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Palliative/DNR/DNI orders #90

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SimoneZappa opened this issue Sep 19, 2023 · 2 comments
Open

Palliative/DNR/DNI orders #90

SimoneZappa opened this issue Sep 19, 2023 · 2 comments

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@SimoneZappa
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Hello,

I am studying the article
P. J. Thoral et al., “Explainable Machine Learning on AmsterdamUMCdb for ICU Discharge Decision Support: Uniting Intensivists and Data Scientists”
and I would like to know how the authors could have identified
"Palliative care patients and patients with do-notresuscitate or do-not-intubate orders"
Unfortunately, I'm not a dutch speaker.

Thanks,
Simone

@patrickthoral
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While it's currently not possible to completely replicate the exclusion of all patients from the public data set, since not all patients had a discrete DNR/DNI order, these are te terms you are looking for:

itemid item value valueid
10673 Beleid I 1
10673 Beleid II 2
10673 Beleid III 3

The 'Code' (Beleid) orders are
I: Full Code
II: Do not Resuscitate/Do not Intubate in addition to order 'Do Not' orders
III: Palliative Care

@SimoneZappa
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Thank you for your accurate answer!
In my first attempt to replicate your analysis I excluded patients who died on the same day or the day after discharge, obtaining higher performance.

This is not the right place to delve into this issue, but I believe that a similar exclusion strategy applied to readmission within 48 hours might not be considered cheating [M.J. Al-Jaghbeer et al.].

Best regards,
Simone

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