Noguchi Yoshihiro, Ueno Anri, Otsubo Manami, Katsuno Hayato, Sugita Ikuto, Kanematsu Yuta, Yoshida Aki, Esaki Hiroki, Tachi Tomoya, Teramachi Hitomi
Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Gifu, Japan.
Front Pharmacol. 2018 Mar 9;9:197. doi: 10.3389/fphar.2018.00197. eCollection 2018.
Adverse events (AEs) can be caused not only by one drug but also by the interaction between two or more drugs. Therefore, clarifying whether an AE is due to a specific suspect drug or drug-drug interaction (DDI) is useful information for proper use of drugs. Whereas previous reports on the search for drug-induced AEs with signal detection using spontaneous reporting systems (SRSs) are numerous, reports on drug interactions are limited. This is because in methods that use "a safety signal indicator" (signal), which is frequently used in pharmacovigilance, a huge number of combinations must be prepared when signal detection is performed, and each risk index must be calculated, which makes interaction search appear unrealistic. In this paper, we propose association rule mining (AR) using large dataset analysis as an alternative to the conventional methods (additive interaction model (AI) and multiplicative interaction model (MI)). The data source used was the Japanese Adverse Drug Event Report database. The combination of drugs for which the risk index is detected by the "combination risk ratio (CR)" as the target was assumed to be true data, and the accuracy of signal detection using the AR methods was evaluated in terms of sensitivity, specificity, Youden's index, -score. Our experimental results targeting Stevens-Johnson syndrome indicate that AR has a sensitivity of 99.05%, specificity of 92.60%, Youden's index of 0.917, -score of 0.876, AI has a sensitivity of 95.62%, specificity of 96.92%, Youden's index of 0.925, and -score of 0.924, and MI has a sensitivity of 65.46%, specificity of 98.78%, Youden's index of 0.642, and -score of 0.771. This result was about the same level as or higher than the conventional method. If you use similar calculation methods to create combinations from the database, not only for SJS, but for all AEs, the number of combinations would be so enormous that it would be difficult to perform the calculations. However, in the AR method, the "Apriori algorithm" is used to reduce the number of calculations. Thus, the proposed method has the same detection power as the conventional methods, with the significant advantage that its calculation process is simple.
不良事件(AE)不仅可能由一种药物引起,也可能由两种或更多种药物之间的相互作用引起。因此,明确某一不良事件是由特定的可疑药物还是药物相互作用(DDI)所致,对于合理用药是有用的信息。虽然以往利用自发报告系统(SRS)通过信号检测来寻找药物引起的不良事件的报告众多,但关于药物相互作用的报告却很有限。这是因为在药物警戒中常用的使用“安全信号指标”(信号)的方法里,进行信号检测时必须准备大量的组合,且必须计算每个风险指数,这使得相互作用搜索显得不切实际。在本文中,我们提出使用大数据集分析的关联规则挖掘(AR)作为传统方法(相加相互作用模型(AI)和相乘相互作用模型(MI))的替代方法。所使用的数据源是日本药品不良事件报告数据库。将通过“组合风险比(CR)”检测到风险指数的药物组合作为目标假定为真实数据,并从灵敏度、特异度、约登指数、F分数方面评估使用AR方法进行信号检测的准确性。我们针对史蒂文斯 - 约翰逊综合征的实验结果表明,AR的灵敏度为99.05%,特异度为92.60%,约登指数为0.917,F分数为0.876;AI的灵敏度为95.62%,特异度为96.92%,约登指数为0.925,F分数为0.924;MI的灵敏度为65.46%,特异度为98.78%,约登指数为0.642,F分数为0.771。该结果与传统方法处于大致相同水平或更高。如果使用类似的计算方法从数据库中创建组合,不仅针对史蒂文斯 - 约翰逊综合征,对于所有不良事件而言,组合数量将极其庞大,以至于难以进行计算。然而,在AR方法中,使用“Apriori算法”来减少计算量。因此,所提出的方法与传统方法具有相同的检测能力,其显著优点是计算过程简单。