Herpes zoster, also known as zoster or shingles, is caused by a virus called varicella zoster virus (VZV). Initial infection with the virus causes chickenpox. After chickenpox resolves the virus continues to resides in certain nerve cells. It may remain latent for many years. It may also re-activate, many years later, and cause shingles which is a painful skin rash. How the virus remains latent in the body is not well understood.
Phenotype ID:
112
Status:
Type of Phenotype:
Phenotype Attributes:
Files:
Institution:
Date Created:
Sunday, June 24, 2012
Age:
Race:
Ethnicity:
Owner Phenotyping Groups:
View Phenotyping Groups:
Suggested Citation
Group Health/University of Washington. Group Health and University of Washington. Herpes Zoster. PheKB; 2012 Available from: https://phekb.org/phenotype/112
Comments
Updated pseudo code and data dictionary, November 26, 2012
The updated pseudo code and data dictionary for the zoster phenotype posted Nov 26, 2012 contain: 1) minor but important modifications to some phenotype criteria and logic, 2) a revised data dictionary that specifies separate tables for subject-level and repeated measures covariate data, 3) revised definitions for some covariate data, and 4) a simplified flow diagram for the phenotype algoritym.
Question about of Continuous Enrollment
How should one map the term "continuous enrollment" to a provider of clinical care? The
pseudocode states, "Has ≥5 years of continuous enrollment (or encounter) history since age 35."
It would seem that a minimum of 3 month gaps between enounters is a bit too strict to be representative of
our cohort. Can we change that to maybe yearly or biyearly visits over a minimum of 5 years if using encounters?
Thanks,
Ken
Question about Continuous Enrollment
In non-HMO/integrated care settings "continuous enrollment" may be defined as a history of contiguous 18-month periods with at least one encounter per period. Thus, 5 years of contiouous enrollment would require encounters in at least 4 contiguous 18-month periods. This is somewhat arbitrary. If you feel a more stringent definition (e.g., encounters in contiguous 12-months periods) is more appropriate for your site, please let us know so we can discuss. We want the criteria to be reasonably consistent across sites, but are aware it is impossible to come up with strictly equivalent criteria across the different care models.
We will update the pseudocode to reflect this.
-David
CPT Q0081
The CPT code Q0081 doesn't seem to be linked to chemotherapy in our EMR. Is anyone else having this issue?
Thanks,
Ken
CPT Q0081
Thanks for catching this, Ken. Code Q0081 appears to be an error (see this Web page: http://www.findacode.com/hcpcs/q0081-infusion-therapy-using-than-chemotherapeutic-drugs-hcpcs-code.html). Please exclude code Q0081. We will update the pseudo code documents.
David
Updated, simplified algorithm for zoster
We discovered that our definition of cancer chemotherapy infusion, used as an exclusion criterion for cases and requested as one of the covariates for both cases and controls, was unnecessarily complicated. The definition is simplified in this version of the pseudo code, dated Dec. 11, 2012.
Q0081 back in Appendix A
Looks like CPT Q0081 made it back into the Appendix A list. We should still exclude it, correct?
Is this the latest algorithm and data dictionary?
Hi everyone -- is this the final algorithm and data dictionary? Thanks, Jyoti
The 23/4/2013 pseudo code is
The 23/4/2013 pseudo code is the latest (and likely final) version. It incorporates a minor change suggested by Geisinger to address false positives (see section 1-2-a). The data dictionary is also up to date.
Is this the latest algorithm and data dictionary?
Yes
Clarifications to Zoster pseudocode and data dictionary
Today (3/7/2013) we provided versions of the pseudocode and data dictionary containing additional descriptions to clarify issues raised by implementing sites. The logic of the algorithm and definition of data elements has not changed. There have been no changes to the algorithm or data dictionary since 2/4/2013 and 1/18/2013, respectively.
Hi David -
Hi David -
We have a question about Nursing Home status. The algorithm says NH status ever, but the DD has it limited to 3 months. Can you clarify?
Thanks in advance!
~~~ sarah
Sarah C. Stallings, PhD | VICTR - Vanderbilt Institute for Clinical and Translational Research
615.343.4949 | sarah.stallings@vanderbilt.edu
Nursing Home covariate data (timeframe is ever)
Hi,
Thanks for catching that discrepancy Sarah. The time frame for nurshing home covariate data is "ever." This was properly stated in the data definition Excel file's "Zoster_Subject" tab, but incorrectly stated on the "NH-SNF status" tab (where the shorter period was referenced). I've corrected the data definition Excel file and uploaded a fresh version as of today (3/26/2013).
The three nursing home related covarites all used "ever" as the time frame. They are below.
Cheers,
-David