Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
Department of Oncology, Mayo Clinic, Rochester, MN, USA.
J Biomed Inform. 2019 Mar;91:103119. doi: 10.1016/j.jbi.2019.103119. Epub 2019 Feb 7.
Supplementing the Spontaneous Reporting System (SRS) with Electronic Health Record (EHR) data for adverse drug reaction detection could augment sample size, increase population heterogeneity and cross-validate results for pharmacovigilance research. The difference in the underlying data structures and terminologies between SRS and EHR data presents challenges when attempting to integrate the two into a single database. The Observational Health Data Sciences and Informatics (OHDSI) collaboration provides a Common Data Model (CDM) for organizing and standardizing EHR data to support large-scale observational studies. The objective of the study is to develop and evaluate an informatics platform known as ADEpedia-on-OHDSI, where spontaneous reporting data from FDA's Adverse Event Reporting System (FAERS) is converted into the OHDSI CDM format towards building a next generation pharmacovigilance signal detection platform.
An extraction, transformation and loading (ETL) tool was designed, developed, and implemented to convert FAERS data into the OHDSI CDM format. A comprehensive evaluation, including overall ETL evaluation, mapping quality evaluation of drug names to RxNorm, and an evaluation of transformation and imputation quality, was then performed to assess the mapping accuracy and information loss using the FAERS data collected between 2012 and 2017. Previously published findings related to vascular safety profile of triptans were validated using ADEpedia-on-OHDSI in pharmacovigilance research. For the triptan-related vascular event detection, signals were detected by Reporting Odds Ratio (ROR) in high-level group terms (HLGT) level, high-level terms (HLT) level and preferred term (PT) level using the original FAERS data and CDM-based FAERS respectively. In addition, six standardized MedDRA queries (SMQs) related to vascular events were applied.
A total of 4,619,362 adverse event cases were loaded into 8 tables in the OHDSI CDM. For drug name mapping, 93.9% records and 47.0% unique names were matched with RxNorm codes. Mapping accuracy of drug names was 96% based on a manual verification of randomly sampled 500 unique mappings. Information loss evaluation showed that more than 93% of the data is loaded into the OHDSI CDM for most fields, with the exception of drug route data (66%). The replication study detected 5, 18, 47 and 6, 18, 50 triptan-related vascular event signals in MedDRA HLGT level, HLT level, and PT level for the original FAERS data and CDM-based FAERS respectively. The signal detection scores of six standardized MedDRA queries (SMQs) of vascular events in the raw data study were found to be lower than those scores in the CDM study.
The outcome of this work would facilitate seamless integration and combined analyses of both SRS and EHR data for pharmacovigilance in ADEpedia-on-OHDSI, our platform for next generation pharmacovigilance.
通过电子健康记录(EHR)数据对自发报告系统(SRS)进行补充,以检测药物不良反应,从而增加样本量,增加人群异质性,并对药物警戒研究进行交叉验证。尝试将这两种数据集成到一个单一的数据库中时,SRS 和 EHR 数据的底层数据结构和术语存在差异,这带来了挑战。观察性健康数据科学和信息学(OHDSI)合作提供了一个通用数据模型(CDM),用于组织和标准化 EHR 数据,以支持大规模观察性研究。本研究的目的是开发和评估一个名为 ADEpedia-on-OHDSI 的信息学平台,该平台将 FDA 的不良事件报告系统(FAERS)中的自发报告数据转换为 OHDSI CDM 格式,以构建下一代药物警戒信号检测平台。
设计、开发和实施了一个提取、转换和加载(ETL)工具,将 FAERS 数据转换为 OHDSI CDM 格式。然后,使用 2012 年至 2017 年期间收集的 FAERS 数据,对整体 ETL 评估、药物名称到 RxNorm 的映射质量评估以及转换和插补质量评估进行了全面评估,以评估映射准确性和信息丢失。使用 ADEpedia-on-OHDSI 在药物警戒研究中验证了先前发表的与曲坦类药物血管安全性特征相关的研究结果。对于曲坦类药物相关血管事件检测,使用原始 FAERS 数据和基于 CDM 的 FAERS 分别在高级组术语(HLGT)、高级术语(HLT)和首选术语(PT)水平上使用报告比值比(ROR)检测信号。此外,还应用了六个与血管事件相关的标准化 MedDRA 查询(SMQs)。
共将 4619362 例不良事件病例加载到 OHDSI CDM 的 8 个表中。对于药物名称映射,93.9%的记录和 47.0%的唯一名称与 RxNorm 代码匹配。基于对 500 个随机抽样的唯一映射的手动验证,药物名称的映射准确率为 96%。信息丢失评估显示,对于大多数字段,超过 93%的数据加载到 OHDSI CDM 中,除了药物途径数据(66%)。复制研究在原始 FAERS 数据和基于 CDM 的 FAERS 中分别在 MedDRA HLGT 水平、HLT 水平和 PT 水平检测到 5、18、47 和 6、18、50 个曲坦类药物相关血管事件信号。在原始数据研究中,六个与血管事件相关的标准化 MedDRA 查询(SMQs)的信号检测评分低于 CDM 研究中的评分。
这项工作的结果将促进 ADEpedia-on-OHDSI 中 SRS 和 EHR 数据的无缝集成和联合分析,这是我们下一代药物警戒的平台。