Treatment

This represents treatment with an agent such as a drug (pharmaceutical agent), broadly defined as prescription and over-the-counter medicines, vaccines, and large-molecule biologic therapies.

Data model

Definition of the Treatment element
Field Type Multiplicity Description
agent OntologyClass 1..1 The drug or therapeutic agent. REQUIRED.
route_of_administration OntologyClass 0..1 How was the drug administered. RECOMMENDED.
dose_intervals DoseInterval (List) 0..* dosages. RECOMMENDED.
drug_type DrugType 0..1 Context of the drug administration
cumulative_dose Quantity 0..1 The cumulative dose administered during the period of the treatment.

Example

The following example describes twice daily dosing of 30 mg of losartan given orally.

treatment:
  agent:
    id: "DrugCentral:1610"
    label: "losartan"
  routeOfAdministration:
    id: "NCIT:C38288"
    label: "Oral Route of Administration"
  doseIntervals:
  - quantity:
      unit:
        id: "UO:0000022"
        label: "milligram"
      value: 30.0
    scheduleFrequency:
      id: "NCIT:C64496"
      label: "Twice Daily"
    interval:
      start: "2020-03-15T13:00:00Z"
      end: "2020-03-25T09:00:00Z"
  drugType: "PRESCRIPTION"

The following example specifies that aclarubicin (a type of anthracycline) was given intravenously every three weeks in the time period from 2020-07-10 to 2020-08-10, as part of a cancer chemotherapy treatment for a cumulative dose of 200 mg/kg.

treatment:
    treatment:
        agent:
            id: "DrugCentral:80"
            label: "aclarubicin"
        routeOfAdministration:
            id: "NCIT:C38276"
            label: "Intravenous Route of Administration"
        doseIntervals:
            - quantity:
                unit:
                    id: "NCIT:C124458"
                    label: "Milligram per Kilogram per Dose"
                value: 100.0
            scheduleFrequency:
                id: "NCIT:C64535"
                label: "Every Three Weeks"
            interval:
                start: "2020-07-10T00:00:00Z"
                end: "2020-08-10T00:00:00Z"
        drugType: "EHR_MEDICATION_LIST"
    cumulativeDose:
        unit:
            id: "EFO:0002902"
            label: "milligram per kilogram"
        value: 200.0

This example represents treatment with tamoxifen, 20 mg a day by mouth, administered over a time period of 5 years from 2015 to 2020 with a total cumulative dose of 36500 mg.

treatment:
    agent:
        id: "DrugCentral:2561"
        label: "tamoxifen"
    routeOfAdministration:
        id: "NCIT:C38288"
        label: "Oral Route of Administration"
    doseIntervals:
        - quantity:
            unit:
                id: "NCIT:C28253"
                label: "Milligram"
            value: 20.0
    scheduleFrequency:
        id: "NCIT:C125004"
        label: "Once Daily"
    interval:
        start: "2020-03-15T13:00:00Z"
        end: "2020-03-25T09:00:00Z"
    drugType: "PRESCRIPTION"
cumulativeDose:
    unit:
        id: "NCIT:C28253"
        label: "Milligram"
    value: 36500.0

Explanations

agent

An ontology term representing the therapeutic agent. This can be a term from DrugCentral, RxNorm, Drugbank, ChEBI, or other ontologies.

route_of_administration

How the drug is administered, e.g., by mouth or intravenously. This can be specified by ontology terms from the NCIT subhierarchy for Route of Administration.

dose_intervals

block of time in which the dosage of a medication was constant, e.g., 30 mg/day for an interval of 10 days. See DoseInterval.

drug_type

The context in which a drug was administered. See DrugType.

cumulative_dose

The cumulative dose, defined as the total dose from repeated exposures to chemotherapy, monitoring of which is an important part of treatment with chemotherapy. For instance, cardiac side effect risk increases with greater cumulative doses of antrhacycline.