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利用大规模医疗理赔数据库开发数据驱动的用药指征知识库。

Developing a Data-driven Medication Indication Knowledge Base using a Large Scale Medical Claims Database.

作者信息

Li Ying, Xiao Cao

机构信息

IBM T. J. Watson Research Center, Yorktown Heights, NY, USA.

AI for Healthcare, IBM Research, Cambridge, MA, USA.

出版信息

AMIA Jt Summits Transl Sci Proc. 2019 May 6;2019:741-750. eCollection 2019.

PMID:31259031
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6568115/
Abstract

Medication-indication knowledge base (KB) is useful for clinical care and also a key enabler for secondary use of observational health data. Over the years there are several indication KBs being developed, however, they were built based on curated data sources and thus may not reflect actual clinical practice. The longitudinal observational health data contain information about real world practice of medication indication, but were rarely used in KB construc- tion. A major challenge of leveraging them is the confounders in multi-medication multi-diagnoses relations. In this study, we proposed a sampling based approach that could explicitly handle the aforementioned confounders, and consequently detect more accurate medication-indication relations. Based on this method, we created a medication- indication KB that reflects actual clinical practice and has broad medication and indication coverages. Our work represents the first attempt to develop a medication-indication KB from a large scale observational health data in an automated and unsupervised manner.

摘要

药物适应症知识库(KB)对临床护理很有用,也是观察性健康数据二次利用的关键推动因素。多年来,有几个适应症知识库正在开发中,然而,它们是基于精心策划的数据源构建的,因此可能无法反映实际临床实践。纵向观察性健康数据包含有关药物适应症实际应用的信息,但很少用于知识库构建。利用这些数据的一个主要挑战是多种药物与多种诊断关系中的混杂因素。在本研究中,我们提出了一种基于抽样的方法,该方法可以明确处理上述混杂因素,从而检测出更准确的药物-适应症关系。基于此方法,我们创建了一个反映实际临床实践且具有广泛药物和适应症覆盖范围的药物-适应症知识库。我们的工作代表了首次尝试以自动化和无监督的方式从大规模观察性健康数据中开发药物-适应症知识库。

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An MCEM Framework for Drug Safety Signal Detection and Combination from Heterogeneous Real World Evidence.一个用于从异构真实世界证据中检测和组合药物安全信号的 MCEM 框架。
Sci Rep. 2018 Jan 29;8(1):1806. doi: 10.1038/s41598-018-19979-7.
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Monitoring prescribing patterns using regression and electronic health records.使用回归和电子健康记录监测处方模式。
BMC Med Inform Decis Mak. 2017 Dec 19;17(1):175. doi: 10.1186/s12911-017-0575-5.
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Electronic health records to facilitate clinical research.电子健康记录助力临床研究。
Clin Res Cardiol. 2017 Jan;106(1):1-9. doi: 10.1007/s00392-016-1025-6. Epub 2016 Aug 24.
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Medication-indication knowledge bases: a systematic review and critical appraisal.药物-适应症知识库:系统评价与批判性评估
J Am Med Inform Assoc. 2015 Nov;22(6):1261-70. doi: 10.1093/jamia/ocv129. Epub 2015 Sep 2.
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Automated detection of off-label drug use.非适应证用药的自动检测。
PLoS One. 2014 Feb 19;9(2):e89324. doi: 10.1371/journal.pone.0089324. eCollection 2014.
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Validation and enhancement of a computable medication indication resource (MEDI) using a large practice-based dataset.使用基于大型实践的数据集对可计算药物适应症资源(MEDI)进行验证和增强。
AMIA Annu Symp Proc. 2013 Nov 16;2013:1448-56. eCollection 2013.
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Empirical performance of a new user cohort method: lessons for developing a risk identification and analysis system.新用户队列方法的实证性能:开发风险识别和分析系统的经验教训。
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A method for controlling complex confounding effects in the detection of adverse drug reactions using electronic health records.利用电子健康记录控制药物不良反应检测中复杂混杂效应的方法。
J Am Med Inform Assoc. 2014 Mar-Apr;21(2):308-14. doi: 10.1136/amiajnl-2013-001718. Epub 2013 Aug 1.
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Caveats for the use of operational electronic health record data in comparative effectiveness research.使用操作性电子健康记录数据进行比较有效性研究的注意事项。
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Development and evaluation of an ensemble resource linking medications to their indications.开发并评估一个药物与适应证关联的集成资源。
J Am Med Inform Assoc. 2013 Sep-Oct;20(5):954-61. doi: 10.1136/amiajnl-2012-001431. Epub 2013 Apr 10.