Nguyen Phung Anh, Syed-Abdul Shabbir, Iqbal Usman, Hsu Min-Huei, Huang Chen-Ling, Li Hsien-Chang, Clinciu Daniel Livius, Jian Wen-Shan, Li Yu-Chuan Jack
Institute of Biomedical Informatics, National Yang-Ming University, Taipei, Taiwan ; College of Medicine Science and Technology, Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan.
PLoS One. 2013 Dec 3;8(12):e82401. doi: 10.1371/journal.pone.0082401. eCollection 2013.
Medication errors are common, life threatening, costly but preventable. Information technology and automated systems are highly efficient for preventing medication errors and therefore widely employed in hospital settings. The aim of this study was to construct a probabilistic model that can reduce medication errors by identifying uncommon or rare associations between medications and diseases.
Association rules of mining techniques are utilized for 103.5 million prescriptions from Taiwan's National Health Insurance database. The dataset included 204.5 million diagnoses with ICD9-CM codes and 347.7 million medications by using ATC codes. Disease-Medication (DM) and Medication-Medication (MM) associations were computed by their co-occurrence and associations' strength were measured by the interestingness or lift values which were being referred as Q values. The DMQs and MMQs were used to develop the AOP model to predict the appropriateness of a given prescription. Validation of this model was done by comparing the results of evaluation performed by the AOP model and verified by human experts. The results showed 96% accuracy for appropriate and 45% accuracy for inappropriate prescriptions, with a sensitivity and specificity of 75.9% and 89.5%, respectively.
We successfully developed the AOP model as an efficient tool for automatic identification of uncommon or rare associations between disease-medication and medication-medication in prescriptions. The AOP model helps to reduce medication errors by alerting physicians, improving the patients' safety and the overall quality of care.
用药错误很常见,会危及生命,成本高昂,但可预防。信息技术和自动化系统在预防用药错误方面效率极高,因此在医院环境中广泛应用。本研究的目的是构建一个概率模型,通过识别药物与疾病之间不常见或罕见的关联来减少用药错误。
利用关联规则挖掘技术对来自台湾国民健康保险数据库的1.035亿份处方进行分析。该数据集包括使用ICD9 - CM编码的2.045亿条诊断信息和使用ATC编码的3.477亿种药物。通过疾病与药物(DM)以及药物与药物(MM)的共现情况计算关联,并通过被称为Q值的趣味性或提升值来衡量关联强度。DMQ和MMQ用于开发AOP模型以预测给定处方的适宜性。通过比较AOP模型执行的评估结果并由专家进行验证来对该模型进行验证。结果显示,对于适宜处方,准确率为96%,对于不适宜处方,准确率为45%,敏感性和特异性分别为75.9%和89.5%。
我们成功开发了AOP模型,作为一种有效工具,用于自动识别处方中疾病与药物以及药物与药物之间不常见或罕见的关联。AOP模型通过提醒医生,有助于减少用药错误,提高患者安全性和整体护理质量。