Surgery Start Date/Time

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Description

This phenotype returns the documented date/time of procedure start for each case. One value per case.

Limitation

Sites must map to specific MPOG concepts to be identified by this phenotype. See logic section for concepts included in this phenotype.

This phenotype only results "observed" dates and times. "Observed" dates and times are those that are explicitly entered or documented in the record and must be documented as part of the note. MPOG will not default to the "time entered" to determine case start. "Time entered" reflects the time that the documentation was written, and not necessarily the time that care was provided.

Data quality is limited to individual site documentation accuracy, completeness, and variable mapping, which is performed by each site, independently. MPOG, as the coordinating center, reviews data quality at each data upload and monthly via Data Diagnostics and Case Validation tools. This review, while thorough, may not contain all data elements relevant to this phenotype and thus should be carefully reviewed by the user.

Value Type

Enumeration

Value	Value Code	Definition

Return Columns

Name	Data Type

Granularity

Logic

This phenotype assesses the case for documentation related to procedure start time of the case. Only the observed date/time will be used; entered time is not considered for this phenotype.

Step 1. Look for the earliest documentation of Procedure Start Date/Time (MPOG Concept ID: 50006) and Surgical Incision Time (MPOG Concept ID: 50235) between Anesthesia Start and Anesthesia End. If available return that date/time and concept used then stop. If not available check for Procedure Start Date/Time or Surgical Incision Time documented within 1 hour before Anesthesia Start and then select the time closest to the Anesthesia Start time. If available return that date/time and concept used then stop. If none available, proceed to step 2.

Step 2. Look for the following documentation and check in the following order:

1st Check for Induction End (Concept ID: 50018) Date/Time. If available return that date/time and "Induction End" then stop. If not available proceed to next check.
2nd Check for Anesthesia Ready (Concept ID: 50277) Date/Time. If available return that date/time and "Anesthesia Ready" then stop. If not available proceed to next check.
3rd Check for Induction Start (Concept ID: 50004) Date/Time. If available return that date/time and "Induction Start" then stop. If not available proceed to next check.
4th Check for Patient In Room. If available return that date/time and "Patient in Room" then stop. If not available, return NULL for the date/time and concept used.