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Predicting adverse drug reactions in older adults; a systematic review of the risk prediction models

Adverse drug reaction (ADR) risk-prediction models for use in older adults have been developed, but it is not clear if they are suitable for use in clinical practice. This systematic review aimed to identify and investigate the quality of validated ADR risk-prediction models for use in older adults....

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Autores principales: Stevenson, Jennifer M, Williams, Josceline L, Burnham, Thomas G, Prevost, A Toby, Schiff, Rebekah, Erskine, S David, Davies, J Graham
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4178502/
https://www.ncbi.nlm.nih.gov/pubmed/25278750
http://dx.doi.org/10.2147/CIA.S65475
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author Stevenson, Jennifer M
Williams, Josceline L
Burnham, Thomas G
Prevost, A Toby
Schiff, Rebekah
Erskine, S David
Davies, J Graham
author_facet Stevenson, Jennifer M
Williams, Josceline L
Burnham, Thomas G
Prevost, A Toby
Schiff, Rebekah
Erskine, S David
Davies, J Graham
author_sort Stevenson, Jennifer M
collection PubMed
description Adverse drug reaction (ADR) risk-prediction models for use in older adults have been developed, but it is not clear if they are suitable for use in clinical practice. This systematic review aimed to identify and investigate the quality of validated ADR risk-prediction models for use in older adults. Standard computerized databases, the gray literature, bibliographies, and citations were searched (2012) to identify relevant peer-reviewed studies. Studies that developed and validated an ADR prediction model for use in patients over 65 years old, using a multivariable approach in the design and analysis, were included. Data were extracted and their quality assessed by independent reviewers using a standard approach. Of the 13,423 titles identified, only 549 were associated with adverse outcomes of medicines use. Four met the inclusion criteria. All were conducted in inpatient cohorts in Western Europe. None of the models satisfied the four key stages in the creation of a quality risk prediction model; development and validation were completed, but impact and implementation were not assessed. Model performance was modest; area under the receiver operator curve ranged from 0.623 to 0.73. Study quality was difficult to assess due to poor reporting, but inappropriate methods were apparent. Further work needs to be conducted concerning the existing models to enable the development of a robust ADR risk-prediction model that is externally validated, with practical design and good performance. Only then can implementation and impact be assessed with the aim of generating a model of high enough quality to be considered for use in clinical care to prioritize older people at high risk of suffering an ADR.
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spelling pubmed-41785022014-10-02 Predicting adverse drug reactions in older adults; a systematic review of the risk prediction models Stevenson, Jennifer M Williams, Josceline L Burnham, Thomas G Prevost, A Toby Schiff, Rebekah Erskine, S David Davies, J Graham Clin Interv Aging Original Research Adverse drug reaction (ADR) risk-prediction models for use in older adults have been developed, but it is not clear if they are suitable for use in clinical practice. This systematic review aimed to identify and investigate the quality of validated ADR risk-prediction models for use in older adults. Standard computerized databases, the gray literature, bibliographies, and citations were searched (2012) to identify relevant peer-reviewed studies. Studies that developed and validated an ADR prediction model for use in patients over 65 years old, using a multivariable approach in the design and analysis, were included. Data were extracted and their quality assessed by independent reviewers using a standard approach. Of the 13,423 titles identified, only 549 were associated with adverse outcomes of medicines use. Four met the inclusion criteria. All were conducted in inpatient cohorts in Western Europe. None of the models satisfied the four key stages in the creation of a quality risk prediction model; development and validation were completed, but impact and implementation were not assessed. Model performance was modest; area under the receiver operator curve ranged from 0.623 to 0.73. Study quality was difficult to assess due to poor reporting, but inappropriate methods were apparent. Further work needs to be conducted concerning the existing models to enable the development of a robust ADR risk-prediction model that is externally validated, with practical design and good performance. Only then can implementation and impact be assessed with the aim of generating a model of high enough quality to be considered for use in clinical care to prioritize older people at high risk of suffering an ADR. Dove Medical Press 2014-09-19 /pmc/articles/PMC4178502/ /pubmed/25278750 http://dx.doi.org/10.2147/CIA.S65475 Text en © 2014 Stevenson et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Stevenson, Jennifer M
Williams, Josceline L
Burnham, Thomas G
Prevost, A Toby
Schiff, Rebekah
Erskine, S David
Davies, J Graham
Predicting adverse drug reactions in older adults; a systematic review of the risk prediction models
title Predicting adverse drug reactions in older adults; a systematic review of the risk prediction models
title_full Predicting adverse drug reactions in older adults; a systematic review of the risk prediction models
title_fullStr Predicting adverse drug reactions in older adults; a systematic review of the risk prediction models
title_full_unstemmed Predicting adverse drug reactions in older adults; a systematic review of the risk prediction models
title_short Predicting adverse drug reactions in older adults; a systematic review of the risk prediction models
title_sort predicting adverse drug reactions in older adults; a systematic review of the risk prediction models
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4178502/
https://www.ncbi.nlm.nih.gov/pubmed/25278750
http://dx.doi.org/10.2147/CIA.S65475
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