Generating a Comprehensive, Multi-Modal, Ontology-Driven Value Set for Renal Replacement Therapy (RRT) Identification in Critical Care Databases
This document outlines a comprehensive, multi-modal strategy for the creation of a definitive value set to identify all instances of Renal Replacement Therapy (RRT) within the MIMIC-IV and eICU-CRD databases. The accurate and exhaustive identification of RRT is paramount for the integrity of the Sepsis-Associated Acute Kidney Injury (SA-AKI) cohort, where the initiation of RRT within the first 24 hours of ICU admission is a critical exclusion criterion that fundamentally alters the natural history of the disease.
The primary challenge in this task is the fragmented nature of RRT evidence in electronic health records (EHRs). RRT is not documented in a single, standardized field but is scattered across disparate data sources, including procedure records, charted machine parameters, specific fluid and medication inputs