Utility of Electronic Medical Record Alerts to Prevent Drug Nephrotoxicity
Utility of Electronic Medical Record Alerts to Prevent Drug Nephrotoxicity
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DOI：
10.2215/cjn.13841217
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发表时间：
2019-01-07
影响因子：
9.8
通讯作者：
Wilson, F. Perry
中科院分区：
文献类型：
--
作者：
Martin, Melissa;Wilson, F. Perry
肾毒素诱导的 AKI 是 AKI 的一种医源性形式，通过及时识别和适当的处方措施可以避免或改善。针对有 AKI 风险的患者或已患有 AKI 的患者的药物针对性警报可能会导致更合适的药物剂量和管理，并改善临床结果。然而，这种类型的警报创建起来很复杂，很可能出现错误和脱靶效应，并且可能难以评估。尽管许多研究表明这些警报可以降低不适当处方的发生率，但很少有研究检验此类警报在患者利益方面的效用。在这篇综述中，我们研究了该领域文献的现状，确定了关键的技术挑战，并提出了药物靶向 AKI 警报的评估方法。
Nephrotoxin-induced AKI is an iatrogenic form of AKI that can be potentially avoided or ameliorated by prompt recognition and appropriate prescriber actions. Drug-targeted alerts, either for patients at risk of AKI or patients with existing AKI, may lead to more appropriate drug dosing and management and improved clinical outcomes. However, alerts of this type are complicated to create, have a high potential for error and off-target effects, and may be difficult to evaluate. Although many studies have shown that these alerts can reduce the rate of inappropriate prescribing, few studies have examined the utility of such alerts in terms of patient benefit. In this review, we examine the current state of the literature in this area, identify key technical challenges, and suggest methods of evaluation for drug-targeted AKI alerts.