Pharmacovigilance Centre Lareb, Goudsbloemvallei 7, 5237 MH, s-Hertogenbosch, The Netherlands.
Groningen Research Institute of Pharmacy, PharmacoTherapy, -Epidemiology and -Economics, University of Groningen, Groningen, The Netherlands.
Drug Saf. 2024 Mar;47(3):261-270. doi: 10.1007/s40264-023-01389-y. Epub 2024 Jan 6.
BACKGROUND: To assess the causal relationship between a medicinal product and a reported event, relevant information needs to be present. Information elements for assessing cases of exposure to medicinal products during pregnancy were predefined and used in a new tool to assess the quality of information. However, the extent in which the presence or absence of these predefined information elements is associated with the overall clinical quality of these cases, as evaluated by pharmacovigilance experts, remains uncertain. OBJECTIVE: We aimed to validate a novel method to assess the clinical quality of information in real-world pregnancy pharmacovigilance case reports. METHODS: The clinical quality of case reports regarding medicinal product exposure and pregnancy-related outcomes was appraised from spontaneous reports, literature, Teratology Information Services (UK and Switzerland), The Dutch Pregnancy Drug Register, the Gilenya pregnancy registry and the Enhanced PV programme of Novartis. Assessment was done by means of the novel standardised tool based on the presence and relevance of information, and by expert judgement. The novel tool was validated compared to the expert assessment as the gold standard expressed as the area under the receiver operating characteristic curves, after which the sensitivity and specificity were calculated using cross-tabulations. Inter-rater variability was determined by means of weighted Cohen's kappa. RESULTS: One hundred and eighty-six case reports were included. The clinical quality score as assessed by the novel method was divided into three categories with cut-off values of 45% (poor to intermediate) and 65% (intermediate to excellent). Sensitivity was 0.93 and 0.96 for poor to intermediate and intermediate to excellent, respectively. Specificity was respectively 0.52 and 0.73. Inter-rater variability was 0.65 (95% confidence interval 0.53-0.78) for the newly developed approach, and 0.40 (95% confidence interval 0.28-0.52) for the gold standard assessment. CONCLUSIONS: The tool described in this study using the presence and relevance of elements of information is the first designed, validated and standardised method for the assessment of the quality of information of case reports in pregnancy pharmacovigilance data. This method confers less inter-rater variability compared with a quality assessment by experts of pregnancy-related pharmacovigilance data.
背景:为了评估药品与报告事件之间的因果关系,需要提供相关信息。已预先定义了评估妊娠期间药物暴露病例的信息要素,并将其用于评估信息质量的新工具中。然而,这些预先定义的信息要素的存在或缺失与药物警戒专家评估的这些病例的整体临床质量之间的关联程度尚不确定。
目的:我们旨在验证一种评估真实世界妊娠药物警戒病例报告中信息临床质量的新方法。
方法:从自发报告、文献、致畸信息服务(英国和瑞士)、荷兰妊娠药物登记处、Gilenya 妊娠登记处和诺华增强药物警戒计划中评估与药物暴露和妊娠相关结局相关的病例报告的临床质量。评估是通过基于信息的存在和相关性的新型标准化工具以及专家判断进行的。将新工具与作为金标准的专家评估进行比较,通过接受者操作特征曲线下的面积来表示,然后使用交叉表计算灵敏度和特异性。通过加权 Cohen's kappa 确定组内变异系数。
结果:共纳入 186 例病例报告。新型方法评估的临床质量评分分为三个类别,截断值分别为 45%(差到中等)和 65%(中等到优秀)。灵敏度分别为差到中等和中等到优秀的 0.93 和 0.96。特异性分别为 0.52 和 0.73。新方法的组内变异系数为 0.65(95%置信区间为 0.53-0.78),金标准评估的组内变异系数为 0.40(95%置信区间为 0.28-0.52)。
结论:本研究中使用信息要素的存在和相关性描述的工具是第一个专门设计、验证和标准化的方法,用于评估妊娠药物警戒数据中病例报告的信息质量。与专家对妊娠相关药物警戒数据的质量评估相比,该方法的组内变异系数更小。
Cochrane Database Syst Rev. 2022-2-1
Pharmacoepidemiol Drug Saf. 2018-8-30
Int J Clin Pharm. 2018-8
Pharmacoepidemiol Drug Saf. 2025-7
Ther Adv Neurol Disord. 2018-11-3
Drug Saf. 2019-1
Expert Opin Drug Saf. 2017-10
Emerg Med J. 2017-6
Biochem Med (Zagreb). 2012