Validation of a transparent decision model to rate drug interactions 英文参考文献.docVIP

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Validation of a transparent decision model to rate drug interactions 英文参考文献.doc

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Validation of a transparent decision model to rate drug interactions 英文参考文献

Faretal.BMCClinicalPharmacology2012,13:7 /1472-6904/13/7 RESEARCH ARTICLE OpenAccess Validationofatransparentdecisionmodeltorate druginteractions ElmiraFar1?,IvankaCurkovic1?,KellyByrne1,MalgorzataRoos2,IsabelleEgloff1,MichaelDietrich3,WilhelmKirch4, Gerd-AKullak-Ublick1andMarcoEgbring1* Abstract Background:Multipledatabasesprovideratingsofdrug-druginteractions.Theratingsareoftenbasedondifferent criteriaandlackbackgroundinformationonthedecisionmakingprocess.Useracceptanceofratingsystemscould beimprovedbyprovidingatransparentdecisionpathforeachcategory. Methods:Werated200randomlyselectedpotentialdrug-druginteractionsbyatransparentdecisionmodel developedbyourteam.Thecasesweregeneratedfromwardroundobservationsandphysicians’queriesfroman outpatientsetting.Wecomparedourratingstothoseassignedbyaseniorclinicalpharmacologistandbya standardinteractiondatabase,andthusvalidatedthemodel. Results:Thedecisionmodelratedconsistentlywiththestandarddatabaseandthepharmacologistin94and156 cases,respectively.Intwocasesthemodeldecisionrequiredcorrection.Followingremovalofsystematicmodel constructiondifferences,theDMwasfullyconsistentwithotherratingsystems. Conclusion:Thedecisionmodelreproduciblyratesinteractionsandelucidatessystematicdifferences.Wepropose tosupplyvalidateddecisionpathsalongsidetheinteractionratingtoimprovecomprehensibilityandtoenable physicianstointerprettheratingsinaclinicalcontext. Keywords:Algorithm,Severity,Validation,Drug,Interaction,Decision,Model,Mmx,Epha.ch Background Inthepast,DDIswereclassifiedaccordingtotheirpo- The management of adverse drug events (ADEs) is an tentialseveritye.g.minor,moderate,ormajor.In2001a importantissueinhealthcare[1].WhilesomeADEsare new management-oriented approach to DDI classifica- unpredictable (e.g. anaphylaxis), ADEs caused by drug- tionwasadvancedbyHanstenandHorn[7].Morethan drug interactions (DDI) are likely to be preventable [2]. 75% of majorly severe interactions are considered man- Nevertheless,DDIscontinuetopresen