Calling AdhereR from Python 3

Dan Dediu

2020-05-12

Table of Contents

Introduction

While AdhereR is written in R and makes extensive use of various R packages and techniques (such as data.table and parallel processing), it is possible to use it from other programming languages and applications. This is accomplished through a very generic mecahnism that only requires the caller to be able to read and write files in a location of its choice and to invoke an external command with a set of arguments. These requirements are widely available in programming languages (such as C/C++, Java, Python 2 and 3, and R itself), can be accomplished from the scripting available in several applications (e.g., VBA in Microsoft Excel, STATA scripting or SAS programs), and works in similar ways across the major Operating Systems (Linux flavors, macOS/Mac OS X/OS X and Microsoft Windows).

We present here this generic mechanism using its reference implementation for Python 3. While this reference implementation is definitely useable in production environments, this can probably be improved both in terms of calling and passing data between Python and R, as well as in terms of the “pythonicity” of the Python side of the implementation. Nevertheless, we hope this implementation will be useful to users of Python that would like to access AdhereR without switching to R, and will provide a template and working example for further implementations that aim to make AdhereR available to other programming languages and platforms.

General ideas

The mechanism is very general, and is based on a wrapper being available on the caller platform (here, Python 3) that performs the following general tasks:

The full protocol is detailed in Appendix I.

Fundamentals of calling AdhereR from Python 3

We will use here a macOS setup for illustration purposes, but this is very similar on the other supported OSs. Essentially, the Python 3 wrapper creates the input files parameters.log and dataset.csv in the data sharing directory (let us denote it as DATA_SHARING_DIRECTORY, by default, a unique temorary directory). Let’s assume that DATA_SHARING_DIRECTORY is set to /var/folders/kx/bphryt7j5tz1n_fcjk5809940000gn/T/adherer-qmx4pw7t; then, before calling AdhereR, this directory should contain the files:

~
 |-parameters.log
 \-dataset.csv

Please note that R must be properly installed on the system such that Rscript (or Rscript.exe on Windows) does exist and works; the Python 3 wrapper tries to locate it using a variety of strategies (in order, which, followed by a set of standard locations on macOS and Linux or a set of standard Windows Registry Keys on MS Windows) but if this fails or if the user wants to use a non-standard R installation, the wrapper allows this through the exported function set_rscript_path(). Let’s assume for now that Rscript is located in /usr/local/bin/Rscript and its automatic detection was successful (let us denote this path as RSCRIPT_PATH).

With these path variables automatically or manually set, the Python 3 wrapper is ready to call AdhereR:

import subprocess # allow shell calls

[...]

# Call adhereR:
rscript_cmd = '"' + RSCRIPT_PATH + '"' + ' --vanilla -e ' + \
              '"library(AdhereR); ' + \
              `callAdhereR(` + DATA_SHARING_DIRECTORY + '\')"'
return_code = subprocess.call(rscript_cmd, shell=True)

When the Rscript process returns, return_code should be 0 for success (in the sense of calling AdhereR, not in the sense that AdhereR also succeeded in the task it was assigned to do) or something else for errors.

If return_code != 0, the process returns with a warning. Otherwise, an attempt is made to read the messages produced by AdhereR (available in the Adherer-results.txt file in the DATA_SHARING_DIRECTORY directory) and checking if the last line begins with OK:. If it does not, a warning contaning the messages is thrown and the process returns.

If it does, the appropriate output files are read, parsed and loaded (depending on the invoked function, these files might differ). For example, after successfully invoking CMA1, the DATA_SHARING_DIRECTORY might look like:

~
 |-parameters.log
 |-dataset.csv
 |-Adherer-results.txt
 \-CMA.csv

In this example, the wrapper would parse and load CMA.csv as a pandas table:

import pandas # load pandas

[...]

# Expecting CMA.csv
ret_val['CMA'] = pandas.read_csv(os.path.join(path_to_data_directory,
                                              'CMA.csv'), sep='\t', header=0)

If plotting was requested, the resulting plot is also loaded using the PIL/Pillow library:

from PIL import Image # load images

[...]

# Load the produced image (if any):
ret_val['plot'] = Image.open(os.path.join((plot_save_to
                                          if not (plot_save_to is None) else
                                          DATA_SHARING_DIRECTORY),
                                          'adherer-plot' + '.' + plot_save_as))

where plot_save_to and plot_save_as may specify where the plots are to be saved and in which format.

The Python 3 wrapper: the adherer module

The reference implementation is contained in single file (adherer.py) included with the R AdhereR package and whose location can be obtained using the function getCallerWrapperLocation(full.path=TRUE) from AdhereR (N.B. it is located in the directory where the AdhereR package is installed on the system, subdirectory wrappers/python3/adherer.py; for example, on the example macos machine this is /Library/Frameworks/R.framework/Versions/3.4/Resources/library/AdhereR/wrappers/python3/adherer.py). In the future, as more wrappers are added, the argument callig.platform will allow the selection of the desired wrapper (now it is implicitely set to python3).

This file can be either:

On the example macos machine, this can be achiveded by adding:

# Add AdhereR to PYTHONPATH
export PYTHONPATH=$PYTHONPATH:/Library/Frameworks/[...]/AdhereR/wrappers/python3

to the .bash_profile file in the user’s home folder (if this file does not exist, then it can be created using a text editor such as nano; please note that the [...] are for shortening the path and should be replaced by the actual path given in full above). The process should be very simular on Linux, while on MS Windows one should use the system’s “Environment Variables” settings (for example, see here for details).

NOTE: we will consistently use AdhereR to refer to the R package, and adherer to refer to the Python 3 module.

Importing the adherer module and initializations

Thus, the reference implementation is technically a module called adherer that can be imported in your code (we assume here the recommended solution, but see above for other ways of doing it):

When the adherer module is imported for the first time, it runs the following initialization code:

  1. it tries to autodetect the location where R is installed on the system. More precisely, it looks for Rscript (or Rscript.exe on Windows) using several strategies, in order: which, followed by a set of standard locations on macOS (/usr/bin/Rscript, /usr/local/bin/Rscript, /opt/local/bin/Rscript and /Library/Frameworks/R.framework/Versions/Current/Resources/bin/Rscript) and Linux (/usr/bin/Rscript, /usr/local/bin/Rscript, /opt/local/bin/Rscript and ~/bin/Rscript) or a set of standard Windows Registry Keys on MS Windows (HKEY_CURRENT_USER\SOFTWARE\R-core\R, HKEY_CURRENT_USER\SOFTWARE\R-core\R32, HKEY_CURRENT_USER\SOFTWARE\R-core\R64, HKEY_LOCAL_MACHINE\SOFTWARE\R-core\R, HKEY_LOCAL_MACHINE\SOFTWARE\R-core\R32 and HKEY_LOCAL_MACHINE\SOFTWARE\R-core\R64) which should contain Current Version and InstallPath (with the added complexity that 64 bits Windows hists both 32 and 64 bits regsistries). This procedure is inspired by the way RStudio checks for R: - if this process fails, a warning is thrown instructing the user to manually set the path using the set_rscript_path() function exposed by the adherer module, and sets the internal variable _RSCRIPT_PATH to None (which insures that all future calls to AdhereR will fail; - if the process succeeds, it checks if the AdhereR package is installed for the detected R and has a correct version:
    • if this check fails, an appropriate warning is thrown and _RSCRIPT_PATH is set to None;
    • if it succeeds, continue to step (2) below.
  2. it tries to create a temporary directory (with prefix adherer-) with read and write access for the current user: - if this fails, it throws a warning instructing the user to manually set this to a directory with read & write access using the set_data_sharing_directory() function, and sets the internal variable _DATA_SHARING_DIRECTORY to None (ensuring that calls to AdhereR will fail); - if it succeeds, the initialization code is considered to have finished successfully; also, on exit this temporary _DATA_SHARING_DIRECTORY is automatically deleted.

The class hierarchy

The adherer module tries to emulate the same philosophy as the AhereR package, where various types of CMAs (“continuous multiple-interval measures of medication availability/gaps”) that implement different ways of computing adherence encapsulate the data on which they were computed, the various relevant parameter values used, as well as the results of the computation.

Here, we implemented this through the following class hierarchy (image generated with pyreverse, not showing the private attributes):

class hierarchy

We will discuss now the main classes in turn.

The CallAdhereRError exception class

Errors in the adherer code are signalled by throwing CallAdhereRError exceptions (the red class shown in the bottom right corner).

The base class CMA0

All classes that implement ways to compute adherence (CMAs) are derived from CMA0. CMA0 does not in itself compute any sort of adherence, but instead provides the infrastructure for storing the data, parameter values and results (including errors), and for interacting with AdhereR. Please note that in the “higher” CMAs, the class constructor __init()__ implicitely performs the actual computation of the CMA and saves the results (for CMA0 there are no such computations and `init()’ only saves the parameters internally)!

  1. storage of data and parameter values: CMA0 allows the user to set various parameters through the constructor __init()__, parameters that are stored for later use, printing, saving, and for facilitating easy reconstruction of all types of computations. By main groups, these are (please, see the manual entry for ?CMA0 in the AdhereR package and the full protocol in Appendix I as well):
- `dataset` stores the primary data (as a `Pandas` table with various columns) containing the actual events; must be given;

- `id_colname`, `event_date_colname`, `event_duration_colname`, `event_daily_dose_colname` and `medication_class_colname`: these give the *names* of the columns in the `dataset` table containing important information about the events (the first three are required, the last two are optional);

- `carryover_within_obs_window`, `carryover_into_obs_window`, `carry_only_for_same_medication`, `consider_dosage_change`, `medication_change_means_new_treatment_episode`, `maximum_permissible_gap`, `maximum_permissible_gap_unit`: optional parameters defining the types of carry-over, changes and treatment episode triggers;

- `followup_window_start_type`, `followup_window_start `followup_window_start_unit`, `followup_window_duration_type `followup_window_duration`, `followup_window_duration_unit`, `observation_window_start_type`, `observation_window_start`, `observation_window_start_unit `observation_window_duration_type`, `observation_window_duration`, `observation_window_duration_unit`: optional parameters defining the follow-up and observation windows;

- `sliding_window_start_type`, `sliding_window_start`, `sliding_window_start_unit`, `sliding_window_duration_type`, `sliding_window_duration`, `sliding_window_duration_unit`, `sliding_window_step_duration_type`, `sliding_window_step_duration`, `sliding_window_step_unit`, `sliding_window_no_steps`: optional parameters defining the sliding windows;

- `cma_to_apply`: optional parameter specifying which "simple" `CMA` is to be used when computing sliding windos and treatment episodes;

- `date_format`: optional parameter describing the format of column dates in `dataset` (defaults to month/day/year);

- `event_interval_colname`, `gap_days_colname`: optional parameters allowing the user to change the names of the columns where these computed data are stored in the resuling table;

- `force_na_cma_for_failed_patients`, `keep_window_start_end_dates`, `remove_events_outside_followup_window`, `keep_event_interval_for_all_events`: optional parameters governing the content of the resuling table;

- `parallel_backend`, `parallel_threads`: these optional parameters control the parallelism of the computations (if any); see **PARALLEL PROCESSING** for details;

- `suppress_warnings`: should all the internal warning be shown?

- `save_event_info`: should this "advanced" info be also made available?

- `na_symbol_numeric`, `na_symbol_string`, `logical_symbol_true`, `logical_symbol_false`, `colnames_dot_symbol`, `colnames_start_dot`: these optional parameters allow `AdhereR` to adapt to "non-`R`" conventions concerning the data format for missing values, logicals and column names;

- `path_to_rscript`, `path_to_data_directory`: these parameters allow the user to override the `_RSCRIPT_PATH` and `_DATA_SHARING_DIRECTORY` variables;

- `print_adherer_messages`: should the important messages be printed to the user as well?
  1. storage of, and access to, the results:
- `get_dataset()`: returns the internally saved `Pandas` table `dataset`;

- `get_cma()`: returns the computed `CMA` (if any);

- `get_event_info()`: returns the computed event information (if any);

- `get_treatment_episodes()`: returns the computed treatment episodes information (if any);

2.5. `get_computation_results()`: return the results of the last computation (if any); more precisely, a `dictionary` containing the numeric `code` returned by `AdhereR` and the string `messages` written by `AdhereR` during the computation;

  1. computing event interval and treatment episode info: this can be done by explicitelly calling the compute_event_int_gaps() and compute_treatment_episodes() functions;

  2. plotting:

- *static plotting*: this is realized by the `plot()` function that takes several plotting-specific parameters:

    + `patients_to_plot`: should a subset of the patients present in the `dataset` be plotted (by default, all will be)?
  
    + `save_to`, `save_as`, `width`, `height`, `quality`, `dpi`: where should the plot be saved, in what format, dimentions and quality?
  
    + `duration`, `align_all_patients`, `align_first_event_at_zero`, `show_period`, `period_in_days`: duration to plots and alignment of patients;
    
    + `show_legend`, `legend_x`, `legend_y`, `legend_bkg_opacity`: legend parameters;
    
    + `cex`, `cex_axis`, `cex_lab`: the relative size of various text elements;
    
    + `show_cma`, `print_cma`, `plot_cma`, `plot_cma_as_histogram`, `cma_plot_ratio`, `cma_plot_col`, `cma_plot_border`, `cma_plot_bkg`, `cma_plot_text`: should the cma be shown and how?
    
    + `unspecified_category_label`: implicit label of unlabelled categories?
    
    + `lty_event`, `lwd_event`, `pch_start_event`, `pch_end_event`, `show_event_intervals`, `col_na`, `col_continuation`, `lty_continuation`, `lwd_continuation`: visual aspects of events and continuations;
    
    + `highlight_followup_window`, `followup_window_col`, `highlight_observation_window`, `observation_window_col`, `observation_window_density`, `observation_window_angle`, `show_real_obs_window_start`, `real_obs_window_density`, `real_obs_window_angle`:  visual appearance of the follow-up, obervation and "real observation" windows (the latter for `CMA`s that djust it);
    
    + `bw_plot`: produce a grayscel plot?
    
 - *interactive plotting*: the `plot_interactive()` function launches a [Shiny](https://shiny.rstudio.com/)-powered interactive plot using the system's WEB browser; the only parameter `patient_to_plot` may specify which patient to show initially, as all the relevant parameters can be interactively altered ar run-time;

  1. printing: the __repr__() function implements a very simple printing mechanism showing the CMA type and a summary of the dataset;

  2. calling AdhereR: the private function _call_adherer() is the real workhorse that manages all the interaction with the R AdhereR package as described above. This function can take many parameters covering all that AdhereR can do, but it is not intended to be directly called by the end-user but instead to be internally called by various exposed functions such as plot(), compute_event_int_gaps() and __init()__. Roughly, after some checks, it creates the files needed for communication, calls AdhereR, analyses any errors, warnings and messages that it might have generated, and packs the results in a manageable format.

To preserve the generality of the interaction with AdhereR, all the CMA classes define a private static member _adherer_function which is the name of the corresponding S3 class as implemented in AdhereR.

Class CMA1 and its daughter classes CMA2, CMA3 and CMA4

CMA1 is derived from CMA0 by redefining the __init__() constructor to (a) take only a subset of arguments relevant for the CMAs 1–4 (see the AdhereR help for them), and (b) to internally call _call_adherer() with these parameters. It checks if the result of _call_adherer() signals an error, in which case ir throws a CallAdhereRError exception, otherwise packing the code, messages, cma and (possibly) event information in the corresponding member variables for later access.

Due to the generic mechanism implemented by _adherer_function, CMA2, CMA3 and CMA4 are derived directly from CMA1 but only redefine _adherer_function appropriately.

Class CMA5 and its daughter classes CMA6, CMA7, CMA8 and CMA9

The same story applies here, with CMA5 being derived from CMA0 and redefining __init__(), with CMA6–CMA9 only using the _adherer_function mechanism. Compared with CMA1, CMA5 defines new required arguments related to medication type and dosage.

Classes CMAPerEpisode and CMASlidingWindow

Just like CMA1 and CMA5, these two require specific parameters and are thus derived directly from CMA0 (but, in contrast, they don’t have their own derived classes).

Examples of use

Below we show some examples of using the Python 3 reference wrapper. We are using IPython from the Spyder 3 environment; the In [n]: represents the input prompt, the ...: the continuation of the input on the following line(s), and Out[n]: the produced output.

Basic usage

Export the test dataset from R and import it in Python

Let’s export the sample dataset med.events included in AdhereR as a TAB-separated CSV file in a location for use here (please note that this must be done from an R console, such as from RStudio, and not from Python!):

Now, back to Python:

All good so far, the data was imported successfully as a Pandas table.

Compute and plot test CMA

Now let’s compute CMA8 on these data in Python:

We can see that things went pretty well, as no exceptions were being thrown and the message starts with a reassuring Adherer returned code 0, followed by precisely what AdhereR said:

  • AdhereR 0.2.0 on R 3.4.3 started at 2018-06-04 22:27:10:: first, self-identification (its own version and R’s version), followed by the date and time the processing was initated;
  • OK: the results were exported successfully (but there might be warnings and messages above worth paying attention to)!, which means that basically all seems allright but that there might still be some messages or warning displayed above that could be informative or point to subtler issues.

Let’s see how these results look like:

The output produced in this case (Out[11]) consists of the actual image plotted in the IPython console (thanks to the PIL/Pillow package) and reproduced below: static plotting in Python

Now, we turn again to R:

Again, the output is an image (here, shown in the “Plots” panel in RStudio): static plotting in R

It can be seen that, except for the slightly different dimensions (and x/y ratio and quality) due to the actual plotting and exporting, the images show identical patterns.

Interactive plotting

We will initate now an interactive plotting session from Python:

The output is represented by an interactive session in the default browser; below is a screenshot of this session in Firefox: interactive plotting screenshot The interactive session ends by pressing the “Exit” button in the browser (and optinally also closing the browser tab/window), at which point the usual text output is provided to Python and a True value signalling success is returned:

Please note that it does not matter how the interactive session is started, as it only needs access to the base CMA0 object and, more precisely, the raw dataset; all relevant parameters, including the CMA type can be changed interactively (this is why the CMA shown in the screenshot is CMA1 even if the function cma8.plot_interactive() was initiated from a CMA8 object).

Parallel processing (locally and on different machines)

AdhereR uses R’s parallel procesing capacities to split expensive computations and distribute them across multiple CPUs/cores in a single computer or even across a network of computers. As an example, we will compute here CMA1 across sliding windows on the whole dataset, first in R and then in Python 3.

Single thread on the local machine

The default mode of computation uses just a single CPU/core on the local machine.

Multi-threaded on the local machine

If the local machine has multiple CPUs/cores (even with hyperthreading), it might make sense to use them for lengthy computations. AdhereR can use several backends (as provided by the parallel package in R), of which the most used are “multicore” (preffered on Linux and macOS but currently not available on Windows) and “SNOW” (on all three OS’s). AdhereR is smart enough to use “SNOW” on Windows even if “multicore” was requested.

Python 3
In [15]: # Sliding windows with CMA1 (two threads, multicore, locally):
    ...: cma1w_2ml = ad.CMASlidingWindow(dataset=df,
    ...:                                 cma_to_apply="CMA1",
    ...:                                 id_colname='PATIENT_ID',
    ...:                                 event_date_colname='DATE',
    ...:                                 event_duration_colname='DURATION',
    ...:                                 event_daily_dose_colname='PERDAY',
    ...:                                 medication_class_colname='CATEGORY',
    ...:                                 sliding_window_duration=30,
    ...:                                 sliding_window_step_duration=30,
    ...:                                 parallel_backend="multicore",  # <--- multicore
    ...:                                 parallel_threads=2)
    ...:                                 
Adherer returned code 0 and said:
AdhereR  0.2.0 on R 3.4.3 started at 2018-06-07 11:44:49:
OK: the results were exported successfully (but there might be warnings and messages above worth paying attention to)!


In [16]: cma1w_2ml.get_cma().head(6)
Out[16]: 
   PATIENT_ID  window.ID window.start  window.end        CMA
0           1          1   04/26/2033  05/26/2033        NaN
1           1          2   05/26/2033  06/25/2033        NaN
2           1          3   06/25/2033  07/25/2033        NaN
3           1          4   07/25/2033  08/24/2033   2.142857
4           1          5   08/24/2033  09/23/2033        NaN
5           1          6   09/23/2033  10/23/2033  10.000000

In [17]: # Sliding windows with CMA1 (two threads, snow, locally):
    ...: cma1w_2sl = ad.CMASlidingWindow(dataset=df,
    ...:                                 cma_to_apply="CMA1",
    ...:                                 id_colname='PATIENT_ID',
    ...:                                 event_date_colname='DATE',
    ...:                                 event_duration_colname='DURATION',
    ...:                                 event_daily_dose_colname='PERDAY',
    ...:                                 medication_class_colname='CATEGORY',
    ...:                                 sliding_window_duration=30,
    ...:                                 sliding_window_step_duration=30,
    ...:                                 parallel_backend="snow",  # <--- SNOW
    ...:                                 parallel_threads=2)
    ...:                                 
Adherer returned code 0 and said:
AdhereR  0.2.0 on R 3.4.3 started at 2018-06-07 11:44:49:
OK: the results were exported successfully (but there might be warnings and messages above worth paying attention to)!


In [18]: cma1w_2sl.get_cma().head(6)
Out[18]: 
   PATIENT_ID  window.ID window.start  window.end        CMA
0           1          1   04/26/2033  05/26/2033        NaN
1           1          2   05/26/2033  06/25/2033        NaN
2           1          3   06/25/2033  07/25/2033        NaN
3           1          4   07/25/2033  08/24/2033   2.142857
4           1          5   08/24/2033  09/23/2033        NaN
5           1          6   09/23/2033  10/23/2033  10.000000
Parallel on remote machines over a network

Sometimes it is better to use one or more powerful machines over a network to do very expensive computations, usually, a Linux cluster from a Windows/macos laptop. AdhereR leverages the power of R’s snow package (as exposed through the parallel package) to distribute workloads across a network of computing nodes. There are several types of “Simple Network of Workstations” (snow), described in the package’s manual. For example, one may use an already existing MPI (Message Passing Interface) cluster, but an even simpler setup (and the one that we will illustrate here) involves a collection of machines running Linux and connected to a network (local or even over the Internet).

The machines are called workhorse1 and workhorse2, have differen hardware configurations (both sport quad-core i7 CPUs of different generations with 16Gb RAM) but run the same version of Ubuntu 16.04 and R 3.4.2 (not a requirement, as the architecture can be seriously heterogeneous, combining different OS’s and versions of R). These two machines are connected to the same WiFi router (but they could be on different networks or even across the Internet). The “master” is the same macOS laptop used before, connected to the same WiFi router (not a requirement).

As pre-requisites, the worker machines should allow SSH access (for easiness, we use here passwordless SSH access from the “master”; see for example here for this setup) and should have the snow package installed in R. Let’s assume that the username allowing ssh into the workers is user, so that

works with no password needed. With these, we can distribute our processing to the two “workers” (two parallel threads for each, totalling 4 parallel threads):

Python 3

A quick for Python is that due to the communication protocol between the wrapper and AdhereR, the specification of the computer cluster must be a one-line string literally contaning the R code defining it, string that will be verbatim parsed and interpreted by AdhereR:

Some caveats for over-the-network distributed computation

While this is a very good way to transparently distribute processing to more powerful nodes over a network, there are several (potential) issues one must be aware of:

  • it may be very hard to debug failures: failures of this might result from network issues, firewals blocking connections, incorrect SSH setup on the “workers” or errors in accesing the “workers” with the given user accounts; see, for examples, discussion here and here in case you need to solve such problems;

  • latency over the network: starting the “workers” and especially transmitting the data to the “workers” and the results back to the “master” may take a non-negligible time, especially on slow networks (such as the Internet) and for large datasets; therefore, the best scenarios would involve relatively large computations (but not too large; see below) distributed to several nodes over a fast network;

  • you need to wait for the results: this process assumes that the “master” will wait for the “workers” to finish and return their results; thus, putting the “master” to sleep, shutting it down or disconnecting it from the network will probably result in not being able to collect the resuls back. If one needs very long computations (say 3+ hours), offline mobility or the network is unreliable, we would suggest setting up a separate compute process (that may itself parallelise computations) on the remote machines using, for example, screen, nohup or a more specialised cluster management platform such as Son of a Grid Engine (SGE).

Appendix I: the communication protocol

Context

All arguments are written to the text file parameters.log; the input data are in the TAB-separated no quotes file dataset.csv. The call returns any errors, warning and messages in the text file Adherer-results.txt file, and the actual results as TAB-separated no quotes files (not all necessarily produced, depending on the specific methods called) CMA.csv, EVENTINFO.csv and TREATMENTEPISODES.csv, and various image file(s). The argument values in the parameters.log are contained between single (' ') or double (" ") quotes.

Protocol

PARAMETERS1

Some are required and must be explicitly defined, but for most we can use implicit values (i.e., if the user doesn’t set them explicitly, we may simply not specify them to the parameters.log file and the default values in AdhereR will be used).

COMMENTS

Everything on a line following /// or # is considered a comment and ignored (except when included within quotes " " or ' ').

SPECIAL PARAMETERS2

PARAMETER MEANING DEFAULT VALUE IF MISSING PYHTON 3 STATA
NA.SYMBOL.NUMERIC the numeric missing data symbol NA NA .
NA.SYMBOL.STRING the string missing data symbol NA NA ""
LOGICAL.SYMBOL.TRUE the logical TRUE symbol TRUE TRUE 1
LOGICAL.SYMBOL.FALSE the logical FALSE symbol FALSE FALSE 0
COLNAMES.DOT.SYMBOL can we use . in column names, and if not, what to replace it with? . . _
COLNAMES.START.DOT can begin column names with . (or equivalent symbol), and if not, what to replace it with? . . internal_

FUNCTIONS

Possible values are:

  • CMA0,
  • CMA1 …CMA9,
  • CMA_per_episode,
  • CMA_sliding_window,
  • compute.event.int.gaps,
  • compute.treatment.episodes and
  • plot_interactive_cma.

PLOTTING

For all the CMA functions (i.e., CMA0, CMA1 …CMA9, CMA_per_episode, CMA_sliding_window) one can ask for a plot of (a subset) of the patients, in which case the parameter plot.show must be TRUE, and there are several plotting-specific parameters that can be set:

PARAMETER REQUIRED DEFAULT_VALUE POSSIBLE_VALUES
function YES "CMA0" can also be "CMA0" for plotting!
plot.show NO "FALSE" [do the plotting? If TRUE, save the resulting dataset with a "-plotted" suffix to avoid overwriting previous results]
plot.save.to NO "" [the folder where to save the plots (by default, same folder as the results)]
plot.save.as NO "jpg" "jpg", "png", "tiff", "eps", "pdf" [the type of image to save]
plot.width NO "7" [plot width in inches]
plot.height NO "7" [plot height in inches]
plot.quality NO "90" [plot quality (applies only to some types of plots]
plot.dpi NO "150" [plot DPI (applies only to some types of plots]
plot.patients.to.plot NO "" [the patient IDs to plot (if missing, all patients) given as "id1;id2; .. ;idn"]
plot.duration NO "" [duration to plot in days (if missing, determined from the data)]
plot.align.all.patients NO "FALSE" [should all patients be aligned? and, if so, place the first event as the horizontal 0?]
plot.align.first.event.at.zero NO "TRUE"
plot.show.period NO "days" "dates", "days" [draw vertical bars at regular interval as dates or days?]
plot.period.in.days NO "90" [the interval (in days) at which to draw vertical lines]
plot.show.legend NO "TRUE" [legend params and position]
plot.legend.x NO "bottom right"
plot.legend.y NO ""
plot.legend.bkg.opacity NO "0.5" [background opacity]
plot.cex NO "1.0" [various plotting font sizes]
plot.cex.axis NO "0.75"
plot.cex.lab NO "1.0"
plot.show.cma NO "TRUE" [show the CMA type]
plot.unspecified.category.label NO "drug" [the label of the unspecified category of medication]
plot.lty.event NO "solid" [style parameters controlling the plotting of events]
plot.lwd.event NO "2"
plot.pch.start.event NO "15"
plot.pch.end.event NO "16"
plot.show.event.intervals NO "TRUE" [show the actual prescription intervals]
plot.col.na NO "lightgray" [colour for missing data]
plot.col.continuation NO "black" [colour, style and width of the continuation lines connecting consecutive events]
plot.lty.continuation NO "dotted"
plot.lwd.continuation NO "1"
plot.print.CMA NO "TRUE" [print CMA next to the participant’s ID?]
plot.plot.CMA NO "TRUE" [plot the CMA next to the participant ID?]
plot.plot.CMA.as.histogram NO "TRUE" [lot CMA as a histogram or as a density plot?]
plot.CMA.plot.ratio NO "0.10" [the proportion of the total horizontal plot to be taken by the CMA plot]
plot.CMA.plot.col NO "lightgreen" [attributes of the CMA plot]
plot.CMA.plot.border NO "darkgreen"
plot.CMA.plot.bkg NO "aquamarine"
plot.CMA.plot.text NO "" [by default, the same as plot.CMA.plot.border]
plot.highlight.followup.window NO "TRUE"
plot.followup.window.col NO "green"
plot.highlight.observation.window NO "TRUE"
plot.observation.window.col NO "yellow"
plot.observation.window.density NO "35"
plot.observation.window.angle NO "-30"
plot.show.real.obs.window.start NO "TRUE" [for some CMAs, the real observation window starts at a different date]
plot.real.obs.window.density NO "35"
plot.real.obs.window.angle NO "30"
plot.bw.plot NO "FALSE" [if TRUE, override all user-given colours and replace them with a scheme suitable for grayscale plotting]

CMA1, CMA2, CMA3, CMA4

The parameters for these functions are (N.B.: the plotting parameters can also appear if plotting is required):

PARAMETER REQUIRED DEFAULT_VALUE POSSIBLE_VALUES
ID.colname YES
event.date.colname YES
event.duration.colname YES
followup.window.start.type NO "numeric" "numeric", "character", "date"
followup.window.start NO 0
followup.window.start.unit NO "days" "days", "weeks", "months", "years"
followup.window.duration.type NO "numeric" "numeric", "character", "date"
followup.window.duration NO "365 * 2"
followup.window.duration.unit NO "days" "days", "weeks", "months", "years"
observation.window.start.type NO "numeric" "numeric", "character", "date"
observation.window.start NO 0
observation.window.start.unit NO "days" "days", "weeks", "months", "years"
observation.window.duration.type NO "numeric" "numeric", "character", "date"
observation.window.duration NO "365 * 2"
observation.window.duration.unit NO "days" "days", "weeks", "months", "years"
date.format NO "%m/%d/%Y"
event.interval.colname NO "event.interval"
gap.days.colname NO "gap.days"
force.NA.CMA.for.failed.patients NO "TRUE"
parallel.backend NO "none" "none", "multicore", "snow", "snow(SOCK)", "snow(MPI)", "snow(NWS)"
parallel.threads NO "auto"
suppress.warnings NO "FALSE"
save.event.info NO "FALSE"
RETURN VALUE(S) FILE OBSERVATIONS
Errors, warnings and other messages Adherer-results.txt Possibly more than one line; if the processing was successful, the last line must begin with OK:
The computed CMAs, as a TAB-separated no quotes CSV file CMA.csv Always generated in case of successful processing
The gap days and event info data, as a TAB-separated no quotes CSV file EVENTINFO.csv Only by explicit request (i.e., save.event.info = "TRUE")

CMA5, CMA6, CMA7, CMA8, CMA9

The parameters for these functions are (N.B.: the plotting parameters can also appear if plotting is required):

PARAMETER REQUIRED DEFAULT_VALUE POSSIBLE_VALUES
ID.colname YES
event.date.colname YES
event.duration.colname YES
event.daily.dose.colname YES
medication.class.colname YES
carry.only.for.same.medication NO "FALSE"
consider.dosage.change NO "FALSE"
followup.window.start.type NO "numeric" "numeric", "character", "date"
followup.window.start NO 0
followup.window.start.unit NO "days" "days", "weeks", "months", "years"
followup.window.duration.type NO "numeric" "numeric", "character", "date"
followup.window.duration NO "365 * 2"
followup.window.duration.unit NO "days" "days", "weeks", "months", "years"
observation.window.start.type NO "numeric" "numeric", "character", "date"
observation.window.start NO 0
observation.window.start.unit NO "days" "days", "weeks", "months", "years"
observation.window.duration.type NO "numeric" "numeric", "character", "date"
observation.window.duration NO "365 * 2"
observation.window.duration.unit NO "days" "days", "weeks", "months", "years"
date.format NO "%m/%d/%Y"
event.interval.colname NO "event.interval"
gap.days.colname NO "gap.days"
force.NA.CMA.for.failed.patients NO "TRUE"
parallel.backend NO "none" "none", "multicore", "snow", "snow(SOCK)", "snow(MPI)", "snow(NWS)"
parallel.threads NO "auto"
suppress.warnings NO "FALSE"
save.event.info NO "FALSE"
RETURN VALUE(S) FILE OBSERVATIONS
Errors, warnings and other messages Adherer-results.txt Possibly more than one line; if the processing was successful, the last line must begin with OK:
The computed CMAs, as a TAB-separated no quotes CSV file CMA.csv Always generated in case of successful processing
The gap days and event info data, as a TAB-separated no quotes CSV file EVENTINFO.csv Only by explicit request (i.e., save.event.info = "TRUE")

CMA_per_episode

The parameters for this function are (N.B.: the plotting parameters can also appear if plotting is required):

PARAMETER REQUIRED DEFAULT_VALUE POSSIBLE_VALUES
CMA.to.apply YES CMA1, CMA2, CMA3, CMA4, CMA5, CMA6, CMA7, CMA8, CMA9
ID.colname YES
event.date.colname YES
event.duration.colname YES
event.daily.dose.colname YES
medication.class.colname YES
carry.only.for.same.medication NO "FALSE"
consider.dosage.change NO "FALSE"
medication.change.means.new.treatment.episode NO "TRUE"
maximum.permissible.gap NO "90"
maximum.permissible.gap.unit NO "days" "days", "weeks", "months", "years", "percent"
followup.window.start.type NO "numeric" "numeric", "character", "date"
followup.window.start NO 0
followup.window.start.unit NO "days" "days", "weeks", "months", "years"
followup.window.duration.type NO "numeric" "numeric", "character", "date"
followup.window.duration NO "365 * 2"
followup.window.duration.unit NO "days" "days", "weeks", "months", "years"
observation.window.start.type NO "numeric" "numeric", "character", "date"
observation.window.start NO 0
observation.window.start.unit NO "days" "days", "weeks", "months", "years"
observation.window.duration.type NO "numeric" "numeric", "character", "date"
observation.window.duration NO "365 * 2"
observation.window.duration.unit NO "days" "days", "weeks", "months", "years"
date.format NO "%m/%d/%Y"
event.interval.colname NO "event.interval"
gap.days.colname NO "gap.days"
force.NA.CMA.for.failed.patients NO "TRUE"
parallel.backend NO "none" "none", "multicore", "snow", "snow(SOCK)", "snow(MPI)", "snow(NWS)"
parallel.threads NO "auto"
suppress.warnings NO "FALSE"
save.event.info NO "FALSE"
RETURN VALUE(S) FILE OBSERVATIONS
Errors, warnings and other messages Adherer-results.txt Possibly more than one line; if the processing was successful, the last line must begin with OK:
The computed CMAs, as a TAB-separated no quotes CSV file CMA.csv Always generated in case of successful processing
The gap days and event info data, as a TAB-separated no quotes CSV file EVENTINFO.csv Only by explicit request (i.e., save.event.info = "TRUE")

CMA_sliding_window

The parameters for this function are (N.B.: the plotting parameters can also appear if plotting is required):

PARAMETER REQUIRED DEFAULT_VALUE POSSIBLE_VALUES
CMA.to.apply YES CMA1, CMA2, CMA3, CMA4, CMA5, CMA6, CMA7, CMA8, CMA9
ID.colname YES
event.date.colname YES
event.duration.colname YES
event.daily.dose.colname YES
medication.class.colname YES
carry.only.for.same.medication NO "FALSE"
consider.dosage.change NO "FALSE"
followup.window.start.type NO "numeric" "numeric", "character", "date"
followup.window.start NO 0
followup.window.start.unit NO "days" "days", "weeks", "months", "years"
followup.window.duration.type NO "numeric" "numeric", "character", "date"
followup.window.duration NO "365 * 2"
followup.window.duration.unit NO "days" "days", "weeks", "months", "years"
observation.window.start.type NO "numeric" "numeric", "character", "date"
observation.window.start NO 0
observation.window.start.unit NO "days" "days", "weeks", "months", "years"
observation.window.duration.type NO "numeric" "numeric", "character", "date"
observation.window.duration NO "365 * 2"
observation.window.duration.unit NO "days" "days", "weeks", "months", "years"
sliding.window.start.type NO "numeric" "numeric", "character', "date'
sliding.window.start NO 0
sliding.window.start.unit NO "days" "days", "weeks", "months", "years"
sliding.window.duration.type NO "numeric" "numeric", "character", "date"
sliding.window.duration NO "90"
sliding.window.duration.unit NO "days" "days", "weeks", "months", "years"
sliding.window.step.duration.type NO "numeric" "numeric", "character"
sliding.window.step.duration NO "30"
sliding.window.step.unit NO "days" "days", "weeks", "months", "years"
sliding.window.no.steps NO "-1"
date.format NO "%m/%d/%Y"
event.interval.colname NO "event.interval"
gap.days.colname NO "gap.days"
force.NA.CMA.for.failed.patients NO "TRUE"
parallel.backend NO "none" "none", "multicore", "snow", "snow(SOCK)", "snow(MPI)", "snow(NWS)"
parallel.threads NO "auto"
suppress.warnings NO "FALSE"
save.event.info NO "FALSE"
RETURN VALUE(S) FILE OBSERVATIONS
Errors, warnings and other messages Adherer-results.txt Possibly more than one line; if the processing was successful, the last line must begin with OK:
The computed CMAs, as a TAB-separated no quotes CSV file CMA.csv Always generated in case of successful processing
The gap days and event info data, as a TAB-separated no quotes CSV file EVENTINFO.csv Only by explicit request (i.e., save.event.info = "TRUE")

compute_event_int_gaps

This function is intended for advanced users only; the parameters for this function are:

PARAMETER REQUIRED DEFAULT_VALUE POSSIBLE_VALUES
ID.colname YES
event.date.colname YES
event.duration.colname YES
event.daily.dose.colname NO
medication.class.colname NO
carryover.within.obs.window NO "FALSE"
carryover.into.obs.window NO "FALSE"
carry.only.for.same.medication NO "FALSE"
consider.dosage.change NO "FALSE"
followup.window.start.type NO "numeric" "numeric", "character", "date"
followup.window.start NO "0"
followup.window.start.unit NO "days" "days", "weeks", "months", "years"
followup.window.duration.type NO "numeric" "numeric", "character", "date"
followup.window.duration NO "365 * 2"
followup.window.duration.unit NO "days" "days", "weeks", "months", "years"
observation.window.start.type NO "numeric" "numeric", "character", "date"
observation.window.start NO "0"
observation.window.start.unit NO "days" "days", "weeks", "months", "years"
observation.window.duration.type NO "numeric" "numeric", "character", "date"
observation.window.duration NO "365 * 2"
observation.window.duration.unit NO "days" "days", "weeks", "months", "years"
date.format NO "%m/%d/%Y"
keep.window.start.end.dates NO "FALSE"
remove.events.outside.followup.window NO "TRUE"
keep.event.interval.for.all.events NO "FALSE"
event.interval.colname NO "event.interval"
gap.days.colname NO "gap.days"
force.NA.CMA.for.failed.patients NO "TRUE"
parallel.backend NO "none " "none", "multicore", "snow", "snow(SOCK)", "snow(MPI)", "snow(NWS)"
parallel.threads NO "auto"
suppress.warnings NO "FALSE"
RETURN VALUE(S) FILE OBSERVATIONS
Errors, warnings and other messages Adherer-results.txt Possibly more than one line; if the processing was successful, the last line must begin with OK:
The gap days and event info data, as a TAB-separated no quotes CSV file EVENTINFO.csv In this case, always returned is successful

compute_treatment_episodes

This function is intended for advanced users only; the parameters for this function are:

PARAMETER REQUIRED DEFAULT_VALUE POSSIBLE_VALUES
ID.colname YES
event.date.colname YES
event.duration.colname YES
event.daily.dose.colname NO
medication.class.colname NO
carryover.within.obs.window NO "FALSE"
carryover.into.obs.window NO "FALSE"
carry.only.for.same.medication NO "FALSE"
consider.dosage.change NO "FALSE"
medication.change.means.new.treatment.episode NO "TRUE"
maximum.permissible.gap NO "90"
maximum.permissible.gap.unit NO "days" "days", "weeks", "months", "years", "percent"
followup.window.start.type NO "numeric" "numeric", "character", "date"
followup.window.start NO 0
followup.window.start.unit NO "days" "days", "weeks", "months", "years"
followup.window.duration.type NO "numeric" "numeric", "character", "date"
followup.window.duration NO "365 * 2"
followup.window.duration.unit NO "days" "days", "weeks", "months", "years"
observation.window.start.type NO "numeric" "numeric", "character", "date"
observation.window.start NO 0
observation.window.start.unit NO "days" "days", "weeks", "months", "years"
observation.window.duration.type NO "numeric" "numeric", "character", "date"
observation.window.duration NO "365 * 2"
observation.window.duration.unit NO "days" "days", "weeks", "months", "years"
date.format NO "%m/%d/%Y"
keep.window.start.end.dates NO "FALSE"
remove.events.outside.followup.window NO "TRUE"
keep.event.interval.for.all.events NO "FALSE"
event.interval.colname NO "event.interval"
gap.days.colname NO "gap.days"
force.NA.CMA.for.failed.patients NO "TRUE"
parallel.backend NO "none" "none", "multicore", "snow", "snow(SOCK)", "snow(MPI)", "snow(NWS)"
parallel.threads NO "auto"
suppress.warnings NO "FALSE"
RETURN VALUE(S) FILE OBSERVATIONS
Errors, warnings and other messages Adherer-results.txt Possibly more than one line; if the processing was successful, the last line must begin with OK:
The treatment episodes data, as a TAB-separated no quotes CSV file TREATMENTEPISODES.csv Always if successful

plot_interactive_cma

This function initiates the interactive plotting in AdhereR using Shiny: all the plotting will be done in the current internet browser and there are no results expected (except for errors, warnings and other messages). This function ignores the argument plot.show = "TRUE" and takes very few arguments of its own, as most of the relevant parameters can be set interactively through the Shiny interface.

PARAMETER REQUIRED DEFAULT_VALUE POSSIBLE_VALUES
patient_to_plot NO defaults to the first patient in the dataset
ID.colname YES
event.date.colname YES
event.duration.colname YES
event.daily.dose.colname NO
medication.class.colname NO
date.format NO "%m/%d/%Y"
followup.window.start.max NO integer >0
followup.window.duration.max NO integer >0
observation.window.start.max NO integer >0
observation.window.duration.max NO integer >0
maximum.permissible.gap.max NO integer >0
sliding.window.start.max NO integer >0
sliding.window.duration.max NO integer >0
sliding.window.step.duration.max NO integer >0

Appendix II: the Python 3 code

This annex lists the Python 3 code included in this vignette in an easy-to-run form (i.e., no In [], Out [] and prompts):

# Import adherer as ad:
import adherer as ad

# Show the _DATA_SHARING_DIRECTORY (should be set automatically to a temporary location):
ad._DATA_SHARING_DIRECTORY.name
# Show the _RSCRIPT_PATH (should be dectedt automatically):
ad._RSCRIPT_PATH


# Import Pandas as pd:
import pandas as pd
# Load the test dataset
df = pd.read_csv('~/Temp/med-events.csv', sep='\t', header=0)
# Let's look at first 6 rows (it should match the R output above except for the row names):
df.head(6)


# Compute CMA8 as a test:
cma8 = ad.CMA8(df,
               id_colname='PATIENT_ID',
               event_date_colname='DATE',
               event_duration_colname='DURATION',
               event_daily_dose_colname='PERDAY',
               medication_class_colname='CATEGORY')
# Summary of cma8:
cma8
# The return value and messages:
cma8.get_computation_results()
# The CMA (the first 6 rows out of all 100):
cma8.get_cma().head(6)
# Plot it (statically):
cma8.plot(patients_to_plot=['1', '2', '3'],
          align_all_patients=True,
          period_in_days=30,
          cex=0.5)

# Interactive plotting:
cma8.plot_interactive()


# Sliding windows with CMA1 (single thread, locally):
cma1w_1l = ad.CMASlidingWindow(dataset=df,
                               cma_to_apply="CMA1",
                               id_colname='PATIENT_ID',
                               event_date_colname='DATE',
                               event_duration_colname='DURATION',
                               event_daily_dose_colname='PERDAY',
                               medication_class_colname='CATEGORY',
                               sliding_window_duration=30,
                               sliding_window_step_duration=30,
                               parallel_backend="none",
                               parallel_threads=1)
cma1w_1l.get_cma().head(6)

# Sliding windows with CMA1 (two threads, multicore, locally):
cma1w_2ml = ad.CMASlidingWindow(dataset=df,
                                cma_to_apply="CMA1",
                                id_colname='PATIENT_ID',
                                event_date_colname='DATE',
                                event_duration_colname='DURATION',
                                event_daily_dose_colname='PERDAY',
                                medication_class_colname='CATEGORY',
                                sliding_window_duration=30,
                                sliding_window_step_duration=30,
                                parallel_backend="multicore",  # <--- multicore
                                parallel_threads=2)
cma1w_2ml.get_cma().head(6)

# Sliding windows with CMA1 (two threads, snow, locally):
cma1w_2sl = ad.CMASlidingWindow(dataset=df,
                                cma_to_apply="CMA1",
                                id_colname='PATIENT_ID',
                                event_date_colname='DATE',
                                event_duration_colname='DURATION',
                                event_daily_dose_colname='PERDAY',
                                medication_class_colname='CATEGORY',
                                sliding_window_duration=30,
                                sliding_window_step_duration=30,
                                parallel_backend="snow",  # <--- SNOW
                                parallel_threads=2)
cma1w_2sl.get_cma().head(6)

# Sliding windows with CMA1 (two remote machines with two threads each):
# The workers are defined as *literal R code* this is verbatim sent to AdhereR for parsing and interpretation
# Please note, however, that this string should not contain line breaks (i.e., it should be a one-liner):
workers = 'c(rep(list(list(host="workhorse1", user="user", rscript="/usr/local/bin/Rscript", snowlib="/usr/local/lib64/R/library/")), 2), rep(list(list(host="workhorse2", user="user", rscript="/usr/local/bin/Rscript", snowlib="/usr/local/lib64/R/library/")), 2))'
cma1w_2sw = ad.CMASlidingWindow(dataset=df,
                               cma_to_apply="CMA1",
                                id_colname='PATIENT_ID',
                                event_date_colname='DATE',
                                event_duration_colname='DURATION',
                                event_daily_dose_colname='PERDAY',
                                medication_class_colname='CATEGORY',
                                sliding_window_duration=30,
                                sliding_window_step_duration=30,
                                parallel_backend="snow",
                                parallel_threads=workers)
cma1w_2sw.get_cma().head(6)

Notes

  1. For more info on the parameters and their values for all these functions please see the AdhereR documentation and vignette.↩

  2. While this document concerns mainly Python 3, we also give the default values for other platforms, in particular STATA.↩