mimic-meld-24h-raw

Reference SQL (matched-content control)

The following block is the public reference SQL used to construct the ground truth for this task. It is provided verbatim, without procedural prose, to test whether matched task-relevant content alone explains the WITH-SKILL gain.

-- ------------------------------------------------------------------
-- Title: Model for End-Stage Liver Disease (MELD) score
-- This query extracts the MELD-Na score for the first 24 hours of
-- each ICU stay. MELD uses logarithmic transformations of creatinine,
-- bilirubin, and INR with a conditional sodium adjustment.
-- ------------------------------------------------------------------

-- Reference for MELD:
--    Kamath PS et al. "A model to predict survival in patients with
--    end-stage liver disease." Hepatology. 2001;33(2):464-470.
--    Kim WR et al. "Hyponatremia and mortality among patients on the
--    liver-transplant waiting list." NEJM. 2008;359(10):1018-1026.

-- Adapted from mimic-code meld.sql

WITH cohort AS (
    SELECT
        ie.subject_id,
        ie.hadm_id,
        ie.stay_id,
        labs.creatinine_max,
        labs.bilirubin_total_max,
        labs.inr_max,
        labs.sodium_min,
        r.dialysis_present AS rrt
    FROM mimiciv_icu.icustays AS ie
    LEFT JOIN mimiciv_derived.first_day_lab AS labs
        ON ie.stay_id = labs.stay_id
    LEFT JOIN mimiciv_derived.first_day_rrt AS r
        ON ie.stay_id = r.stay_id
)

, score AS (
    SELECT
        subject_id, hadm_id, stay_id,
        rrt, creatinine_max, bilirubin_total_max, inr_max, sodium_min,
        CASE
            WHEN sodium_min IS NULL THEN 0.0
            WHEN sodium_min > 137 THEN 0.0
            WHEN sodium_min < 125 THEN 12.0
            ELSE 137.0 - sodium_min
        END AS sodium_score,
        CASE
            WHEN rrt = 1 OR creatinine_max > 4.0
            THEN (0.957 * LN(4))
            WHEN creatinine_max < 1
            THEN (0.957 * LN(1))
            ELSE 0.957 * COALESCE(LN(creatinine_max), LN(1))
        END AS creatinine_score,
        CASE
            WHEN bilirubin_total_max < 1
            THEN 0.378 * LN(1)
            ELSE 0.378 * COALESCE(LN(bilirubin_total_max), LN(1))
        END AS bilirubin_score,
        CASE
            WHEN inr_max < 1
            THEN (1.120 * LN(1) + 0.643)
            ELSE (1.120 * COALESCE(LN(inr_max), LN(1)) + 0.643)
        END AS inr_score
    FROM cohort
)

, score2 AS (
    SELECT
        subject_id, hadm_id, stay_id,
        rrt, creatinine_max, bilirubin_total_max, inr_max, sodium_min,
        creatinine_score, sodium_score, bilirubin_score, inr_score,
        CASE
            WHEN (creatinine_score + bilirubin_score + inr_score) > 4
            THEN 40.0
            ELSE ROUND(TRY_CAST(creatinine_score + bilirubin_score + inr_score AS DECIMAL), 1) * 10
        END AS meld_initial
    FROM score
)

SELECT
    subject_id, hadm_id, stay_id
    , CASE
        WHEN meld_initial > 11
        THEN meld_initial + 1.32 * sodium_score - 0.033 * meld_initial * sodium_score
        ELSE meld_initial
    END AS meld
FROM score2
;