Abstract

Background: Adverse events (AEs) can be caused not only by one drug but also by the interaction between two or more drugs. Therefore, clarifying whether an AE is due to a specific suspect drug or drug-drug interaction (DDI) is useful information for proper use of drugs. Whereas previous reports on the search for drug-induced AEs with signal detection using spontaneous reporting systems (SRSs) are numerous, reports on drug interactions are limited. This is because in methods that use “a safety signal indicator” (signal), which is frequently used in pharmacovigilance, a huge number of combinations must be prepared when signal detection is performed, and each risk index must be calculated, which makes interaction search appear unrealistic.Objective: In this paper, we propose association rule mining (AR) using large dataset analysis as an alternative to the conventional methods (additive interaction model (AI) and multiplicative interaction model (MI)).Methods: The data source used was the Japanese Adverse Drug Event Report database. The combination of drugs for which the risk index is detected by the “combination risk ratio (CR)” as the target was assumed to be true data, and the accuracy of signal detection using the AR methods was evaluated in terms of sensitivity, specificity, Youden's index, F-score.Results: Our experimental results targeting Stevens-Johnson syndrome indicate that AR has a sensitivity of 99.05%, specificity of 92.60%, Youden's index of 0.917, F-score of 0.876, AI has a sensitivity of 95.62%, specificity of 96.92%, Youden's index of 0.925, and F-score of 0.924, and MI has a sensitivity of 65.46%, specificity of 98.78%, Youden's index of 0.642, and F-score of 0.771. This result was about the same level as or higher than the conventional method.Conclusions: If you use similar calculation methods to create combinations from the database, not only for SJS, but for all AEs, the number of combinations would be so enormous that it would be difficult to perform the calculations. However, in the AR method, the “Apriori algorithm” is used to reduce the number of calculations. Thus, the proposed method has the same detection power as the conventional methods, with the significant advantage that its calculation process is simple.

Highlights

  • Pharmacovigilance is defined as “the science and activities relating to the detection, assessment, understanding and prevention of drug-related problems” by the World Health Organization (WHO) (World Health Organization, 2002)

  • The data mining algorithms of the quantitative signal detection from such a large database, include the proportional reporting ratio (PRR) (Evans et al, 2001) is used in the Medicines and Healthcare Products Regulatory Agency (MHRA), the reporting odds ratio (ROR) which is used by the Netherlands Pharmacovigilance Centre Lareb, the information component (IC) as Bayesian Confidence Propagation Neural Network (BCPNN) (Bate et al, 1998) is used by the Uppsala Monitoring Centre, Sweden, and the Gamma-Poisson Shrinker (GPS) (Szarfman et al, 2002) as empirical Bayes geometric mean (EBGM)

  • In pre-marketing randomized clinical trials, patients with multiple drug use are usually excluded because focus is on establishing the safety and efficacy of single drugs and not on the investigation of drug-drug interactions (DDIs)

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Summary

Introduction

Pharmacovigilance is defined as “the science and activities relating to the detection, assessment, understanding and prevention of drug-related problems” by the World Health Organization (WHO) (World Health Organization, 2002). The data mining algorithms of the quantitative signal detection from such a large database, include the proportional reporting ratio (PRR) (Evans et al, 2001) is used in the Medicines and Healthcare Products Regulatory Agency (MHRA), the reporting odds ratio (ROR) (van Puijenbroek et al, 2002) which is used by the Netherlands Pharmacovigilance Centre Lareb, the information component (IC) as Bayesian Confidence Propagation Neural Network (BCPNN) (Bate et al, 1998) is used by the Uppsala Monitoring Centre, Sweden, and the Gamma-Poisson Shrinker (GPS) (Szarfman et al, 2002) as empirical Bayes geometric mean (EBGM) These methods are useful for early detection of unknown ADEs. in pre-marketing randomized clinical trials, patients with multiple drug use are usually excluded because focus is on establishing the safety and efficacy of single drugs and not on the investigation of drug-drug interactions (DDIs). This is because in methods that use “a safety signal indicator” (signal), which is frequently used in pharmacovigilance, a huge number of combinations must be prepared when signal detection is performed, and each risk index must be calculated, which makes interaction search appear unrealistic

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