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Copy file name to clipboardExpand all lines: docs/api/covidcast-signals/changehc.md
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| Signal | Description |
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| --- | --- |
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|`smoothed_cli`| Estimated percentage of outpatient doctor visits with confirmed COVID-19, based on data from Change Healthcare, smoothed in time using a Gaussian linear smoother |
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|`smoothed_adj_cli`| Same, but with systematic day-of-week effects removed; see [details below](#day-of-week-adjustment)|
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|`smoothed_covid`| Estimated percentage of outpatient doctor visits with confirmed COVID-19, based on data from Change Healthcare, smoothed in time using a Gaussian linear smoother |
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|`smoothed_adj_covid`| Same, but with systematic day-of-week effects removed; see [details below](#day-of-week-adjustment)|
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## Table of contents
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{: .no_toc .text-delta}
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Due to changes in medical-seeking behavior on holidays, this data source has
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upward spikes in the fraction of doctor's visits that are COVID-related around
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major holidays (e.g. Memorial Day, July 4, Labor Day, etc.). These spikes are
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not necessarily indicative of a true increase of COVID-like illness in a
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location.
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not necessarily indicative of a true increase of COVID-19 in a location.
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## Qualifying Conditions
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We receive data on the following two categories of counts:
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- Denominator: Daily count of all unique outpatient visits.
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- Covid: Daily count of all unique visits with primary ICD-10 code in any of:
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{U071, U072, B9721, or B9729}.
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{U07.1, B97.21, or B97.29}.
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## Estimation
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### COVID-Like Illness
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For a fixed location $i$ and time $t$, let $Y_{it}$
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denote the Covid counts and let $N_{it}$ be the
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total count of visits (the *Denominator*). Our estimate of the CLI percentage is
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given by
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total count of visits (the *Denominator*). Our estimate of the COVID-19
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percentage is given by
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$$
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\hat p_{it} = 100 \cdot \frac{Y_{it}}{N_{it}}
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$$
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### Day-of-Week Adjustment
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The fraction of visits due to CLI is dependent on the day of the week. On
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The fraction of visits due to COVID-19 is dependent on the day of the week. On
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weekends, doctors see a higher percentage of acute conditions, so the percentage
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of CLI is higher. Each day of the week has a different behavior, and if we do
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of COVID-19 is higher. Each day of the week has a different behavior, and if we do
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not adjust for this effect, we will not be able to meaningfully compare the
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doctor visits signal across different days of the week. We use a Poisson
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regression model to produce a signal adjusted for this effect.
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We assume that this weekday effect is multiplicative. For example, if the
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underlying rate of CLI on each Monday was the same as the previous Sunday, then
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underlying rate of COVID-19 on each Monday was the same as the previous Sunday, then
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the ratio between the doctor visit signals on Sunday and Monday would be a
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constant. Formally, we assume that
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\end{aligned}
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$$
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where $Y_{it}$ is the observed doctor visits percentage of CLI at time $t$,
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where $Y_{it}$ is the observed doctor visits percentage of COVID-19 at time $t$,
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$\text{wd}(t) \in \{0, \dots, 6\}$ is the day-of-week of time $t$,
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$\alpha_{\text{wd}(t)}$ is the corresponding weekday correction, and
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$\phi_t$ is the corrected doctor visits percentage of CLI at time $t$.
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$\phi_t$ is the corrected doctor visits percentage of COVID-19 at time $t$.
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For simplicity, we assume that the weekday parameters do not change over time or
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location. To fit the $\alpha$ parameters, we minimize the following convex
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$$\dot{Y}_{it} = Y_{it} / \alpha_{wd(t)}.$$
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We then use these adjusted counts to estimate the CLI percentage as described
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We then use these adjusted counts to estimate the COVID-19 percentage as described
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