Clinical review: Document BUN threshold discrepancy in LODS skill

[freshetomate17]

Summary

Clinical review of the LODS (Logistic Organ Dysfunction Score) skill with focus on scoring accuracy.

Changes Made

• SKILL.md: Added "Known Issue" documentation for BUN threshold discrepancy

  • Current MIMIC-Code implementation: BUN >= 7.5 mg/dL for renal Score 1
  • Original Le Gall 1996 publication: BUN >= 17 mg/dL for renal Score 1
  • This affects scoring accuracy for patients with BUN 7.5-16.9 mg/dL

• PROVENANCE.yaml: Created provenance tracking file

  • Added clinical review entry (Marlene Mörig, MD, 2026-02-11)
  • Documented scope: clinical-accuracy
  • Flagged issue for upstream correction in MIMIC-Code

Clinical Impact

Patients with BUN values between 7.5 and 16.9 mg/dL are currently receiving renal Score 1 when they should receive Score 0 according to the original publication. This may affect overall LODS score interpretation in research using this derived table.

Review Scope

• Verified against original Le Gall 1996 publication (Table 5)
• Identified unit conversion error (likely mg/dL vs mmol/L)
• Documented in both SKILL.md and PROVENANCE.yaml

Next Steps

This issue should be flagged with the MIT-LCP MIMIC-Code repository for correction in the derived tables