Generating the line of therapy

[carl_miles]

Hi Folks, This is going to be big discussion, Keep focused and share your only usefull or helpfull ideas 

and It will be great help if could share the codes 
[Note: People who know how to text don't comment i don't want trash opinions in my post]

Rule 1: Line of therapy will be defined as all eligible treatments given within 28 days. The name of the “regimen” for that line of therapy is a combination of therapies in that line
Understanding of Rule 1: 

1. The team will categorize regimens based on the first drug's start date + 28 days as the first line. Subsequently, the immediate drug start date + 28 days will be considered the second line, and so forth, continuing unless another Line of Therapy (LoT) rule intervenes.

Example: Records:

Patientid	Drug name	Start date	End date	Start date + 28
1001	A	1-Jan-24	15-Jan-24	29-Jan-24
1001	B	15-Jan-24	25-Jan-24
1001	C	1-Feb-24	15-Feb-24	29-Feb-24
1001	D	16-Feb-24	20-Feb-24

                         Transformed Records

Patientid	Drug name	Start date	End date	Line number
1001	A + B	1-Jan-24	25-Jan-24	1
1001	C + D	1-Feb-24	20-Feb-24	2

Rule 2: • CAR-T cellular therapy infusions always advance a line of therapy. Any treatment started within 14 days before CAR-T cell infusion as part of a conditioning regimen are ineligible for line of therapy. 
[Note: Before LoT development itself we will drop records which ever comes on or in between CAR-T start date - 14 days
We have two CAR-T drugs: Drug_B_A, Drug_UTC]
Understanding of Rule 2: 

1. Records with start dates falling on or between CAR-T start date - 14 days before LoT development will be dropped.
2. The team will advance the line if CAR-T is received within a 28-day interval or at any point unless it is start of 28 days interval. After advancing, drugs received on CAR-T start date + 28 days will be combined.
   Example: 

   Secenarion 1: where CAR-T comes later(second or latter) after the first drug start 28 days interval
   	Patientid	Drug_name	Start date	End date	start date +28
   	1001	A	1-Jan	15-Feb	29-Jan
   	1001	Drug_B_A	20-Jan	20-Jan
   	Patientid	Drug_name	Start date	End date	Line number
   	1001	A	1-Jan	15-Feb	1
   	1001	Drug_B_A	20-Jan	20-Jan	2

Secenario 2: After Advancement CAR-T start date +28 will be one line
	Patientid	Drug_name	Start date	End date	start date +28
	1001	A	1-Jan	15-Feb
	1001	Drug_UTC	20-Jan	20-Jan	17-Feb
	1001	B	15-Feb	20-Feb
	Patientid	Drug_name	Start date	End date	Line number
	1001	A	1-Jan	15-Feb	1
	1001	Drug_UTC + B	20-Jan	20-Feb	2

Rule 3: When an episode of Drug_RU, Drug_OB, and Drug_OF occurs one day before a new line-defining episode, the day of Drug_RU, Drug_OB, and Drug_OF episode is used as the start date for the new line
Understanding of the Rule: 

1. The start date of Drug_RU, Drug_OB, and Drug_OF will be used as the new regimen start date if any of them precede the new line by one day.
   Example: 
   1. Records:

   Patientid	Drug_name	Start date	End date	start date +28
   1001	A	1-Jan-24	15-Feb-24	29-Jan-24
   1001	B	24-Jan-24	29-Jan-24
   1001	Drug_OB	29-Jan-24	15-Mar-24
   1001	C	30-Jan-24	20-Mar-24

                            Transformed Records

   Patientid	Drug name	Start date	End date	Line number
   1001	A+B	1-Jan-24	29-Jan-24	1
   1001	Drug_OB + C	29-Jan-24	20-Mar-24	2

   
   Rule 4: Episodes of Drug_RU and Drug_RUH within 60 days of the line start date are included in that line
   Understanding of the Rule; The team will check after 28 day interval of one line the next immediate drugs is Drug_RU and Drug_RUH then we will combine it with the previous line 
   

   patientid	drugname	start_date	end_date	stdt_28	stdt_60
   1001	Drug_IX	1-Dec-18	1-Jan-19	29-Dec-18	30-Jan-19
   1001	Drug_RU	1-Dec-18	1-Jan-19
   1001	Drug_RU	19-Jan-21	20-Jan-21
   1001	Drug_IX	21-Jun-21	23-Jun-21
   Transformed
   patientid	drugname	start_date	end_date	Line number
   1001	Drug_IX, Drug_RU	1-Dec-18	20-Jan-21	1
   1001	Drug_IX	21-Jun-21	23-Jun-21	2

   
   Advanced in line of therapy based on gaps
   Rule 5:
   If the gap is > 120 days from the previous end date to the subsequent start date, then the line will advance.
   Understanding the Rule 5:
   The team will advance the line irrespective of drugs if the gap greater than 120 days from the previous drug end date to the subsequent drug start date, then the line will advance else we would be combining the lines
   Example:
   

   Secenario - 1

   Different drugs

   Transformed

   Patientid

   Drug_name

   Start date

   End date

   Previous end date - subsequent start date

   Patientid

   Drug_name

   Start date

   End date

   Line_number

   1001

   A

   1-Jan-24

   15-Jan-24

   1/15/2024 - 05/15/2024

   1001

   A

   1-Jan

   15-Jan

   1

   1001

   B

   15-May-24

   25-May-24

   121

   1001

   B

   15-May

   25-May

   2

   Secenario - 2

   Same drugs retaining over the time

   Transformed

   Patientid

   Drug_name

   Start date

   End date

   Previous end date - subsequent start date

   Patientid

   Drug_name

   Start date

   End date

   Line_number

   1001

   A+B

   1-Jan-24

   15-Jan-24

   1/15/2024 - 02/01/2024

   1001

   A+B

   1-Jan

   25-May-24

   1

   1001

   A

   1-Feb-24

   25-May-24

   17

   
   Rule 6:
   For the following drugs, a gap of 90 days is required to advance the line: Drug_RU, Drug_RUH
   Understanding of Rule 6:
   If Drug_RU or Drug_RUH received at the end of 28 day interval of line definition then we will wcheck gap of the the previous line end date and subsequent start date is less than 90 days then bothe lines we will combine else we will separate it 
   Example 1:
   
   

   Patientid	Drug_name	Start date	End date	Start date  + 28	Start date  + 60	End date + 90
   1001	A	1-Jan-24	20-Jan-24	29-Jan-24	1-Mar-24
   1001	B	10-Jan-24	30-Jan-24				40		Combine? A+ B + Ritu
   1001	Drug_RU	10-Mar-24	25-May-24			23-Aug-24

   Transformed A + B + Drug_RU as LINE 1
   
   Example 2: 
   

   Patientid	Drug_name	Start date	End date	Start date  + 28	Start date  + 60	End date + 90
   1001	A	1-Jan-24	15-Jan-24	29-Jan-24	1-Mar-24
   1001	Drug_RU	15-Jan-24	25-Jan-24			24-Apr-24
   1001	B	26-Jan-24	15-Feb-24			15-May-24
   1001	C	15-Jul-24	25-Jul-24
   1001	D	15-Oct-24	20-Oct-24
   1001	E	17-Oct-24	20-Oct-24

   
   Transform A +Drug_RU + B as line 1
   C as 2
   D + E as 3
   Its becoz Drug_RU is received in-between the 28 day interval and not as the last drug
   
   Rule 7: If the gap is ≤ 120 days from the previous end date to the subsequent start date, then the following will advance the line:
   7a. If the new agent overlaps with the line regimen, then the end of line is the last day before the initiation of the new agent.
   Understanding of Rule 7: 
   Example:
   

   Raw Records
   Patientid	Drug_name	Start date	End date	Start date  + 28	Start date  + 60
   1001	A	1-Jan-24	15-Jan-24	29-Jan-24	1-Mar-24
   1001	B	15-Jan-24	25-Jan-24
   1001	C	31-Jan-24	15-Feb-24
   Transform
   Patientid	Drug_name	Start date	End date	Line_number
   1001	A +  B	1-Jan-24	25-Jan-24	1
   1001	C	31-Jan-24	15-Feb-24	2

   
   
   7b. If the new agent does not overlap with the line regimen (i.e. discontinuation of all agents in line), then the end of the line is the end date of the last line agent. If only a single agent or portion of the total multi-drug regimen is discontinued, this is not considered a new LoT.
   

   Example;
   
   

   Records
   Patientid	Drug_name	Start date	End date	Start date  + 28	Start date  + 60
   1001	A	1-Jan-24	15-Jan-24	29-Jan-24	1-Mar-24
   1001	B	15-Jan-24	25-Jan-24
   1001	A	1-Feb-24	15-Feb-24	29-Feb-24
   1001	D	16-Feb-24	20-Feb-24
   Transform
   Patientid	Drug_name	Start date	End date	Line_number
   1001	A +  B	1-Jan-24	15-Feb-24	1
   1001	D	16-Feb-24	20-Feb-24	2

   Here the patient received Drug_A and Drug_B
   Later he dropped B 
   
   And contniued A 
   
   So A + B + A = A+B AS line 1
   D line 2
   
   Rule 8: The addition of Drug_LC, Drug_LLC, Drug_MS, or Drug_MTXT to another therapy does not advance the LOT
   Understanding of Rule 8:
   The team will not advance the line if the following drugs comes after line end: Drug_LC, Drug_LLC, Drug_MS, or Drug_MTXT. And If the mentioned drug dates are overlapping with the line of therapy, then it will be reported in that line and if dates are not overlapping then it will reported with the previous line of therapy. The mentioned drugs start date and end date will be not used to define line start and end dates
   Example:
   

   Table - 1

   Table - 2

   Patientid

   Drug_name

   Start date

   End date

   Start date  + 28

   Start date  + 60

   Patientid

   Drug_name

   Start date

   End date

   Start date  + 28

   Start date  + 60

   1001

   A

   1-Jan

   15-Jan

   29-Jan

   1-Mar

   1001

   A

   1-Jan

   15-Jan

   29-Jan

   1-Mar

   1001

   B

   15-Jan

   29-Jan

   1001

   B

   15-Jan

   29-Jan

   1001

   Drug_MS

   25-Jan

   25-Feb

   1001

   Drug_MS

   2-Feb

   10-Feb

   1001

   C

   1-Feb

   15-Feb

   29-Feb

   1001

   C

   11-Feb

   15-Feb

   10-Mar

   1001

   D

   16-Feb

   20-Feb

   1001

   D

   16-Feb

   20-Feb

   final

   final

   Patientid

   Drug_name

   Start date

   End date

   Line _number

   Patientid

   Drug_name

   Start date

   End date

   1001

   A + B + Drug_MS

   1-Jan

   29-Jan

   1

   1001

   A + B  + Drug_MS

   1-Jan

   29-Jan

   1

   1001

   C + D + Drug_MS

   1-Feb

   20-Feb

   2

   1001

   C + D

   11-Feb

   20-Feb

   2

   
   
   I want to combine all the Rules and code for it 
   Even ideas and approching ways and  base code something like that also will be usefull if you share it 
   So guys kindly comment IF you can't understand any rules 
   
   KIndly help me out 
   
   
   
   

[ballardw]

First useful and possibly quite critical comment:

Provide some example data in the form of a working data step posted in a text box. The data should be typical of what you have. The working data step is so we understand your data. For instance, with some "table" copied from a word processor or spreadsheet we cannot tell which of your variables are numeric or text, whether your "dates" are proper SAS date values or character. This a an extremely critical bit when doing any manipulation related to date manipulation as otherwise the first step is to create actual date values.

Second, make sure you are consistent internally in your description, use VARIABLE names (see first comment about data step). You start with " therapy will be defined as all eligible treatments ". Since there is no column or variable indicated as having a name of Treatment then we are left guessing what that actually means. Same with "Line of Therapy (LoT)", not clearly defined. Other instances of not defined, please fix them. There is nothing shown that identifies what a "CAR-T" is.

Third, since there may be some order dependence going on is a "Drug_A_B" actually different than a "Drug_B_A" value in later processing?