Abstract
In accordance with Article 25-2 of the Pharmacists Act, pharmacists provide patients with information about the initial symptoms of adverse drug reactions for detecting and preventing those reactions. Thus far, however, there have been no reports quantitatively evaluating the usefulness of such information. We present a theory of information evaluation using posterior probability (PP), positive likelihood ratio (LR(+)) and incidence of nonspecific initial symptoms (NIS)-a measure of general symptoms without anything come to mind. First, we calculated using the data from the clinical trials. For liver damage caused by loxoprofen sodium hydrate, the LR(+) was as high as 27.9 in the presence of rash, but the PP was 0.002067, which means there were only 2 liver damage cases among 1000 rash cases. Calculated in the same way for voriconazole, the LR(+) was 5 and the PP was 0.2 (1 liver damage case among 5 rash cases). This suggests that information about rash as an initial symptom of liver damage is useful for patients taking voriconazole. However, the PP was greatly reduced when it was calculated by considering NIS. Since patients cannot distinguish initial symptom of side effect from mere change in body condition, the calculation considering NIS is realistic. Therefore, it is necessary to study in order to raise the value of the information service of the pharmacist. Our study demonstrates how PP and NIS, our new effective measure, allow a quantitative evaluation of the usefulness of information about initial symptoms.
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