Sleep Apnea | emtelligent Documentation

Synopsis

This query searches mentions of Sleep Apnea in patient records by querying for a set of related SNOMED concepts.

Processing Requirements

This query assumes that at least the following emtellipro-db-client processing options were enabled:

--feature snomed-ontology
--store-sections-and-sentences

For this query, Clinical notes were processed with the following document type:

--category Clinical
--subcategory generic (or more specific report types such as Discharge Summary, SOAP Note, CCD as applicable)

Clinical Context

Sleep apnea is a disorder characterized by intermittent periods of apnea (arrest of respiration) during sleep. However, in day-to-day clinical practice, this condition can be referred to by multiple different terms such as obstructive sleep apnea, sleep apnea, or it may be written that the patient has PND or paroxysmal nocturnal dyspnea, or there may be no mention of sleep apnea and it may just be written that the patient uses a continuous positive airway pressure (CPAP) machine at night. Thus, we must look for multiple concepts related to the same (or similar) clinical entities.

78275009|Obstructive sleep apnea syndrome (disorder)|
73430006|Sleep apnea (disorder)|
55442000|Paroxysmal nocturnal dyspnea (finding)|
62744007|Orthopnea (finding)|
47545007|Continuous positive airway pressure ventilation treatment (regime/therapy)|

This type of query can easily be modified to retrieve occurrences of other clinical entities by identifying a subset of associated concepts to use in place of the list of SNOMED concept IDs used in this sample query.

SQL query

SQL

Snowflake

-- Multi-concept query for sleep apnea without experiencer relation
SELECT c.concept_id  As concept_id,
    c.description AS concept_description,
    fe.section_name,
    fe.text      AS annotated_text,
    sl.text       AS sentence
    FROM entity e
            JOIN foundentity fe ON fe.id = e.entity_id AND e.type_ = 'found' -- IMPORTANT: e.type_ = 'found' is required
            JOIN foundentityconcept fec ON fe.id = fec.found_entity_id
            JOIN concept c ON c.concept_id = fec.concept_id AND c.ontology = fec.concept_ontology
            JOIN foundentitylocation fel ON fe.id = fel.found_entity_id
            JOIN location l
                ON fel.location_id = l.id AND l.type_ = 'sentence' -- IMPORTANT: check that location type is 'sentence'
            JOIN sentencelocation sl ON sl.id = l.location_id
    WHERE c.ontology = 'snomed'
    AND c.concept_id IN ('78275009', '73430006', '55442000', '62744007', '47545007') -- REPLACE: with target concepts
    AND fe.polarity = 'asserted'
    AND fe.uncertainty = 'certain';

concept_id	concept_description	section_name	annotated_text	sentence
47545007	Continuous positive airway pressure ventilation treatment (regime/therapy)	SUBJECTIVE	CPAP	As noted, the patient is not snoring on CPAP.
47545007	Continuous positive airway pressure ventilation treatment (regime/therapy)	ASSESSMENT	CPAP	I recommend he continues CPAP indefinitely.
47545007	Continuous positive airway pressure ventilation treatment (regime/therapy)	ASSESSMENT	CPAP	If this continues, we can consider a new sleep study to determine whether he still needs CPAP.
47545007	Continuous positive airway pressure ventilation treatment (regime/therapy)	SUBJECTIVE	CPAP	Mr. Sidney is a 50-year-old man who returns to discuss his still moderate-to- sleep apnea, and to review his response to CPAP.
47545007	Continuous positive airway pressure ventilation treatment (regime/therapy)	SUBJECTIVE	CPAP	He was found to have moderate-to-severe sleep apnea, and was treated with nasal CPAP for the past few months.
47545007	Continuous positive airway pressure ventilation treatment (regime/therapy)	SUBJECTIVE	CPAP	He estimates that he uses the CPAP approximately 4-6 nights per week, and on occasion takes it off and does not replace the mask when he awakens spontaneously in the middle of the night.
73430006	Sleep apnea (disorder)	SUBJECTIVE	sleep apnea	Mr. Sidney is a 50-year-old man who returns to discuss his still moderate-to- sleep apnea, and to review his response to CPAP.
73430006	Sleep apnea (disorder)	SUBJECTIVE	sleep apnea	He was found to have moderate-to-severe sleep apnea, and was treated with nasal CPAP for the past few months.
73430006	Sleep apnea (disorder)	ASSESSMENT	sleep apnea	Moderate-to-severe sleep apnea.
78275009	Obstructive sleep apnea syndrome (disorder)	PAST MEDICAL HISTORY	OSA	OSA

Next steps

The list of sleep apnea and related mentions can be further filtered to return only those that pertain to the patient. See Sleep Apnea Experienced by Patients.

Entity-level Tables