College of Pharmacy and Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan 15588, Korea.
College of Pharmacy, Yeungnam University, Gyeongsan 38541, Korea.
Int J Environ Res Public Health. 2021 Aug 13;18(16):8572. doi: 10.3390/ijerph18168572.
There are various trigger tools for detecting adverse drug events (ADEs), however, a drug-related emergency department (ED) visit trigger tool (DrEDTT) has not yet been developed. We aimed to develop and validate a DrEDTT with a multi-center cohort. In this cross-sectional study, we developed the DrEDTT consisting of 28 triggers through a comprehensive literature review and three phase expert group discussion. Next, we evaluated the performance of the DrEDTT by applying it to relevant medical records retrieved from four hospitals from January 2016 to June 2016. Two experts performed an in-depth chart review of a 25% of random sample of trigger flagged and unflagged ED visits and a true ADE was determined through causality assessment. Among 66,564 patients who visited the ED for reasons other than traffic accident and trauma during the study period, at least one trigger was found in 21,268 (32.0%) patients. A total of 959 true ADE cases (5.8%) were identified from a randomly selected 25% of ED visit cases. The overall positive predictive value was 14.0% (range: 8.3-66.7%). Sensitivity and specificity of DrEDTT were 77.7% and 70.4%, respectively. In conclusion, this newly developed trigger tool might be helpful to detect ADE-related ED visits.
目前已有多种用于检测药物不良事件（ADE）的触发工具，但尚未开发出与药物相关的急诊科（ED）就诊触发工具（DrEDTT）。我们旨在通过多中心队列研究开发和验证 DrEDTT。在这项横断面研究中，我们通过全面的文献回顾和三轮专家组讨论，制定了包含 28 个触发因素的 DrEDTT。接下来，我们将 DrEDTT 应用于从 2016 年 1 月至 6 月从 4 家医院中检索到的相关病历，以评估其性能。两名专家对 25%随机选择的标记和未标记的 ED 就诊触发病例进行了深入的图表审查，并通过因果关系评估确定了真实的 ADE。在研究期间，因非交通事故和创伤而到 ED 就诊的 66564 名患者中，有 21268 名（32.0%）患者至少存在一个触发因素。从随机选择的 25%ED 就诊病例中确定了总共 959 例真实的 ADE 病例（5.8%）。总体阳性预测值为 14.0%（范围：8.3-66.7%）。DrEDTT 的敏感性和特异性分别为 77.7%和 70.4%。总之，这种新开发的触发工具可能有助于检测与 ADE 相关的 ED 就诊。
