Sakai Takamasa
Drug Informatics, Faculty of Pharmacy, Meijo University.
Yakugaku Zasshi. 2021;141(2):165-168. doi: 10.1248/yakushi.20-00196-1.
In recent years, a variety of medical information has been digitized, and hence, various medical big data have become available. Spontaneous reporting databases are a part of the medical big data. In Japan, the Pharmaceuticals and Medical Devices Agency has developed the "Japanese Adverse Drug Event Report (JADER) database" which has been available since 2012. Thus, everyone can publish safety signal information based on the results of disproportionality analysis using the spontaneous reporting database. Since the release of JADER, many researchers and healthcare professionals are interested in it, and many reports have been prepared using JADER. Although we tend to focus on the fact that it is a publicly available database with many cases, it also has various limitations such as lack of the denominator information, under-reporting, and reporting biases. Detected signals do not necessarily imply a causal relationship between the drug and adverse event. In the "Guideline on good pharmacovigilance practices (GVP) Module IX by European Medicines Agency", signal detection is the first step in the signal management process. Signal detection alone does not complete pharmacovigilance activities. It is important to understand that spontaneous reporting databases are not only for researchers but also for those who are considering to apply them to clinical work by referring to research using these databases. In this symposium review, I will discuss the role and applicability of spontaneous reporting databases in medical big data.
近年来,各种医学信息已被数字化,因此,各种医学大数据已变得可用。自发报告数据库是医学大数据的一部分。在日本,药品和医疗器械管理局开发了“日本药品不良反应报告(JADER)数据库”,该数据库自2012年起可用。因此,每个人都可以根据使用自发报告数据库进行的不成比例分析结果发布安全信号信息。自JADER发布以来,许多研究人员和医疗保健专业人员都对其感兴趣,并使用JADER编写了许多报告。尽管我们倾向于关注它是一个有许多案例的公开可用数据库这一事实,但它也有各种局限性,例如缺乏分母信息、报告不足和报告偏差。检测到的信号不一定意味着药物与不良事件之间存在因果关系。在欧洲药品管理局的《药品警戒规范(GVP)模块IX指南》中,信号检测是信号管理过程的第一步。仅信号检测并不能完成药品警戒活动。重要的是要明白,自发报告数据库不仅适用于研究人员,也适用于那些考虑通过参考使用这些数据库的研究将其应用于临床工作的人员。在本次研讨会综述中,我将讨论自发报告数据库在医学大数据中的作用和适用性。