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从临床环境的角度看:药物流行病学作为反向转化研究(rTR)

[From a Viewpoint of Clinical Settings: Pharmacoepidemiology as Reverse Translational Research (rTR)].

作者信息

Kawakami Junichi

机构信息

Department of Hospital Pharmacy, Hamamatsu University School of Medicine.

出版信息

Yakugaku Zasshi. 2017;137(6):681-683. doi: 10.1248/yakushi.16-00250-2.

Abstract

Clinical pharmacology and pharmacoepidemiology research may converge in practise. Pharmacoepidemiology is the study of pharmacotherapy and risk management in patient groups. For many drugs, adverse reaction(s) that were not seen and/or clarified during research and development stages have been reported in the real world. Pharmacoepidemiology can detect and verify adverse drug reactions as reverse translational research. Recently, development and effective use of medical information databases (MID) have been conducted in Japan and elsewhere for the purpose of post-marketing safety of drugs. The Ministry of Health, Labour and Welfare, Japan has been promoting the development of 10-million scale database in 10 hospitals and hospital groups as "the infrastructure project of medical information database (MID-NET)". This project enables estimation of the frequency of adverse reactions, the distinction between drug-induced reactions and basal health-condition changes, and usefulness verification of administrative measures of drug safety. However, because the database information is different from detailed medical records, construction of methodologies for the detection and evaluation of adverse reactions is required. We have been performing database research using medical information system in some hospitals to establish and demonstrate useful methods for post-marketing safety. In this symposium, we aim to discuss the possibility of reverse translational research from clinical settings and provide an introduction to our research.

摘要

临床药理学与药物流行病学研究在实践中可能会相互融合。药物流行病学是对患者群体中药物治疗和风险管理的研究。对于许多药物而言,在研发阶段未观察到和/或未阐明的不良反应已在现实世界中被报道。药物流行病学可作为逆向转化研究来检测和验证药物不良反应。最近,为了药物上市后的安全性,日本及其他地区开展了医学信息数据库(MID)的开发和有效利用。日本厚生劳动省一直在推动在10家医院和医院集团中开发千万级规模的数据库,即“医学信息数据库基础设施项目(MID-NET)”。该项目能够估计不良反应的发生率,区分药物引起的反应和基础健康状况变化,并验证药物安全管理措施的有效性。然而,由于数据库信息与详细的病历不同,因此需要构建不良反应检测和评估的方法。我们一直在一些医院使用医学信息系统进行数据库研究,以建立和展示用于上市后安全性的有用方法。在本次研讨会上,我们旨在讨论从临床环境进行逆向转化研究的可能性,并介绍我们的研究。

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