Health Outcomes of Interest

OMOP established an open-source library of Health Outcomes of Interest (HOI) definitions for use in observational studies. Mini-Sentinel for the FDA also conducted identification of health outcomes projects. We have found that there is very little consensus in the literature about outcome definitions. Within the IMEDS Research Plan we are continuing projects to catalogue, systematize and investigate methods for defining health outcomes in administrative databases and EHRs. The links below provide links to definitions from the OMOP HOI initiative.

Library of OMOP HOI Definitions

Angioedema

1. Narrow definition

ICD-9 995.1

Concept ID: 500000101
Initiative*: O

2. Narrow definition and diagnostic procedure or drug treatment

ICD-9 995.1
AND within 2 days after the diagnostic code

Diagnostic or therapeutic procedure code for
intubation, tracheostomy or laryngoscopy, OR
Oral antihistamine medication code OR
i.v. or i.m. anaphylactic shock medication code of
steroids, H1-blockers and H2-blockers

Concept ID: 500000102
Initiative*: O

Aplastic Anemia

1. Broad definition

ICD-9 284.0*, 284.8*, 284.9

Concept ID: 500000201
Initiative*: O

2. Broad definition and diagnostic procedure

ICD-9:284.0*, 284.8*, 284.9
AND within 60 days prior to the diagnostic code

Diagnostic procedure code for bone marrow aspiration or biopsy

Concept ID: 500000202
Initiative*: O, E

3. Narrow definition and diagnostic procedure

ICD-9 284.8*
AND within 60 days prior to the diagnostic code

Diagnostic procedure code for bone marrow aspiration or biopsy

Concept ID: 500000203
Initiative*: O

4. Lab-based definition

Occurrence of two out of three following lab tests and test results within a 7 day period

Leukocyte count <= 3.5 x 10^9/L
Platelet count <= 50 x 10^9 /L
Hemoglobin <= 100 g/L

Concept ID: 500000204
Initiative*: O

5. Narrow definition and lab-based defintion

Definition #3 AND Definition #4

Concept ID: 500000205
Initiative*: O

Acute Liver Injury

1. Broad definition

ICD-9 277.4, 570*, 572.2, 572.4*, 573*, 576.8, 782.4, 789.1*, 790.4*, 794.8*

Concept ID: 500000301
Initiative*: O

2. Narrow Definition

ICD-9 570*, 572.2, 572.4*, 573*

Concept ID: 500000302
Initiative*: O, E

3. Narrow definition and therapeutic procedure

Definition #2 (narrow definition)
AND within 30 days prior to diagnostic code

Diagnostic procedure code

AND within 60 days after the diagnostic code

Therapeutic procedure code

Concept ID: 500000303
Initiative*: O

4. Narrow definition, diagnostic procedure and Hy’s Law

Definition #2 (narrow definition)
AND within 30 days prior to diagnostic code

Diagnostic procedure code

AND within 60 days after the diagnostic code

Therapeutic procedure code

AND

Definition #5 (Hy’s law)

Concept ID: 500000304
Initiative*: O

5. Laboratory-based defintion indicative of Hy’s Law

Laboratory results indicative of Hy’s law:
(ALT >= 3xULN OR AST >= 3xULN) AND Bilirubin >= 2xULN
within 7 days.

Concept ID: 500000305
Initiative*: O

6. Laboratory-based defintion strongly indicative of Hy’s law

Lab tests and test results within 7 day period

Alanine aminotransferase >= 10 times the upper
limit of normal as defined in OBS_RANGE_HIGH, or
40 IU/L if not available
Aspartate aminotransferase >= 10 times the upper
limit of normal as defined in OBS_RANGE_HIGH, or
40 IU/L if not available

AND

Total bilirubin >= 2 times the upper limit of normal as
defined in OBS_RANGE_HIGH, or 1.2 mg/dL if not
available

Concept ID: 500000306
Initiative*: O

7. Alternative narrow definition

ICD-9 570*, 572.4, 573.0, 573.1, 573.4

Concept ID: 500000307 Initiative*: O

8. Narrow definition with hospitalization

ICD-9 570*, 572.2, 572.4*, 573*

AND at date of diagnostic code

Hospitalization

Concept ID: 500000308
Initiative*: O

Acute Kidney Injury

1. Narrow definition

ICD-9 584*

Concept ID: 500000401
Initiative*: O

2. Narrow definition and diagnostic procedure

Definition #1
AND

ICD-9 procedure codes 39.95, 54.98

AND excluding anytime before the diagnostic code

Diagnostic code of chronic dialysis status ICD-9
V45.1, V56.0, V56.31, V56.32, V56.8

Concept ID: 500000402
Initiative*: O, E

3. Lab-based defintion

Occurrence of the LOINC lab test codes 2160-0 and test
results Serum creatinine >= 0.5 mg/dL for patients with a
baseline level of <= 1.9 mg/dLSerum creatinine >= 1.0 mg/dL
for patients with a baseline level of 2.0–4.9 mg/dLSerum
creatinine >= 1.5 mg/dL for patients with a baseline level >=
5.0 mg/dL. The baseline level is defined as the occurrence of
most recent lab test result any time prior to the elevated test
result.

Concept ID: 500000403
Initiative*: O

4.
Narrow definition

ICD-9 584, 584.5, 584.6, 584.7

Concept ID: 500000404
Initiative*: O

5. Narrow definition with hospitalization

Definition of Acute Renal Failure #1 AND Hospitalization at date of diagnostic code.

Concept ID: 500000405
Initiative*: O

Bleeding

1. Broad definition

Broad diagnosis code

Concept ID: 500000501
Initiative*: O

2. Broad definition with hospitalization

Definition #1
AND Hospitalization at date of diagnostic code

Concept ID: 500000502
Initiative*: O, E

3. Narrow definition

Diagnosis code.

Concept ID: 500000503
Initiative*: O

Hip Fracture

1. Narrow definition

ICD-9 820*

Concept ID: 500000601
Initiative*: O

2. Narrow definition and diagnostic radiological procedure

Definition #1
AND

diagnostic radiological procedure code
within 30 days prior to diagnostic code

Concept ID: 500000602
Initiative*: O, E

3. Broad definition, or text evidence in radiological procedure, and radiological and therapeutic procedure

Definition #1

OR Text evidence of fracture in radiological procedure results

AND diagnostic radiological procedure code within 30 days
prior to diagnostic code
AND therapeutic procedure code within 60 days after the
diagnostic date.

Concept ID: 500000603
Initiative*: O

4. Narrow definition, radiological and therapeutic procedure

Definition #1
AND diagnostic radiological procedure code within 30 days
prior
to diagnostic code
AND therapeutic procedure code within 60 days after the
diagnostic date.

Concept ID: 500000604
Initiative*: O

Hospitalization

1. Narrow definition

Occurrence of visit with visit type for hospitalization.

Concept ID: 500000701
Initiative*: O

Acute Myocardial Infarction

1. Broad definition with hospitalization

ICD9 410*, 411.1, 411.8*

angina (413.9) during hospitalization.

Concept ID: 500000801
Initiative*: O

2. Narrow definition

ICD-9 410*.

Concept ID: 500000802
Initiative*: O, M, E

3. Narrow definition, diagnostic and treatment procedure

Narrow diagnosis code
AND (diagnostic procedure <=30d before diagnosis

(treatment procedure >=60d after diagnosis)

Concept ID: 500000803
Initiative*: O

4. Lab-based definition

Laboratory results indicative of AMI

Concept ID: 500000804
Initiative*: O

5. Narrow definition with hospitalization

Definition of Acute Myocardial Infarction (410*) #2
AND Hospitalization at date of diagnostic code

Concept ID: 500000805
Initiative*: O

Mortality After Myocardial Infarction

1. Narrow definition, with hospitalization

Date of death after broad diagnosis code
ICD9 410*, 411.1, 411.8*

angina (413.9) during hospitalization

Concept ID: 500000901
Initiative*: O

2. Narrow definition

Date of death after narrow diagnosis code
ICD9 410*

Concept ID: 500000902
Initiative*: O

3. Narrow definition, diagnostic and treatment procedure

Date of death after narrow diagnosis code
AND (diagnostic procedure <=30d before diagnosis

(treatment procedure >=60d after diagnosis)

Concept ID: 500000903
Initiative*: O

4. Lab-based definition

Date of death after laboratory results indicative of AMI

Concept ID: 500000904
Initiative*: O

GI Ulcer Hospitalization

1. Broad definition with hospitalization

Occurrence of at least one diagnostic code (See sheet ICD9 Code)
AND Hospitalization (Concept Ids 9201 and 9203, Inpatient Visit and Emergency Room Visit) at date of diagnostic code

Concept ID: 500001001
Initiative*: O, E

2. Narrow definition and diagnostic procedure with hospitalization

Diagnostic code AND Hospitalization at date of diagnostic
code
AND diagnostic procedure (endoscopy) within the same
hospitalization.

Concept ID: 5000001002
Initiative*: O

3. Narrow definition without hospitalization

Definition of Upper GI Ulcer Hospitalization 1 but without hospitalization.

Concept ID: 5000001003
Initiative*: O