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Medical informatics Linking diseases, drugs, and adverse reactions Lars Juhl Jensen

Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

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Page 1: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

Medical informaticsLinking diseases, drugs, and adverse reactions

Lars Juhl Jensen

Page 2: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

structured data

Page 3: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

Jensen et al., Nature Reviews Genetics, 2012

Page 4: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

unstructured data

Page 5: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation
Page 6: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

central registries

Page 7: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

hospital EHR systems

Page 8: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation
Page 9: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

opt-out

Page 10: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

opt-in

Page 11: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

registry data

Page 12: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

civil registration system

Page 13: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

established in 1968

Page 14: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

CPR number

Page 15: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

Jensen et al., Nature Reviews Genetics, 2012

Page 16: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

national discharge registry

Page 17: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

14 years

Page 18: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

6.2 million patients

Page 19: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

45 million admissions

Page 20: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

68 million records

Page 21: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

119 million diagnosis

Page 22: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

ICD-10

Page 23: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

Jensen et al., Nature Reviews Genetics, 2012

Page 24: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

not research

Page 25: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

reimbursement

Page 26: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

diagnosis trajectories

Page 27: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

comorbidity

Page 28: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

contingency table

Page 29: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

Jensen et al., Nature Reviews Genetics, 2012

Page 30: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

confounding factors

Page 31: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

“known knowns”

Page 32: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

gender

Page 33: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

age

Page 34: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

type of hospital encounter

Page 35: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

Jensen et al., Nature Communications, 2014

Page 36: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

“known unknowns”

Page 37: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

smoking

Page 38: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

diet

Page 39: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

“unknown unknowns”

Page 40: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

reporting biases

Page 41: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

matched controls

Page 42: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

proxy diagnoses

Page 43: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

temporal correlations

Page 44: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

diagnosis trajectories

Page 45: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

Jensen et al., Nature Communications, 2014

Page 46: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

trajectory networks

Page 47: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

Jensen et al., Nature Communications, 2014

Page 48: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

key diagnoses

Page 49: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

Jensen et al., Nature Communications, 2014

Page 50: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

direct medical implications

Page 51: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

clinical text

Page 52: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

unstructured data

Page 53: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation
Page 54: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

free text

Page 55: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

Danish

Page 56: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

complex terminology

Page 57: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

busy doctors

Page 58: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

abbreviations

Page 59: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

misspellings

Page 60: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

a lot of it

Page 61: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

computer

Page 62: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

as smart as a dog

Page 63: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

teach it specific tricks

Page 64: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation
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Page 66: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

named entity recognition

Page 67: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

comprehensive dictionary

Page 68: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

diseases

Page 69: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

drugs

Page 70: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

adverse drug reactions

Page 71: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

synonyms

Page 72: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

orthographic variation

Page 73: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

flexible matching

Page 74: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

hyphens and spaces

Page 75: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

expansion rules

Page 76: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

spelling variants

Page 77: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

Clozapine

Page 78: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

Clozapine clozapin

clossapin klozapine

chlosapin

chlosapine

chlozapin

chlozapine

klossapin

closapine

klozapin klosapin

Page 79: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

“black list”

Page 80: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

pest eller kolera

Page 81: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

pharmacovigilance

Page 82: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

clinical trials

Page 83: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

spontaneous reports

Page 84: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation
Page 85: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

underreporting

Page 86: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

text/data mining

Page 87: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

medication

Page 88: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

Jensen et al., Nature Reviews Genetics, 2012

Page 89: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

adverse events

Page 90: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation
Page 91: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

hand-crafted rules

Page 92: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

Eriksson et al., Drug Safety, 2014

Drug introduction Drug discontinuationAdverse event

Adverse eventNegative modifier Indication Pre-existingcondition

Adverse drug reaction Possibleadverse drug reaction

ADR ofadditional drug

Page 93: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

Eriksson et al., Drug Safety, 2014

Drug introduction Drug discontinuationAdverse eventIdentification start

Adverse eventNegative modifier Indication Pre-existingcondition

Adverse drug reaction Possibleadverse drug reaction

ADR ofadditional drug

Page 94: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

Eriksson et al., Drug Safety, 2014

Drug introduction Drug discontinuation

Adverse eventNegative modifier Indication Pre-existingcondition

Adverse drug reaction Possibleadverse drug reaction

Adverse event

ADR ofadditional drug

Identification start

Page 95: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

Eriksson et al., Drug Safety, 2014

Drug introduction Drug discontinuation

Adverse eventNegative modifier Indication Pre-existingcondition

Adverse drug reaction Possibleadverse drug reaction

Adverse event

ADR ofadditional drug

Identification start

Page 96: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

recall known ADRs

Page 97: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

estimate ADR frequencies

Page 98: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

Eriksson et al., Drug Safety, 2014

Page 99: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

discover new ADRs

Page 100: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

Drug substance ADE p-value Chlordiazepoxide Nystagmus 4.0e-8 Simvastatin Personality changes 8.4e-8 Dipyridamole Visual impairment 4.4e-4

Citalopram Psychosis 8.8e-4 Bendroflumethiazide Apoplexy 8.5e-3

Eriksson et al., Drug Safety, 2014

Page 101: Medical informaticsaidanbudd.github.io/ppisnd/trainingMaterial/larsJuhlJensen/jensen2016talk7.pdf · Eriksson et al., Drug Safety, 2014 Drug introduction Adverse event Drug discontinuation

Acknowledgments Disease trajectories Anders Bøck Jensen Tudor Oprea Pope Moseley Søren Brunak

Adverse drug reactions Robert Eriksson Thomas Werge Søren Brunak

EHR text mining Peter Bjødstrup Jensen

Robert Eriksson Henriette Schmock Francisco S. Roque

Anders Juul Marlene Dalgaard

Massimo Andreatta Sune Frankild Eva Roitmann

Thomas Hansen Karen Søeby

Søren Bredkjær Thomas Werge

Søren Brunak


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