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Detecting Adverse Drug Events Through the Chronological Relationship Between the Medication Period and the Presence of Adverse Reactions From Electronic Medical Record Systems: Observational Study
BACKGROUND: Medicines may cause various adverse reactions. An enormous amount of money and effort is spent investigating adverse drug events (ADEs) in clinical trials and postmarketing surveillance. Real-world data from multiple electronic medical records (EMRs) can make it easy to understand the AD...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
JMIR Publications
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8593795/ https://www.ncbi.nlm.nih.gov/pubmed/33993103 http://dx.doi.org/10.2196/28763 |
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author | Teramoto, Kei Takeda, Toshihiro Mihara, Naoki Shimai, Yoshie Manabe, Shirou Kuwata, Shigeki Kondoh, Hiroshi Matsumura, Yasushi |
author_facet | Teramoto, Kei Takeda, Toshihiro Mihara, Naoki Shimai, Yoshie Manabe, Shirou Kuwata, Shigeki Kondoh, Hiroshi Matsumura, Yasushi |
author_sort | Teramoto, Kei |
collection | PubMed |
description | BACKGROUND: Medicines may cause various adverse reactions. An enormous amount of money and effort is spent investigating adverse drug events (ADEs) in clinical trials and postmarketing surveillance. Real-world data from multiple electronic medical records (EMRs) can make it easy to understand the ADEs that occur in actual patients. OBJECTIVE: In this study, we generated a patient medication history database from physician orders recorded in EMRs, which allowed the period of medication to be clearly identified. METHODS: We developed a method for detecting ADEs based on the chronological relationship between the presence of an adverse event and the medication period. To verify our method, we detected ADEs with alanine aminotransferase elevation in patients receiving aspirin, clopidogrel, and ticlopidine. The accuracy of the detection was evaluated with a chart review and by comparison with the Roussel Uclaf Causality Assessment Method (RUCAM), which is a standard method for detecting drug-induced liver injury. RESULTS: The calculated rates of ADE with ALT elevation in patients receiving aspirin, clopidogrel, and ticlopidine were 3.33% (868/26,059 patients), 3.70% (188/5076 patients), and 5.69% (226/3974 patients), respectively, which were in line with the rates of previous reports. We reviewed the medical records of the patients in whom ADEs were detected. Our method accurately predicted ADEs in 90% (27/30patients) treated with aspirin, 100% (9/9 patients) treated with clopidogrel, and 100% (4/4 patients) treated with ticlopidine. Only 3 ADEs that were detected by the RUCAM were not detected by our method. CONCLUSIONS: These findings demonstrate that the present method is effective for detecting ADEs based on EMR data. |
format | Online Article Text |
id | pubmed-8593795 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | JMIR Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-85937952021-12-07 Detecting Adverse Drug Events Through the Chronological Relationship Between the Medication Period and the Presence of Adverse Reactions From Electronic Medical Record Systems: Observational Study Teramoto, Kei Takeda, Toshihiro Mihara, Naoki Shimai, Yoshie Manabe, Shirou Kuwata, Shigeki Kondoh, Hiroshi Matsumura, Yasushi JMIR Med Inform Original Paper BACKGROUND: Medicines may cause various adverse reactions. An enormous amount of money and effort is spent investigating adverse drug events (ADEs) in clinical trials and postmarketing surveillance. Real-world data from multiple electronic medical records (EMRs) can make it easy to understand the ADEs that occur in actual patients. OBJECTIVE: In this study, we generated a patient medication history database from physician orders recorded in EMRs, which allowed the period of medication to be clearly identified. METHODS: We developed a method for detecting ADEs based on the chronological relationship between the presence of an adverse event and the medication period. To verify our method, we detected ADEs with alanine aminotransferase elevation in patients receiving aspirin, clopidogrel, and ticlopidine. The accuracy of the detection was evaluated with a chart review and by comparison with the Roussel Uclaf Causality Assessment Method (RUCAM), which is a standard method for detecting drug-induced liver injury. RESULTS: The calculated rates of ADE with ALT elevation in patients receiving aspirin, clopidogrel, and ticlopidine were 3.33% (868/26,059 patients), 3.70% (188/5076 patients), and 5.69% (226/3974 patients), respectively, which were in line with the rates of previous reports. We reviewed the medical records of the patients in whom ADEs were detected. Our method accurately predicted ADEs in 90% (27/30patients) treated with aspirin, 100% (9/9 patients) treated with clopidogrel, and 100% (4/4 patients) treated with ticlopidine. Only 3 ADEs that were detected by the RUCAM were not detected by our method. CONCLUSIONS: These findings demonstrate that the present method is effective for detecting ADEs based on EMR data. JMIR Publications 2021-11-01 /pmc/articles/PMC8593795/ /pubmed/33993103 http://dx.doi.org/10.2196/28763 Text en ©Kei Teramoto, Toshihiro Takeda, Naoki Mihara, Yoshie Shimai, Shirou Manabe, Shigeki Kuwata, Hiroshi Kondoh, Yasushi Matsumura. Originally published in JMIR Medical Informatics (https://medinform.jmir.org), 01.11.2021. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Medical Informatics, is properly cited. The complete bibliographic information, a link to the original publication on https://medinform.jmir.org/, as well as this copyright and license information must be included. |
spellingShingle | Original Paper Teramoto, Kei Takeda, Toshihiro Mihara, Naoki Shimai, Yoshie Manabe, Shirou Kuwata, Shigeki Kondoh, Hiroshi Matsumura, Yasushi Detecting Adverse Drug Events Through the Chronological Relationship Between the Medication Period and the Presence of Adverse Reactions From Electronic Medical Record Systems: Observational Study |
title | Detecting Adverse Drug Events Through the Chronological Relationship Between the Medication Period and the Presence of Adverse Reactions From Electronic Medical Record Systems: Observational Study |
title_full | Detecting Adverse Drug Events Through the Chronological Relationship Between the Medication Period and the Presence of Adverse Reactions From Electronic Medical Record Systems: Observational Study |
title_fullStr | Detecting Adverse Drug Events Through the Chronological Relationship Between the Medication Period and the Presence of Adverse Reactions From Electronic Medical Record Systems: Observational Study |
title_full_unstemmed | Detecting Adverse Drug Events Through the Chronological Relationship Between the Medication Period and the Presence of Adverse Reactions From Electronic Medical Record Systems: Observational Study |
title_short | Detecting Adverse Drug Events Through the Chronological Relationship Between the Medication Period and the Presence of Adverse Reactions From Electronic Medical Record Systems: Observational Study |
title_sort | detecting adverse drug events through the chronological relationship between the medication period and the presence of adverse reactions from electronic medical record systems: observational study |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8593795/ https://www.ncbi.nlm.nih.gov/pubmed/33993103 http://dx.doi.org/10.2196/28763 |
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