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Class: TreatmentEffectModifier

A reported difference in a treatment's effect between patient subgroups: the stratum, what it is compared with, the outcome, the direction of the difference, and how the difference was established. Records heterogeneity of treatment effect so it is queryable ("which treatments work less well in women?") rather than buried in a treatment description.

URI: dismech:class/TreatmentEffectModifier

 classDiagram
    class TreatmentEffectModifier
    click TreatmentEffectModifier href "../../classes/TreatmentEffectModifier/"
      TreatmentEffectModifier : comparator_stratum

      TreatmentEffectModifier : description

      TreatmentEffectModifier : effect_in_stratum





        TreatmentEffectModifier --> "1" EffectModificationDirectionEnum : effect_in_stratum
        click EffectModificationDirectionEnum href "../../enums/EffectModificationDirectionEnum/"



      TreatmentEffectModifier : effect_modifier_type





        TreatmentEffectModifier --> "1" EffectModifierTypeEnum : effect_modifier_type
        click EffectModifierTypeEnum href "../../enums/EffectModifierTypeEnum/"



      TreatmentEffectModifier : evidence





        TreatmentEffectModifier --> "* _recommended_" EvidenceItem : evidence
        click EvidenceItem href "../../classes/EvidenceItem/"



      TreatmentEffectModifier : interaction_tested

      TreatmentEffectModifier : mhc_term





        TreatmentEffectModifier --> "0..1" MHCDescriptor : mhc_term
        click MHCDescriptor href "../../classes/MHCDescriptor/"



      TreatmentEffectModifier : modification_analysis





        TreatmentEffectModifier --> "0..1" EffectModificationAnalysisEnum : modification_analysis
        click EffectModificationAnalysisEnum href "../../enums/EffectModificationAnalysisEnum/"



      TreatmentEffectModifier : modified_outcome

      TreatmentEffectModifier : notes

      TreatmentEffectModifier : stratum

Slots

Name Cardinality and Range Description Inheritance
effect_modifier_type 1
EffectModifierTypeEnum		 The kind of patient characteristic that defines the stratum direct
stratum 1
String		 The subgroup the reported effect applies to, in the source's own terms (for e... direct
mhc_term 0..1
MHCDescriptor		 Optional MRO (MHC Restriction Ontology) term for an HLA/MHC allele, serotype,... direct
comparator_stratum 0..1
String		 The subgroup the stratum is compared with (for example "men") direct
modified_outcome 1
String		 The outcome on which the effect differs (for example "handgrip strength", "mo... direct
effect_in_stratum 1
EffectModificationDirectionEnum		 How the effect in the stratum compares with the comparator, for the named out... direct
modification_analysis 0..1
EffectModificationAnalysisEnum		 How the subgroup difference was established direct
interaction_tested 0..1
Boolean		 True when the source reports a formal treatment-by-subgroup interaction test ... direct
description 0..1
String		 direct
evidence * recommended
EvidenceItem		 direct
notes 0..1
String		 direct

Usages

used by used in type used
Treatment effect_modifiers range TreatmentEffectModifier

Comments

  • Effect modification is not a mechanism. Where a mechanism for the difference is known, record that as a pathophysiology node and name it in description.
  • A difference resting on POST_HOC_SUBGROUP, CROSS_STRATUM_COMPARISON or CROSS_STUDY_COMPARISON without an interaction test is a hypothesis; say so in description rather than inflating effect_in_stratum.

Identifier and Mapping Information

Schema Source

  • from schema: https://w3id.org/monarch-initiative/dismech

Mappings

Mapping Type Mapped Value
self dismech:TreatmentEffectModifier
native dismech:TreatmentEffectModifier

LinkML Source

Direct

name: TreatmentEffectModifier
description: 'A reported difference in a treatment''s effect between patient subgroups:
  the stratum, what it is compared with, the outcome, the direction of the difference,
  and how the difference was established. Records heterogeneity of treatment effect
  so it is queryable ("which treatments work less well in women?") rather than buried
  in a treatment description.'
comments:
- Effect modification is not a mechanism. Where a mechanism for the difference is
  known, record that as a pathophysiology node and name it in description.
- A difference resting on POST_HOC_SUBGROUP, CROSS_STRATUM_COMPARISON or CROSS_STUDY_COMPARISON
  without an interaction test is a hypothesis; say so in description rather than inflating
  effect_in_stratum.
from_schema: https://w3id.org/monarch-initiative/dismech
slots:
- effect_modifier_type
- stratum
- mhc_term
- comparator_stratum
- modified_outcome
- effect_in_stratum
- modification_analysis
- interaction_tested
- description
- evidence
- notes
slot_usage:
  effect_modifier_type:
    name: effect_modifier_type
    required: true
  stratum:
    name: stratum
    required: true
  modified_outcome:
    name: modified_outcome
    required: true
  effect_in_stratum:
    name: effect_in_stratum
    required: true
  evidence:
    name: evidence
    recommended: true

Induced

name: TreatmentEffectModifier
description: 'A reported difference in a treatment''s effect between patient subgroups:
  the stratum, what it is compared with, the outcome, the direction of the difference,
  and how the difference was established. Records heterogeneity of treatment effect
  so it is queryable ("which treatments work less well in women?") rather than buried
  in a treatment description.'
comments:
- Effect modification is not a mechanism. Where a mechanism for the difference is
  known, record that as a pathophysiology node and name it in description.
- A difference resting on POST_HOC_SUBGROUP, CROSS_STRATUM_COMPARISON or CROSS_STUDY_COMPARISON
  without an interaction test is a hypothesis; say so in description rather than inflating
  effect_in_stratum.
from_schema: https://w3id.org/monarch-initiative/dismech
slot_usage:
  effect_modifier_type:
    name: effect_modifier_type
    required: true
  stratum:
    name: stratum
    required: true
  modified_outcome:
    name: modified_outcome
    required: true
  effect_in_stratum:
    name: effect_in_stratum
    required: true
  evidence:
    name: evidence
    recommended: true
attributes:
  effect_modifier_type:
    name: effect_modifier_type
    description: The kind of patient characteristic that defines the stratum.
    from_schema: https://w3id.org/monarch-initiative/dismech
    rank: 1000
    alias: effect_modifier_type
    owner: TreatmentEffectModifier
    domain_of:
    - TreatmentEffectModifier
    range: EffectModifierTypeEnum
    required: true
  stratum:
    name: stratum
    description: The subgroup the reported effect applies to, in the source's own
      terms (for example "women", "age 75 years or younger", "SPPB 8-9").
    from_schema: https://w3id.org/monarch-initiative/dismech
    rank: 1000
    alias: stratum
    owner: TreatmentEffectModifier
    domain_of:
    - TreatmentEffectModifier
    range: string
    required: true
  mhc_term:
    name: mhc_term
    description: 'Optional MRO (MHC Restriction Ontology) term for an HLA/MHC allele,
      serotype, haplotype, or presenting protein complex. On a Genetic entry, complements
      `gene_term` (which binds the locus in HGNC, e.g. HLA-DQA1 or HLA-B) with the
      allele, serotype, haplotype, or heterodimer specificity (e.g. `MRO:0000283`
      HLA-DQ2 serotype, `MRO:0001284` HLA-DRB1*03:01 protein complex). On a TreatmentEffectModifier
      with `effect_modifier_type: GENOTYPE`, grounds an HLA-restricted vaccine or
      immunotherapy responder/non-responder stratum.'
    from_schema: https://w3id.org/monarch-initiative/dismech
    rank: 1000
    alias: mhc_term
    owner: TreatmentEffectModifier
    domain_of:
    - Genetic
    - TreatmentEffectModifier
    range: MHCDescriptor
    inlined: true
  comparator_stratum:
    name: comparator_stratum
    description: The subgroup the stratum is compared with (for example "men"). Omit
      only when the comparison is to the whole trial population.
    from_schema: https://w3id.org/monarch-initiative/dismech
    rank: 1000
    alias: comparator_stratum
    owner: TreatmentEffectModifier
    domain_of:
    - TreatmentEffectModifier
    - VariantPopulationEffect
    range: string
  modified_outcome:
    name: modified_outcome
    description: The outcome on which the effect differs (for example "handgrip strength",
      "mobility disability"). Free text; a subgroup difference is outcome-specific.
    from_schema: https://w3id.org/monarch-initiative/dismech
    rank: 1000
    alias: modified_outcome
    owner: TreatmentEffectModifier
    domain_of:
    - TreatmentEffectModifier
    range: string
    required: true
  effect_in_stratum:
    name: effect_in_stratum
    description: How the effect in the stratum compares with the comparator, for the
      named outcome.
    from_schema: https://w3id.org/monarch-initiative/dismech
    rank: 1000
    alias: effect_in_stratum
    owner: TreatmentEffectModifier
    domain_of:
    - TreatmentEffectModifier
    range: EffectModificationDirectionEnum
    required: true
  modification_analysis:
    name: modification_analysis
    description: How the subgroup difference was established.
    from_schema: https://w3id.org/monarch-initiative/dismech
    rank: 1000
    alias: modification_analysis
    owner: TreatmentEffectModifier
    domain_of:
    - TreatmentEffectModifier
    range: EffectModificationAnalysisEnum
  interaction_tested:
    name: interaction_tested
    description: True when the source reports a formal treatment-by-subgroup interaction
      test (whatever its result); false when the difference rests only on separate
      within-stratum results. Omit when the source does not say.
    from_schema: https://w3id.org/monarch-initiative/dismech
    rank: 1000
    alias: interaction_tested
    owner: TreatmentEffectModifier
    domain_of:
    - TreatmentEffectModifier
    range: boolean
  description:
    name: description
    from_schema: https://w3id.org/monarch-initiative/dismech
    rank: 1000
    alias: description
    owner: TreatmentEffectModifier
    domain_of:
    - Descriptor
    - DietaryModification
    - GenomicRegion
    - GeneticContext
    - Dataset
    - ExperimentalModel
    - Experiment
    - ExperimentalPerturbation
    - ExperimentalReadout
    - ExperimentalControl
    - ExecutableProtocol
    - ClinicalTrial
    - ComputationalModel
    - ModelVariable
    - DifferentialDiagnosis
    - Subtype
    - CausalEdge
    - TreatmentMechanismTarget
    - EnvironmentalMechanismTarget
    - ModelDivergence
    - ModelMechanismLink
    - BiomarkerReadout
    - PhenotypeReadout
    - SurrogateEndpointCollection
    - GeneClassificationCollection
    - ProteinStructure
    - ExternalAssertion
    - EpidemiologyInfo
    - Pathophysiology
    - Phenotype
    - HistopathologyFinding
    - ImagingFinding
    - Environmental
    - Disease
    - Stage
    - AgentLifeCycle
    - AgentLifeCycleStage
    - AnimalModel
    - Treatment
    - TreatmentEffectModifier
    - DeliverySystem
    - InfectiousAgent
    - Transmission
    - Assay
    - Diagnosis
    - Inheritance
    - Variant
    - VariantPopulationEffect
    - FunctionalEffect
    - Mechanism
    - ModelingConsideration
    - Definition
    - CriteriaSet
    - ConditionDescriptor
    - GOEnrichment
    - ComorbidityHypothesis
    - UpstreamConditionHypothesis
    - MechanisticHypothesis
    - Grouping
    - GroupingCriteria
    - LogicalCriterion
    - DifferentiatingMechanism
    - ModuleCollection
    - ModuleCollectionMember
    range: string
  evidence:
    name: evidence
    from_schema: https://w3id.org/monarch-initiative/dismech
    rank: 1000
    alias: evidence
    owner: TreatmentEffectModifier
    domain_of:
    - PhenotypeContext
    - Dataset
    - ExperimentalModel
    - Experiment
    - ExperimentalPerturbation
    - ExperimentalReadout
    - ExperimentalControl
    - ExecutableProtocol
    - ClinicalTrial
    - ComputationalModel
    - DifferentialDiagnosis
    - Subtype
    - CausalEdge
    - TreatmentMechanismTarget
    - EnvironmentalMechanismTarget
    - ModelDivergence
    - ModelMechanismLink
    - BiomarkerReadout
    - PhenotypeReadout
    - ReferenceRange
    - SurrogateEndpoint
    - ExternalAssertion
    - Finding
    - Prevalence
    - GeneCaseFraction
    - GeneDiseaseValidityAssertion
    - ProgressionInfo
    - ClinicalBurden
    - EpidemiologyInfo
    - Pathophysiology
    - Phenotype
    - Biochemical
    - HistopathologyFinding
    - ImagingFinding
    - Genetic
    - Environmental
    - Stage
    - AgentLifeCycle
    - AgentLifeCycleStage
    - AnimalModel
    - Treatment
    - TreatmentEffectModifier
    - DeliverySystem
    - InfectiousAgent
    - Transmission
    - Diagnosis
    - Inheritance
    - Variant
    - VariantPopulationEffect
    - ModelingConsideration
    - ClassificationAssignment
    - Definition
    - AlgorithmValidationStatus
    - CriteriaSet
    - AssociationSignal
    - AssociationStatistics
    - ComorbidityHypothesis
    - UpstreamConditionHypothesis
    - MechanisticHypothesis
    - Discussion
    - GroupingCriteria
    - GroupingMember
    - DifferentiatingMechanism
    - ModuleCollection
    - ModuleCollectionMember
    range: EvidenceItem
    recommended: true
    multivalued: true
    inlined: true
    inlined_as_list: true
  notes:
    name: notes
    examples:
    - value: Contagious stage where symptoms appear and the bacteria can be spread
        to others.
    from_schema: https://w3id.org/monarch-initiative/dismech
    rank: 1000
    alias: notes
    owner: TreatmentEffectModifier
    domain_of:
    - GeneticContext
    - OnsetDescriptor
    - PhenotypeContext
    - Dataset
    - ExperimentalModel
    - Experiment
    - ExperimentalPerturbation
    - ExperimentalReadout
    - ExperimentalControl
    - ExecutableProtocol
    - ClinicalTrial
    - ComputationalModel
    - ModelVariable
    - DifferentialDiagnosis
    - ReferenceRange
    - SurrogateEndpoint
    - SurrogateEndpointCollection
    - GeneClassification
    - GeneClassificationCollection
    - ExternalAssertion
    - TrackedIssue
    - Prevalence
    - GeneCaseFraction
    - GeneDiseaseValidityAssertion
    - ProgressionInfo
    - ClinicalBurden
    - EpidemiologyInfo
    - Pathophysiology
    - Phenotype
    - Biochemical
    - HistopathologyFinding
    - ImagingFinding
    - Genetic
    - Environmental
    - Disease
    - Stage
    - AgentLifeCycle
    - AgentLifeCycleStage
    - AnimalModel
    - Treatment
    - TreatmentEffectModifier
    - DeliverySystem
    - Transmission
    - Diagnosis
    - VariantPopulationEffect
    - ClassificationAssignment
    - Definition
    - CriteriaSet
    - TermMapping
    - MappingConsistency
    - ComorbidityAssociation
    - AssociationSignal
    - AssociationMetric
    - AssociationStatistics
    - MechanisticHypothesis
    - Discussion
    - Grouping
    - GroupingCriteria
    - GroupingMember
    - DifferentiatingMechanism
    - ModuleCollection
    - ModuleCollectionMember
    range: string