Objective: Develop a near-comprehensive opioid medications valueset for population measures of opioid related treatments and outcomes. The opioid valueset should be free, open source, and conform to the RxNorm standard federally mandated in every US-certified electronic health record. Materials and Methods: Cumulus opioid valueset was manually curated by the authors and expanded using computer assisted curation. Opioid classifier rules were developed to select opioid RxNorm concepts with known opioid receptor interactions, ingredients, keywords, and drug product formulations. Twelve publicly available valuesets were used to develop and validate the Cumulus opioid valueset. Validation accuracy was measured against a corpus of opioid medication orders and non-opioid pain relievers. Results: Cumulus opioid valueset recall was >99.9% when measured against opioid prescription RxNorm codes from UC Davis Health and Brigham and Women's Hospital. Cumulus opioid valueset was 100% specific compared to three valuesets of non-opioid pain relievers. Discussion and Conclusion: To the authors' knowledge, Cumulus opioid valueset is the largest publicly available valueset of opioid medications (8,926 RxNorm concepts). The intended use of this opioid valueset is for population health measures of opioid medications and related patient outcomes.

Elizabeth Sprouse is the founder of Double Lantern Informatics, a for-profit consulting firm, and served as a consultant to the CDC Foundation during this project. The author has no significant conflicts of interest that would affect the integrity of the research. All other authors declare no conflicts of interest.

This work was supported by the Office of the National Coordinator for Health Information Technology contract numbers 90AX0031/01-00, 90AX0022/01-00, and 90AX0040/01-00; Centers for Disease Control and Prevention of the United States Department of Health and Human Services (HHS) as part of a financial assistance award, Strengthened Community Partnerships for More Holistic Approaches to Interoperability totaling $1,985,178 (The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by the CDC Foundation, CDC/HHS, or the U.S. Government); The National Center for Advancing Translational Sciences/National Institutes of Health Cooperative Agreements U01TR002623 and U01TR002997; National Association of Chronic Disease Directors/Centers for Disease Control and Prevention Grant No. NU38OT000286; Centers for Disease Control and Prevention Grant No. U18DP006500; and Centers for Disease Control and Prevention Cooperative Agreement Nos. NU58IP000004 and 1U01TR002997-01A1.

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