Name Confusion Research Articles

Identification of potential drug name confusion errors in the Sentinel System.

In July 2015, the US Food and Drug Administration (FDA) published a drug safety communication regarding errors in prescribing and dispensing of the antidepressant Brintellix (vortioxetine) and the antiplatelet Brilinta (ticagrelor) that arose due to proprietary drug name confusion. Brintellix is indicated for major depressive disorder; Brilinta is indicated to reduce cardiovascular death, myocardial infarction, and stroke in patients with acute coronary syndrome or history of myocardial infarction. Brintellix was renamed to Trintellix in May 2016. Using Brilinta and Brintellix as a proof-of-concept feasibility use case, we assessed whether drug name confusion errors between the pair could be identified in electronic health care data via the combination of a claims-based algorithm and limited manual claims data review. Using data from the Sentinel System, we defined potential errors as Brintellix users without an on- or off-label indication for Brintellix, without a dispensing for a drug with the same indications as Brintellix, and with an on- or off-label indication for Brilinta between -365 and +30 days after index Brintellix dispensing; the reverse was done for Brilinta. We manually reviewed claims profiles of potential cases. We identified 27 (0.1%) potential errors among 21 208 Brintellix users; 16 appeared to be likely errors based on claims profile review. Fifty-one (0.3%) of the 16 779 Brilinta users were identified as potential errors, and four appeared to be likely errors. A claims-based algorithm combined with manual review of claims profiles could identify potential drug name confusion errors, and narrow down likely errors that warrant further investigation.

Experimentally Induced Single and Repeated Personal Name Confusions: The Impact of Phonological and Semantic Similarity.

Three experiments investigated a common but intriguing phenomenon, that is, repeated personal name confusion, a phenomenon at the border between language and memory. The purpose of those experiments was to evaluate the impact of the semantic and phonological similarities on name confusion and to compare repeated naming confusions (i.e., repeatedly confounding two names) with single confusions (i.e., confounding two names only once) in a same experimental paradigm. In all experiments, participants (64 middle-aged participants for each experiment) were asked to memorize the association between 16 names and 16 faces (face-name learning task). In Experiments 1 and 2, the two studied variables were the phonological similarity between the confused names and the semantic similarity between the two bearers of the confused names (using a visually derived semantic code in Experiment 1 and an identity-specific semantic code in Experiment 2). In Experiment 3, the impact of those two semantic similarities between the bearers of the confused names was taken into account, whereas the phonological similarity was not taken into account. First, results showed a main effect of the phonological and semantic similarity on name confusion (more confusions when the names were phonologically related or when the bearers of the names were semantically related). Second, we found that (1) the combination of the phonological and the semantic similarity and (2) the combination of the two semantic similarities led to an increase of name confusions. Third, in the three experiments, we found that the semantic and phonological similarities had a similar impact on repeated and single confusions. Finally, results showed that participants always made more single than repeated confusions, except in the case when the bearers of the confused names shared two semantic features.

Artificial intelligence using neural network architecture for radiology (AINNAR): classification of MR imaging sequences.

The confusion of MRI sequence names could be solved if MR images were automatically identified after image data acquisition. We revealed the ability of deep learning to classify head MRI sequences. Seventy-eight patients with mild cognitive impairment (MCI) having apparently normal head MR images and 78 intracranial hemorrhage (ICH) patients with morphologically deformed head MR images were enrolled. Six imaging protocols were selected to be performed: T2-weighted imaging, fluid attenuated inversion recovery imaging, T2-star-weighted imaging, diffusion-weighted imaging, apparent diffusion coefficient mapping, and source images of time-of-flight magnetic resonance angiography. The proximal first image slices and middle image slices having ambiguous and distinctive contrast patterns, respectively, were classified by two deep learning imaging classifiers, AlexNet and GoogLeNet. AlexNet had accuracies of 73.3%, 73.6%, 73.1%, and 60.7% in the middle slices of MCI group, middle slices of ICH group, first slices of MCI group, and first slices of ICH group, while GoogLeNet had accuracies of 100%, 98.1%, 93.1%, and 94.8%, respectively. AlexNet significantly had lower classification ability than GoogLeNet for all datasets. GoogLeNet could judge the types of head MRI sequences with a small amount of training data, irrespective of morphological or contrast conditions.

Preventing dispensing errors by alerting for drug confusions in the pharmacy information system-A survey of users.

IntroductionDrug confusion is thought to be the most common type of dispensing error. Several strategies can be implemented to reduce the risk of medication errors. One of these are alerts in the pharmacy information system.ObjectiveTo evaluate the experiences of pharmacists and pharmacy technicians with alerts for drug name and strength confusion.MethodsIn May 2017, a cross-sectional survey of pharmacists and pharmacy technicians was performed in community pharmacies in the Netherlands using an online questionnaire.ResultsOf the 269 respondents, 86% (n = 230) had noticed the alert for drug name confusion, and 26% (n = 67) for drug strength confusion. Of those 230, 9% (n = 20) had experienced that the alert had prevented dispensing the wrong drug. For drug strength confusion, this proportion was 12% (n = 8). Respondents preferred to have an alert for drug name and strength confusion in the pharmacy information system. ‘Alert fatigue’ was an important issue, so alerts should only be introduced for frequent confusions or confusions with serious consequences.ConclusionPharmacists and pharmacy technicians were positive about having alerts for drug confusions in their pharmacy information system and experienced that alerts contributed to the prevention of dispensing errors. To prevent alert fatigue, it was considered important not to include all possible confusions as a new alert: the potential contribution to the prevention of drug confusion should be weighed against the risk of alert fatigue.

Dispensing errors/drug name confusion for four GSK inhalers

Dispensing errors/drug name confusion for four GSK inhalers

A profusion of confusion in NGS methods naming.

A profusion of confusion in NGS methods naming.

DNA barcoding reveals the mislabeling of fish in a popular tourist destination in Brazil.

The consumption of raw fish has increased considerably in the West, since it is said to be potentially healthier than processed fish (for containing omega 3 and 6, essential amino acids and vitamins). However this potential benefit, as well as the taste, value and even the risk of extinction are not the same for all species of fish, constituting grounds for fraud. Using the principles of the DNA barcode we revealed mislabelling of fish in Japanese restaurants and fishmarkets in Florianópolis, a popular tourist capital in Brazil. We sequenced the COI gene of 65 samples from fisheries and 80 from restaurants and diagnosed 30% of mislabeled samples in fisheries and 26% in restaurants. We discussed that frauds may have occurred for different reasons: to circumvent surveillance on threatened species; to sell fish with sizes smaller than allowed or abundant species as being a much rarer species (law of supply); to induce product consumption using species with better taste. It should be noted that some substitutions are derived from incorrect identification and are not a fraud per se; they are due to confusion of popular names or misunderstanding by the sellers. Therefore, we suggest the implementation of a systematic regulatory program conducted by governmental agencies to reduce mislabelling in order to avoid further damage to the community (in health and financial issues) and fish stocks.

Event-related brain potentials and the study of reward processing: Methodological considerations.

There is growing interest in using electroencephalography and specifically the event-related brain potential (ERP) methodology to study human reward processing. Since the discovery of the feedback related negativity (Miltner et al., 1997) and the development of theories associating the feedback related negativity and more recently the reward positivity with reinforcement learning, midbrain dopamine function, and the anterior cingulate cortex (i.e., Holroyd and Coles, 2002) researchers have used the ERP methodology to probe the neural basis of reward learning in humans. However, examination of the feedback related negativity and the reward positivity cannot be done without an understanding of some key methodological issues that must be taken into account when using ERPs and examining these ERP components. For example, even the component name - the feedback related negativity - is a source of debate within the research community as some now strongly feel that the component should be named the reward positivity (Proudfit, 2015). Here, ten key methodological issues are discussed - confusion in component naming, the reward positivity, component identification, peak quantification and the use of difference waveforms, frequency (the N200) and component contamination (the P300), the impact of feedback timing, action, and task learnability, and how learning results in changes in the amplitude of the feedback-related negativity/reward positivity. The hope here is to not provide a definitive approach for examining the feedback related negativity/reward positivity, but instead to outline the key issues that must be taken into account when examining this component to assist researchers in their study of human reward processing with the ERP methodology.

Brand name confusion: Subjective and objective measures of orthographic similarity.

Determining brand name similarity is vital in areas of trademark registration and brand confusion. Students rated the orthographic (spelling) similarity of word pairs (Experiments 1, 2, and 4) and brand name pairs (Experiment 5). Similarity ratings were consistently higher when words shared beginnings rather than endings, whereas shared pronunciation of the stressed vowel had small and less consistent effects on ratings. In Experiment 3 a behavioral task confirmed the similarity of shared beginnings in lexical processing. Specifically, in a task requiring participants to decide whether 2 words presented in the clear (a probe and a later target) were the same or different, a masked prime word preceding the target shortened response latencies if it shared its initial 3 letters with the target. The ratings of students for word and brand name pairs were strongly predicted by metrics of orthographic similarity from the visual word identification literature based on the number of shared letters and their relative positions. The results indicate a potential use for orthographic metrics in brand name registration and trademark law. (PsycINFO Database Record

Computer algorithm targets possible drug name confusions

Computer algorithm targets possible drug name confusions

Characteristics That May Help in the Identification of Potentially Confusing Proprietary Drug Names.

This study aimed to provide a descriptive analysis of characteristics that are common among drug name pairs involved in name confusion medication errors. We evaluated drug name pairs that contained at least one proprietary name from the Institute for Safe Medication Practices (ISMP) List of Confused Drug Names. For each name pair, we analyzed whether the following characteristics were present: (1) the same first letter, (2) a shared letter string of at least 3 letters, and (3) similarity in the number of letters. Additionally, we obtained the combined Phonetic and Orthographic Computer Analysis (POCA) score. Ninety-nine percent of the drug name pairs reflected at least one of the 3 characteristics analyzed. Additionally, 75% of the names had a combined POCA score of ≥50%. This descriptive analysis provides some insight into characteristics that may be associated with name confusion, which should be considered when formulating and evaluating proposed proprietary drug names.

Abstract P5-02-03: Evaluating the feasibility of a web-based preference-tolerant randomized trial of risk-based vs. annual breast cancer screening: WISDOM study pilot

Abstract Background: The WISDOM Study (Women Informed to Screen Depending on Measures of risk) aims to examine the effectiveness of personalized breast cancer screening and to bring objective recommendations to the current mammography screening debate. The WISDOM Study is a 100,000 woman randomized trial with a preference-tolerant design that will determine if risk-based screening (RBS) vs. annual screening, is as safe, less morbid, enables prevention and is preferred by women. A pilot was conducted to test the logistics of online participation and examine the acceptance of the study design and approach. Methods: Women were recruited from the UCSF site of the Athena Breast Health Network, a clinical care-research cohort of 110,000 women from the 5 University of California Medical Centers and Sanford Health. The pilot recruited women via email who were 40 -74 years of age with no history of breast cancer and a normal mammogram in the past year. Those interested visited the WISDOM Study website (wisdomstudy.org), signed up, elected randomization or self-selection, provided electronic consent using DocuSign (eConsent), and completed genetic testing (RBS arm). The Breast Cancer Surveillance Consortium (BCSC) model (standard risk factors, ethnicity, and breast density) in addition to genetic testing (9 genes and 75 SNPs) was used to calculate breast cancer risks that informed the start and frequency of screening for women in the RBS arm. BCSC was also used in the annual screening arm but did not inform mammography screening recommendations. The pilot used a mixed method approach (using enrollment data, Exit Survey data, individual interviews and focus groups) to assess enrollment preferences, randomization acceptance and overall study workflow. Results: The online electronic enrollment process and patient engagement portal was successfully implemented. In total, 639 women were invited, 235 registered (34%), and 171 (27%) consented to the pilot. Of these, 74% (127) elected to be randomized, and 26% chose to self-assign (66% chose annual screening (29)). Mean age was 56 years and the ethnic breakdown of the cohort was: 79% White, 10% Asian, 7% Latino, 3% Black, 1% other. 92% of those in the risk-based arm of the study completed genetic testing and were given results; only one genetic mutation was identified and occurred in CHEK2. Within the RBS arm (78), mammography recommendations were: 61% no further mammography until the age of 50, 22% biennial, 11% annual, and 6% every 6 month alternating MRI and mammogram. Exit Survey data illuminated confusion in study arm names (risk-based vs. annual), randomization acceptance (74%), annual arm preference in the self-selection group (66%), eConsent satisfaction (90%), enrollment process ease of use (88%), and website content, navigation and appearance satisfaction (66%). The pilot concluded in May 2016 to allow for refinements prior to the full trial. Conclusion: Our pilot demonstrates that the majority of women are willing to be randomized and participate in an online screening study to answer the important question on optimal breast cancer screening. The pilot study results will inform implementation of the 100,000 women WISDOM Study which launches in fall of 2016. Citation Format: Stover Fiscalini A, Theiner S, Kaplan C, Sarrafan S, Sawyer S, Liang A, Rosenberg-Wohl S, Gordon D, Frick M, Borowsky A, Anton-Culver H, Naeim A, LaCroix A, Cink T, Collaboration Athena Breast Health Network and Advocate Partners, Esserman L, van 't Veer L. Evaluating the feasibility of a web-based preference-tolerant randomized trial of risk-based vs. annual breast cancer screening: WISDOM study pilot [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-02-03.

The Trade in African Medicinal Plants in Matonge-Ixelles, Brussels (Belgium).

(English)Maintaining cultural identity and preference to treat cultural bound ailments with herbal medicine are motivations for migrants to continue using medicinal plants from their home country after moving to Europe and the USA. As it is generally easier to import exotic food than herbal medicine, migrants often shift to using species that double as food and medicine. This paper focuses on the trade in African medicinal plants in a Congolese neighborhood in Brussels (Belgium). What African medicinal plants are sold in Matonge, where do they come from, and to which extent are they food medicines? Does vendor ethnicity influence the diversity of the herbal medicine sold? We hypothesized that most medicinal plants, traders, and clients in Matonge were of Congolese origin, most plants used medicinally were mainly food crops and that culture-bound illnesses played a prominent role in medicinal plant use. We carried out a market survey in 2014 that involved an inventory of medicinal plants in 19 shops and interviews with 10 clients of African descent, voucher collection and data gathering on vernacular names and uses. We encountered 83 medicinal plant species, of which 71% was primarily used for food. The shredded leaves of Gnetum africanum Welw., Manihot esculenta Crantz, and Ipomoea batatas (L.) Lam were among the most frequently sold vegetables with medicinal uses. Cola nuts, shea butter, Aloe vera (L.) Burm.f., and Mondia whitei (Hook.f.). Skeels were the main non-food medicines sold. Women’s health, aphrodisiacs, and rituals were the most important medicinal applications, but culture-bound ailments did not entirely dominate the plant uses. While most clients in Matonge were Congolese, most vendors and plant species were not. The Pakistanis dominated the food trade, and typical Congolese plants were sometimes replaced by West African species, creating confusion in vernacular names. African-managed shops had significantly more species of medicinal plants in stock than shops managed by Pakistanis. Almost all non-food herbal medicine was sold by Africans. Apart from informal shops, non-food herbal medicine was also sold from private homes and by ambulant vendors, probably to reduce costs and escape taxes and control by the authorities. We expect that in the future, increasing rent, strict regulations, and decreasing investments by the Congolese community will force the medicinal plant trade in Matonge to go even more underground.Electronic supplementary materialThe online version of this article (doi:10.1007/s12231-016-9365-8) contains supplementary material, which is available to authorized users.

Addressing perceptions of opiate-using prisoners to take-home naloxone: findings from one English region

Purpose– The purpose of this paper is to understand prisoner perceptions on being trained and having received take-home naloxone (THN) kits once released from prison back into the community, in order to prevent an opiate-related overdose.Design/methodology/approach– A survey was run of all prisoners receiving THN training across ten prisons in one English region. In total, 142 prisoners were surveyed out of 206 (69 per cent) being trained in THN across the ten prisons. Five focus groups (n=26) with prisoners were conducted across four remand and one open prison that included discussions on THN within a range of topics. Discussions were recorded using short-hand and the data were subsequently thematically interpreted using visual mapping techniques.Findings– The survey highlighted a high degree of exposure amongst prisoners to overdose either directly (54 per cent) or having witnessed another person’s overdose (73 per cent). For prisoners who had overdosed, only a minority (38 per cent) were taken to hospital by an ambulance. In total, 81 per cent of prisoners surveyed also expressed little or no knowledge about THN prior to training. Prisoners were resistant to THN as an intervention resulting from this lack of prior knowledge. Focus group interviews suggested that there was a confused and mixed message in providing a harm reduction initiative within the context of recovery-orientated treatment. Prisoners also exhibited name confusion with other drugs (naltrexone) and there was some degree of resistance to being trained based on perceived side-effects brought on by its administration. Prisoners were also acutely aware of official agency perceptions (e.g. police) if seen to be in possession of THN kits.Practical implications– The distribution of THN within a custodial setting requires consideration of wider marketing approaches to address levels of confusion and misapprehension amongst prisoners.Originality/value– The study is one of the few focused on THN based on a UK prison environment.

Cognitive tests predict real-world errors: the relationship between drug name confusion rates in laboratory-based memory and perception tests and corresponding error rates in large pharmacy chains

BackgroundDrug name confusion is a common type of medication error and a persistent threat to patient safety. In the USA, roughly one per thousand prescriptions results in the wrong drug...

On streamlining the Ukrainian names of plants. Information 6. Names of some subtribe Malinae Reveal taxa (information 6)

Purpose. To analyse the Ukrainian nomenclature of subtribe Malinae representatives and improve terminological system of the Ukrainian names of a species and a generic levels and names of fruit crops. Results. There is a confusion in the Ukrainian names of plants of Cydonia-Chaenomeles–Pseudocydonia, Mespilus–Eriobotrya, Amelanchier–Cotoneaster. Considering the division of Sorbus s.l. on separate genera Sorbus s.str., Aria, Cormus, Chamaemespilus, Torminalis and availability of numerous hybrids with their involvement, the Ukrainian names for both taxa and nothotaxa of species and generic levels are offered, principles of their choice are also considered. Formation of the Ukrainian generic names on the basis of specific epithets leads to undesirable tautonomy. Aspects of derussification of the Ukrainian professional terminology are discussed. Conclusions. Ukrainian scientific generic and nothogeneric plant names for subtribe Malinae are transliterated/transcripted, borrowed as a calque of latin names or have their own origin, consisting of one or two words. The choice of the best variants of generic and species names from a number of possible ones has a temporal component and largely depends on experts who apply them and basic principles of choice. It is necessary to improve the modern Ukrainian plant nomenclature on a national basis involving the transformed Latin scientific names for introduced species and hybrids.

Nonformulary medications can throw a wrench into your CPOE system

Nonformulary medications can throw a wrench into your CPOE system

Avoiding errors with allergy and immunology meds

Avoiding errors with allergy and immunology meds

Scientific publishing. Publishers embrace scheme to end name confusion.

ORCID gives every Smith and Wang a unique number.

Phylogeny and morphology of the freshwater red alga Nemalionopsis shawii (Rhodophyta, Thoreales) from Nepal

SummaryPhylogenetic relationships and morphological characters are presented for a population of Nemalionopsis shawii Skuja collected from Nepal. Molecular data (sequences of rbcL and cox1) were generated and morphological characters were described in detail. The rbcL sequence analyses showed that specimens from Nepal are most similar to N. shawii from Indonesia and Japan and that these entities form a clade with high support (>95% bootstrap and 0.95 posterior probability). The cox1 barcode sequence, however, only had 90.9–91.9% identity with specimens of N. shawii from Hawaii. The rbcL sequence of the specimen from Nepal was positioned in a clade having sequence identity of 99.3–99.7% with three samples: N. shawii from Indonesia and two from Japan identified as N. tortuosa. The comparison of morphological characters of Nemalionopsis from Nepal allowed unequivocal identification with N. shawii. Identifications from previous studies using molecular data were mistaken since most reports of N. shawii are actually of N. tortuosa or vice‐versa. This confusion of names presumably occurred because most specimens previously sequenced were from culture collections or from ‘Chantransia’ stages. Small tufts of ‘Chantransia’ stage were observed growing epiphytically on gametophytes and on the basal system. Carpogonia and spermatangia were fully described in specimens from Nepal. Monosporangia were not observed, whereas carposporangia were unequivocally described for the first time in the genus. An unusual flat strap‐like basal system was observed, interpreted as an additional mode of maintenance in nature under unfavorable environmental conditions.