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COVID-19 – high risk shielded patient list identification methodology

Amendments from previous version

Summary

This is a summary of the changes made from Version 1 of the algorithm.

Rule Disease group Amendment from previous version
1 Solid organ transplant recipients who remain on long term immune suppression therapy Amendment improves specificity of selection by ensuring that there is evidence of condition and medication.
2a

Cancer undergoing active chemo/ radiotherapy

or radical radiotherapy for lung cancer.
No amendment to algorithm rules. The time window for the algorithm means a later set of data is used.
  People having immunotherapy or other continuing antibody treatments for cancer * No amendment
  People having other targeted cancer treatments which affect the immune system, such as protein kinase or PARP inhibitors. * No amendment
2b People with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma at any stage of treatment

No amendment to algorithm rules. The time window for the algorithm means a later set of data is used.

  People who have had bone marrow or stem cell transplants in the last 6 months, or still taking immunosuppression drugs.

No amendment to algorithm rules. The time window for the algorithm means a later set of data is used.

3 People with severe respiratory conditions including all cystic fibrosis, severe asthma and severe COPD Amendment improves specificity of selection by ensuring that there is evidence of condition and medication.
  Cystic Fibrosis, idiopathic pulmonary Fibrosis, etc. Need to go straight through. Regardless of treatment. Idiopathic pulmonary fibrosis and related interstitial fibrosis conditions were added to SNOMED-CT extract only. ICD coding was not added as it appears a number of bronchopneumonia have been coded into these categories.
4 People with rare diseases and inborn errors of metabolism that significantly increase the risk of infections (such as SCID, homozygous sickle cell) From analysis of this group during the production, unusual numbers of patients were found coded with D70 – Agranulocytosis, therefore this code was removed from this subset and account for this reduction. Note D70 is still within the cancer category and is captured in GP extracts.  Minor numbers were lost due to clinical review of some genetic conditions, which do not carry increased infection risks. In addition, sickle cell disease was broken down in ICD10 into sub-categories to remove sickle cell trait.
  People on immunosuppression therapies sufficient to significantly increase risk of infection From analysis of this group during the production, unusual numbers of patients were found coded with D70 – Agranulocytosis, therefore this code was removed from this subset and account for this reduction. Note D70 is still within the cancer category and is captured in GP extracts.  Minor numbers were lost due to clinical review of some genetic conditions, which do not carry increased infection risks. In addition, sickle cell disease was broken down in ICD10 into sub-categories to remove sickle cell trait.
5 People who are pregnant with significant congenital heart disease No amendment.

 

Version 2 to version 3 amendments

Amendments as follows: 

  • switch from one-off GPFLU to weekly GPSPL extract
  • update of 6 month date range for PCPM data

Version 3 to version 4 amendments

Amendments as follows:

  • SNOMED-CT: 716872004 anti-neoplastic chemotherapy regimen moved from category 4 (People with rare diseases and inborn errors of metabolism that significantly increase the risk of infections) to category 2b (People with cancers of the blood or bone marrow)
  • additions (general practice and NHS Trust) and subtractions (general practice only) logic applied

Version 4 to version 5 amendments

Amendments as follows:

  • update of 6 month date range for PCPM data

Version 5 to version 6 amendments

No amendments made.

Version 6 to version 7 amendments

Amendments as follows:

  • subtractions (NHS Trust) logic applied

Version 7 to version 8 amendments

No amendments made.

Version 17 amendments

  • Introduction of the Detained Person’s SPL.
  • Removal of the following codes due to clinical assessment that these should be classed as speciality guidance. Note that all of the below codes have been included in the SPL since the introduction of GPFLU data in version 2 and subsequent use of GP SPL data.
SNOMED concept ID Code description Rule Disease group  Group 
175901007 Live donor renal transplant 1 Transplant Speciality guidance 
175902000 Cadaveric renal transplant 1 Transplant Speciality guidance 
236138007 Xenograft renal transplant 1 Transplant Speciality guidance 
236436003 End stage renal failure with renal transplant 1 Transplant Speciality guidance 
240047005 X-linked muscular dystrophy with limb girdle distribution 4 Rare genetic, metabolic and autoimmune diseases Speciality guidance 
240048000 X-linked muscular dystrophy with abnormal dystrophin 4 Rare genetic, metabolic and autoimmune diseases Speciality guidance
240049008 Intermediate X-linked muscular dystrophy 4 Rare genetic, metabolic and autoimmune diseases Speciality guidance
240050008 Manifesting female carrier of X-linked muscular dystrophy 4 Rare genetic, metabolic and autoimmune diseases Speciality guidance
240051007 X-linked limb girdle muscular dystrophy with normal dystrophin 4 Rare genetic, metabolic and autoimmune diseases Speciality guidance
240071003 X-linked muscular dystrophy not predominantly limb girdle 4 Rare genetic, metabolic and autoimmune diseases Speciality guidance
6471000179103 Transplantation of kidney and pancreas 1 Transplant Speciality guidance
697923008 Pulmonary hypertension in lymphangioleiomyomatosis 3 Respiratory Speciality guidance
70536003 Transplant of kidney 1 Transplant Speciality guidance
711411006 Allotransplantation of kidney from beating heart cadaver 1 Transplant Speciality guidance
711413009 Allotransplantation of kidney from non-beating heart cadaver 1 Transplant Speciality guidance

 

Version 23 amendments

Amendments as follows:

  • Implementation of RCPCH guidance
Last edited: 6 October 2020 4:45 pm