This macro extracts pregnancy outcomes (live or non-live birth deliveries) based on the pregnancy lookup file. More...

Detailed Description

This macro extracts pregnancy outcomes (live or non-live birth deliveries) based on the pregnancy lookup file.

Loop through partitions.
Collapse same-day/near competing outcomes for the following situations:
Outcome 1 Outcome 2 Collapse Outcome Date LIVE NONLIVE (any) MIX Earliest LIVE UNC LIVE LIVE LIVE MIX MIX Earliest NONLIVE (any) UNC NONLIVE NONLIVE NONLIVE (any) MIX MIX Earliest UNC MIX MIX MIX
- Add preg_outcomecat and priority to collapse records.
- If MIL outcomes are selected, drop disregard competing outcomes ouccuring in MIL evaluation window.
- Because there can be many same day codes for a same outcome, keep only one outcome per adate/priority. All relevant codes will be added after collapsing.
- For same day outcomes, keep the first 2 with the highest priority.
- Identify code dates within 3 days of one another and keep first 2 codes of span.
  - Recode preg_outcomecat to UNC when preg_outcome = UNC.
  - If lag(adate) is NOT within 3 days of n adate, or if there is no change in preg_outcomecat then identify as different span. Otherwise mark as chained for collapsing.
  - In the situation where 3+ competing outcomes are daisy-chained together, only consider the first two outcomes pair and drop any subsequent outcomes.
- Compare codes across span and recode according to prescribed algorithm.
- Identify competing outcome cats:
  - LIVE and NONLIVE = MIX, earliest adate.
  - MIX and UNC = MIX, MIX adate.
  - MIX and (LIVE or NONLIVE) = MIX, earliest adate.
  - NONLIVE and UNC = NONLIVE, NONLIVE adate.
  - LIVE and UNC = LIVE, LIVE adate.
  - Output collapsed outcomes.
    - Restore UNC preg_outcomecat to its original value.
    - For same day collapsed records resulting in a mix outcome, output both outcomes to get their codes.
- Assign new outcome/outcome category and get codes if required.
Deduplicate conflicting same day outcomes based on priority.
- Collapse _tempPregOutcomes to patid adate enctype for the outcome level with highest priority.
Apply the outcome incidence algorithm.
Estimate gestational start date using pregnancy marker codes.
Assign evaluation period for pregnancy markers based on pregnancy outcome being checked.
Evaluation period for pregnancy marker codes relative to outcome date must be truncated on evidence of another valid outcome. Do not truncate same day outcome episodes.
Join markers to outcomes by patid and marker dates that fall within evaluation period.
- If a marker causes a pregnancy episode duration to be longer than the lookback period, consider it as non existing.
The macro variable durationanchor_marker will determine if additional steps are required to process marker codes anchored to marker date instead of outcome date.
Limit marker codes to that with the highest priority based on mpriority and cpriority keep all patient outcomes having the same mpriority cpriority so different outcomes can be selected in different scenarios.
- Initializing cumulative counts for invalid SB/LIVE outcomes.
- Restore mpriority and cpriority to missing values if they were set to 1000 for sorting purposes.
- If no marker claims, assign preduration the defaultpregdur value.
- Calculate the indexdt (estimated LMP) based on outcome date (when durationanchor=OUTCOME) or marker date (when durationanchor=MARKER) minus pregnancy duration.
- Compute number of days between the marker date and the outcome date.
  - This will be used to keep marker closest to outcome.
- Recode still birth outcome as invalid if duration is < 140 days.
- Recode live birth outcome as invalid if duration is < 140 days.
If additional steps are required to process marker codes anchored to marker date instead of outcome date:
- Keep marker code closest to outcome date.
- In the situation where we have a marker prior to the outcome and another one the same number of days after the outcome, we need to keep only the earlier one.
- Now that some observations could have been removed, we need to count the invalid number of stillbirth and live birth outcomes again.
- Initializing invalid counts for SB/LIVE outcomes as macro variables.
- Check if some SB or LIVE outcomes were reclassified as invalid.
- If there are overlapping episodes, truncate the episode and set the start date at the day following the end date of the preceding episode. Do not truncate same day outcome episodes.
- Create final pregnancy outcomes dataset.

Program inputs

&PREGDURFILE. (Dataset containing pregnancy duration.)
&PREGLOOKFILE. (Dataset containing pregnancy codes.)
&PREGNANCYMETA. (Dataset for Type 4 analysis containing pregnancy outcome metadata.)
medstemp.meds_&P. (Dataset containing the raw claims.)
pregnancymeta (Dataset containing preg_outcomenum.)
worktemp.meds (Dataset containing combination of _diags and _procs.)
worktemp.milextract (Dataset containing pregnancy outcomes from the MIL table.)

Program outputs

work.pregnancyoutcomes (Dataset with incident pregnancy outcomes and estimated gestational start date.)

Usage

%ms_process_pregnancyoutcomes(PREGLOOKFILE=&PREGNANCYCODES.,
                              PREGDURFILE=&PREGNANCYDURATION.);

Parameters

[in]	PREGLOOKFILE	Name of pregnancycodes lookupfile.
[in]	PREGDURFILE	Name of pregnancyduration file.

SAS Macros Dependencies

Author: Sentinel Coordinating Center (info@.nosp@m.sent.nosp@m.inels.nosp@m.yste.nosp@m.m.org)

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