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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