Abstract
Because drug‐induced interstitial pneumonia (DIP) is a serious adverse drug reaction, its quantitative risk with individual medications should be taken into due consideration when selecting a medicine. We developed an algorithm to detect DIP using medical record data accumulated in a hospital. Chest computed tomography (CT) is mainly used for the diagnosis of IP, and chest X‐ray reports, KL‐6, and SP‐D values are used to support the diagnosis. The presence of IP in the reports was assessed by a method using natural language‐processing, in which IP was estimated according to the product of the likelihood ratio of characteristic keywords in each report. The sensitivity and the specificity of the method for chest CT reports were 0.92 and 0.97, while those for chest X‐ray reports were 0.83 and 1, respectively. The occurrence of DIP was estimated by the patterns of presence of IP before, during, and after the administration of the target medicine. The occurrence rate of DIP in cases administered Gefitinib; Methotrexate (MTX); Tegafur, Gimeracil, and Oteracil potassium (TS‐1); and Tegafur and Uracil (UTF) was 6.0%, 2.3%, 1.4%, and 0.7%, respectively. The estimated DIP cases were checked by having the medical records independently reviewed by medical doctors. By chart review, the positive predictive values of DIP against Gefitinib, MTX, TS‐1, and UFT were 69.2%, 44.4%, 58.6%, and 77.8%, respectively. Although the cases extracted by this method included some that did not have DIP, this method can estimate the relative risk of DIP between medicines.
Highlights
We initially developed a method for detecting the occurrence of Interstitial pneumonia (IP) from the text data of chest computed tomography (CT) and chest X‐ray reports and the data of the KL‐ 6 (KL‐6) and surfactant protein D (SP‐D)
We evaluated the risk of drug‐induced interstitial pneumonia (DIP) with Gefitinib; Methotrexate (MTX); Tegafur, Gimeracil, and Oteracil potassium (TS‐1); and Tegafur and Uracil (UTF) from the reports of chest CT and chest X‐ray and the level of KL‐6 and SP‐D
Because chest CT is a key examination for the diagnosis of IP, reports of chest CT—which are written in free text—had to be analyzed
Summary
The quantitative risk for adverse reaction associated with individual medications should be strongly considered when selecting a medicine. We developed an algorithm to estimate the occurrence rate of drug‐induced IP (DIP) of a designated medicine by assessing the certainty of IP from imaging reports and blood test results in EMR before, during, and after the administration of the medicine. We selected the reports of chest X‐ray performed nearest the examination date for chest CT within 3 months in the same patients in the learning data, test data 1, and test data 2, respectively. Reports for X‐ray performed on the day nearest to the CT examination within 3 months were selected in the same patients in the learning data and test data 1 ratios were calculated. We evaluated the risk of DIP with Gefitinib; Methotrexate (MTX); Tegafur, Gimeracil, and Oteracil potassium (TS‐1); and Tegafur and Uracil (UTF) from the reports of chest CT and chest X‐ray and the level of KL‐6 and SP‐D. If the judgments of the 3 doctors were all completely different, the overall judgment was set as “not determined.”
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