# ==================================================================== # # TITLE: # # AMR: An R Package for Working with Antimicrobial Resistance Data # # # # SOURCE CODE: # # https://github.com/msberends/AMR # # # # PLEASE CITE THIS SOFTWARE AS: # # Berends MS, Luz CF, Friedrich AW, Sinha BNM, Albers CJ, Glasner C # # (2022). AMR: An R Package for Working with Antimicrobial Resistance # # Data. Journal of Statistical Software, 104(3), 1-31. # # https://doi.org/10.18637/jss.v104.i03 # # # # Developed at the University of Groningen and the University Medical # # Center Groningen in The Netherlands, in collaboration with many # # colleagues from around the world, see our website. # # # # This R package is free software; you can freely use and distribute # # it for both personal and commercial purposes under the terms of the # # GNU General Public License version 2.0 (GNU GPL-2), as published by # # the Free Software Foundation. # # We created this package for both routine data analysis and academic # # research and it was publicly released in the hope that it will be # # useful, but it comes WITHOUT ANY WARRANTY OR LIABILITY. # # # # Visit our website for the full manual and a complete tutorial about # # how to conduct AMR data analysis: https://msberends.github.io/AMR/ # # ==================================================================== # #' Determine Clinical or Epidemic Episodes #' #' These functions determine which items in a vector can be considered (the start of) a new episode. This can be used to determine clinical episodes for any epidemiological analysis. The [get_episode()] function returns the index number of the episode per group, while the [is_new_episode()] function returns `TRUE` for every new [get_episode()] index. Both absolute and relative episode determination are supported. #' @param x vector of dates (class `Date` or `POSIXt`), will be sorted internally to determine episodes #' @param episode_days episode length in days to specify the time period after which a new episode begins, can also be less than a day or `Inf`, see *Details* #' @param case_free_days (inter-epidemic) interval length in days after which a new episode will start, can also be less than a day or `Inf`, see *Details* #' @param ... ignored, only in place to allow future extensions #' @details Episodes can be determined in two ways: absolute and relative. #' #' 1. Absolute #' #' This method uses `episode_days` to define an episode length in days, after which a new episode will start. A common use case in AMR data analysis is microbial epidemiology: episodes of *S. aureus* bacteraemia in ICU patients for example. The episode length could then be 30 days, so that new *S. aureus* isolates after an ICU episode of 30 days will be considered a different (or new) episode. #' #' Thus, this method counts **since the start of the previous episode**. #' #' 2. Relative #' #' This method uses `case_free_days` to quantify the duration of case-free days (the inter-epidemic interval), after which a new episode will start. A common use case is infectious disease epidemiology: episodes of norovirus outbreaks in a hospital for example. The case-free period could then be 14 days, so that new norovirus cases after that time will be considered a different (or new) episode. #' #' Thus, this methods counts **since the last case in the previous episode**. #' #' In a table: #' #' | Date | Using `episode_days = 7` | Using `case_free_days = 7` | #' |:----------:|:------------------------:|:--------------------------:| #' | 2023-01-01 | 1 | 1 | #' | 2023-01-02 | 1 | 1 | #' | 2023-01-05 | 1 | 1 | #' | 2023-01-08 | 2** | 1 | #' | 2023-02-21 | 3 | 2*** | #' | 2023-02-22 | 3 | 2 | #' | 2023-02-23 | 3 | 2 | #' | 2023-02-24 | 3 | 2 | #' | 2023-03-01 | 4 | 2 | #' #' ** This marks the start of a new episode, because 8 January 2023 is more than 7 days since the start of the previous episode (1 January 2023). \cr #' *** This marks the start of a new episode, because 21 January 2023 is more than 7 days since the last case in the previous episode (8 January 2023). #' #' Either `episode_days` or `case_free_days` must be provided in the function. #' #' ### Difference between `get_episode()` and `is_new_episode()` #' #' The [get_episode()] function returns the index number of the episode, so all cases/patients/isolates in the first episode will have the number 1, all cases/patients/isolates in the second episode will have the number 2, etc. #' #' The [is_new_episode()] function on the other hand, returns `TRUE` for every new [get_episode()] index. #' #' To specify, when setting `episode_days = 365` (using method 1 as explained above), this is how the two functions differ: #' #' | patient | date | `get_episode()` | `is_new_episode()` | #' |:---------:|:----------:|:---------------:|:------------------:| #' | A | 2019-01-01 | 1 | TRUE | #' | A | 2019-03-01 | 1 | FALSE | #' | A | 2021-01-01 | 2 | TRUE | #' | B | 2008-01-01 | 1 | TRUE | #' | B | 2008-01-01 | 1 | FALSE | #' | C | 2020-01-01 | 1 | TRUE | #' #' ### Other #' #' The [first_isolate()] function is a wrapper around the [is_new_episode()] function, but is more efficient for data sets containing microorganism codes or names and allows for different isolate selection methods. #' #' The `dplyr` package is not required for these functions to work, but these episode functions do support [variable grouping][dplyr::group_by()] and work conveniently inside `dplyr` verbs such as [`filter()`][dplyr::filter()], [`mutate()`][dplyr::mutate()] and [`summarise()`][dplyr::summarise()]. #' @return #' * [get_episode()]: an [integer] vector #' * [is_new_episode()]: a [logical] vector #' @seealso [first_isolate()] #' @rdname get_episode #' @export #' @examples #' # difference between absolute and relative determination of episodes: #' x <- data.frame(dates = as.Date(c( #' "2021-01-01", #' "2021-01-02", #' "2021-01-05", #' "2021-01-08", #' "2021-02-21", #' "2021-02-22", #' "2021-02-23", #' "2021-02-24", #' "2021-03-01", #' "2021-03-01" #' ))) #' x$absolute <- get_episode(x$dates, episode_days = 7) #' x$relative <- get_episode(x$dates, case_free_days = 7) #' x #' #' #' # `example_isolates` is a data set available in the AMR package. #' # See ?example_isolates #' df <- example_isolates[sample(seq_len(2000), size = 100), ] #' #' get_episode(df$date, episode_days = 60) # indices #' is_new_episode(df$date, episode_days = 60) # TRUE/FALSE #' #' # filter on results from the third 60-day episode only, using base R #' df[which(get_episode(df$date, 60) == 3), ] #' #' # the functions also work for less than a day, e.g. to include one per hour: #' get_episode( #' c( #' Sys.time(), #' Sys.time() + 60 * 60 #' ), #' episode_days = 1 / 24 #' ) #' #' \donttest{ #' if (require("dplyr")) { #' # is_new_episode() can also be used in dplyr verbs to determine patient #' # episodes based on any (combination of) grouping variables: #' df %>% #' mutate(condition = sample( #' x = c("A", "B", "C"), #' size = 100, #' replace = TRUE #' )) %>% #' group_by(patient, condition) %>% #' mutate(new_episode = is_new_episode(date, 365)) %>% #' select(patient, date, condition, new_episode) %>% #' arrange(patient, condition, date) #' } #' #' if (require("dplyr")) { #' df %>% #' group_by(ward, patient) %>% #' transmute(date, #' patient, #' new_index = get_episode(date, 60), #' new_logical = is_new_episode(date, 60) #' ) %>% #' arrange(patient, ward, date) #' } #' #' if (require("dplyr")) { #' df %>% #' group_by(ward) %>% #' summarise( #' n_patients = n_distinct(patient), #' n_episodes_365 = sum(is_new_episode(date, episode_days = 365)), #' n_episodes_60 = sum(is_new_episode(date, episode_days = 60)), #' n_episodes_30 = sum(is_new_episode(date, episode_days = 30)) #' ) #' } #' #' # grouping on patients and microorganisms leads to the same #' # results as first_isolate() when using 'episode-based': #' if (require("dplyr")) { #' x <- df %>% #' filter_first_isolate( #' include_unknown = TRUE, #' method = "episode-based" #' ) #' #' y <- df %>% #' group_by(patient, mo) %>% #' filter(is_new_episode(date, 365)) %>% #' ungroup() #' #' identical(x, y) #' } #' #' # but is_new_episode() has a lot more flexibility than first_isolate(), #' # since you can now group on anything that seems relevant: #' if (require("dplyr")) { #' df %>% #' group_by(patient, mo, ward) %>% #' mutate(flag_episode = is_new_episode(date, 365)) %>% #' select(group_vars(.), flag_episode) #' } #' } get_episode <- function(x, episode_days = NULL, case_free_days = NULL, ...) { meet_criteria(x, allow_class = c("Date", "POSIXt"), allow_NA = TRUE) meet_criteria(episode_days, allow_class = c("numeric", "integer"), has_length = 1, is_positive = TRUE, is_finite = FALSE, allow_NULL = TRUE) meet_criteria(case_free_days, allow_class = c("numeric", "integer"), has_length = 1, is_positive = TRUE, is_finite = FALSE, allow_NULL = TRUE) as.integer(exec_episode(x, episode_days, case_free_days, ...)) } #' @rdname get_episode #' @export is_new_episode <- function(x, episode_days = NULL, case_free_days = NULL, ...) { meet_criteria(x, allow_class = c("Date", "POSIXt"), allow_NA = TRUE) meet_criteria(episode_days, allow_class = c("numeric", "integer"), has_length = 1, is_positive = TRUE, is_finite = FALSE, allow_NULL = TRUE) meet_criteria(case_free_days, allow_class = c("numeric", "integer"), has_length = 1, is_positive = TRUE, is_finite = FALSE, allow_NULL = TRUE) !duplicated(exec_episode(x, episode_days, case_free_days, ...)) } exec_episode <- function(x, episode_days, case_free_days, ...) { stop_ifnot(is.null(episode_days) || is.null(case_free_days), "either argument `episode_days` or argument `case_free_days` must be set.", call = -2 ) # running as.double() on a POSIXct object will return its number of seconds since 1970-01-01 x <- as.double(as.POSIXct(x)) # as.POSIXct() required for Date classes # since x is now in seconds, get seconds from episode_days as well episode_seconds <- episode_days * 60 * 60 * 24 case_free_seconds <- case_free_days * 60 * 60 * 24 if (length(x) == 1) { # this will also match 1 NA, which is fine return(1) } else if (length(x) == 2 && all(!is.na(x))) { if ((length(episode_seconds) > 0 && (max(x) - min(x)) >= episode_seconds) || (length(case_free_seconds) > 0 && (max(x) - min(x)) >= case_free_seconds)) { if (x[1] <= x[2]) { return(c(1, 2)) } else { return(c(2, 1)) } } else { return(c(1, 1)) } } run_episodes <- function(x, episode_seconds, case_free) { NAs <- which(is.na(x)) x[NAs] <- 0 indices <- integer(length = length(x)) start <- x[1] ind <- 1 indices[ind] <- 1 for (i in 2:length(x)) { if ((length(episode_seconds) > 0 && (x[i] - start) >= episode_seconds) || (length(case_free_seconds) > 0 && (x[i] - x[i - 1]) >= case_free_seconds)) { ind <- ind + 1 start <- x[i] } indices[i] <- ind } indices[NAs] <- NA indices } ord <- order(x) out <- run_episodes(x[ord], episode_seconds, case_free_seconds)[order(ord)] out[is.na(x) & ord != 1] <- NA # every NA expect for the first must remain NA out }