Mental health diagnosis in members with new cancer diagnoses (ICD-10 diagnoses for both)
Mental health diagnosis in members with new cancer diagnoses (from tumor), by stage
How many patients have a pre-existing mental health diagnosis before their cancer diagnosis? How many receive a mental health diagnosis after their cancer diagnosis? How many patient with cancer have not mental health diagnosis?
Do we see differences in patient background or in survival between the patients with/without MH diagnosis pre/post cancer diagnosis?
Rates of mental health diagnoses are higher in patients with metastasized cancers compared to those with earlier stage cancers (33.5% vs 28.2%), particularly for anxiety and depressive disorders. This trend was observed when using cancer diagnosis by ICD-10 code and when using cancer stage at diagnosis from tumor registry data.
Ellis will convene discussion with MHRN members interested in further research on this topic to discuss potential next steps. Next steps may include a MHRN pilot project or other grant proposal.
For what indications are antipsychotics being prescribed in our healthcare systems?
Manuscript in preparation
Examine the recent rate of patients with depression dx but not on drug treatments or receiving psychotherapy (2016 onwards)
Are the rates of these newly-constructed code lists reasonable and consistent across sites?
QA Pass, accidental higher than self-inflicted, others very low as expected
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Code lists were used in Zero Suicide Opioid Supplement, are ready to use in general where needed.
How has the prevalence of self-injury and ideation changed between 2014 and 2020 with respect to ICD10 and COVID
Please enter a brief (1-2 sentence) description of what you plan to do with these results.
Evaluate changes in documented mental health factors during COVID (Monthly rates of diagnosis, prescriptions, psychotherapy.
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COVID supplement to MHRN proposed, awarded, in progress.
What are the demographic characteristics of youth identified as having experienced child maltreatment compared to those who have not. Are patterns the same across health systems?
Diagnosis codes are insufficient for identifying this population
Identification of population by NLP Pilot in progress
What are the network-wide rates and Ns of self harm in ages 0-4 and 5-11
<0.01% and 0.01%, respectively
None, not feasible to look at age/gender/race/ethnicity in these small numbers.
Use preliminary data where available to look at very recent suicide death rates
Overall suicide mortality rates did not increase with the pandemic, and in fact slightly declined from March to December 2020.
Paper under review by Medical Care.
Describe rates of use of clozapine in people with diagnoses of schizophrenia-spectrum disorders or schizoaffective disorder
Across MHRN health systems, only 3-4% of people with psychotic disorders are current or recent users of clozapine
More detailed analyses will examine clozapine use among people who appear to have a clear indication (e.g. recent hospitalization, recent self-harm).
Describe how intentional and undetermined intent overdoses break down across medication classes.
"Other and unspecified" categories account for over 1/4 of self-harm overdoses. It is not possible to accurately estimate the proportion of self-harm overdoses that involve medications recently dispensed.
Different data will be required to estimate the potential impact of a safe medication dispensing (i.e. blister packaging) intervention
How are virtual visits documented in the VDW? (by enctype and encounter_subtype)
Enctype = 'VC' with encounter_subtype = 'VV' or 'TS' represent virtual care replacing outpatient visits.
Use this as tentative definition of virtual visits - continue to monitor
How frequently are various ASD-related treatments being used in our healthcare systems?
Cummings JR, Lynch FL, Rust KC, et al. Health Services Utilization Among Children With and Without Autism Spectrum Disorders. J Autism Dev Disord. 2016;46(3):910-920. doi:10.1007/s10803-015-2634-z
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4747787/
What proportion of injury (S) codes have an accompanying external cause where that code is not embedded.(by section).
Note: re-run of MHRN_SelfHarm_QA_V2 for 2016-2021.
Repeating with revised set of ICD-10 codes per Michael Schoenbaum, 5/2022. Revised manuscript under review as of 4/11/24.
How often are glucagon-like peptide 1 (GLP-1) agonists medications used by people with and without mental health conditions, and how does that vary by subgroup?
Among patients experiencing a self-harm event and patients with significant suicidal ideation, only 3% had any prior clozapine use and only 1% initiated clozapine during the following 12 months. Among patients with hospitalization or ED visit despite pharmacotherapy, 9% had any prior clozapine treatment, and 3% initiated clozapine over 12 months. Among those with significant suicidal ideation, rates of both prior clozapine treatment and subsequent initiation varied significantly by race and ethnicity, with rates among Hispanic and Non-Hispanic Black patients lower than among Non-Hispanic Whites.
Paper in press at J Clin Psych
What are the questions (map ID to item on a scale) and answers in the PRO data, starting with CSSRS and SDOH PROs
Mapping of question_ids to items completed for GAD, AUDIT, PHQ, Columbia.
Survey of SDOH measures (only KP has in PRO tables), rates of completion where possible. Documentation in G:/...Workgroup_VDW/MHRN3quarterly/2022-04
Mapping to be used in multi-site programs. SDOH - will continue to see if administrations grow. Can map SRQ items, may want new query to count people with different types of needs, or those desiring help. Can use existing SDOH pros as covariates but need to understand the demographics of who receives these questions.
What are the rates of recording in people with and without other MH diagnoses.
Manuscript under review.
Routine quarterly analyses show a significant increase in diagnoses of eating disorder diagnoses since 2019. Does that increase occur across all of the types of eating disorders?