Consensus recommendations for systematic evaluation of drug-drug interaction evidence for clinical decision support.
Consensus recommendations for systematic evaluation of drug-drug interaction evidence for clinical decision support.
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DOI：
10.1007/s40264-014-0262-8
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发表时间：
2015-02
期刊：
影响因子：
4.2
通讯作者：
Malone DC
中科院分区：
文献类型：
--
作者：
Scheife RT;Hines LE;Boyce RD;Chung SP;Momper JD;Sommer CD;Abernethy DR;Horn JR;Sklar SJ;Wong SK;Jones G;Brown ML;Grizzle AJ;Comes S;Wilkins TL;Borst C;Wittie MA;Malone DC
医疗保健组织、药典和药物知识库供应商使用不同的方法来评估和合成关于药物相互作用(DDiS)的证据。这种情况对电子处方和药物信息系统产生了负面影响，这些信息系统警告临床医生潜在的有害药物组合。为科学文献、药品标签和法规文件中有关DDIS的证据的系统评估提供建议，以用于临床决策支持。举行了一系列会议，以制定一个结构化的程序，以提高DDI警报系统的质量。召集了三个专家工作组讨论会议的目标。证据工作组由15名具有药理学、药物信息、生物医学信息学和临床决策支持专业知识的个人组成。工作组成员于2013年1月至2014年2月通过网络研讨会举行会议。2013年5月和9月举行了两次面对面会议，以就建议达成共识。我们制定了三个关键问题的专家共识答案：1)评估DDI证据的最佳方法是什么？2)DDI需要什么证据才能适用于整个药物类别？3)应该如何审查和验证结构化的评估过程？对DDIS的循证决策支持需要一致地应用透明和系统的方法来评估证据。实施这些建议的药物信息系统应该能够在药品汇编和临床决策支持工具中提供关于DDIS的更高质量的信息。
Healthcare organizations, compendia, and drug knowledgebase vendors use varying methods to evaluate and synthesize evidence on drug-drug interactions (DDIs). This situation has a negative effect on electronic prescribing and medication information systems that warn clinicians of potentially harmful medication combinations. To provide recommendations for systematic evaluation of evidence from the scientific literature, drug product labeling, and regulatory documents with respect to DDIs for clinical decision support. A conference series was conducted to develop a structured process to improve the quality of DDI alerting systems. Three expert workgroups were assembled to address the goals of the conference. The Evidence Workgroup consisted of 15 individuals with expertise in pharmacology, drug information, biomedical informatics, and clinical decision support. Workgroup members met via webinar from January 2013 to February 2014. Two in-person meetings were conducted in May and September 2013 to reach consensus on recommendations. We developed expert-consensus answers to three key questions: 1) What is the best approach to evaluate DDI evidence?; 2) What evidence is required for a DDI to be applicable to an entire class of drugs?; and 3) How should a structured evaluation process be vetted and validated? Evidence-based decision support for DDIs requires consistent application of transparent and systematic methods to evaluate the evidence. Drug information systems that implement these recommendations should be able to provide higher quality information about DDIs in drug compendia and clinical decision support tools.