4267428,4066293,4066293,4300853,4300853,4049624,4049624,2002064,2002062,4267428,4027229,4027229,2002228,2002190,2002250,4264656,4264656,4264656,4313138,4183308,4183308,2002030,2002030,4225375,4170544,4170544,4295138,4295138,4181152,4181152,2002016,2002019,4238497,4238497,40489937,40489937,4189721,4189721,4271057,4271057,4100324,4100324,2002146,2002143,2002142,2002145,2002210,2002231,2002224,2002286,2002188,2002124,2002127,2002123,2002126,2002125,2002191)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4168166,4074687,4242396,4128700,4013041,4041980,4221381,4195076,4078220,4148793,4025993,4000882,4185246,4022807,4010266,42872878,4273866,4327488,4280567,4253207,4218137,4296622,4202994,4029416,4295965,4168926,4030148,4124310,4220195,4131021,4316068,4148948,2002085,2002082,4054342,4054342,4054342,2002071,4196199,4196199,4267428,4066293,4066293,4300853,4300853,4049624,4049624,2002064,2002062,4267428,4027229,4027229,2002228,2002190,2002250,4264656,4264656,4264656,4313138,4183308,4183308,2002030,2002030,4225375,4170544,4170544,4295138,4295138,4181152,4181152,2002016,2002019,4238497,4238497,40489937,40489937,4189721,4189721,4271057,4271057,4100324,4100324,2002146,2002143,2002142,2002145,2002210,2002231,2002224,2002286,2002188,2002124,2002127,2002123,2002126,2002125,2002191))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4198190,4311405,4272324,4249893,4063540,4304358,4250892,4300528,4138127,4080965,4094240,4101252,4143728,4065590,4043174,4042673,4053719,4146536,4184652,2107774,4029954,4271587,2002965)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4198190,4311405,4272324,4249893,4063540,4304358,4250892,4300528,4138127,4080965,4094240,4101252,4143728,4065590,4043174,4042673,4053719,4146536,4184652,2107774,4271587,2002965))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C;

UPDATE STATISTICS #Codesets;

SELECT event_id, person_id, start_date, end_date, op_start_date, op_end_date, visit_occurrence_id INTO #qualified_events FROM ( select pe.event_id, pe.person_id, pe.start_date, pe.end_date, pe.op_start_date, pe.op_end_date, row_number() over (partition by pe.person_id order by pe.start_date ASC) as ordinal, cast(pe.visit_occurrence_id as bigint) as visit_occurrence_id FROM (– Begin Primary Events select P.ordinal as event_id, P.person_id, P.start_date, P.end_date, op_start_date, op_end_date, cast(P.visit_occurrence_id as bigint) as visit_occurrence_id FROM ( select E.person_id, E.start_date, E.end_date, row_number() OVER (PARTITION BY E.person_id ORDER BY E.sort_date ASC, E.event_id) ordinal, OP.observation_period_start_date as op_start_date, OP.observation_period_end_date as op_end_date, cast(E.visit_occurrence_id as bigint) as visit_occurrence_id FROM ( – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 1) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 2) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 45) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 57) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 58) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 61) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 55) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 51) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 56) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 47) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 62) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 63) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 64) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 65) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 66) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 59) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 67) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 68) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 69) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 70) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 71) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 30) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 31) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 32) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 33) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 34) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 48) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 72) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 38) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 73) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 74) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 46) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 75) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 44) ) C

– End Procedure Occurrence Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 76) ) C

– End Procedure Occurrence Criteria

) E JOIN @cdm_database_schema.observation_period OP on E.person_id = OP.person_id and E.start_date >= OP.observation_period_start_date and E.start_date <= op.observation_period_end_date WHERE DATEADD(day,0,OP.OBSERVATION_PERIOD_START_DATE) <= E.START_DATE AND DATEADD(day,0,E.START_DATE) <= OP.OBSERVATION_PERIOD_END_DATE ) P WHERE P.ordinal = 1 – End Primary Events ) pe

) QE

;

— Inclusion Rule Inserts

select 0 as inclusion_rule_id, person_id, event_id INTO #Inclusion_0 FROM ( select pe.person_id, pe.event_id FROM #qualified_events pe

JOIN ( – Begin Criteria Group select 0 as index_id, person_id, event_id FROM ( select E.person_id, E.event_id FROM #qualified_events E INNER JOIN ( – Begin Demographic Criteria SELECT 0 as index_id, e.person_id, e.event_id FROM #qualified_events E JOIN @cdm_database_schema.PERSON P ON P.PERSON_ID = E.PERSON_ID WHERE YEAR(E.start_date) - P.year_of_birth >= 45 GROUP BY e.person_id, e.event_id – End Demographic Criteria

) CQ on E.person_id = CQ.person_id and E.event_id = CQ.event_id GROUP BY E.person_id, E.event_id HAVING COUNT(index_id) = 1 ) G – End Criteria Group ) AC on AC.person_id = pe.person_id AND AC.event_id = pe.event_id ) Results ;

select 1 as inclusion_rule_id, person_id, event_id INTO #Inclusion_1 FROM ( select pe.person_id, pe.event_id FROM #qualified_events pe

JOIN ( – Begin Criteria Group select 0 as index_id, person_id, event_id FROM ( select E.person_id, E.event_id FROM #qualified_events E INNER JOIN ( – Begin Correlated Criteria select 0 as index_id, cc.person_id, cc.event_id from (SELECT p.person_id, p.event_id FROM #qualified_events P JOIN ( select PE.person_id, PE.event_id, PE.start_date, PE.end_date, PE.visit_occurrence_id, PE.sort_date FROM ( – Begin Visit Occurrence Criteria select C.person_id, C.visit_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select vo.person_id,vo.visit_occurrence_id,vo.visit_concept_id,vo.visit_start_date as start_date, vo.visit_end_date as end_date FROM @cdm_database_schema.VISIT_OCCURRENCE vo JOIN #Codesets cs on (vo.visit_concept_id = cs.concept_id and cs.codeset_id = 0) ) C

– End Visit Occurrence Criteria

) PE JOIN ( – Begin Criteria Group select 0 as index_id, person_id, event_id FROM ( select E.person_id, E.event_id FROM (SELECT Q.person_id, Q.event_id, Q.start_date, Q.end_date, Q.visit_occurrence_id, OP.observation_period_start_date as op_start_date, OP.observation_period_end_date as op_end_date FROM (– Begin Visit Occurrence Criteria select C.person_id, C.visit_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select vo.person_id,vo.visit_occurrence_id,vo.visit_concept_id,vo.visit_start_date as start_date, vo.visit_end_date as end_date FROM @cdm_database_schema.VISIT_OCCURRENCE vo JOIN #Codesets cs on (vo.visit_concept_id = cs.concept_id and cs.codeset_id = 0) ) C

– End Visit Occurrence Criteria ) Q JOIN @cdm_database_schema.OBSERVATION_PERIOD OP on Q.person_id = OP.person_id and OP.observation_period_start_date <= Q.start_date and OP.observation_period_end_date >= Q.start_date ) E INNER JOIN ( – Begin Correlated Criteria select 0 as index_id, p.person_id, p.event_id from (SELECT Q.person_id, Q.event_id, Q.start_date, Q.end_date, Q.visit_occurrence_id, OP.observation_period_start_date as op_start_date, OP.observation_period_end_date as op_end_date FROM (– Begin Visit Occurrence Criteria select C.person_id, C.visit_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select vo.person_id,vo.visit_occurrence_id,vo.visit_concept_id,vo.visit_start_date as start_date, vo.visit_end_date as end_date FROM @cdm_database_schema.VISIT_OCCURRENCE vo JOIN #Codesets cs on (vo.visit_concept_id = cs.concept_id and cs.codeset_id = 0) ) C

– End Visit Occurrence Criteria ) Q JOIN @cdm_database_schema.OBSERVATION_PERIOD OP on Q.person_id = OP.person_id and OP.observation_period_start_date <= Q.start_date and OP.observation_period_end_date >= Q.start_date ) p LEFT JOIN ( SELECT p.person_id, p.event_id FROM (SELECT Q.person_id, Q.event_id, Q.start_date, Q.end_date, Q.visit_occurrence_id, OP.observation_period_start_date as op_start_date, OP.observation_period_end_date as op_end_date FROM (– Begin Visit Occurrence Criteria select C.person_id, C.visit_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select vo.person_id,vo.visit_occurrence_id,vo.visit_concept_id,vo.visit_start_date as start_date, vo.visit_end_date as end_date FROM @cdm_database_schema.VISIT_OCCURRENCE vo JOIN #Codesets cs on (vo.visit_concept_id = cs.concept_id and cs.codeset_id = 0) ) C

– End Visit Occurrence Criteria ) Q JOIN @cdm_database_schema.OBSERVATION_PERIOD OP on Q.person_id = OP.person_id and OP.observation_period_start_date <= Q.start_date and OP.observation_period_end_date >= Q.start_date ) P JOIN ( – Begin Visit Occurrence Criteria select C.person_id, C.visit_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select vo.person_id,vo.visit_occurrence_id,vo.visit_concept_id,vo.visit_start_date as start_date, vo.visit_end_date as end_date FROM @cdm_database_schema.VISIT_OCCURRENCE vo JOIN #Codesets cs on (vo.visit_concept_id = cs.concept_id and cs.codeset_id = 43) ) C

– End Visit Occurrence Criteria

) A on A.person_id = P.person_id AND A.START_DATE >= P.OP_START_DATE AND A.START_DATE <= P.OP_END_DATE AND A.START_DATE >= DATEADD(day,-2,P.START_DATE) AND A.START_DATE <= DATEADD(day,0,P.START_DATE) ) cc on p.person_id = cc.person_id and p.event_id = cc.event_id GROUP BY p.person_id, p.event_id HAVING COUNT(cc.event_id) = 0 – End Correlated Criteria

) CQ on E.person_id = CQ.person_id and E.event_id = CQ.event_id GROUP BY E.person_id, E.event_id HAVING COUNT(index_id) = 1 ) G – End Criteria Group ) AC on AC.person_id = pe.person_id and AC.event_id = pe.event_id

) A on A.person_id = P.person_id AND A.START_DATE >= P.OP_START_DATE AND A.START_DATE <= P.OP_END_DATE AND A.START_DATE >= DATEADD(day,-1,P.START_DATE) AND A.START_DATE <= DATEADD(day,0,P.START_DATE) AND A.END_DATE >= DATEADD(day,1,P.START_DATE) AND A.END_DATE <= P.OP_END_DATE ) cc GROUP BY cc.person_id, cc.event_id HAVING COUNT(cc.event_id) >= 1 – End Correlated Criteria

) CQ on E.person_id = CQ.person_id and E.event_id = CQ.event_id GROUP BY E.person_id, E.event_id HAVING COUNT(index_id) = 1 ) G – End Criteria Group ) AC on AC.person_id = pe.person_id AND AC.event_id = pe.event_id ) Results ;

select 2 as inclusion_rule_id, person_id, event_id INTO #Inclusion_2 FROM ( select pe.person_id, pe.event_id FROM #qualified_events pe

JOIN ( – Begin Criteria Group select 0 as index_id, person_id, event_id FROM ( select E.person_id, E.event_id FROM #qualified_events E INNER JOIN ( – Begin Correlated Criteria select 0 as index_id, cc.person_id, cc.event_id from (SELECT p.person_id, p.event_id FROM #qualified_events P JOIN ( – Begin Observation Period Criteria select C.person_id, C.observation_period_id as event_id, C.start_date as start_date, C.end_date as end_date, CAST(NULL as bigint) as visit_occurrence_id, C.start_date as sort_date

from ( select op.person_id,op.observation_period_id,op.period_type_concept_id,op.observation_period_start_date as start_date, op.observation_period_end_date as end_date , row_number() over (PARTITION BY op.person_id ORDER BY op.observation_period_start_date) as ordinal FROM @cdm_database_schema.OBSERVATION_PERIOD op ) C

– End Observation Period Criteria

) A on A.person_id = P.person_id AND A.START_DATE >= P.OP_START_DATE AND A.START_DATE <= P.OP_END_DATE AND A.START_DATE >= P.OP_START_DATE AND A.START_DATE <= DATEADD(day,-365,P.START_DATE) AND A.END_DATE >= DATEADD(day,1,P.START_DATE) AND A.END_DATE <= P.OP_END_DATE ) cc GROUP BY cc.person_id, cc.event_id HAVING COUNT(cc.event_id) >= 1 – End Correlated Criteria

) CQ on E.person_id = CQ.person_id and E.event_id = CQ.event_id GROUP BY E.person_id, E.event_id HAVING COUNT(index_id) = 1 ) G – End Criteria Group ) AC on AC.person_id = pe.person_id AND AC.event_id = pe.event_id ) Results ;

select 3 as inclusion_rule_id, person_id, event_id INTO #Inclusion_3 FROM ( select pe.person_id, pe.event_id FROM #qualified_events pe

JOIN ( – Begin Criteria Group select 0 as index_id, person_id, event_id FROM ( select E.person_id, E.event_id FROM #qualified_events E INNER JOIN ( – Begin Correlated Criteria select 0 as index_id, cc.person_id, cc.event_id from (SELECT p.person_id, p.event_id FROM #qualified_events P JOIN ( – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 78) ) C

– End Procedure Occurrence Criteria

) A on A.person_id = P.person_id AND A.START_DATE >= P.OP_START_DATE AND A.START_DATE <= P.OP_END_DATE AND A.START_DATE >= DATEADD(day,0,P.START_DATE) AND A.START_DATE <= DATEADD(day,0,P.START_DATE) AND A.visit_occurrence_id = P.visit_occurrence_id ) cc GROUP BY cc.person_id, cc.event_id HAVING COUNT(cc.event_id) >= 1 – End Correlated Criteria

) CQ on E.person_id = CQ.person_id and E.event_id = CQ.event_id GROUP BY E.person_id, E.event_id HAVING COUNT(index_id) > 0 ) G – End Criteria Group ) AC on AC.person_id = pe.person_id AND AC.event_id = pe.event_id ) Results ;

SELECT inclusion_rule_id, person_id, event_id INTO #inclusion_events FROM (select inclusion_rule_id, person_id, event_id from #Inclusion_0 UNION ALL select inclusion_rule_id, person_id, event_id from #Inclusion_1 UNION ALL select inclusion_rule_id, person_id, event_id from #Inclusion_2 UNION ALL select inclusion_rule_id, person_id, event_id from #Inclusion_3) I; TRUNCATE TABLE #Inclusion_0; DROP TABLE #Inclusion_0;

TRUNCATE TABLE #Inclusion_1; DROP TABLE #Inclusion_1;

TRUNCATE TABLE #Inclusion_2; DROP TABLE #Inclusion_2;

TRUNCATE TABLE #Inclusion_3; DROP TABLE #Inclusion_3;

select event_id, person_id, start_date, end_date, op_start_date, op_end_date into #included_events FROM ( SELECT event_id, person_id, start_date, end_date, op_start_date, op_end_date, row_number() over (partition by person_id order by start_date ASC) as ordinal from ( select Q.event_id, Q.person_id, Q.start_date, Q.end_date, Q.op_start_date, Q.op_end_date, SUM(coalesce(POWER(cast(2 as bigint), I.inclusion_rule_id), 0)) as inclusion_rule_mask from #qualified_events Q LEFT JOIN #inclusion_events I on I.person_id = Q.person_id and I.event_id = Q.event_id GROUP BY Q.event_id, Q.person_id, Q.start_date, Q.end_date, Q.op_start_date, Q.op_end_date ) MG – matching groups

– the matching group with all bits set ( POWER(2,# of inclusion rules) - 1 = inclusion_rule_mask WHERE (MG.inclusion_rule_mask = POWER(cast(2 as bigint),4)-1)

) Results WHERE Results.ordinal = 1 ;

– generate cohort periods into #final_cohort select person_id, start_date, end_date INTO #cohort_rows from ( – first_ends select F.person_id, F.start_date, F.end_date FROM ( select I.event_id, I.person_id, I.start_date, CE.end_date, row_number() over (partition by I.person_id, I.event_id order by CE.end_date) as ordinal from #included_events I join ( – cohort_ends – cohort exit dates – By default, cohort exit at the event’s op end date select event_id, person_id, op_end_date as end_date from #included_events ) CE on I.event_id = CE.event_id and I.person_id = CE.person_id and CE.end_date >= I.start_date ) F WHERE F.ordinal = 1 ) FE;

select person_id, min(start_date) as start_date, DATEADD(day,-1 * 0, max(end_date)) as end_date into #final_cohort from ( select person_id, start_date, end_date, sum(is_start) over (partition by person_id order by start_date, is_start desc rows unbounded preceding) group_idx from ( select person_id, start_date, end_date, case when max(end_date) over (partition by person_id order by start_date rows between unbounded preceding and 1 preceding) >= start_date then 0 else 1 end is_start from ( select person_id, start_date, DATEADD(day,0,end_date) as end_date from #cohort_rows ) CR ) ST ) GR group by person_id, group_idx;

DELETE FROM @target_database_schema.@target_cohort_table where cohort_definition_id = @target_cohort_id; INSERT INTO @target_database_schema.@target_cohort_table (cohort_definition_id, subject_id, cohort_start_date, cohort_end_date) select @target_cohort_id as cohort_definition_id, person_id, start_date, end_date FROM #final_cohort CO ;

TRUNCATE TABLE #cohort_rows; DROP TABLE #cohort_rows;

TRUNCATE TABLE #final_cohort; DROP TABLE #final_cohort;

TRUNCATE TABLE #inclusion_events; DROP TABLE #inclusion_events;

TRUNCATE TABLE #qualified_events; DROP TABLE #qualified_events;

TRUNCATE TABLE #included_events; DROP TABLE #included_events;

TRUNCATE TABLE #Codesets; DROP TABLE #Codesets;

Predictor: Revised Cardiac Risk Index - Covariate - Renal impairment creatinine

Friendly Definition

Cohort Entry Events

People enter the cohort when observing any of the following:

1. measurements of ‘Creatinine Measurement’, numeric value between 2 and 20; unit: “milligram per deciliter”, “milligram per deciliter adult” or “milligram per deciliter calculated”.

2. measurements of ‘Creatinine Measurement’, numeric value between 20 and 200; unit: “milligram per liter”.

3. measurements of ‘Creatinine Measurement’, numeric value between 176 and 1,776; unit: “micromole per liter”.

4. condition occurrences of ‘Renal impairment’.

Cohort Exit

The cohort end date will be offset from index event’s start date plus 365 days. The person exits the cohort when encountering any of the following events: 1. measurements of ‘Creatinine Measurement’, numeric value between 0.1 and 1.99; unit: “milligram per deciliter”, “milligram per deciliter adult” or “milligram per deciliter calculated”. 2. measurements of ‘Creatinine Measurement’, numeric value between 1 and 19.99; unit: “milligram per liter”. 3. measurements of ‘Creatinine Measurement’, numeric value between 8.8 and 175; unit: “micromole per liter”.

Cohort Eras

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

JSON

{ “cdmVersionRange” : “>=5.0.0”, “PrimaryCriteria” : { “CriteriaList” : [ { “Measurement” : { “CodesetId” : 0, “MeasurementTypeExclude” : false, “ValueAsNumber” : { “Value” : 2, “Op” : “bt”, “Extent” : 20 }, “Unit” : [ { “CONCEPT_ID” : 8840, “CONCEPT_NAME” : “milligram per deciliter”, “STANDARD_CONCEPT” : null, “STANDARD_CONCEPT_CAPTION” : “Unknown”, “INVALID_REASON” : null, “INVALID_REASON_CAPTION” : “Unknown”, “CONCEPT_CODE” : “mg/dL”, “DOMAIN_ID” : “Unit”, “VOCABULARY_ID” : “UCUM”, “CONCEPT_CLASS_ID” : null }, { “CONCEPT_ID” : 8954, “CONCEPT_NAME” : “milligram per deciliter adult”, “STANDARD_CONCEPT” : null, “STANDARD_CONCEPT_CAPTION” : “Unknown”, “INVALID_REASON” : null, “INVALID_REASON_CAPTION” : “Unknown”, “CONCEPT_CODE” : “mg/dL{adult}”, “DOMAIN_ID” : “Unit”, “VOCABULARY_ID” : “UCUM”, “CONCEPT_CLASS_ID” : null }, { “CONCEPT_ID” : 9028, “CONCEPT_NAME” : “milligram per deciliter calculated”, “STANDARD_CONCEPT” : null, “STANDARD_CONCEPT_CAPTION” : “Unknown”, “INVALID_REASON” : null, “INVALID_REASON_CAPTION” : “Unknown”, “CONCEPT_CODE” : “mg/dL{calc}”, “DOMAIN_ID” : “Unit”, “VOCABULARY_ID” : “UCUM”, “CONCEPT_CLASS_ID” : null } ] } }, { “Measurement” : { “CodesetId” : 0, “MeasurementTypeExclude” : false, “ValueAsNumber” : { “Value” : 20, “Op” : “bt”, “Extent” : 200 }, “Unit” : [ { “CONCEPT_ID” : 8751, “CONCEPT_NAME” : “milligram per liter”, “STANDARD_CONCEPT” : null, “STANDARD_CONCEPT_CAPTION” : “Unknown”, “INVALID_REASON” : null, “INVALID_REASON_CAPTION” : “Unknown”, “CONCEPT_CODE” : “mg/L”, “DOMAIN_ID” : “Unit”, “VOCABULARY_ID” : “UCUM”, “CONCEPT_CLASS_ID” : null } ] } }, { “Measurement” : { “CodesetId” : 0, “MeasurementTypeExclude” : false, “ValueAsNumber” : { “Value” : 176, “Op” : “bt”, “Extent” : 1776 }, “Unit” : [ { “CONCEPT_ID” : 8749, “CONCEPT_NAME” : “micromole per liter”, “STANDARD_CONCEPT” : null, “STANDARD_CONCEPT_CAPTION” : “Unknown”, “INVALID_REASON” : null, “INVALID_REASON_CAPTION” : “Unknown”, “CONCEPT_CODE” : “umol/L”, “DOMAIN_ID” : “Unit”, “VOCABULARY_ID” : “UCUM”, “CONCEPT_CLASS_ID” : null } ] } }, { “ConditionOccurrence” : { “CodesetId” : 1 } } ], “ObservationWindow” : { “PriorDays” : 0, “PostDays” : 0 }, “PrimaryCriteriaLimit” : { “Type” : “All” } }, “ConceptSets” : [ { “id” : 0, “name” : “Creatinine Measurement”, “expression” : { “items” : [ { “concept” : { “CONCEPT_ID” : 2212294, “CONCEPT_NAME” : “Creatinine; blood”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “82565”, “DOMAIN_ID” : “Measurement”, “VOCABULARY_ID” : “CPT4”, “CONCEPT_CLASS_ID” : “CPT4” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4275203, “CONCEPT_NAME” : “Creatinine level - finding”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “365756002”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : 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“CONCEPT_ID” : 3016723, “CONCEPT_NAME” : “Creatinine [Mass/volume] in Serum or Plasma”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “2160-0”, “DOMAIN_ID” : “Measurement”, “VOCABULARY_ID” : “LOINC”, “CONCEPT_CLASS_ID” : “Lab Test” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 3017250, “CONCEPT_NAME” : “Creatinine [Mass/volume] in Urine”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “2161-8”, “DOMAIN_ID” : “Measurement”, “VOCABULARY_ID” : “LOINC”, “CONCEPT_CLASS_ID” : “Lab Test” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4324383, “CONCEPT_NAME” : “Creatinine measurement”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : 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“STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “90961”, “DOMAIN_ID” : “Observation”, “VOCABULARY_ID” : “CPT4”, “CONCEPT_CLASS_ID” : “CPT4” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 2213587, “CONCEPT_NAME” : “End-stage renal disease (ESRD) related services monthly, for patients 20 years of age and older; with 4 or more face-to-face visits by a physician or other qualified health care professional per month”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “90960”, “DOMAIN_ID” : “Observation”, “VOCABULARY_ID” : “CPT4”, “CONCEPT_CLASS_ID” : “CPT4” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 2213580, “CONCEPT_NAME” : “End-stage renal disease (ESRD) related services monthly, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 1 face-to-face visit by a physicia”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “90953”, “DOMAIN_ID” : “Observation”, “VOCABULARY_ID” : “CPT4”, “CONCEPT_CLASS_ID” : “CPT4” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 2213579, “CONCEPT_NAME” : “End-stage renal disease (ESRD) related services monthly, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2-3 face-to-face visits by a physi”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “90952”, “DOMAIN_ID” : “Observation”, “VOCABULARY_ID” : “CPT4”, “CONCEPT_CLASS_ID” : “CPT4” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 2213578, “CONCEPT_NAME” : “End-stage renal disease (ESRD) related services monthly, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face visits by a”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “90951”, “DOMAIN_ID” : “Observation”, “VOCABULARY_ID” : “CPT4”, “CONCEPT_CLASS_ID” : “CPT4” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 133810, “CONCEPT_NAME” : “Hyperparathyroidism due to renal insufficiency”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “19034001”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 44784640, “CONCEPT_NAME” : “Hypertensive heart AND chronic kidney disease stage 1”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “96751000119106”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 43021853, “CONCEPT_NAME” : “Malignant hypertensive chronic kidney disease stage 1”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “285851000119102”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 38001421, “CONCEPT_NAME” : “Renal failure w CC”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “683”, “DOMAIN_ID” : “Observation”, “VOCABULARY_ID” : “DRG”, “CONCEPT_CLASS_ID” : “MS-DRG” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 38001420, “CONCEPT_NAME” : “Renal failure w MCC”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “682”, “DOMAIN_ID” : “Observation”, “VOCABULARY_ID” : “DRG”, “CONCEPT_CLASS_ID” : “MS-DRG” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4030518, “CONCEPT_NAME” : “Renal impairment”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “236423003”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 37116834, “CONCEPT_NAME” : “Postpartum acute renal failure”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “733839001”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 196455, “CONCEPT_NAME” : “Hepatorenal syndrome”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “51292008”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 444044, “CONCEPT_NAME” : “Acute tubular necrosis”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “35455006”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 197320, “CONCEPT_NAME” : “Acute renal failure syndrome”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “14669001”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 44809061, “CONCEPT_NAME” : “Acute kidney injury stage 1”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “851931000000107”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : true, “includeMapped” : false } ] } } ], “QualifiedLimit” : { “Type” : “First” }, “ExpressionLimit” : { “Type” : “All” }, “InclusionRules” : [], “EndStrategy” : { “DateOffset” : { “DateField” : “StartDate”, “Offset” : 365 } }, “CensoringCriteria” : [ { “Measurement” : { “CodesetId” : 0, “MeasurementTypeExclude” : false, “ValueAsNumber” : { “Value” : 0.10000000000000000555112, “Op” : “bt”, “Extent” : 1.9899999999999999911182 }, “Unit” : [ { “CONCEPT_ID” : 8840, “CONCEPT_NAME” : “milligram per deciliter”, “STANDARD_CONCEPT” : null, “STANDARD_CONCEPT_CAPTION” : “Unknown”, “INVALID_REASON” : null, “INVALID_REASON_CAPTION” : “Unknown”, “CONCEPT_CODE” : “mg/dL”, “DOMAIN_ID” : “Unit”, “VOCABULARY_ID” : “UCUM”, “CONCEPT_CLASS_ID” : null }, { “CONCEPT_ID” : 8954, “CONCEPT_NAME” : “milligram per deciliter adult”, “STANDARD_CONCEPT” : null, “STANDARD_CONCEPT_CAPTION” : “Unknown”, “INVALID_REASON” : null, “INVALID_REASON_CAPTION” : “Unknown”, “CONCEPT_CODE” : “mg/dL{adult}”, “DOMAIN_ID” : “Unit”, “VOCABULARY_ID” : “UCUM”, “CONCEPT_CLASS_ID” : null }, { “CONCEPT_ID” : 9028, “CONCEPT_NAME” : “milligram per deciliter calculated”, “STANDARD_CONCEPT” : null, “STANDARD_CONCEPT_CAPTION” : “Unknown”, “INVALID_REASON” : null, “INVALID_REASON_CAPTION” : “Unknown”, “CONCEPT_CODE” : “mg/dL{calc}”, “DOMAIN_ID” : “Unit”, “VOCABULARY_ID” : “UCUM”, “CONCEPT_CLASS_ID” : null } ] } }, { “Measurement” : { “CodesetId” : 0, “MeasurementTypeExclude” : false, “ValueAsNumber” : { “Value” : 1, “Op” : “bt”, “Extent” : 19.989999999999998436806 }, “Unit” : [ { “CONCEPT_ID” : 8751, “CONCEPT_NAME” : “milligram per liter”, “STANDARD_CONCEPT” : null, “STANDARD_CONCEPT_CAPTION” : “Unknown”, “INVALID_REASON” : null, “INVALID_REASON_CAPTION” : “Unknown”, “CONCEPT_CODE” : “mg/L”, “DOMAIN_ID” : “Unit”, “VOCABULARY_ID” : “UCUM”, “CONCEPT_CLASS_ID” : null } ] } }, { “Measurement” : { “CodesetId” : 0, “MeasurementTypeExclude” : false, “ValueAsNumber” : { “Value” : 8.8000000000000007105427, “Op” : “bt”, “Extent” : 175 }, “Unit” : [ { “CONCEPT_ID” : 8749, “CONCEPT_NAME” : “micromole per liter”, “STANDARD_CONCEPT” : null, “STANDARD_CONCEPT_CAPTION” : “Unknown”, “INVALID_REASON” : null, “INVALID_REASON_CAPTION” : “Unknown”, “CONCEPT_CODE” : “umol/L”, “DOMAIN_ID” : “Unit”, “VOCABULARY_ID” : “UCUM”, “CONCEPT_CLASS_ID” : null } ] } } ], “CollapseSettings” : { “CollapseType” : “ERA”, “EraPad” : 0 }, “CensorWindow” : {} }

SQL

CREATE TABLE #Codesets ( codeset_id int NOT NULL, concept_id bigint NOT NULL ) ;

INSERT INTO #Codesets (codeset_id, concept_id) SELECT 0 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (2212294,4275203,3004239,3016662,3016723,3017250,4324383,4013964,4150621,40762887,3020564,3009508,2212295,37392176,37392176,4276437,37394438)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (2212294,4275203,3004239,3016662,3016723,3017250,4324383,4013964,4150621,40762887,3020564,3009508,2212295,37392176,37392176,4276437,37394438))

) I ) C UNION ALL SELECT 1 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (432961,444044,45768812,2213596,2213595,2213597,2213594,2213592,2213591,2213593,2213590,2213586,2213585,2213584,2213583,2213582,2213581,2213589,2213588,2213587,2213580,2213579,2213578,133810,38001421,38001420,4030518,444044,197320)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (432961,444044,45768812,2213596,2213595,2213597,2213594,2213592,2213591,2213593,2213590,2213586,2213585,2213584,2213583,2213582,2213581,2213589,2213588,2213587,2213580,2213579,2213578,133810,38001421,38001420,4030518,444044,197320))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (37116430,44809061,765535,443614,46270354,44782703,45773576,44784640,43021853,37116834,196455,44809061)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (37116430,44809061,765535,443614,46270354,44782703,45773576,44784640,43021853,37116834,196455,44809061))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C;

UPDATE STATISTICS #Codesets;

SELECT event_id, person_id, start_date, end_date, op_start_date, op_end_date, visit_occurrence_id INTO #qualified_events FROM ( select pe.event_id, pe.person_id, pe.start_date, pe.end_date, pe.op_start_date, pe.op_end_date, row_number() over (partition by pe.person_id order by pe.start_date ASC) as ordinal, cast(pe.visit_occurrence_id as bigint) as visit_occurrence_id FROM (– Begin Primary Events select P.ordinal as event_id, P.person_id, P.start_date, P.end_date, op_start_date, op_end_date, cast(P.visit_occurrence_id as bigint) as visit_occurrence_id FROM ( select E.person_id, E.start_date, E.end_date, row_number() OVER (PARTITION BY E.person_id ORDER BY E.sort_date ASC, E.event_id) ordinal, OP.observation_period_start_date as op_start_date, OP.observation_period_end_date as op_end_date, cast(E.visit_occurrence_id as bigint) as visit_occurrence_id FROM ( – Begin Measurement Criteria select C.person_id, C.measurement_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select m.person_id,m.measurement_id,m.measurement_concept_id,m.visit_occurrence_id,m.value_as_number,m.range_high,m.range_low,m.unit_concept_id,m.measurement_date as start_date, DATEADD(day,1,m.measurement_date) as end_date FROM @cdm_database_schema.MEASUREMENT m JOIN #Codesets cs on (m.measurement_concept_id = cs.concept_id and cs.codeset_id = 0) ) C

WHERE (C.value_as_number >= 2.0000 and C.value_as_number <= 20.0000) AND C.unit_concept_id in (8840,8954,9028) – End Measurement Criteria

UNION ALL – Begin Measurement Criteria select C.person_id, C.measurement_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select m.person_id,m.measurement_id,m.measurement_concept_id,m.visit_occurrence_id,m.value_as_number,m.range_high,m.range_low,m.unit_concept_id,m.measurement_date as start_date, DATEADD(day,1,m.measurement_date) as end_date FROM @cdm_database_schema.MEASUREMENT m JOIN #Codesets cs on (m.measurement_concept_id = cs.concept_id and cs.codeset_id = 0) ) C

WHERE (C.value_as_number >= 20.0000 and C.value_as_number <= 200.0000) AND C.unit_concept_id in (8751) – End Measurement Criteria

UNION ALL – Begin Measurement Criteria select C.person_id, C.measurement_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select m.person_id,m.measurement_id,m.measurement_concept_id,m.visit_occurrence_id,m.value_as_number,m.range_high,m.range_low,m.unit_concept_id,m.measurement_date as start_date, DATEADD(day,1,m.measurement_date) as end_date FROM @cdm_database_schema.MEASUREMENT m JOIN #Codesets cs on (m.measurement_concept_id = cs.concept_id and cs.codeset_id = 0) ) C

WHERE (C.value_as_number >= 176.0000 and C.value_as_number <= 1776.0000) AND C.unit_concept_id in (8749) – End Measurement Criteria

UNION ALL – Begin Condition Occurrence Criteria SELECT C.person_id, C.condition_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date FROM ( SELECT co.person_id,co.condition_occurrence_id,co.condition_concept_id,co.visit_occurrence_id,co.condition_start_date as start_date, COALESCE(co.condition_end_date, DATEADD(day,1,co.condition_start_date)) as end_date FROM @cdm_database_schema.CONDITION_OCCURRENCE co JOIN #Codesets cs on (co.condition_concept_id = cs.concept_id and cs.codeset_id = 1) ) C

– End Condition Occurrence Criteria

) E JOIN @cdm_database_schema.observation_period OP on E.person_id = OP.person_id and E.start_date >= OP.observation_period_start_date and E.start_date <= op.observation_period_end_date WHERE DATEADD(day,0,OP.OBSERVATION_PERIOD_START_DATE) <= E.START_DATE AND DATEADD(day,0,E.START_DATE) <= OP.OBSERVATION_PERIOD_END_DATE ) P

– End Primary Events ) pe

) QE

;

— Inclusion Rule Inserts

create table #inclusion_events (inclusion_rule_id bigint, person_id bigint, event_id bigint );

select event_id, person_id, start_date, end_date, op_start_date, op_end_date into #included_events FROM ( SELECT event_id, person_id, start_date, end_date, op_start_date, op_end_date, row_number() over (partition by person_id order by start_date ASC) as ordinal from ( select Q.event_id, Q.person_id, Q.start_date, Q.end_date, Q.op_start_date, Q.op_end_date, SUM(coalesce(POWER(cast(2 as bigint), I.inclusion_rule_id), 0)) as inclusion_rule_mask from #qualified_events Q LEFT JOIN #inclusion_events I on I.person_id = Q.person_id and I.event_id = Q.event_id GROUP BY Q.event_id, Q.person_id, Q.start_date, Q.end_date, Q.op_start_date, Q.op_end_date ) MG – matching groups

) Results

;

– date offset strategy

select event_id, person_id, case when DATEADD(day,365,start_date) > op_end_date then op_end_date else DATEADD(day,365,start_date) end as end_date INTO #strategy_ends from #included_events;

– generate cohort periods into #final_cohort select person_id, start_date, end_date INTO #cohort_rows from ( – first_ends select F.person_id, F.start_date, F.end_date FROM ( select I.event_id, I.person_id, I.start_date, CE.end_date, row_number() over (partition by I.person_id, I.event_id order by CE.end_date) as ordinal from #included_events I join ( – cohort_ends – cohort exit dates – End Date Strategy SELECT event_id, person_id, end_date from #strategy_ends

UNION ALL – Censor Events select i.event_id, i.person_id, MIN(c.start_date) as end_date FROM #included_events i JOIN ( – Begin Measurement Criteria select C.person_id, C.measurement_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select m.person_id,m.measurement_id,m.measurement_concept_id,m.visit_occurrence_id,m.value_as_number,m.range_high,m.range_low,m.unit_concept_id,m.measurement_date as start_date, DATEADD(day,1,m.measurement_date) as end_date FROM @cdm_database_schema.MEASUREMENT m JOIN #Codesets cs on (m.measurement_concept_id = cs.concept_id and cs.codeset_id = 0) ) C

WHERE (C.value_as_number >= 0.1000 and C.value_as_number <= 1.9900) AND C.unit_concept_id in (8840,8954,9028) – End Measurement Criteria

) C on C.person_id = I.person_id and C.start_date >= I.start_date and C.START_DATE <= I.op_end_date GROUP BY i.event_id, i.person_id

UNION ALL select i.event_id, i.person_id, MIN(c.start_date) as end_date FROM #included_events i JOIN ( – Begin Measurement Criteria select C.person_id, C.measurement_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select m.person_id,m.measurement_id,m.measurement_concept_id,m.visit_occurrence_id,m.value_as_number,m.range_high,m.range_low,m.unit_concept_id,m.measurement_date as start_date, DATEADD(day,1,m.measurement_date) as end_date FROM @cdm_database_schema.MEASUREMENT m JOIN #Codesets cs on (m.measurement_concept_id = cs.concept_id and cs.codeset_id = 0) ) C

WHERE (C.value_as_number >= 1.0000 and C.value_as_number <= 19.9900) AND C.unit_concept_id in (8751) – End Measurement Criteria

) C on C.person_id = I.person_id and C.start_date >= I.start_date and C.START_DATE <= I.op_end_date GROUP BY i.event_id, i.person_id

UNION ALL select i.event_id, i.person_id, MIN(c.start_date) as end_date FROM #included_events i JOIN ( – Begin Measurement Criteria select C.person_id, C.measurement_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select m.person_id,m.measurement_id,m.measurement_concept_id,m.visit_occurrence_id,m.value_as_number,m.range_high,m.range_low,m.unit_concept_id,m.measurement_date as start_date, DATEADD(day,1,m.measurement_date) as end_date FROM @cdm_database_schema.MEASUREMENT m JOIN #Codesets cs on (m.measurement_concept_id = cs.concept_id and cs.codeset_id = 0) ) C

WHERE (C.value_as_number >= 8.8000 and C.value_as_number <= 175.0000) AND C.unit_concept_id in (8749) – End Measurement Criteria

) C on C.person_id = I.person_id and C.start_date >= I.start_date and C.START_DATE <= I.op_end_date GROUP BY i.event_id, i.person_id

) CE on I.event_id = CE.event_id and I.person_id = CE.person_id and CE.end_date >= I.start_date
) F
WHERE F.ordinal = 1

) FE;

select person_id, min(start_date) as start_date, DATEADD(day,-1 * 0, max(end_date)) as end_date into #final_cohort from ( select person_id, start_date, end_date, sum(is_start) over (partition by person_id order by start_date, is_start desc rows unbounded preceding) group_idx from ( select person_id, start_date, end_date, case when max(end_date) over (partition by person_id order by start_date rows between unbounded preceding and 1 preceding) >= start_date then 0 else 1 end is_start from ( select person_id, start_date, DATEADD(day,0,end_date) as end_date from #cohort_rows ) CR ) ST ) GR group by person_id, group_idx;

DELETE FROM @target_database_schema.@target_cohort_table where cohort_definition_id = @target_cohort_id; INSERT INTO @target_database_schema.@target_cohort_table (cohort_definition_id, subject_id, cohort_start_date, cohort_end_date) select @target_cohort_id as cohort_definition_id, person_id, start_date, end_date FROM #final_cohort CO ;

TRUNCATE TABLE #strategy_ends; DROP TABLE #strategy_ends;

TRUNCATE TABLE #cohort_rows; DROP TABLE #cohort_rows;

TRUNCATE TABLE #final_cohort; DROP TABLE #final_cohort;

TRUNCATE TABLE #inclusion_events; DROP TABLE #inclusion_events;

TRUNCATE TABLE #qualified_events; DROP TABLE #qualified_events;

TRUNCATE TABLE #included_events; DROP TABLE #included_events;

TRUNCATE TABLE #Codesets; DROP TABLE #Codesets;

Predictor: Revised Cardiac Risk Index - Covariate - Ischemic heart disease

Friendly Definition

Cohort Entry Events

People enter the cohort when observing any of the following:

1. condition occurrences of ‘Coronary artery disease not including atherosclerosis’.

2. observations of ‘Coronary artery disease not including atherosclerosis’.

3. procedure occurrences of ‘Coronary artery disease not including atherosclerosis’.

Limit cohort entry events to the earliest event per person.

Cohort Exit

The person exits the cohort at the end of continuous observation.

Cohort Eras

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

JSON

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“includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4124834, “CONCEPT_NAME” : “Abdominal aortic atherosclerosis”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “233955003”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4121623, “CONCEPT_NAME” : “Aortoiliac atherosclerosis”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “233956002”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4234991, “CONCEPT_NAME” : “Arteriolar nephrosclerosis”, “STANDARD_CONCEPT” : “S”, 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: “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 37110250, “CONCEPT_NAME” : “Atherosclerosis of artery of lower limb”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “724440007”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 36713014, “CONCEPT_NAME” : “Atherosclerosis of bilateral iliac arteries”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “16018831000119106”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 36712955, “CONCEPT_NAME” : “Atherosclerosis of bilateral renal arteries”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “15648771000119103”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40483538, “CONCEPT_NAME” : “Atherosclerosis of bypass graft of limb”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “442439008”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 46271459, “CONCEPT_NAME” : “Atherosclerosis of bypass graft of lower limb”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “709584004”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 43021851, “CONCEPT_NAME” : “Atherosclerosis of left carotid artery”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “284871000119105”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40484551, “CONCEPT_NAME” : “Atherosclerosis of nonautologous biological bypass graft of limb”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “442701004”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40484912, “CONCEPT_NAME” : “Atherosclerosis of nonautologous bypass graft of limb”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “442735001”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 195834, “CONCEPT_NAME” : “Atherosclerosis of renal artery”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “45281005”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 43020493, “CONCEPT_NAME” : “Atherosclerosis of right carotid artery”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “284881000119108”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 37209668, “CONCEPT_NAME” : “Atherosclerosis of superior mesenteric artery”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “16899261000119106”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4030425, “CONCEPT_NAME” : “Atherosclerotic occlusive disease”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “129573006”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4119141, “CONCEPT_NAME” : “Atherosclerotic renal artery stenosis”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “302910002”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4268756, “CONCEPT_NAME” : “Benign arteriolar nephrosclerosis”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “62240004”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 37109252, “CONCEPT_NAME” : “Bilateral atherosclerosis of carotid arteries”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “284861000119104”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 35615028, “CONCEPT_NAME” : “Bilateral atherosclerosis of lower limbs with gangrene”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “15649941000119102”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 35611566, “CONCEPT_NAME” : “Bilateral lower limb atherosclerosis pain at rest co-occurrent and due to atherosclerosis”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “12236991000119103”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4102124, “CONCEPT_NAME” : “Carotid atherosclerosis”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “300920004”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4278243, “CONCEPT_NAME” : “Cerebral arteriosclerosis”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “65312002”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 316437, “CONCEPT_NAME” : “Cerebral atherosclerosis”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “55382008”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 321882, “CONCEPT_NAME” : “Generalized atherosclerosis”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “39823006”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4173261, “CONCEPT_NAME” : “Idiopathic pulmonary arteriosclerosis”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “49778009”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4219755, “CONCEPT_NAME” : “Ischemic contracture of left ventricle syndrome”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “82522008”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4288295, “CONCEPT_NAME” : “Monckeberg’s medial sclerosis”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “69742007”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 36712807, “CONCEPT_NAME” : “Pain at rest of right lower limb co-occurrent and due to atherosclerosis”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “12237231000119107”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 315830, “CONCEPT_NAME” : “Prinzmetal angina”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “87343002”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4064346, “CONCEPT_NAME” : “EKG myocardial ischemia”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “164861001”, “DOMAIN_ID” : “Observation”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 42537729, “CONCEPT_NAME” : “Aortocoronary bypass graft present”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “737276005”, “DOMAIN_ID” : “Observation”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 36712807, “CONCEPT_NAME” : “Pain at rest of right lower limb due to atherosclerosis”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “12237231000119107”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Disorder” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 37168520, “CONCEPT_NAME” : “Arteriosclerosis of aorta”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “1284863004”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Disorder” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 35611566, “CONCEPT_NAME” : “Bilateral lower limb pain at rest due to atherosclerosis”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “12236991000119103”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Disorder” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false } ] } } ], “QualifiedLimit” : { “Type” : “All” }, “ExpressionLimit” : { “Type” : “First” }, “InclusionRules” : [], “CensoringCriteria” : [], “CollapseSettings” : { “CollapseType” : “ERA”, “EraPad” : 0 }, “CensorWindow” : {} }

SQL

CREATE TABLE #Codesets ( codeset_id int NOT NULL, concept_id bigint NOT NULL ) ;

INSERT INTO #Codesets (codeset_id, concept_id) SELECT 3 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (42742403,40761421,4194618,37109912,4134723,316995,45766165,4108220,4080593,606159,4108680,4132088,43020660,4187067,4185932,43533187,37109911,4134586,316427,317576,42537729,438172,4064346,4108678,4124687,44783188,43528002,37109910,37312532,40769283,4064346,42537729)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (37109912,4134723,316995,45766165,4108220,4080593,4108680,43020660,4185932,37109911,317576,42537729,438172,4108678,4124687,44783188,37109910,42537729))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (4127089,318443,4124834,4121623,4234991,4262560,762752,40484167,762755,317577,4318983,312934,315558,40479625,37110250,36713014,36712955,40483538,46271459,43021851,40484551,40484912,195834,43020493,37209668,4030425,4119141,4268756,37109252,35615028,35611566,4102124,4278243,316437,321882,4173261,4219755,4288295,36712807,315830,36712807,37168520,35611566))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C;

UPDATE STATISTICS #Codesets;

SELECT event_id, person_id, start_date, end_date, op_start_date, op_end_date, visit_occurrence_id INTO #qualified_events FROM ( select pe.event_id, pe.person_id, pe.start_date, pe.end_date, pe.op_start_date, pe.op_end_date, row_number() over (partition by pe.person_id order by pe.start_date ASC) as ordinal, cast(pe.visit_occurrence_id as bigint) as visit_occurrence_id FROM (– Begin Primary Events select P.ordinal as event_id, P.person_id, P.start_date, P.end_date, op_start_date, op_end_date, cast(P.visit_occurrence_id as bigint) as visit_occurrence_id FROM ( select E.person_id, E.start_date, E.end_date, row_number() OVER (PARTITION BY E.person_id ORDER BY E.sort_date ASC, E.event_id) ordinal, OP.observation_period_start_date as op_start_date, OP.observation_period_end_date as op_end_date, cast(E.visit_occurrence_id as bigint) as visit_occurrence_id FROM ( – Begin Condition Occurrence Criteria SELECT C.person_id, C.condition_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date FROM ( SELECT co.person_id,co.condition_occurrence_id,co.condition_concept_id,co.visit_occurrence_id,co.condition_start_date as start_date, COALESCE(co.condition_end_date, DATEADD(day,1,co.condition_start_date)) as end_date FROM @cdm_database_schema.CONDITION_OCCURRENCE co JOIN #Codesets cs on (co.condition_concept_id = cs.concept_id and cs.codeset_id = 3) ) C

– End Condition Occurrence Criteria

UNION ALL – Begin Observation Criteria select C.person_id, C.observation_id as event_id, C.start_date, C.END_DATE, C.visit_occurrence_id, C.start_date as sort_date from ( select o.person_id,o.observation_id,o.observation_concept_id,o.visit_occurrence_id,o.value_as_number,o.observation_date as start_date, DATEADD(day,1,o.observation_date) as end_date FROM @cdm_database_schema.OBSERVATION o JOIN #Codesets cs on (o.observation_concept_id = cs.concept_id and cs.codeset_id = 3) ) C

– End Observation Criteria

UNION ALL – Begin Procedure Occurrence Criteria select C.person_id, C.procedure_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select po.person_id,po.procedure_occurrence_id,po.procedure_concept_id,po.visit_occurrence_id,po.quantity,po.procedure_date as start_date, DATEADD(day,1,po.procedure_date) as end_date FROM @cdm_database_schema.PROCEDURE_OCCURRENCE po JOIN #Codesets cs on (po.procedure_concept_id = cs.concept_id and cs.codeset_id = 3) ) C

– End Procedure Occurrence Criteria

) E JOIN @cdm_database_schema.observation_period OP on E.person_id = OP.person_id and E.start_date >= OP.observation_period_start_date and E.start_date <= op.observation_period_end_date WHERE DATEADD(day,0,OP.OBSERVATION_PERIOD_START_DATE) <= E.START_DATE AND DATEADD(day,0,E.START_DATE) <= OP.OBSERVATION_PERIOD_END_DATE ) P WHERE P.ordinal = 1 – End Primary Events ) pe

) QE

;

— Inclusion Rule Inserts

create table #inclusion_events (inclusion_rule_id bigint, person_id bigint, event_id bigint );

select event_id, person_id, start_date, end_date, op_start_date, op_end_date into #included_events FROM ( SELECT event_id, person_id, start_date, end_date, op_start_date, op_end_date, row_number() over (partition by person_id order by start_date ASC) as ordinal from ( select Q.event_id, Q.person_id, Q.start_date, Q.end_date, Q.op_start_date, Q.op_end_date, SUM(coalesce(POWER(cast(2 as bigint), I.inclusion_rule_id), 0)) as inclusion_rule_mask from #qualified_events Q LEFT JOIN #inclusion_events I on I.person_id = Q.person_id and I.event_id = Q.event_id GROUP BY Q.event_id, Q.person_id, Q.start_date, Q.end_date, Q.op_start_date, Q.op_end_date ) MG – matching groups

) Results WHERE Results.ordinal = 1 ;

– generate cohort periods into #final_cohort select person_id, start_date, end_date INTO #cohort_rows from ( – first_ends select F.person_id, F.start_date, F.end_date FROM ( select I.event_id, I.person_id, I.start_date, CE.end_date, row_number() over (partition by I.person_id, I.event_id order by CE.end_date) as ordinal from #included_events I join ( – cohort_ends – cohort exit dates – By default, cohort exit at the event’s op end date select event_id, person_id, op_end_date as end_date from #included_events ) CE on I.event_id = CE.event_id and I.person_id = CE.person_id and CE.end_date >= I.start_date ) F WHERE F.ordinal = 1 ) FE;

select person_id, min(start_date) as start_date, DATEADD(day,-1 * 0, max(end_date)) as end_date into #final_cohort from ( select person_id, start_date, end_date, sum(is_start) over (partition by person_id order by start_date, is_start desc rows unbounded preceding) group_idx from ( select person_id, start_date, end_date, case when max(end_date) over (partition by person_id order by start_date rows between unbounded preceding and 1 preceding) >= start_date then 0 else 1 end is_start from ( select person_id, start_date, DATEADD(day,0,end_date) as end_date from #cohort_rows ) CR ) ST ) GR group by person_id, group_idx;

DELETE FROM @target_database_schema.@target_cohort_table where cohort_definition_id = @target_cohort_id; INSERT INTO @target_database_schema.@target_cohort_table (cohort_definition_id, subject_id, cohort_start_date, cohort_end_date) select @target_cohort_id as cohort_definition_id, person_id, start_date, end_date FROM #final_cohort CO ;

TRUNCATE TABLE #cohort_rows; DROP TABLE #cohort_rows;

TRUNCATE TABLE #final_cohort; DROP TABLE #final_cohort;

TRUNCATE TABLE #inclusion_events; DROP TABLE #inclusion_events;

TRUNCATE TABLE #qualified_events; DROP TABLE #qualified_events;

TRUNCATE TABLE #included_events; DROP TABLE #included_events;

TRUNCATE TABLE #Codesets; DROP TABLE #Codesets;

Predictor: Revised Cardiac Risk Index - Covariate - Cerebrovascular disease inpatient

Friendly Definition

Cohort Entry Events

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

1. condition occurrences of ‘Cerebral infarction’.

2. condition occurrences of ‘Hemorrhagic stroke_updated 2023’.

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.

Inclusion Criteria

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

Entry events having no condition occurrences of ‘Cerebral infarction’, 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’ start date and ending between 0 days before and all days after ‘Cerebral infarction’ start date.

Cohort Exit

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

Cohort Eras

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

JSON

{ “cdmVersionRange” : “>=5.0.0”, “PrimaryCriteria” : { “CriteriaList” : [ { “ConditionOccurrence” : { “CodesetId” : 3 } }, { “ConditionOccurrence” : { “CodesetId” : 4 } } ], “ObservationWindow” : { “PriorDays” : 0, “PostDays” : 0 }, “PrimaryCriteriaLimit” : { “Type” : “All” } }, “AdditionalCriteria” : { “Type” : “ALL”, “CriteriaList” : [ { “Criteria” : { “VisitOccurrence” : { “CodesetId” : 2, “VisitTypeExclude” : false } }, “StartWindow” : { “Start” : { “Coeff” : -1 }, “End” : { “Days” : 0, “Coeff” : 1 }, “UseIndexEnd” : false, “UseEventEnd” : false }, “EndWindow” : { “Start” : { “Days” : 0, “Coeff” : -1 }, “End” : { “Coeff” : 1 }, “UseIndexEnd” : false, “UseEventEnd” : true }, “RestrictVisit” : false, “IgnoreObservationPeriod” : false, “Occurrence” : { “Type” : 2, “Count” : 1, “IsDistinct” : false } } ], “DemographicCriteriaList” : [], “Groups” : [] }, “ConceptSets” : [ { “id” : 2, “name” : “Inpatient or Inpatient/ER visit”, “expression” : { “items” : [ { “concept” : { “CONCEPT_ID” : 262, “CONCEPT_NAME” : “Emergency Room and Inpatient Visit”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “ERIP”, “DOMAIN_ID” : “Visit”, “VOCABULARY_ID” : “Visit”, “CONCEPT_CLASS_ID” : “Visit” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 9201, “CONCEPT_NAME” : “Inpatient Visit”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “IP”, “DOMAIN_ID” : “Visit”, “VOCABULARY_ID” : “Visit”, “CONCEPT_CLASS_ID” : “Visit” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false } ] } }, { “id” : 3, “name” : “Cerebral infarction”, “expression” : { “items” : [ { “concept” : { “CONCEPT_ID” : 443454, “CONCEPT_NAME” : “Cerebral infarction”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “432504007”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40479572, “CONCEPT_NAME” : “Infarct of cerebrum due to iatrogenic cerebrovascular accident”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “441526008”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4046360, “CONCEPT_NAME” : “Lacunar infarction”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “230698000”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 372435, “CONCEPT_NAME” : “Periventricular leukomalacia”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “230769007”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 377254, “CONCEPT_NAME” : “Multi-infarct dementia, uncomplicated”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “70936005”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 379778, “CONCEPT_NAME” : “Multi-infarct dementia”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “56267009”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 443790, “CONCEPT_NAME” : “Multi-infarct dementia with delusions”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “25772007”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 443864, “CONCEPT_NAME” : “Multi-infarct dementia with depression”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “14070001”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 444091, “CONCEPT_NAME” : “Multi-infarct dementia with delirium”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “10349009”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4046089, “CONCEPT_NAME” : “Vascular dementia of acute onset”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “230285003”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4046090, “CONCEPT_NAME” : “Mixed cortical and subcortical vascular dementia”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “230287006”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4129534, “CONCEPT_NAME” : “Pituitary apoplexy”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “237701005”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false } ] } }, { “id” : 4, “name” : “Hemorrhagic stroke_updated 2023”, “expression” : { “items” : [ { “concept” : { “CONCEPT_ID” : 439847, “CONCEPT_NAME” : “Intracranial hemorrhage”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “1386000”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 432923, “CONCEPT_NAME” : “Subarachnoid hemorrhage”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “21454007”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 376713, “CONCEPT_NAME” : “Cerebral hemorrhage”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “274100004”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4148906, “CONCEPT_NAME” : “Spontaneous subarachnoid hemorrhage”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “270907008”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4144154, “CONCEPT_NAME” : “Non-traumatic intracerebral ventricular hemorrhage”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “425957003”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4111709, “CONCEPT_NAME” : “Non-traumatic subdural hemorrhage”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “195176009”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 42535426, “CONCEPT_NAME” : “Acute nontraumatic subdural hemorrhage”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “291581000119109”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 43530728, “CONCEPT_NAME” : “Subacute non-traumatic intracranial subdural hemorrhage”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “291591000119107”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4174299, “CONCEPT_NAME” : “Perinatal intracranial hemorrhage”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “276647007”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 36716544, “CONCEPT_NAME” : “Fetal or neonatal non-traumatic intraventricular hemorrhage”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “722581000”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4345688, “CONCEPT_NAME” : “Intracerebral hemorrhage in fetus or newborn”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “240313004”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 43530727, “CONCEPT_NAME” : “Spontaneous cerebral hemorrhage”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “291571000119106”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4108952, “CONCEPT_NAME” : “Subarachnoid hemorrhage from carotid siphon and bifurcation”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “195155004”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4111708, “CONCEPT_NAME” : “Subarachnoid hemorrhage from vertebral artery”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “195160000”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 35609033, “CONCEPT_NAME” : “Haemorrhagic stroke”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “1078001000000105”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 43530674, “CONCEPT_NAME” : “Spontaneous cerebellar hemorrhage”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “142851000119103”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : false, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 42535425, “CONCEPT_NAME” : “Spontaneous hemorrhage of cerebral hemisphere”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “291531000119108”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : false, “includeMapped” : false } ] } } ], “QualifiedLimit” : { “Type” : “All” }, “ExpressionLimit” : { “Type” : “All” }, “InclusionRules” : [ { “name” : “has no events in prior ‘clean window’ - 365 days”, “expression” : { “Type” : “ALL”, “CriteriaList” : [ { “Criteria” : { “ConditionOccurrence” : { “CorrelatedCriteria” : { “Type” : “ALL”, “CriteriaList” : [ { “Criteria” : { “VisitOccurrence” : { “CodesetId” : 2, “VisitTypeExclude” : false } }, “StartWindow” : { “Start” : { “Coeff” : -1 }, “End” : { “Days” : 0, “Coeff” : 1 }, “UseIndexEnd” : false, “UseEventEnd” : false }, “EndWindow” : { “Start” : { “Days” : 0, “Coeff” : -1 }, “End” : { “Coeff” : 1 }, “UseIndexEnd” : false, “UseEventEnd” : true }, “RestrictVisit” : false, “IgnoreObservationPeriod” : false, “Occurrence” : { “Type” : 2, “Count” : 1, “IsDistinct” : false } } ], “DemographicCriteriaList” : [], “Groups” : [] }, “CodesetId” : 3 } }, “StartWindow” : { “Start” : { “Days” : 365, “Coeff” : -1 }, “End” : { “Days” : 1, “Coeff” : -1 }, “UseIndexEnd” : false, “UseEventEnd” : false }, “RestrictVisit” : false, “IgnoreObservationPeriod” : true, “Occurrence” : { “Type” : 0, “Count” : 0, “IsDistinct” : false } } ], “DemographicCriteriaList” : [], “Groups” : [] } } ], “EndStrategy” : { “DateOffset” : { “DateField” : “StartDate”, “Offset” : 1 } }, “CensoringCriteria” : [], “CollapseSettings” : { “CollapseType” : “ERA”, “EraPad” : 0 }, “CensorWindow” : {} }

SQL

CREATE TABLE #Codesets ( codeset_id int NOT NULL, concept_id bigint NOT NULL ) ;

INSERT INTO #Codesets (codeset_id, concept_id) SELECT 2 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (262,9201)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (262,9201))

) I ) C UNION ALL SELECT 3 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (443454)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (443454))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (40479572,4046360,372435,377254,379778,443790,443864,444091,4046089,4046090,4129534)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (40479572,4046360))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C UNION ALL SELECT 4 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (439847,432923,4148906,4144154,4111709,42535426,43530728,43530727,4108952,4111708,35609033,43530674,42535425))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (376713,4174299,36716544,4345688)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (4174299,36716544,4345688))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C;

UPDATE STATISTICS #Codesets;

SELECT event_id, person_id, start_date, end_date, op_start_date, op_end_date, visit_occurrence_id INTO #qualified_events FROM ( select pe.event_id, pe.person_id, pe.start_date, pe.end_date, pe.op_start_date, pe.op_end_date, row_number() over (partition by pe.person_id order by pe.start_date ASC) as ordinal, cast(pe.visit_occurrence_id as bigint) as visit_occurrence_id FROM (– Begin Primary Events select P.ordinal as event_id, P.person_id, P.start_date, P.end_date, op_start_date, op_end_date, cast(P.visit_occurrence_id as bigint) as visit_occurrence_id FROM ( select E.person_id, E.start_date, E.end_date, row_number() OVER (PARTITION BY E.person_id ORDER BY E.sort_date ASC, E.event_id) ordinal, OP.observation_period_start_date as op_start_date, OP.observation_period_end_date as op_end_date, cast(E.visit_occurrence_id as bigint) as visit_occurrence_id FROM ( – Begin Condition Occurrence Criteria SELECT C.person_id, C.condition_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date FROM ( SELECT co.person_id,co.condition_occurrence_id,co.condition_concept_id,co.visit_occurrence_id,co.condition_start_date as start_date, COALESCE(co.condition_end_date, DATEADD(day,1,co.condition_start_date)) as end_date FROM @cdm_database_schema.CONDITION_OCCURRENCE co JOIN #Codesets cs on (co.condition_concept_id = cs.concept_id and cs.codeset_id = 3) ) C

– End Condition Occurrence Criteria

UNION ALL – Begin Condition Occurrence Criteria SELECT C.person_id, C.condition_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date FROM ( SELECT co.person_id,co.condition_occurrence_id,co.condition_concept_id,co.visit_occurrence_id,co.condition_start_date as start_date, COALESCE(co.condition_end_date, DATEADD(day,1,co.condition_start_date)) as end_date FROM @cdm_database_schema.CONDITION_OCCURRENCE co JOIN #Codesets cs on (co.condition_concept_id = cs.concept_id and cs.codeset_id = 4) ) C

– End Condition Occurrence Criteria

) E JOIN @cdm_database_schema.observation_period OP on E.person_id = OP.person_id and E.start_date >= OP.observation_period_start_date and E.start_date <= op.observation_period_end_date WHERE DATEADD(day,0,OP.OBSERVATION_PERIOD_START_DATE) <= E.START_DATE AND DATEADD(day,0,E.START_DATE) <= OP.OBSERVATION_PERIOD_END_DATE ) P

– End Primary Events ) pe

JOIN ( – Begin Criteria Group select 0 as index_id, person_id, event_id FROM ( select E.person_id, E.event_id FROM (– Begin Primary Events select P.ordinal as event_id, P.person_id, P.start_date, P.end_date, op_start_date, op_end_date, cast(P.visit_occurrence_id as bigint) as visit_occurrence_id FROM ( select E.person_id, E.start_date, E.end_date, row_number() OVER (PARTITION BY E.person_id ORDER BY E.sort_date ASC, E.event_id) ordinal, OP.observation_period_start_date as op_start_date, OP.observation_period_end_date as op_end_date, cast(E.visit_occurrence_id as bigint) as visit_occurrence_id FROM ( – Begin Condition Occurrence Criteria SELECT C.person_id, C.condition_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date FROM ( SELECT co.person_id,co.condition_occurrence_id,co.condition_concept_id,co.visit_occurrence_id,co.condition_start_date as start_date, COALESCE(co.condition_end_date, DATEADD(day,1,co.condition_start_date)) as end_date FROM @cdm_database_schema.CONDITION_OCCURRENCE co JOIN #Codesets cs on (co.condition_concept_id = cs.concept_id and cs.codeset_id = 3) ) C

– End Condition Occurrence Criteria

UNION ALL – Begin Condition Occurrence Criteria SELECT C.person_id, C.condition_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date FROM ( SELECT co.person_id,co.condition_occurrence_id,co.condition_concept_id,co.visit_occurrence_id,co.condition_start_date as start_date, COALESCE(co.condition_end_date, DATEADD(day,1,co.condition_start_date)) as end_date FROM @cdm_database_schema.CONDITION_OCCURRENCE co JOIN #Codesets cs on (co.condition_concept_id = cs.concept_id and cs.codeset_id = 4) ) C

– End Condition Occurrence Criteria

) E JOIN @cdm_database_schema.observation_period OP on E.person_id = OP.person_id and E.start_date >= OP.observation_period_start_date and E.start_date <= op.observation_period_end_date WHERE DATEADD(day,0,OP.OBSERVATION_PERIOD_START_DATE) <= E.START_DATE AND DATEADD(day,0,E.START_DATE) <= OP.OBSERVATION_PERIOD_END_DATE ) P

– End Primary Events ) E INNER JOIN ( – Begin Correlated Criteria select 0 as index_id, cc.person_id, cc.event_id from (SELECT p.person_id, p.event_id FROM (– Begin Primary Events select P.ordinal as event_id, P.person_id, P.start_date, P.end_date, op_start_date, op_end_date, cast(P.visit_occurrence_id as bigint) as visit_occurrence_id FROM ( select E.person_id, E.start_date, E.end_date, row_number() OVER (PARTITION BY E.person_id ORDER BY E.sort_date ASC, E.event_id) ordinal, OP.observation_period_start_date as op_start_date, OP.observation_period_end_date as op_end_date, cast(E.visit_occurrence_id as bigint) as visit_occurrence_id FROM ( – Begin Condition Occurrence Criteria SELECT C.person_id, C.condition_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date FROM ( SELECT co.person_id,co.condition_occurrence_id,co.condition_concept_id,co.visit_occurrence_id,co.condition_start_date as start_date, COALESCE(co.condition_end_date, DATEADD(day,1,co.condition_start_date)) as end_date FROM @cdm_database_schema.CONDITION_OCCURRENCE co JOIN #Codesets cs on (co.condition_concept_id = cs.concept_id and cs.codeset_id = 3) ) C

– End Condition Occurrence Criteria

UNION ALL – Begin Condition Occurrence Criteria SELECT C.person_id, C.condition_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date FROM ( SELECT co.person_id,co.condition_occurrence_id,co.condition_concept_id,co.visit_occurrence_id,co.condition_start_date as start_date, COALESCE(co.condition_end_date, DATEADD(day,1,co.condition_start_date)) as end_date FROM @cdm_database_schema.CONDITION_OCCURRENCE co JOIN #Codesets cs on (co.condition_concept_id = cs.concept_id and cs.codeset_id = 4) ) C

– End Condition Occurrence Criteria

) E JOIN @cdm_database_schema.observation_period OP on E.person_id = OP.person_id and E.start_date >= OP.observation_period_start_date and E.start_date <= op.observation_period_end_date WHERE DATEADD(day,0,OP.OBSERVATION_PERIOD_START_DATE) <= E.START_DATE AND DATEADD(day,0,E.START_DATE) <= OP.OBSERVATION_PERIOD_END_DATE ) P

– End Primary Events ) P JOIN ( – Begin Visit Occurrence Criteria select C.person_id, C.visit_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select vo.person_id,vo.visit_occurrence_id,vo.visit_concept_id,vo.visit_start_date as start_date, vo.visit_end_date as end_date FROM @cdm_database_schema.VISIT_OCCURRENCE vo JOIN #Codesets cs on (vo.visit_concept_id = cs.concept_id and cs.codeset_id = 2) ) C

– End Visit Occurrence Criteria

) A on A.person_id = P.person_id AND A.START_DATE >= P.OP_START_DATE AND A.START_DATE <= P.OP_END_DATE AND A.START_DATE >= P.OP_START_DATE AND A.START_DATE <= DATEADD(day,0,P.START_DATE) AND A.END_DATE >= DATEADD(day,0,P.START_DATE) AND A.END_DATE <= P.OP_END_DATE ) cc GROUP BY cc.person_id, cc.event_id HAVING COUNT(cc.event_id) >= 1 – End Correlated Criteria

) CQ on E.person_id = CQ.person_id and E.event_id = CQ.event_id GROUP BY E.person_id, E.event_id HAVING COUNT(index_id) = 1 ) G – End Criteria Group ) AC on AC.person_id = pe.person_id and AC.event_id = pe.event_id

) QE

;

— Inclusion Rule Inserts

select 0 as inclusion_rule_id, person_id, event_id INTO #Inclusion_0 FROM ( select pe.person_id, pe.event_id FROM #qualified_events pe

JOIN ( – Begin Criteria Group select 0 as index_id, person_id, event_id FROM ( select E.person_id, E.event_id FROM #qualified_events E INNER JOIN ( – Begin Correlated Criteria select 0 as index_id, p.person_id, p.event_id from #qualified_events p LEFT JOIN ( SELECT p.person_id, p.event_id FROM #qualified_events P JOIN ( select PE.person_id, PE.event_id, PE.start_date, PE.end_date, PE.visit_occurrence_id, PE.sort_date FROM ( – Begin Condition Occurrence Criteria SELECT C.person_id, C.condition_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date FROM ( SELECT co.person_id,co.condition_occurrence_id,co.condition_concept_id,co.visit_occurrence_id,co.condition_start_date as start_date, COALESCE(co.condition_end_date, DATEADD(day,1,co.condition_start_date)) as end_date FROM @cdm_database_schema.CONDITION_OCCURRENCE co JOIN #Codesets cs on (co.condition_concept_id = cs.concept_id and cs.codeset_id = 3) ) C

– End Condition Occurrence Criteria

) PE JOIN ( – Begin Criteria Group select 0 as index_id, person_id, event_id FROM ( select E.person_id, E.event_id FROM (SELECT Q.person_id, Q.event_id, Q.start_date, Q.end_date, Q.visit_occurrence_id, OP.observation_period_start_date as op_start_date, OP.observation_period_end_date as op_end_date FROM (– Begin Condition Occurrence Criteria SELECT C.person_id, C.condition_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date FROM ( SELECT co.person_id,co.condition_occurrence_id,co.condition_concept_id,co.visit_occurrence_id,co.condition_start_date as start_date, COALESCE(co.condition_end_date, DATEADD(day,1,co.condition_start_date)) as end_date FROM @cdm_database_schema.CONDITION_OCCURRENCE co JOIN #Codesets cs on (co.condition_concept_id = cs.concept_id and cs.codeset_id = 3) ) C

– End Condition Occurrence Criteria ) Q JOIN @cdm_database_schema.OBSERVATION_PERIOD OP on Q.person_id = OP.person_id and OP.observation_period_start_date <= Q.start_date and OP.observation_period_end_date >= Q.start_date ) E INNER JOIN ( – Begin Correlated Criteria select 0 as index_id, cc.person_id, cc.event_id from (SELECT p.person_id, p.event_id FROM (SELECT Q.person_id, Q.event_id, Q.start_date, Q.end_date, Q.visit_occurrence_id, OP.observation_period_start_date as op_start_date, OP.observation_period_end_date as op_end_date FROM (– Begin Condition Occurrence Criteria SELECT C.person_id, C.condition_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date FROM ( SELECT co.person_id,co.condition_occurrence_id,co.condition_concept_id,co.visit_occurrence_id,co.condition_start_date as start_date, COALESCE(co.condition_end_date, DATEADD(day,1,co.condition_start_date)) as end_date FROM @cdm_database_schema.CONDITION_OCCURRENCE co JOIN #Codesets cs on (co.condition_concept_id = cs.concept_id and cs.codeset_id = 3) ) C

– End Condition Occurrence Criteria ) Q JOIN @cdm_database_schema.OBSERVATION_PERIOD OP on Q.person_id = OP.person_id and OP.observation_period_start_date <= Q.start_date and OP.observation_period_end_date >= Q.start_date ) P JOIN ( – Begin Visit Occurrence Criteria select C.person_id, C.visit_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date from ( select vo.person_id,vo.visit_occurrence_id,vo.visit_concept_id,vo.visit_start_date as start_date, vo.visit_end_date as end_date FROM @cdm_database_schema.VISIT_OCCURRENCE vo JOIN #Codesets cs on (vo.visit_concept_id = cs.concept_id and cs.codeset_id = 2) ) C

– End Visit Occurrence Criteria

) A on A.person_id = P.person_id AND A.START_DATE >= P.OP_START_DATE AND A.START_DATE <= P.OP_END_DATE AND A.START_DATE >= P.OP_START_DATE AND A.START_DATE <= DATEADD(day,0,P.START_DATE) AND A.END_DATE >= DATEADD(day,0,P.START_DATE) AND A.END_DATE <= P.OP_END_DATE ) cc GROUP BY cc.person_id, cc.event_id HAVING COUNT(cc.event_id) >= 1 – End Correlated Criteria

) CQ on E.person_id = CQ.person_id and E.event_id = CQ.event_id GROUP BY E.person_id, E.event_id HAVING COUNT(index_id) = 1 ) G – End Criteria Group ) AC on AC.person_id = pe.person_id and AC.event_id = pe.event_id

) A on A.person_id = P.person_id AND A.START_DATE >= DATEADD(day,-365,P.START_DATE) AND A.START_DATE <= DATEADD(day,-1,P.START_DATE) ) cc on p.person_id = cc.person_id and p.event_id = cc.event_id GROUP BY p.person_id, p.event_id HAVING COUNT(cc.event_id) = 0 – End Correlated Criteria

) CQ on E.person_id = CQ.person_id and E.event_id = CQ.event_id GROUP BY E.person_id, E.event_id HAVING COUNT(index_id) = 1 ) G – End Criteria Group ) AC on AC.person_id = pe.person_id AND AC.event_id = pe.event_id ) Results ;

SELECT inclusion_rule_id, person_id, event_id INTO #inclusion_events FROM (select inclusion_rule_id, person_id, event_id from #Inclusion_0) I; TRUNCATE TABLE #Inclusion_0; DROP TABLE #Inclusion_0;

select event_id, person_id, start_date, end_date, op_start_date, op_end_date into #included_events FROM ( SELECT event_id, person_id, start_date, end_date, op_start_date, op_end_date, row_number() over (partition by person_id order by start_date ASC) as ordinal from ( select Q.event_id, Q.person_id, Q.start_date, Q.end_date, Q.op_start_date, Q.op_end_date, SUM(coalesce(POWER(cast(2 as bigint), I.inclusion_rule_id), 0)) as inclusion_rule_mask from #qualified_events Q LEFT JOIN #inclusion_events I on I.person_id = Q.person_id and I.event_id = Q.event_id GROUP BY Q.event_id, Q.person_id, Q.start_date, Q.end_date, Q.op_start_date, Q.op_end_date ) MG – matching groups

– the matching group with all bits set ( POWER(2,# of inclusion rules) - 1 = inclusion_rule_mask WHERE (MG.inclusion_rule_mask = POWER(cast(2 as bigint),1)-1)

) Results

;

– date offset strategy

select event_id, person_id, case when DATEADD(day,1,start_date) > op_end_date then op_end_date else DATEADD(day,1,start_date) end as end_date INTO #strategy_ends from #included_events;

– generate cohort periods into #final_cohort select person_id, start_date, end_date INTO #cohort_rows from ( – first_ends select F.person_id, F.start_date, F.end_date FROM ( select I.event_id, I.person_id, I.start_date, CE.end_date, row_number() over (partition by I.person_id, I.event_id order by CE.end_date) as ordinal from #included_events I join ( – cohort_ends – cohort exit dates – End Date Strategy SELECT event_id, person_id, end_date from #strategy_ends

) CE on I.event_id = CE.event_id and I.person_id = CE.person_id and CE.end_date >= I.start_date
) F
WHERE F.ordinal = 1

) FE;

select person_id, min(start_date) as start_date, DATEADD(day,-1 * 0, max(end_date)) as end_date into #final_cohort from ( select person_id, start_date, end_date, sum(is_start) over (partition by person_id order by start_date, is_start desc rows unbounded preceding) group_idx from ( select person_id, start_date, end_date, case when max(end_date) over (partition by person_id order by start_date rows between unbounded preceding and 1 preceding) >= start_date then 0 else 1 end is_start from ( select person_id, start_date, DATEADD(day,0,end_date) as end_date from #cohort_rows ) CR ) ST ) GR group by person_id, group_idx;

DELETE FROM @target_database_schema.@target_cohort_table where cohort_definition_id = @target_cohort_id; INSERT INTO @target_database_schema.@target_cohort_table (cohort_definition_id, subject_id, cohort_start_date, cohort_end_date) select @target_cohort_id as cohort_definition_id, person_id, start_date, end_date FROM #final_cohort CO ;

TRUNCATE TABLE #strategy_ends; DROP TABLE #strategy_ends;

TRUNCATE TABLE #cohort_rows; DROP TABLE #cohort_rows;

TRUNCATE TABLE #final_cohort; DROP TABLE #final_cohort;

TRUNCATE TABLE #inclusion_events; DROP TABLE #inclusion_events;

TRUNCATE TABLE #qualified_events; DROP TABLE #qualified_events;

TRUNCATE TABLE #included_events; DROP TABLE #included_events;

TRUNCATE TABLE #Codesets; DROP TABLE #Codesets;

Predictor: Revised Cardiac Risk Index - Covariate - Heart failure

Friendly Definition

Cohort Entry Events

People enter the cohort when observing any of the following:

1. condition occurrences of ‘Heart failure’.

2. observations of ‘Heart failure’.

Limit cohort entry events to the earliest event per person.

Cohort Exit

The person exits the cohort at the end of continuous observation.

Cohort Eras

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

JSON

{ “cdmVersionRange” : “>=5.0.0”, “PrimaryCriteria” : { “CriteriaList” : [ { “ConditionOccurrence” : { “CodesetId” : 3 } }, { “Observation” : { “CodesetId” : 3, “ObservationTypeExclude” : false } } ], “ObservationWindow” : { “PriorDays” : 0, “PostDays” : 0 }, “PrimaryCriteriaLimit” : { “Type” : “First” } }, “ConceptSets” : [ { “id” : 3, “name” : “Heart failure”, “expression” : { “items” : [ { “concept” : { “CONCEPT_ID” : 316139, “CONCEPT_NAME” : “Heart failure”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “84114007”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 315295, “CONCEPT_NAME” : “Congestive rheumatic heart failure”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “82523003”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : true, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40482727, “CONCEPT_NAME” : “Combined systolic and diastolic dysfunction”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “442304009”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4236658, “CONCEPT_NAME” : “Pleural effusion due to congestive heart failure”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “90727007”, “DOMAIN_ID” : “Condition”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Clinical Finding” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false } ] } } ], “QualifiedLimit” : { “Type” : “All” }, “ExpressionLimit” : { “Type” : “First” }, “InclusionRules” : [], “CensoringCriteria” : [], “CollapseSettings” : { “CollapseType” : “ERA”, “EraPad” : 0 }, “CensorWindow” : {} }

SQL

CREATE TABLE #Codesets ( codeset_id int NOT NULL, concept_id bigint NOT NULL ) ;

INSERT INTO #Codesets (codeset_id, concept_id) SELECT 3 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (316139,40482727,4236658)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (316139,40482727,4236658))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (315295)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (315295))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C;

UPDATE STATISTICS #Codesets;

SELECT event_id, person_id, start_date, end_date, op_start_date, op_end_date, visit_occurrence_id INTO #qualified_events FROM ( select pe.event_id, pe.person_id, pe.start_date, pe.end_date, pe.op_start_date, pe.op_end_date, row_number() over (partition by pe.person_id order by pe.start_date ASC) as ordinal, cast(pe.visit_occurrence_id as bigint) as visit_occurrence_id FROM (– Begin Primary Events select P.ordinal as event_id, P.person_id, P.start_date, P.end_date, op_start_date, op_end_date, cast(P.visit_occurrence_id as bigint) as visit_occurrence_id FROM ( select E.person_id, E.start_date, E.end_date, row_number() OVER (PARTITION BY E.person_id ORDER BY E.sort_date ASC, E.event_id) ordinal, OP.observation_period_start_date as op_start_date, OP.observation_period_end_date as op_end_date, cast(E.visit_occurrence_id as bigint) as visit_occurrence_id FROM ( – Begin Condition Occurrence Criteria SELECT C.person_id, C.condition_occurrence_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id, C.start_date as sort_date FROM ( SELECT co.person_id,co.condition_occurrence_id,co.condition_concept_id,co.visit_occurrence_id,co.condition_start_date as start_date, COALESCE(co.condition_end_date, DATEADD(day,1,co.condition_start_date)) as end_date FROM @cdm_database_schema.CONDITION_OCCURRENCE co JOIN #Codesets cs on (co.condition_concept_id = cs.concept_id and cs.codeset_id = 3) ) C

– End Condition Occurrence Criteria

UNION ALL – Begin Observation Criteria select C.person_id, C.observation_id as event_id, C.start_date, C.END_DATE, C.visit_occurrence_id, C.start_date as sort_date from ( select o.person_id,o.observation_id,o.observation_concept_id,o.visit_occurrence_id,o.value_as_number,o.observation_date as start_date, DATEADD(day,1,o.observation_date) as end_date FROM @cdm_database_schema.OBSERVATION o JOIN #Codesets cs on (o.observation_concept_id = cs.concept_id and cs.codeset_id = 3) ) C

– End Observation Criteria

) E JOIN @cdm_database_schema.observation_period OP on E.person_id = OP.person_id and E.start_date >= OP.observation_period_start_date and E.start_date <= op.observation_period_end_date WHERE DATEADD(day,0,OP.OBSERVATION_PERIOD_START_DATE) <= E.START_DATE AND DATEADD(day,0,E.START_DATE) <= OP.OBSERVATION_PERIOD_END_DATE ) P WHERE P.ordinal = 1 – End Primary Events ) pe

) QE

;

— Inclusion Rule Inserts

create table #inclusion_events (inclusion_rule_id bigint, person_id bigint, event_id bigint );

select event_id, person_id, start_date, end_date, op_start_date, op_end_date into #included_events FROM ( SELECT event_id, person_id, start_date, end_date, op_start_date, op_end_date, row_number() over (partition by person_id order by start_date ASC) as ordinal from ( select Q.event_id, Q.person_id, Q.start_date, Q.end_date, Q.op_start_date, Q.op_end_date, SUM(coalesce(POWER(cast(2 as bigint), I.inclusion_rule_id), 0)) as inclusion_rule_mask from #qualified_events Q LEFT JOIN #inclusion_events I on I.person_id = Q.person_id and I.event_id = Q.event_id GROUP BY Q.event_id, Q.person_id, Q.start_date, Q.end_date, Q.op_start_date, Q.op_end_date ) MG – matching groups

) Results WHERE Results.ordinal = 1 ;

– generate cohort periods into #final_cohort select person_id, start_date, end_date INTO #cohort_rows from ( – first_ends select F.person_id, F.start_date, F.end_date FROM ( select I.event_id, I.person_id, I.start_date, CE.end_date, row_number() over (partition by I.person_id, I.event_id order by CE.end_date) as ordinal from #included_events I join ( – cohort_ends – cohort exit dates – By default, cohort exit at the event’s op end date select event_id, person_id, op_end_date as end_date from #included_events ) CE on I.event_id = CE.event_id and I.person_id = CE.person_id and CE.end_date >= I.start_date ) F WHERE F.ordinal = 1 ) FE;

select person_id, min(start_date) as start_date, DATEADD(day,-1 * 0, max(end_date)) as end_date into #final_cohort from ( select person_id, start_date, end_date, sum(is_start) over (partition by person_id order by start_date, is_start desc rows unbounded preceding) group_idx from ( select person_id, start_date, end_date, case when max(end_date) over (partition by person_id order by start_date rows between unbounded preceding and 1 preceding) >= start_date then 0 else 1 end is_start from ( select person_id, start_date, DATEADD(day,0,end_date) as end_date from #cohort_rows ) CR ) ST ) GR group by person_id, group_idx;

DELETE FROM @target_database_schema.@target_cohort_table where cohort_definition_id = @target_cohort_id; INSERT INTO @target_database_schema.@target_cohort_table (cohort_definition_id, subject_id, cohort_start_date, cohort_end_date) select @target_cohort_id as cohort_definition_id, person_id, start_date, end_date FROM #final_cohort CO ;

TRUNCATE TABLE #cohort_rows; DROP TABLE #cohort_rows;

TRUNCATE TABLE #final_cohort; DROP TABLE #final_cohort;

TRUNCATE TABLE #inclusion_events; DROP TABLE #inclusion_events;

TRUNCATE TABLE #qualified_events; DROP TABLE #qualified_events;

TRUNCATE TABLE #included_events; DROP TABLE #included_events;

TRUNCATE TABLE #Codesets; DROP TABLE #Codesets;

Predictor: Revised Cardiac Risk Index - Covariate - Insulin

Friendly Definition

Cohort Entry Events

People enter the cohort when observing any of the following:

1. drug eras of ‘Insulin JJ’.

2. drug exposures of ‘Insulin JJ’.

Cohort Exit

The cohort end date will be based on a continuous exposure to ‘Insulin JJ’: allowing 60 days between exposures, adding 30 days after exposure ends, and using days supply and exposure end date for exposure duration.

Cohort Eras

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

JSON

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“V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “A10A”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “ATC”, “CONCEPT_CLASS_ID” : “ATC 3rd” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 21500149, “CONCEPT_NAME” : “Insulins”, “STANDARD_CONCEPT” : “C”, “STANDARD_CONCEPT_CAPTION” : “Classification”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “00000149”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “ETC”, “CONCEPT_CLASS_ID” : “ETC” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 2718458, “CONCEPT_NAME” : “Injection, insulin, per 5 units”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “J1815”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “HCPCS”, “CONCEPT_CLASS_ID” : “HCPCS” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 35605670, “CONCEPT_NAME” : “insulin argine”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “1740938”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Ingredient” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 2718459, “CONCEPT_NAME” : “Insulin for administration through dme (i.e., insulin pump) per 50 units”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “J1817”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “HCPCS”, “CONCEPT_CLASS_ID” : “HCPCS” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 35884381, “CONCEPT_NAME” : “Recombinant Human Insulin”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “OMOP5031285”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm Extension”, “CONCEPT_CLASS_ID” : “Ingredient” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 45774435, “CONCEPT_NAME” : “dulaglutide”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “1551291”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Ingredient” }, “isExcluded” : true, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40170911, “CONCEPT_NAME” : “liraglutide”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “475968”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Ingredient” }, “isExcluded” : true, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 44506754, “CONCEPT_NAME” : “lixisenatide”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “1440051”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Ingredient” }, “isExcluded” : true, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 4215993, “CONCEPT_NAME” : “Administration of insulin”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “39543009”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Procedure” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 3655127, “CONCEPT_NAME” : “Administration of insulin using insulin pump”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “846663002”, “DOMAIN_ID” : “Procedure”, “VOCABULARY_ID” : “SNOMED”, “CONCEPT_CLASS_ID” : “Procedure” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40159543, “CONCEPT_NAME” : “insulin isophane Prefilled Syringe”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “847196”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40159519, “CONCEPT_NAME” : “insulin isophane / insulin, regular, human Prefilled Syringe”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : 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“isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40051323, “CONCEPT_NAME” : “ultralente insulin, beef Injectable Suspension”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “378970”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40051363, “CONCEPT_NAME” : “insulin isophane Injectable Suspension”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “378928”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40051377, “CONCEPT_NAME” : “insulin isophane / insulin, regular, human Injectable Suspension”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “378857”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40051331, “CONCEPT_NAME” : “ultralente insulin, beef-pork Injectable Suspension”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “435180”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40051340, “CONCEPT_NAME” : “ultralente insulin, human Injectable Suspension”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “378862”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40051347, “CONCEPT_NAME” : “insulin glargine Injectable Solution”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “378864”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40051353, “CONCEPT_NAME” : “insulin glulisine, human Injectable Solution”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “485209”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40051007, “CONCEPT_NAME” : “insulin aspart protamine, human / insulin aspart, human Injectable Suspension”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “379056”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40052423, “CONCEPT_NAME” : “insulin, regular, beef-pork Injectable Solution”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “376942”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40052389, “CONCEPT_NAME” : “insulin, protamine zinc, beef-pork Injectable Suspension”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “435172”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40052401, “CONCEPT_NAME” : “insulin, protamine zinc, pork Injectable Suspension”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “379007”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40052410, “CONCEPT_NAME” : “insulin, regular, beef Injectable Solution”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “378843”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40052370, “CONCEPT_NAME” : “insulin, prompt zinc, pork Injectable Suspension”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “379055”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40052382, “CONCEPT_NAME” : “insulin, protamine zinc, beef Injectable Suspension”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, 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“CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40052093, “CONCEPT_NAME” : “insulin, prompt zinc, beef Injectable Suspension”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “379006”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40052099, “CONCEPT_NAME” : “insulin, prompt zinc, beef-pork Injectable Suspension”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “435184”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40052808, “CONCEPT_NAME” : “lente insulin, beef Injectable Suspension”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “378967”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40052820, “CONCEPT_NAME” : “lente insulin, beef-pork Injectable Suspension”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “378919”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40052768, “CONCEPT_NAME” : “insulin, regular, human Injectable Solution”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “376915”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40052794, “CONCEPT_NAME” : “insulin, regular, pork Injectable Solution”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “376916”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40053113, “CONCEPT_NAME” : “lente insulin, human Injectable Suspension”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “378860”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40053128, “CONCEPT_NAME” : “lente insulin, pork Injectable Suspension”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “378950”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 1356241, “CONCEPT_NAME” : “insulin, regular, human Inhalation Powder”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “2108525”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 1356260, “CONCEPT_NAME” : “insulin human, rDNA origin Inhalation Powder”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “2108564”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40056632, “CONCEPT_NAME” : “insulin detemir Injectable Solution”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “484321”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 46234190, “CONCEPT_NAME” : “insulin detemir Pen Injector”, “STANDARD_CONCEPT” : 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“includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 46234040, “CONCEPT_NAME” : “insulin aspart, human Cartridge”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “1653195”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 46234046, “CONCEPT_NAME” : “insulin aspart, human Pen Injector”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “1653201”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 46233944, “CONCEPT_NAME” : “insulin lispro Pen Injector”, 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“includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40051314, “CONCEPT_NAME” : “insulin aspart, human Injectable Solution”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “378914”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40051323, “CONCEPT_NAME” : “ultralente insulin, beef Injectable Suspension”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “378970”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40051363, “CONCEPT_NAME” : “insulin isophane Injectable Suspension”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “378928”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40051377, “CONCEPT_NAME” : “insulin isophane / insulin, regular, human Injectable Suspension”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “378857”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40051331, “CONCEPT_NAME” : “ultralente insulin, beef-pork Injectable Suspension”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” 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false }, { “concept” : { “CONCEPT_ID” : 40051007, “CONCEPT_NAME” : “insulin aspart protamine, human / insulin aspart, human Injectable Suspension”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “379056”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40052423, “CONCEPT_NAME” : “insulin, regular, beef-pork Injectable Solution”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “376942”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40052389, “CONCEPT_NAME” : “insulin, protamine zinc, 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false }, { “concept” : { “CONCEPT_ID” : 40052077, “CONCEPT_NAME” : “insulin lispro / insulin lispro protamine, human Injectable Suspension”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “378966”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40052088, “CONCEPT_NAME” : “insulin lispro Injectable Solution”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “378841”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40052093, “CONCEPT_NAME” : “insulin, prompt zinc, beef Injectable Suspension”, 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“CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 1718598, “CONCEPT_NAME” : “insulin glargine / lixisenatide Pen Injector”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “1858993”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 1718705, “CONCEPT_NAME” : “insulin degludec / liraglutide Pen Injector”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “1860166”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 35602719, “CONCEPT_NAME” : “insulin degludec Pen Injector”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “1670010”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 1361259, “CONCEPT_NAME” : “insulin, regular, human Injection”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “2179743”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40159543, “CONCEPT_NAME” : “insulin isophane Prefilled Syringe”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “847196”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40159519, “CONCEPT_NAME” : “insulin isophane / insulin, regular, human Prefilled Syringe”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “847186”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 40159688, “CONCEPT_NAME” : “insulin, regular, human Prefilled Syringe”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “847202”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 35605619, “CONCEPT_NAME” : “insulin, regular, human Pen Injector”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “1731314”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 46234190, “CONCEPT_NAME” : “insulin detemir Pen Injector”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “1654190”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 46234216, “CONCEPT_NAME” : “insulin isophane / insulin, regular, human Pen Injector”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “1654651”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 46234236, “CONCEPT_NAME” : “insulin isophane Pen Injector”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “1654861”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 46234052, “CONCEPT_NAME” : “insulin aspart protamine, human / insulin aspart, human Pen Injector”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “1653207”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 46234097, “CONCEPT_NAME” : “insulin glargine Pen Injector”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “1653497”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 46234016, “CONCEPT_NAME” : “insulin lispro / insulin lispro protamine, human Pen Injector”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “1653104”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 46234040, “CONCEPT_NAME” : “insulin aspart, human Cartridge”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “1653195”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 46234046, “CONCEPT_NAME” : “insulin aspart, human Pen Injector”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “1653201”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 46233944, “CONCEPT_NAME” : “insulin lispro Pen Injector”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “1652238”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 46233973, “CONCEPT_NAME” : “insulin lispro Cartridge”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “1652643”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false }, { “concept” : { “CONCEPT_ID” : 46233875, “CONCEPT_NAME” : “insulin glulisine, human Pen Injector”, “STANDARD_CONCEPT” : “S”, “STANDARD_CONCEPT_CAPTION” : “Standard”, “INVALID_REASON” : “V”, “INVALID_REASON_CAPTION” : “Valid”, “CONCEPT_CODE” : “1651313”, “DOMAIN_ID” : “Drug”, “VOCABULARY_ID” : “RxNorm”, “CONCEPT_CLASS_ID” : “Clinical Drug Form” }, “isExcluded” : false, “includeDescendants” : true, “includeMapped” : false } ] } } ], “QualifiedLimit” : { “Type” : “First” }, “ExpressionLimit” : { “Type” : “All” }, “InclusionRules” : [], “EndStrategy” : { “CustomEra” : { “DrugCodesetId” : 1, “GapDays” : 60, “Offset” : 30 } }, “CensoringCriteria” : [], “CollapseSettings” : { “CollapseType” : “ERA”, “EraPad” : 0 }, “CensorWindow” : {} }

SQL

CREATE TABLE #Codesets ( codeset_id int NOT NULL, concept_id bigint NOT NULL ) ;

INSERT INTO #Codesets (codeset_id, concept_id) SELECT 0 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (21500149)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (21500149))

) I ) C UNION ALL SELECT 1 as codeset_id, c.concept_id FROM (select distinct I.concept_id FROM ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (21600713,21500149,2718458,35605670,2718459,35884381,4215993,3655127,40159543,40159519,40159688,40051314,40051323,40051363,40051377,40051331,40051340,40051347,40051353,40051007,40052423,40052389,40052401,40052410,40052370,40052382,40052077,40052088,40052093,40052099,40052808,40052820,40052768,40052794,40053113,40053128,1356241,1356260,40056632,46234190,46234236,46234052,46234097,46234016,46234040,46234046,46233944,46233973,46233875,793407,40148823,40051314,40051323,40051363,40051377,40051331,40051333,40051340,40051347,40051353,40051007,40052423,40052389,40052393,40052401,40052410,40052361,40052370,40052382,40052077,40052088,40052093,40052050,40052099,40052808,40052820,40052768,40052794,40053128,1356056,1356241,1356260,40056632,1718598,1718705,35602719,1361259,40159543,40159519,40159688,35605619,46234190,46234216,46234236,46234052,46234097,46234016,46234040,46234046,46233944,46233973,46233875)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (21600713,21500149,2718458,35605670,2718459,35884381,4215993,3655127,40159543,40159519,40159688,40051314,40051323,40051363,40051377,40051331,40051340,40051347,40051353,40051007,40052423,40052389,40052401,40052410,40052370,40052382,40052077,40052088,40052093,40052099,40052808,40052820,40052768,40052794,40053113,40053128,1356241,1356260,40056632,46234190,46234236,46234052,46234097,46234016,46234040,46234046,46233944,46233973,46233875,793407,40148823,40051314,40051323,40051363,40051377,40051331,40051333,40051340,40051347,40051353,40051007,40052423,40052389,40052393,40052401,40052410,40052361,40052370,40052382,40052077,40052088,40052093,40052050,40052099,40052808,40052820,40052768,40052794,40053128,1356056,1356241,1356260,40056632,1718598,1718705,35602719,1361259,40159543,40159519,40159688,35605619,46234190,46234216,46234236,46234052,46234097,46234016,46234040,46234046,46233944,46233973,46233875))

) I LEFT JOIN ( select concept_id from @vocabulary_database_schema.CONCEPT where (concept_id in (45774435,40170911,44506754)) UNION select c.concept_id from @vocabulary_database_schema.CONCEPT c join @vocabulary_database_schema.CONCEPT_ANCESTOR ca on c.concept_id = ca.descendant_concept_id WHERE c.invalid_reason is null and (ca.ancestor_concept_id in (45774435,40170911,44506754))

) E ON I.concept_id = E.concept_id WHERE E.concept_id is null ) C;

UPDATE STATISTICS #Codesets;

SELECT event_id, person_id, start_date, end_date, op_start_date, op_end_date, visit_occurrence_id INTO #qualified_events FROM ( select pe.event_id, pe.person_id, pe.start_date, pe.end_date, pe.op_start_date, pe.op_end_date, row_number() over (partition by pe.person_id order by pe.start_date ASC) as ordinal, cast(pe.visit_occurrence_id as bigint) as visit_occurrence_id FROM (– Begin Primary Events select P.ordinal as event_id, P.person_id, P.start_date, P.end_date, op_start_date, op_end_date, cast(P.visit_occurrence_id as bigint) as visit_occurrence_id FROM ( select E.person_id, E.start_date, E.end_date, row_number() OVER (PARTITION BY E.person_id ORDER BY E.sort_date ASC, E.event_id) ordinal, OP.observation_period_start_date as op_start_date, OP.observation_period_end_date as op_end_date, cast(E.visit_occurrence_id as bigint) as visit_occurrence_id FROM ( – Begin Drug Era Criteria select C.person_id, C.drug_era_id as event_id, C.start_date, C.end_date, CAST(NULL as bigint) as visit_occurrence_id,C.start_date as sort_date from ( select de.person_id,de.drug_era_id,de.drug_concept_id,de.drug_exposure_count,de.gap_days,de.drug_era_start_date as start_date, de.drug_era_end_date as end_date FROM @cdm_database_schema.DRUG_ERA de where de.drug_concept_id in (SELECT concept_id from #Codesets where codeset_id = 1) ) C

– End Drug Era Criteria

UNION ALL – Begin Drug Exposure Criteria select C.person_id, C.drug_exposure_id as event_id, C.start_date, C.end_date, C.visit_occurrence_id,C.start_date as sort_date from ( select de.person_id,de.drug_exposure_id,de.drug_concept_id,de.visit_occurrence_id,days_supply,quantity,refills,de.drug_exposure_start_date as start_date, COALESCE(de.drug_exposure_end_date, DATEADD(day,de.days_supply,de.drug_exposure_start_date), DATEADD(day,1,de.drug_exposure_start_date)) as end_date FROM @cdm_database_schema.DRUG_EXPOSURE de JOIN #Codesets cs on (de.drug_concept_id = cs.concept_id and cs.codeset_id = 1) ) C

– End Drug Exposure Criteria

) E JOIN @cdm_database_schema.observation_period OP on E.person_id = OP.person_id and E.start_date >= OP.observation_period_start_date and E.start_date <= op.observation_period_end_date WHERE DATEADD(day,0,OP.OBSERVATION_PERIOD_START_DATE) <= E.START_DATE AND DATEADD(day,0,E.START_DATE) <= OP.OBSERVATION_PERIOD_END_DATE ) P

– End Primary Events ) pe

) QE

;

— Inclusion Rule Inserts

create table #inclusion_events (inclusion_rule_id bigint, person_id bigint, event_id bigint );

select event_id, person_id, start_date, end_date, op_start_date, op_end_date into #included_events FROM ( SELECT event_id, person_id, start_date, end_date, op_start_date, op_end_date, row_number() over (partition by person_id order by start_date ASC) as ordinal from ( select Q.event_id, Q.person_id, Q.start_date, Q.end_date, Q.op_start_date, Q.op_end_date, SUM(coalesce(POWER(cast(2 as bigint), I.inclusion_rule_id), 0)) as inclusion_rule_mask from #qualified_events Q LEFT JOIN #inclusion_events I on I.person_id = Q.person_id and I.event_id = Q.event_id GROUP BY Q.event_id, Q.person_id, Q.start_date, Q.end_date, Q.op_start_date, Q.op_end_date ) MG – matching groups

) Results

;

– custom era strategy

with ctePersons(person_id) as ( select distinct person_id from #included_events )

select person_id, drug_exposure_start_date, drug_exposure_end_date INTO #drugTarget FROM ( select de.PERSON_ID, DRUG_EXPOSURE_START_DATE, COALESCE(DRUG_EXPOSURE_END_DATE, DATEADD(day,DAYS_SUPPLY,DRUG_EXPOSURE_START_DATE), DATEADD(day,1,DRUG_EXPOSURE_START_DATE)) as DRUG_EXPOSURE_END_DATE FROM @cdm_database_schema.DRUG_EXPOSURE de JOIN ctePersons p on de.person_id = p.person_id JOIN #Codesets cs on cs.codeset_id = 1 AND de.drug_concept_id = cs.concept_id

UNION ALL

select de.PERSON_ID, DRUG_EXPOSURE_START_DATE, COALESCE(DRUG_EXPOSURE_END_DATE, DATEADD(day,DAYS_SUPPLY,DRUG_EXPOSURE_START_DATE), DATEADD(day,1,DRUG_EXPOSURE_START_DATE)) as DRUG_EXPOSURE_END_DATE 
FROM @cdm_database_schema.DRUG_EXPOSURE de
JOIN ctePersons p on de.person_id = p.person_id
JOIN #Codesets cs on cs.codeset_id = 1 AND de.drug_source_concept_id = cs.concept_id

) E ;

select et.event_id, et.person_id, ERAS.era_end_date as end_date INTO #strategy_ends from #included_events et JOIN (

select person_id, min(start_date) as era_start_date, DATEADD(day,-1 * 60, max(end_date)) as era_end_date from ( select person_id, start_date, end_date, sum(is_start) over (partition by person_id order by start_date, is_start desc rows unbounded preceding) group_idx from ( select person_id, start_date, end_date, case when max(end_date) over (partition by person_id order by start_date rows between unbounded preceding and 1 preceding) >= start_date then 0 else 1 end is_start from ( select person_id, drug_exposure_start_date as start_date, DATEADD(day,(60 + 30),DRUG_EXPOSURE_END_DATE) as end_date FROM #drugTarget ) DT ) ST ) GR group by person_id, group_idx ) ERAS on ERAS.person_id = et.person_id WHERE et.start_date between ERAS.era_start_date and ERAS.era_end_date;

TRUNCATE TABLE #drugTarget; DROP TABLE #drugTarget;

– generate cohort periods into #final_cohort select person_id, start_date, end_date INTO #cohort_rows from ( – first_ends select F.person_id, F.start_date, F.end_date FROM ( select I.event_id, I.person_id, I.start_date, CE.end_date, row_number() over (partition by I.person_id, I.event_id order by CE.end_date) as ordinal from #included_events I join ( – cohort_ends – cohort exit dates – By default, cohort exit at the event’s op end date select event_id, person_id, op_end_date as end_date from #included_events UNION ALL – End Date Strategy SELECT event_id, person_id, end_date from #strategy_ends

) CE on I.event_id = CE.event_id and I.person_id = CE.person_id and CE.end_date >= I.start_date
) F
WHERE F.ordinal = 1

) FE;

select person_id, min(start_date) as start_date, DATEADD(day,-1 * 0, max(end_date)) as end_date into #final_cohort from ( select person_id, start_date, end_date, sum(is_start) over (partition by person_id order by start_date, is_start desc rows unbounded preceding) group_idx from ( select person_id, start_date, end_date, case when max(end_date) over (partition by person_id order by start_date rows between unbounded preceding and 1 preceding) >= start_date then 0 else 1 end is_start from ( select person_id, start_date, DATEADD(day,0,end_date) as end_date from #cohort_rows ) CR ) ST ) GR group by person_id, group_idx;

DELETE FROM @target_database_schema.@target_cohort_table where cohort_definition_id = @target_cohort_id; INSERT INTO @target_database_schema.@target_cohort_table (cohort_definition_id, subject_id, cohort_start_date, cohort_end_date) select @target_cohort_id as cohort_definition_id, person_id, start_date, end_date FROM #final_cohort CO ;

TRUNCATE TABLE #strategy_ends; DROP TABLE #strategy_ends;

TRUNCATE TABLE #cohort_rows; DROP TABLE #cohort_rows;

TRUNCATE TABLE #final_cohort; DROP TABLE #final_cohort;

TRUNCATE TABLE #inclusion_events; DROP TABLE #inclusion_events;

TRUNCATE TABLE #qualified_events; DROP TABLE #qualified_events;

TRUNCATE TABLE #included_events; DROP TABLE #included_events;

TRUNCATE TABLE #Codesets; DROP TABLE #Codesets;

Plans for addressing missing data

Most of the predictors of RCRI correspond to the patient having a history of certain medical events, whether they are a high risk surgery and are taking insulin. The way these predictors are constructed is to find all the patients with the medical events, high risk surgery and taking insulin then we see whether a patient is in each predictor cohort. Therefore, by design the predictor value is always 1 (patient is also in the predictor cohort so has the medical event) or 0 (not in the predictor cohort). It is not possible to have missing values for these predictors, although patients may be misclassified in the predictor cohorts and have an incorrect value.

The current renal impairment predictor is determined via creatinine values being measured close to surgery index. Creatinine values are often missing in observational data and, even when observed, are unlikely to be observed close to surgery index. To address this changed the predictor to be creatinine measurement >= 2 OR renal impairment condition record. In the majority of the OMOP databases, the renal impairment condition is more likely to be recorded and therefore use to identify patients with this predictor. However, if a patient has creatinine recorded close to index and the value is >=2, then the patient will have a value of 1 for ‘current renal impairment’ even if he/she does not have a medical condition record of renal impairment.

Plans for disseminating and communicating study results

The final results will be disseminated as a journal article.

All statistical analysis code will be made publicly available. This includes the study package for the network study and a cohort diagnostic package.

Sponsor or the project the study is part of

Peter Rijnbeek, Ross Williams, Jenna Reps and Alexander Saelmans work for a research group at Erasmus University Medical Center that receives/received an unconditional grant for methodological research by Johnson & Johnson. The grant is for the institute.

PIs and partners

Principal investigators: Ross Williams, PhD, Assistant Professor Jenna Reps, PhD, Assistant Professor

PhD student: Alexander Saelmans, MD

Professor of department: Peter R Rijnbeek, PhD, Professor

Database partners collaborating:

Database; Acronym; Type; Country; Contributors

IBM MarketScan® Medicare Supplemental Database; MDCR; Claims; USA; Jenna Reps IBM MarketScan® Medicaid Supplemental Database; MDCD; Claims; USA; Jenna Reps Japan Medical Data Center; JMDC; Claims; Japan; Jenna Reps IBM MarketScan Commercial Claims and Encounters Database; CCAE; Claims; USA; Jenna Reps Optum® de-identifed Electronic Health Record dataset; Optum EHR; EHR; USA; Jenna Reps STAnford medicine Research data Repository-OMOP; STARR; EHR; USA; Hannah Morgan-Cooper Tufts Medical Center; Tufts; EHR; USA; Jared Houghtaling University of Colorado Anschutz Medical Campus-Health Data Compass; CU_AMC; EHR; USA; Andrey Soares Parc de Salut Mar Barcelona Information System; IMASIS; EHR; Spain; Miguel-Angel Mayer, Maria de los Angeles Leis Machin IIS La Fe; HULAFE; EHR; Spain; Alvaro Martínez Pérez Carlos Lopez Gomez Albert Einstein Israelita Hospital; Einstein; EHR; Brazil; Cesar Truyts Center for Surgical Science; Css; EHR; Denmark; Andreas Weinberger Rosen

Data governance

This observational study is based on a federated network approach, in which each data partner performs the analysis locally and only shares aggregated data, therefore the analyses will be performed separately for each database. Data partners locally run the analyses in the standards OMOP-CDM format using R Studio, sharing only aggregated results. How data are handled is the responsibility of the local institute.

Ethical aspects

In this study, the legal basis enabling the processing of personal data is grounded in compliance with a mission in the public interest or the exercise of public authority. Consequently, the researchers commit to adhering to national and international guidelines on the processing of personal data. For this reason, explicit consent does not apply, and an exemption from informed consent for the study is requested. This study is conducted within the framework of scientific or statistical research and is of public interest in the field of public health. Data processing is carried out in a pseudonymized manner, ensuring technical and functional separation. In this study, appropriate measures have been taken for the processing of data without the consent of the data subject, in accordance with the Declaration of Helsinki of the World Medical Association.

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