Automatic assessment of adverse drug reaction reports with interactive visual exploration

Abstract

A large number of adverse drug reaction (ADR) reports are collected yearly through the spontaneous report system (SRS). However, experienced experts from ADR monitoring centers (ADR experts, hereafter) reviewed only a few reports based on current policies. Moreover, the causality assessment of ADR reports was conducted according to the official approach based on the WHO-UMC system, a knowledge- and labor-intensive task that highly relies on an individual’s expertise. Our objective is to devise a method to automatically assess ADR reports and support the efficient exploration of ADRs interactively. Our method could improve the capability to assess and explore a large volume of ADR reports and aid reporters in self-improvement. We proposed a workflow for assisting the assessment of ADR reports by combining an automatic assessment prediction model and a human-centered interactive visualization method. Our automatic causality assessment model (ACA model)—an ordinal logistic regression model—automatically assesses ADR reports under the current causality category. Based on the results of the ACA model, we designed a warning signal to indicate the degree of the anomaly of ADR reports. An interactive visualization technique was used for exploring and examining reports extended by automatic assessment of the ACA model and the warning signal. We applied our method to the SRS report dataset of the year 2019, collected in Guangdong province, China. Our method is evaluated by comparing automatic assessments by the ACA model to ADR reports labeled by ADR experts, i.e., the ground truth results from the multinomial logistic regression and the decision tree. The ACA model achieves an accuracy of 85.99%, a multiclass macro-averaged area under the curve (AUC) of 0.9572, while the multinomial logistics regression and decision tree yield 80.82%, 0.8603, and 85.39%, 0.9440, respectively, on the testing set. The new warning signal is able to assist ADR experts to quickly focus on reports of interest with our interactive visualzation tool. Reports of interest that are selected with high scores of the warning signal are analyzed in details by an ADR expert. The usefulness of the overall method is further evaluated through the interactive analysis of the data by ADR expert. Our ACA model achieves good performance and is superior to the multinomial logistics and the decision tree. The warning signal we designed allows efficient filtering of the full ADR reports down to much fewer reports showing anomalies. The usefulness of our interactive visualization is demonstrated by examples of unusual reports that are quickly identified. Our overall method could potentially improve the capability of analyzing ADR reports and reduce human labor and the chance of missing critical reports.