Criteria for assessing high-priority drug-drug interactions for clinical decision support in electronic health records.
Criteria for assessing high-priority drug-drug interactions for clinical decision support in electronic health records.
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DOI：
10.1186/1472-6947-13-65
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发表时间：
2013-06-13
影响因子：
3.5
通讯作者：
Bates DW
中科院分区：
文献类型：
--
作者：
Phansalkar S;Desai A;Choksi A;Yoshida E;Doole J;Czochanski M;Tucker AD;Middleton B;Bell D;Bates DW
电子健康记录（EHRs）中药物-药物相互作用（DDI）警报的高覆盖率导致提供者忽视临床重要警报的潜在危险后果。确定这些相互作用的严重性或有效性的标准缺乏一致性，往往导致如何评估这些相互作用的差异。本研究的目的是确定一套用于评估ddi的标准，这些ddi应用于在电子病历中生成临床决策支持（CDS）警报。我们对MEDLINE和EMBASE进行了20年的系统文献综述，以确定高优先级ddi的特征。这些标准由一个专家小组验证，该小组由药物知识库供应商、电子病历供应商、学术医疗中心的内部知识库开发人员以及参与药物使用监管的联邦和私人机构组成。44篇文章符合评估高优先级ddi特征的纳入标准。在评估相互作用时，专家组考虑了五个最重要的标准——严重程度、可能性、相互作用的临床意义、患者特征和支持相互作用的证据。此外，专家组还确定了在电子病历使用的药物知识库中使用这些标准的障碍和考虑因素。需要一个多维的方法来理解相互作用的重要性，以纳入药物知识库为目的的CDS警报。本研究中确定的标准可以作为统一方法的第一步，用于评估哪些交互是关键的，并保证提供商工作流程的中断。
High override rates for drug-drug interaction (DDI) alerts in electronic health records (EHRs) result in the potentially dangerous consequence of providers ignoring clinically significant alerts. Lack of uniformity of criteria for determining the severity or validity of these interactions often results in discrepancies in how these are evaluated. The purpose of this study was to identify a set of criteria for assessing DDIs that should be used for the generation of clinical decision support (CDS) alerts in EHRs. We conducted a 20-year systematic literature review of MEDLINE and EMBASE to identify characteristics of high-priority DDIs. These criteria were validated by an expert panel consisting of medication knowledge base vendors, EHR vendors, in-house knowledge base developers from academic medical centers, and both federal and private agencies involved in the regulation of medication use. Forty-four articles met the inclusion criteria for assessing characteristics of high-priority DDIs. The panel considered five criteria to be most important when assessing an interaction- Severity, Probability, Clinical Implications of the interaction, Patient characteristics, and the Evidence supporting the interaction. In addition, the panel identified barriers and considerations for being able to utilize these criteria in medication knowledge bases used by EHRs. A multi-dimensional approach is needed to understanding the importance of an interaction for inclusion in medication knowledge bases for the purpose of CDS alerting. The criteria identified in this study can serve as a first step towards a uniform approach in assessing which interactions are critical and warrant interruption of a provider’s workflow.
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影响因子：
2.6
作者：
Mille, Frederic;Schwartz, Celine;Jaulent, Marie-Christine
通讯作者：
Jaulent, Marie-Christine
影响因子：
6.7
作者：
Olvey, E. L.;Clauschee, S.;Malone, D. C.
通讯作者：
Malone, D. C.
影响因子：
4.9
作者：
LEHTO, P;KIVISTO, KT
通讯作者：
KIVISTO, KT
DOI：
10.1331/154434504773062591
发表时间：
2004-03-01
期刊：
Journal of the American Pharmacists Association : JAPhA
影响因子：
--
作者：
Malone, Daniel C;Abarca, Jacob;Lipton, Richard B
通讯作者：
Lipton, Richard B
影响因子：
--
作者：
Isaac, Thomas;Weissman, Joel S.;Weingart, Saul N.
通讯作者：
Weingart, Saul N.