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: 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: Records with start dates falling on or between CAR-T start date - 14 days before LoT development will be dropped. 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: 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: 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
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