Development and validation of a near-comprehensive RxNorm valueset of opioid medications

ObjectiveDevelop a near-comprehensive opioid medications valueset for population measures of opioid related treatments and outcomes. The opioid valueset should be free, open source, and conform to the RxNorm standard federally mandated in every US-certified electronic health record. Materials and MethodsCumulus opioid valueset was manually curated by the authors and expanded using computer assisted curation. Opioid classifier rules were developed to select opioid RxNorm concepts with known opioid receptor interactions, ingredients, keywords, and drug product formulations. Twelve publicly available valuesets were used to develop and validate the Cumulus opioid valueset. Validation accuracy was measured against a corpus of opioid medication orders and non-opioid pain relievers. ResultsCumulus opioid valueset recall was >99.9% when measured against opioid prescription RxNorm codes from UC Davis Health and Brigham and Womens Hospital. Cumulus opioid valueset was 100% specific compared to three valuesets of non-opioid pain relievers. Discussion and ConclusionTo the authors knowledge, Cumulus opioid valueset is the largest publicly available valueset of opioid medications (8,926 RxNorm concepts). The intended use of this opioid valueset is for population health measures of opioid medications and related patient outcomes.