Analysis of overridden alerts in a drug-drug interaction detection system
Analysis of overridden alerts in a drug-drug interaction detection system
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DOI：
10.1093/intqhc/mzn038
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发表时间：
2008-12-01
影响因子：
2.6
通讯作者：
Jaulent, Marie-Christine
中科院分区：
文献类型：
--
作者：
Mille, Frederic;Schwartz, Celine;Jaulent, Marie-Christine
本研究的目的是评估计算机化的药物相互作用检测系统产生的信号的相关性，并设计一个被覆盖的药物相互作用警报的分类。两个月的前瞻性研究。510个床位的大学儿科医院。在罗伯特德布雷医院，医生使用计算机化的医嘱输入系统在线生成药物医嘱，该系统还可以真实的检测药物相互作用。我们分析了被医生覆盖的警报样本的相关性。我们分析了613个被覆盖的警报样本。我们定义了三类覆盖警报：信息错误（35）;系统错误（244）和准确警报（334）。两个原因占假阳性警报的40%：系统无法识别药物治疗与说明两种药物可以一起使用的指南之间的真实的冲突，因为药物相互作用的益处超过了副作用的风险。我们创建了一个覆盖警报的分类，在与药物-药物相互作用检测系统耦合的计算机化医嘱输入系统的背景下。药物相互作用软件的开发显然还有改进的余地。这种分类应该可以将这项工作分解为更小的任务，从而可以降低药物相互作用检测系统对背景噪声的敏感性。
The aim of this study was to evaluate the relevance of the signals generated by a computerized drug-drug interaction detection system and to design a classification of overridden drug-drug interaction alerts.Prospective study over two months.Five hundred and ten-bed university paediatric hospital.In Robert Debre Hospital physicians generate drug orders online using a computerized physician order entry system that also detects drug-drug interactions in real time. We analysed the relevance of a sample of alerts overridden by physicians.We analysed a sample of 613 overridden alerts. We defined three categories of overridden alerts: informational errors (35); system errors (244) and accurate alerts (334). Two reasons account for 40% of false-positive alerts: an inability of the system to recognize real conflicts between drug treatments and guidelines stating that the two drugs can be used together, because the benefit outweighs the risk of side effects due to the drug-drug interaction.We created a classification of overridden alerts, in the context of computerized physician order entry system coupled with a drug-drug interaction detection system. There is clearly room for improvement in the development of drug-drug interaction software. This classification should make it possible to break this work down into smaller tasks, making it possible to decrease the sensitivity to background noise of drug-drug interaction detection systems.