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<!DOCTYPE html><html><head><meta charset="utf-8"><style>body {
width: 45em;
border: 1px solid #ddd;
outline: 1300px solid #fff;
margin: 16px auto;
}
body .markdown-body
{
padding: 30px;
}
@font-face {
font-family: octicons-anchor;
src: url(data:font/woff;charset=utf-8;base64,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) format('woff');
}
.markdown-body {
-ms-text-size-adjust: 100%;
-webkit-text-size-adjust: 100%;
color: #333;
overflow: hidden;
font-family: "Helvetica Neue", Helvetica, "Segoe UI", Arial, freesans, sans-serif;
font-size: 16px;
line-height: 1.6;
word-wrap: break-word;
}
.markdown-body a {
background: transparent;
}
.markdown-body a:active,
.markdown-body a:hover {
outline: 0;
}
.markdown-body strong {
font-weight: bold;
}
.markdown-body h1 {
font-size: 2em;
margin: 0.67em 0;
}
.markdown-body img {
border: 0;
}
.markdown-body hr {
-moz-box-sizing: content-box;
box-sizing: content-box;
height: 0;
}
.markdown-body pre {
overflow: auto;
}
.markdown-body code,
.markdown-body kbd,
.markdown-body pre {
font-family: monospace, monospace;
font-size: 1em;
}
.markdown-body input {
color: inherit;
font: inherit;
margin: 0;
}
.markdown-body html input[disabled] {
cursor: default;
}
.markdown-body input {
line-height: normal;
}
.markdown-body input[type="checkbox"] {
-moz-box-sizing: border-box;
box-sizing: border-box;
padding: 0;
}
.markdown-body table {
border-collapse: collapse;
border-spacing: 0;
}
.markdown-body td,
.markdown-body th {
padding: 0;
}
.markdown-body * {
-moz-box-sizing: border-box;
box-sizing: border-box;
}
.markdown-body input {
font: 13px/1.4 Helvetica, arial, freesans, clean, sans-serif, "Segoe UI Emoji", "Segoe UI Symbol";
}
.markdown-body a {
color: #4183c4;
text-decoration: none;
}
.markdown-body a:hover,
.markdown-body a:focus,
.markdown-body a:active {
text-decoration: underline;
}
.markdown-body hr {
height: 0;
margin: 15px 0;
overflow: hidden;
background: transparent;
border: 0;
border-bottom: 1px solid #ddd;
}
.markdown-body hr:before {
display: table;
content: "";
}
.markdown-body hr:after {
display: table;
clear: both;
content: "";
}
.markdown-body h1,
.markdown-body h2,
.markdown-body h3,
.markdown-body h4,
.markdown-body h5,
.markdown-body h6 {
margin-top: 15px;
margin-bottom: 15px;
line-height: 1.1;
}
.markdown-body h1 {
font-size: 30px;
}
.markdown-body h2 {
font-size: 21px;
}
.markdown-body h3 {
font-size: 16px;
}
.markdown-body h4 {
font-size: 14px;
}
.markdown-body h5 {
font-size: 12px;
}
.markdown-body h6 {
font-size: 11px;
}
.markdown-body blockquote {
margin: 0;
}
.markdown-body ul,
.markdown-body ol {
padding: 0;
margin-top: 0;
margin-bottom: 0;
}
.markdown-body ol ol,
.markdown-body ul ol {
list-style-type: lower-roman;
}
.markdown-body ul ul ol,
.markdown-body ul ol ol,
.markdown-body ol ul ol,
.markdown-body ol ol ol {
list-style-type: lower-alpha;
}
.markdown-body dd {
margin-left: 0;
}
.markdown-body code {
font: 12px Consolas, "Liberation Mono", Menlo, Courier, monospace;
}
.markdown-body pre {
margin-top: 0;
margin-bottom: 0;
font: 12px Consolas, "Liberation Mono", Menlo, Courier, monospace;
}
.markdown-body .octicon {
font: normal normal 16px octicons-anchor;
line-height: 1;
display: inline-block;
text-decoration: none;
-webkit-font-smoothing: antialiased;
-moz-osx-font-smoothing: grayscale;
-webkit-user-select: none;
-moz-user-select: none;
-ms-user-select: none;
user-select: none;
}
.markdown-body .octicon-link:before {
content: '\f05c';
}
.markdown-body>*:first-child {
margin-top: 0 !important;
}
.markdown-body>*:last-child {
margin-bottom: 0 !important;
}
.markdown-body .anchor {
position: absolute;
top: 0;
bottom: 0;
left: 0;
display: block;
padding-right: 6px;
padding-left: 30px;
margin-left: -30px;
}
.markdown-body .anchor:focus {
outline: none;
}
.markdown-body h1,
.markdown-body h2,
.markdown-body h3,
.markdown-body h4,
.markdown-body h5,
.markdown-body h6 {
position: relative;
margin-top: 1em;
margin-bottom: 16px;
font-weight: bold;
line-height: 1.4;
}
.markdown-body h1 .octicon-link,
.markdown-body h2 .octicon-link,
.markdown-body h3 .octicon-link,
.markdown-body h4 .octicon-link,
.markdown-body h5 .octicon-link,
.markdown-body h6 .octicon-link {
display: none;
color: #000;
vertical-align: middle;
}
.markdown-body h1:hover .anchor,
.markdown-body h2:hover .anchor,
.markdown-body h3:hover .anchor,
.markdown-body h4:hover .anchor,
.markdown-body h5:hover .anchor,
.markdown-body h6:hover .anchor {
padding-left: 8px;
margin-left: -30px;
line-height: 1;
text-decoration: none;
}
.markdown-body h1:hover .anchor .octicon-link,
.markdown-body h2:hover .anchor .octicon-link,
.markdown-body h3:hover .anchor .octicon-link,
.markdown-body h4:hover .anchor .octicon-link,
.markdown-body h5:hover .anchor .octicon-link,
.markdown-body h6:hover .anchor .octicon-link {
display: inline-block;
}
.markdown-body h1 {
padding-bottom: 0.3em;
font-size: 2.25em;
line-height: 1.2;
border-bottom: 1px solid #eee;
}
.markdown-body h2 {
padding-bottom: 0.3em;
font-size: 1.75em;
line-height: 1.225;
border-bottom: 1px solid #eee;
}
.markdown-body h3 {
font-size: 1.5em;
line-height: 1.43;
}
.markdown-body h4 {
font-size: 1.25em;
}
.markdown-body h5 {
font-size: 1em;
}
.markdown-body h6 {
font-size: 1em;
color: #777;
}
.markdown-body p,
.markdown-body blockquote,
.markdown-body ul,
.markdown-body ol,
.markdown-body dl,
.markdown-body table,
.markdown-body pre {
margin-top: 0;
margin-bottom: 16px;
}
.markdown-body hr {
height: 4px;
padding: 0;
margin: 16px 0;
background-color: #e7e7e7;
border: 0 none;
}
.markdown-body ul,
.markdown-body ol {
padding-left: 2em;
}
.markdown-body ul ul,
.markdown-body ul ol,
.markdown-body ol ol,
.markdown-body ol ul {
margin-top: 0;
margin-bottom: 0;
}
.markdown-body li>p {
margin-top: 16px;
}
.markdown-body dl {
padding: 0;
}
.markdown-body dl dt {
padding: 0;
margin-top: 16px;
font-size: 1em;
font-style: italic;
font-weight: bold;
}
.markdown-body dl dd {
padding: 0 16px;
margin-bottom: 16px;
}
.markdown-body blockquote {
padding: 0 15px;
color: #777;
border-left: 4px solid #ddd;
}
.markdown-body blockquote>:first-child {
margin-top: 0;
}
.markdown-body blockquote>:last-child {
margin-bottom: 0;
}
.markdown-body table {
display: block;
width: 100%;
overflow: auto;
word-break: normal;
word-break: keep-all;
}
.markdown-body table th {
font-weight: bold;
}
.markdown-body table th,
.markdown-body table td {
padding: 6px 13px;
border: 1px solid #ddd;
}
.markdown-body table tr {
background-color: #fff;
border-top: 1px solid #ccc;
}
.markdown-body table tr:nth-child(2n) {
background-color: #f8f8f8;
}
.markdown-body img {
max-width: 100%;
-moz-box-sizing: border-box;
box-sizing: border-box;
}
.markdown-body code {
padding: 0;
padding-top: 0.2em;
padding-bottom: 0.2em;
margin: 0;
font-size: 85%;
background-color: rgba(0,0,0,0.04);
border-radius: 3px;
}
.markdown-body code:before,
.markdown-body code:after {
letter-spacing: -0.2em;
content: "\00a0";
}
.markdown-body pre>code {
padding: 0;
margin: 0;
font-size: 100%;
word-break: normal;
white-space: pre;
background: transparent;
border: 0;
}
.markdown-body .highlight {
margin-bottom: 16px;
}
.markdown-body .highlight pre,
.markdown-body pre {
padding: 16px;
overflow: auto;
font-size: 85%;
line-height: 1.45;
background-color: #f7f7f7;
border-radius: 3px;
}
.markdown-body .highlight pre {
margin-bottom: 0;
word-break: normal;
}
.markdown-body pre {
word-wrap: normal;
}
.markdown-body pre code {
display: inline;
max-width: initial;
padding: 0;
margin: 0;
overflow: initial;
line-height: inherit;
word-wrap: normal;
background-color: transparent;
border: 0;
}
.markdown-body pre code:before,
.markdown-body pre code:after {
content: normal;
}
.markdown-body .highlight {
background: #fff;
}
.markdown-body .highlight .h {
color: #333;
font-style: normal;
font-weight: normal;
}
.markdown-body .highlight .mf,
.markdown-body .highlight .mh,
.markdown-body .highlight .mi,
.markdown-body .highlight .mo,
.markdown-body .highlight .il,
.markdown-body .highlight .m {
color: #945277;
}
.markdown-body .highlight .s,
.markdown-body .highlight .sb,
.markdown-body .highlight .sc,
.markdown-body .highlight .sd,
.markdown-body .highlight .s2,
.markdown-body .highlight .se,
.markdown-body .highlight .sh,
.markdown-body .highlight .si,
.markdown-body .highlight .sx,
.markdown-body .highlight .s1 {
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}</style><title>README</title></head><body><article class="markdown-body"><h1>
<a id="user-content-grand-rounds-data-challenge" class="anchor" href="#grand-rounds-data-challenge" aria-hidden="true"><span class="octicon octicon-link"></span></a>Grand Rounds Data Challenge</h1>
<p>The federal government recently began publicly disclosing provider-identifiable Medicare outpatient data (cf. <a href="https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Physician-and-Other-Supplier.html">CMS</a>). We have provided some cleaned versions of two such data sets and some background information for you to use in the solution of a problem we will present below.</p>
<h2>
<a id="user-content-data" class="anchor" href="#data" aria-hidden="true"><span class="octicon octicon-link"></span></a>Data</h2>
<ol>
<li>
<em>Medicare Procedure Claims</em>: The first data set is contained in <code>npi_proc_counts.csv</code> and holds records from 2013 indicating how many times each physician billed Medicare for a specific procedure code (these are "HCPCS" or "CPT" codes) . Procedure codes exist for every type of surgery, test, office visit, and office-administered treatment. The columns are:
<ol>
<li>
<code>NPI</code>: This is the NPI ("National Provider Identifier) of the given provider;</li>
<li>
<code>HCPCS_CODE</code>: the procedure code of the service;</li>
<li>
<code>LINE_SRVC_CNT</code>: the number of times the service was performed;</li>
<li>
<code>BENE_UNIQUE_CNT</code>: the number of unique Medicare beneficiaries receiving the service from the given provider.</li>
</ol>
</li>
<li>
<em>Medicare Pharmacy Claims</em> :The second data set, contained in <code>npi_drugs.csv</code> contains records from 2013 indicating how many prescriptions each physician billed Medicare for a specific drug. The columns are:
<ol>
<li>
<code>NPI</code>: Same as in <code>npi_proc_counts</code>;</li>
<li>
<code>DRUG_NAME</code>: the brand name of the drug in question;</li>
<li>
<code>GENERIC_NAME</code>: the generic name of the drug in question;</li>
<li>
<code>TOTAL_CLAIM_COUNT</code>: the total number of claims for the drug associated to the given provider.</li>
</ol>
</li>
</ol>
<p>In addition, there are some auxillary files that contain other helpful information
:</p>
<ol>
<li>
<code>hcpcs_lookup.csv</code> contains a lookup table for the HCPCS codes that show up in <code>npi_proc_counts.csv</code>. This will allow you to associate these codes with human-readable descriptions. The columns are:
<ol>
<li>
<code>HCPCS_CODE</code>: The HCPCS code in question;</li>
<li>
<code>HCPCS_DESCRIPTION</code>: a readable description of the code.</li>
</ol>
</li>
<li>
<code>npi_specialty.csv</code> contains a list of pairs <code>(npi, specialty)</code> which describes the given specialty of the physician referenced by the NPI. The columns are:
<ol>
<li>
<code>NPI</code>: The NPI of the given physician;</li>
<li>
<code>specialty</code>: the specialty of the given physician. </li>
</ol>
</li>
</ol>
<h2>
<a id="user-content-problem-statement" class="anchor" href="#problem-statement" aria-hidden="true"><span class="octicon octicon-link"></span></a>Problem Statement</h2>
<p>You should aim to spend approximately <em>2-3 hours</em> on this challenge. We'd like to mostly get a sense of how you approach problem solving and data analysis, so do not feel obligated to have produced a complete, perfect analysis in this short time span. You are welcome (and encouraged) to include a discussion of how you would proceed given more time. </p>
<h3>
<a id="user-content-main-goal" class="anchor" href="#main-goal" aria-hidden="true"><span class="octicon octicon-link"></span></a>Main Goal</h3>
<p>The primary objective of this exercise is as follows: There is a collection of doctors in <code>npi_specialty.csv</code> that are labelled as cardiologists, and we would like you to produce a generalizable method for distinguishing these doctors from the general population.</p>
<p>That is:</p>
<ul>
<li>If we were to give you the same data for another year, you ought to be able to give us a list of cardiologists using the same methodology (indeed, CMS has other years of similar Medicare data if you are interested in doing this). </li>
<li>This method should not rely on any external data that amounts to "hard-coding" the fact that the given doctors are cardiologists. </li>
<li>Ideally, there would be some aspects of this method that can be leveraged to provide some usable insights for how cardiologists behave relative to other specialties, but this is not a requirement.<br>
</li>
</ul>
<h3>
<a id="user-content-secondary-goals" class="anchor" href="#secondary-goals" aria-hidden="true"><span class="octicon octicon-link"></span></a>Secondary Goals</h3>
<p>In addition to the main problem, we would like you to discuss your analysis. Some things you might decide to talk about (but are not limited to) are: </p>
<ul>
<li>Why/how did you choose the classification procedure you decided on?</li>
<li>How is this generalizable?</li>
<li>What other types of data did you use/consider using in your analysis? What other data would you use (and how) if it were freely available to you? </li>
<li>If it is possible, are there interpretable components of your model that can be used for an understanding of how cardiologists are distinct from the general population of doctors?</li>
</ul>
<h3>
<a id="user-content-deliverables" class="anchor" href="#deliverables" aria-hidden="true"><span class="octicon octicon-link"></span></a>Deliverables</h3>
<p>Please provide:</p>
<ol>
<li>Your documented code used in the analysis;</li>
<li>Some discussion of your results as described above.</li>
</ol>
<p>These may be contained in the same document, and you may use whatever programming language / packages / document format you like. </p>
</article></body></html>