[ { "phenotype_id": "PH941", "phenotype_version_id": 1961, "name": "Musculoskeletal Pain/injury in Adults", "definition": "A list of SNOMED CT Concept IDs suitable for practical application in UK primary care data for identifying consultations and clinical events for musculoskeletal pain conditions and injuries in adults.\n\n\n\n\n\n\n\n\n\n\nIdentifying potentially relevant MSK Concept IDs from existing studies (pathway 1)\nLists of musculoskeletal Read codes and/or SNOMED CT Concept and Description IDs developed in prior and current studies within the School of Medicine, Keele University were collated:\n - PRELIM: knee pain, hip pain, low back pain, shoulder pain, neck pain, hand/wrist pain, osteoarthritis \n - TAPS: pain and osteoarthritis in the knee, shoulder, neck and back (lower & upper including trauma), and general/widespread pain\n - MSKCOM: low back pain, hand/wrist pain, hip pain, knee pain and osteoarthritis\n - SNIPE: all musculoskeletal disorders\n\nAmalgamation of these code lists resulted in 13,200 provisional unique entities (combination of SNOMED CT Concept ID, Description ID, term). Any additional SNOMED CT description IDs and terms contained within the included Concept IDs were then added. This resulted in an additional 3,414 entities and an overall total of 16,614 entities.\nKPJ (senior statistician and electronic health record researcher), GMP (senior epidemiologist), JH (academic physiotherapist), and EP (academic GP) then met to decide on general categories for inclusion and exclusion (Appendix A).\n\nSelecting relevant MSK pain/injury Concept IDs by consensus\nKPJ allocated the 16,614 entities to \"provisionally include\" (n=6,838), \"provisionally exclude\" (n=9,400), or \"provisionally uncertain\" (n=376) based on matching to the general categories for exclusion above. The \"provisionally uncertain\" list included all entities under a Concept ID where some of the entities within that Concept ID but not all would fit under \"provisionally include\". The rationale here was that final selection would be at the Concept ID level and all entities (including all Description IDs) under an included Concept ID should be included. Similarly all entities under an excluded Concept ID would be excluded. GMP, JH, and EP then independently reviewed each of these three lists, with disagreements resolved in a consensus meeting. This resulted in 6,767 entities being taken forward. These 6,767 entities comprised 3,226 unique Concept IDs.\n\nIndependent search of OpenSafely Codelists (pathway 2)\nAn independent search of the OpenCodelists SAFELY portal within the OpenSAFELY platform was made by KPJ. Phrases searched for within SNOMED CT terms were back, hand, hip, wrist, ankle, foot, spine, knee, shoulder, dislocation, spondylosis, meniscus, arthritis, bursitis, fracture, sprain, strain, subluxation, carpal, rotator, pain, widespread, arthralgia, arthropathy, coxalgia. This resulted in 8258 unique Concept IDs and included 2,454 (76%) of the 3,226 Concept IDs identified from the consensus exercise pathway 1. 5,804 additional Concept IDs were therefore potentially relevant and added to the 3,226 Concept IDs from pathway 1 (9,030 Concept IDs in total).\nReducing the number of Concept IDs for practical application\nThe number of Concept IDs remaining after pathway 1 and 2 was felt to be impractical to apply in practice, and was likely to include a large proportion of codes either describing very rare conditions or rarely used. Following permission from CPRD (on basis of no wider dissemination of detailed findings without further approval), a search was made of the number of recorded uses of each of the 9,030 Concept IDs in the Aurum database from January 2016 to July 2021. 3,762 (42%) Concept IDs had been used at least once during that time period, with 2,982 (79%) of these having been identified through pathway 1 and 780 from pathway 2. Concept IDs with an annual prevalence of 0.5 records per 10,000 registered population (all age) in any year 2016-2021 were retained. This resulted in 488 Concept IDs, which between them accounted for >97% of all events in each year recorded with one of the 3,762 Concept IDs. GMP, JH, and EP then did a final review reducing the list to 473 Concept IDs (466 from pathway 1 and 7 from pathway 2).\n\nFinalising the Core Set\nA final check of the Concept ID list by entering them into the SNOMED CT browser (termbrowser.nhs.uk) revealed 27 of these Concept IDs were inactive as at 30 Sep 2021. Therefore, added to the list were replacement(s) suggested within the SNOMED browser and/or Concept IDs with the same term if these were not already included. The final inclusion list contained 498 Concept IDs.\n\n\n\n", "implementation": "", "publications": [], "validation": "", "citation_requirements": "", "created": "2022-05-09T07:55:38.368838Z", "author": "Professor George Peat, Professor Kelvin Jordan, James Bailey, Doctor Claire Burton, Doctor Victoria Welsh, Simon Wathall, Professor Jonathan Hill, Doctor Emma Parry, Doctor Dahai Yu, Steff Garvin, Michael Longeran", "collections": [ { "name": "Phenotype Library", "value": 18 } ], "tags": null, "organisation": null, "world_access": 1, "updated": "2022-05-09T07:55:38.368863Z", "sex": [ { "name": "Both", "value": "3" } ], "type": [ { "name": "Musculoskeletal", "value": "5" } ], "ontology": null, "phenoflowid": "", "data_sources": [ { "name": "CPRD Aurum", "value": 6, "uid": "1d574c14-1af0-490d-9c4e-be88cfd0e345", "url": "https://healthdatagateway.org/en/dataset/692", "datasource_id": 692 }, { "name": "OpenSAFELY SNOMED CT", "value": 36, "datasource_id": 36 } ], "coding_system": [ { "name": "SNOMED CT codes", "value": 9 }, { "name": "Non-standard codes", "value": 13 } ], "event_date_range": "01/01/2016 - 31/05/2021", "concept_information": [ { "concept_id": 2717, "concept_version_id": 6850, "concept_name": "Musculoskeletal Pain/injury in Adults - SNOMED_CT_CONCEPT_ID code list", "coding_system": { "id": 9, "name": "SNOMED CT codes", "description": "SNOMED CT codes" }, "phenotype_id": "PH941", "phenotype_version_id": 1961, "phenotype_name": "Musculoskeletal Pain/injury in Adults", "code_attribute_header": [ "Body region" ], "codes": [ { "code": "1003721002.0", "description": "Pain of joint of knee ", "attributes": { "Body region": "KNE" } }, { "code": "1003722009.0", "description": "Pain of knee region", "attributes": { "Body region": "KNE" } }, { "code": "10085004.0", "description": "Metatarsalgia", "attributes": { "Body region": "FOT" } }, { "code": "102556003.0", "description": "Pain in upper limb", "attributes": { "Body region": "ARM" } }, { "code": "102570003.0", "description": "Inguinal pain", "attributes": { "Body region": "HIP/LEG " } }, { "code": "103014001.0", "description": "Cervical nerve root pain", "attributes": { "Body region": "NCK" } }, { "code": "10380004.0", "description": "Crushing injury of finger", "attributes": { "Body region": "FTB" } }, { "code": "105606008.0", "description": "Injury of musculoskeletal system", "attributes": { "Body region": "UNS" } }, { "code": "10601006.0", "description": "Pain in lower limb", "attributes": { "Body region": "LEG" } }, { "code": "1088071000000108.0", "description": "Pain in upper arm", "attributes": { "Body region": "ARM" } }, { "code": "11049006.0", "description": "Cervical radiculitis", "attributes": { "Body region": "NCK" } }, { "code": "111222003.0", "description": "Derangement of medial meniscus", "attributes": { "Body region": "KNE" } }, { "code": "111243002.0", "description": "Bursitis of knee", "attributes": { "Body region": "KNE" } }, { "code": "111640008.0", "description": "Closed fracture of radius", "attributes": { "Body region": "ARM" } }, { "code": "1126007.0", "description": "Knee locking", "attributes": { "Body region": "KNE" } }, { "code": "11654001.0", "description": "Achilles tendinitis", "attributes": { "Body region": "ANK/LEG" } }, { "code": "118952005.0", "description": "Joint finding", "attributes": { "Body region": "UNS" } }, { "code": "122481008.0", "description": "Hammer toe", "attributes": { "Body region": "TOE" } }, { "code": "123536004.0", "description": "Sprain of upper extremity", "attributes": { "Body region": "ARM/SHD" } }, { "code": "12519004.0", "description": "Sprain of sacroiliac ligament", "attributes": { "Body region": "BCK/HIP" } }, { "code": "125594001.0", "description": "Injury of shoulder region", "attributes": { "Body region": "SHD" } }, { "code": "125596004.0", "description": "Injury of elbow", "attributes": { "Body region": "ELB" } }, { "code": "125597008.0", "description": "Injury of forearm", "attributes": { "Body region": "ARM" } }, { "code": "125598003.0", "description": "Injury of wrist", "attributes": { "Body region": "WRT" } }, { "code": "125599006.0", "description": "Injury of hand", "attributes": { "Body region": "HND" } }, { "code": "125600009.0", "description": "Injury of hip region", "attributes": { "Body region": "HIP" } }, { "code": "125601008.0", "description": "Injury of knee", "attributes": { "Body region": "KNE" } }, { "code": "125602001.0", "description": "Injury of lower leg", "attributes": { "Body region": "LEG" } }, { "code": "125603006.0", "description": "Injury of ankle", "attributes": { "Body region": "ANK " } }, { "code": "125604000.0", "description": "Injury of foot", "attributes": { "Body region": "FOT" } }, { "code": "125605004.0", "description": "Fracture of bone", "attributes": { "Body region": "UNS" } }, { "code": "125606003.0", "description": "Fracture of cervical spine", "attributes": { "Body region": "NCK" } }, { "code": "125607007.0", "description": "Fracture of thoracic spine", "attributes": { "Body region": "TXS" } }, { "code": "125608002.0", "description": "Fracture of lumbar spine", "attributes": { "Body region": "BCK" } }, { "code": "12584003.0", "description": "Bone pain", "attributes": { "Body region": "UNS" } }, { "code": "12676007.0", "description": "Fracture of radius", "attributes": { "Body region": "WRT/ARM" } }, { "code": "127278005.0", "description": "Injury of upper extremity", "attributes": { "Body region": "ARM" } }, { "code": "127279002.0", "description": "Injury of lower extremity", "attributes": { "Body region": "HIP" } }, { "code": "129179000.0", "description": "Piriformis syndrome", "attributes": { "Body region": "HIP/BCK" } }, { "code": "134407002.0", "description": "Chronic back pain", "attributes": { "Body region": "BCK" } }, { "code": "135897006.0", "description": "Salter-Harris type II", "attributes": { "Body region": "UNS" } }, { "code": "13695006.0", "description": "Fracture of pubic rami", "attributes": { "Body region": "HIP" } }, { "code": "1539003.0", "description": "Acquired trigger finger", "attributes": { "Body region": "FTB" } }, { "code": "157265008.0", "description": "Dislocation of hip joint", "attributes": { "Body region": "HIP" } }, { "code": "157266009.0", "description": "Dislocation of knee joint", "attributes": { "Body region": "KNE" } }, { "code": "16114001.0", "description": "Fracture of ankle", "attributes": { "Body region": "ANK " } }, { "code": "161880003.0", "description": "Stiff neck symptom", "attributes": { "Body region": "NCK" } }, { "code": "161882006.0", "description": "Stiff neck", "attributes": { "Body region": "NCK" } }, { "code": "161891005.0", "description": "Backache", "attributes": { "Body region": "BCK" } }, { "code": "161892003.0", "description": "Backache with radiation", "attributes": { "Body region": "BCK" } }, { "code": "161894002.0", "description": "Complaining of low back pain", "attributes": { "Body region": "BCK" } }, { "code": "161896000.0", "description": "Complaining of upper back ache", "attributes": { "Body region": "TXS/BCK" } }, { "code": "162411004.0", "description": "Complaining of stiffness", "attributes": { "Body region": "UNS" } }, { "code": "162429009.0", "description": "Symptom: upper limb", "attributes": { "Body region": "ARM" } }, { "code": "1.6250001000004108e+16", "description": "Fracture of shoulder", "attributes": { "Body region": "SHD" } }, { "code": "164539000.0", "description": "O/E - joint movement painful", "attributes": { "Body region": "UNS" } }, { "code": "17059001.0", "description": "Prepatellar bursitis", "attributes": { "Body region": "KNE" } }, { "code": "17222009.0", "description": "Closed fracture of distal end of radius", "attributes": { "Body region": "WRT" } }, { "code": "17883008.0", "description": "Sprain of hip", "attributes": { "Body region": "HIP" } }, { "code": "18171007.0", "description": "Fracture of phalanx of finger", "attributes": { "Body region": "FTB" } }, { "code": "18347007.0", "description": "Spinal stenosis of lumbar region", "attributes": { "Body region": "BCK" } }, { "code": "18876004.0", "description": "Pain in finger", "attributes": { "Body region": "FTB" } }, { "code": "1931871000006102.0", "description": "Suspected fracture", "attributes": { "Body region": "UNS" } }, { "code": "19660004.0", "description": "Disorder of soft tissue", "attributes": { "Body region": "UNS" } }, { "code": "201819000.0", "description": "Degenerative joint disease involving multiple joints", "attributes": { "Body region": "MSW" } }, { "code": "201837004.0", "description": "Localized primary osteoarthritis of the ankle and/or foot", "attributes": { "Body region": "ANK/FOT" } }, { "code": "202031002.0", "description": "Generalised arthritis", "attributes": { "Body region": "MSW" } }, { "code": "202246002.0", "description": "Recurrent dislocation of the patellofemoral joint", "attributes": { "Body region": "KNE" } }, { "code": "202336002.0", "description": "Acetabular labrum tear", "attributes": { "Body region": "SHD" } }, { "code": "202381003.0", "description": "Knee joint effusion", "attributes": { "Body region": "KNE" } }, { "code": "202472008.0", "description": "Hand joint pain", "attributes": { "Body region": "HND" } }, { "code": "202479004.0", "description": "Acromioclavicular joint pain", "attributes": { "Body region": "SHD" } }, { "code": "202480001.0", "description": "Elbow joint pain", "attributes": { "Body region": "ELB" } }, { "code": "202482009.0", "description": "Wrist joint pain", "attributes": { "Body region": "WRT" } }, { "code": "202487003.0", "description": "Sacroiliac joint pain", "attributes": { "Body region": "BCK/HIP" } }, { "code": "202490009.0", "description": "Ankle joint pain", "attributes": { "Body region": "ANK " } }, { "code": "202596000.0", "description": "Clicking joint", "attributes": { "Body region": "UNS" } }, { "code": "202606004.0", "description": "Clicking hip", "attributes": { "Body region": "HIP" } }, { "code": "202609006.0", "description": "Clicking knee", "attributes": { "Body region": "KNE" } }, { "code": "202664003.0", "description": "Cervical myelopathy", "attributes": { "Body region": "NCK" } }, { "code": "202683005.0", "description": "Cervical spondylosis with radiculopathy", "attributes": { "Body region": "NCK" } }, { "code": "202693003.0", "description": "Lumbosacral spondylosis with radiculopathy", "attributes": { "Body region": "BCK" } }, { "code": "202708005.0", "description": "Prolapsed lumbar intervertebral disc", "attributes": { "Body region": "BCK" } }, { "code": "202732003.0", "description": "Disc prolapse with radiculopathy", "attributes": { "Body region": "SPN" } }, { "code": "202733008.0", "description": "Cervical disc prolapse with radiculopathy", "attributes": { "Body region": "NCK" } }, { "code": "202735001.0", "description": "Lumbar disc prolapse with radiculopathy", "attributes": { "Body region": "BCK" } }, { "code": "202752002.0", "description": "Lumbar discitis", "attributes": { "Body region": "BCK" } }, { "code": "202757008.0", "description": "Cervical disc disorder with radiculopathy", "attributes": { "Body region": "NCK" } }, { "code": "202788007.0", "description": "Degenerative lumbar spinal stenosis", "attributes": { "Body region": "BCK" } }, { "code": "202794004.0", "description": "Lumbago with sciatica", "attributes": { "Body region": "BCK" } }, { "code": "202805003.0", "description": "Sacroiliac disorder", "attributes": { "Body region": "BCK/HIP" } }, { "code": "202841003.0", "description": "Supraspinatus tendinitis", "attributes": { "Body region": "SHD" } }, { "code": "202842005.0", "description": "Partial thickness rotator cuff tear", "attributes": { "Body region": "SHD" } }, { "code": "202843000.0", "description": "Full thickness rotator cuff tear", "attributes": { "Body region": "SHD" } }, { "code": "202849001.0", "description": "Subacromial impingement", "attributes": { "Body region": "SHD" } }, { "code": "202855006.0", "description": "Lateral epicondylitis", "attributes": { "Body region": "ELB" } }, { "code": "202856007.0", "description": "Biceps tendinitis", "attributes": { "Body region": "ARM" } }, { "code": "202863007.0", "description": "Adductor tendinitis", "attributes": { "Body region": "HIP" } }, { "code": "202881005.0", "description": "Tibialis posterior tendinitis", "attributes": { "Body region": "LEG" } }, { "code": "202882003.0", "description": "Plantar fasciitis", "attributes": { "Body region": "FOT" } }, { "code": "202888004.0", "description": "Anterior shin splints", "attributes": { "Body region": "LEG" } }, { "code": "202900007.0", "description": "Synovitis and tenosynovitis", "attributes": { "Body region": "UNS" } }, { "code": "202914007.0", "description": "Extensor tenosynovitis of wrist", "attributes": { "Body region": "WRT" } }, { "code": "202916009.0", "description": "Extensor tenosynovitis of thumb", "attributes": { "Body region": "FTB" } }, { "code": "202936005.0", "description": "Ganglion and cyst of synovium, tendon and bursa", "attributes": { "Body region": "UNS" } }, { "code": "202942009.0", "description": "Ganglion of wrist", "attributes": { "Body region": "WRT" } }, { "code": "203045001.0", "description": "Dupuytren's disease of palm", "attributes": { "Body region": "HND" } }, { "code": "203082005.0", "description": "Fibromyalgia", "attributes": { "Body region": "MSW" } }, { "code": "203095000.0", "description": "Spasm of back muscles", "attributes": { "Body region": "BCK" } }, { "code": "203131005.0", "description": "Tender heel pad", "attributes": { "Body region": "FOT" } }, { "code": "203509009.0", "description": "Clavicle pain", "attributes": { "Body region": "SHD" } }, { "code": "203534009.0", "description": "Acquired pes planus", "attributes": { "Body region": "FOT" } }, { "code": "203601000.0", "description": "Acquired unequal leg length", "attributes": { "Body region": "LEG" } }, { "code": "203638000.0", "description": "Kyphoscoliosis and scoliosis", "attributes": { "Body region": "TXS/BCK" } }, { "code": "203639008.0", "description": "Idiopathic scoliosis", "attributes": { "Body region": "BCK" } }, { "code": "203645000.0", "description": "Postural scoliosis", "attributes": { "Body region": "BCK" } }, { "code": "203681002.0", "description": "Acquired spondylolisthesis", "attributes": { "Body region": "BCK" } }, { "code": "20511007.0", "description": "Fracture of hand", "attributes": { "Body region": "HND" } }, { "code": "207940009.0", "description": "Closed fracture thoracic vertebra wedge", "attributes": { "Body region": "TXS" } }, { "code": "207957008.0", "description": "Closed fracture lumbar vertebra", "attributes": { "Body region": "BCK" } }, { "code": "207959006.0", "description": "Closed fracture lumbar vertebra, wedge", "attributes": { "Body region": "BCK" } }, { "code": "208145002.0", "description": "Fracture or disruption of pelvis", "attributes": { "Body region": "HIP" } }, { "code": "208165009.0", "description": "Closed fracture pelvis single pubic ramus", "attributes": { "Body region": "HIP" } }, { "code": "208166005.0", "description": "Closed fracture pelvis multiple pubic rami - stable", "attributes": { "Body region": "HIP" } }, { "code": "208240004.0", "description": "Closed fracture proximal humerus, neck", "attributes": { "Body region": "ARM/SHD" } }, { "code": "208242007.0", "description": "Closed fracture proximal humerus, greater tuberosity", "attributes": { "Body region": "ARM" } }, { "code": "208294009.0", "description": "Closed fracture olecranon, extra-articular", "attributes": { "Body region": "ELB" } }, { "code": "208325003.0", "description": "Closed fracture radial styloid", "attributes": { "Body region": "WRT" } }, { "code": "208388003.0", "description": "Fracture at wrist and/or hand level", "attributes": { "Body region": "WRT/HND" } }, { "code": "208393000.0", "description": "Fracture of metacarpal bone", "attributes": { "Body region": "WRT/HND" } }, { "code": "208394006.0", "description": "Closed fracture of metacarpal bone", "attributes": { "Body region": "HND" } }, { "code": "208399001.0", "description": "Closed fracture finger metacarpal neck", "attributes": { "Body region": "HND" } }, { "code": "208401007.0", "description": "Closed fracture finger metacarpal", "attributes": { "Body region": "HND" } }, { "code": "208430000.0", "description": "Closed fracture of one or more phalanges of hand", "attributes": { "Body region": "FTB" } }, { "code": "208444006.0", "description": "Closed fracture finger proximal phalanx", "attributes": { "Body region": "FTB" } }, { "code": "208450001.0", "description": "Closed fracture finger middle phalanx", "attributes": { "Body region": "FTB" } }, { "code": "208634001.0", "description": "Closed fracture distal tibia", "attributes": { "Body region": "LEG" } }, { "code": "208687001.0", "description": "Closed fracture metatarsal base", "attributes": { "Body region": "FOT" } }, { "code": "208710000.0", "description": "Closed fracture proximal phalanx, toe", "attributes": { "Body region": "TOE" } }, { "code": "208712008.0", "description": "Closed fracture distal phalanx, toe", "attributes": { "Body region": "TOE" } }, { "code": "208719004.0", "description": "Fracture of great toe", "attributes": { "Body region": "TOE" } }, { "code": "2089002.0", "description": "Paget's disease of bone", "attributes": { "Body region": "UNS" } }, { "code": "208916003.0", "description": "Acute meniscal tear medial posterior horn", "attributes": { "Body region": "KNE" } }, { "code": "208921000.0", "description": "Acute meniscal tear lateral", "attributes": { "Body region": "KNE" } }, { "code": "209238002.0", "description": "Closed fracture dislocation shoulder joint", "attributes": { "Body region": "SHD" } }, { "code": "209354002.0", "description": "Closed fracture dislocation foot", "attributes": { "Body region": "FOT" } }, { "code": "209409002.0", "description": "Sprains and strains of joints and adjacent muscles", "attributes": { "Body region": "UNS" } }, { "code": "209436000.0", "description": "Sprain of wrist and/or hand", "attributes": { "Body region": "WRT/HND" } }, { "code": "209520004.0", "description": "Partial tear knee anterior cruciate ligament", "attributes": { "Body region": "KNE" } }, { "code": "209529003.0", "description": "Sprain of ankle and/or foot", "attributes": { "Body region": "ANK/FOT" } }, { "code": "209532000.0", "description": "Sprain, ankle joint, lateral", "attributes": { "Body region": "ANK " } }, { "code": "209557005.0", "description": "Neck sprain", "attributes": { "Body region": "NCK" } }, { "code": "209565008.0", "description": "Lumbar sprain", "attributes": { "Body region": "BCK" } }, { "code": "209574005.0", "description": "Pulled back muscle", "attributes": { "Body region": "BCK" } }, { "code": "209629006.0", "description": "Complete tear knee anterior cruciate ligament", "attributes": { "Body region": "KNE" } }, { "code": 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