Journal of Biomedical Informatics

Abstract:
Patients on multiple medications are at increased risk for adverse drug events. While physicians can reduce this risk by regularly reviewing the side-effect profiles of their patients’ medications, this process can be time-consuming. We created a decision support system designed to expedite reviewing potential adverse reactions through information visualization. The system includes a database containing 16,340 unique drug and side-effect pairs, representing 250 common medications. A numeric score is assigned to each pair reflecting the strength of association between drug and effect. Based on these scores, the system generates graphical adverse reaction maps for any user-selected combination of drugs. A study comparing speed and accuracy of retrieving side-effect data using this tool versus UpToDate demonstrated a 60% reduction in time to complete a query (61 s vs. 155 s, p < 0.0001) with no decrease in accuracy. These findings suggest that information visualization can significantly expedite review of potential adverse drug events. – J Biomed Inform. 2010 Apr;43(2):326-3

The visual support tool mentioned in the abstract above is called Rxplore and was developed by Jon D. Duke, M.D., a medical informatics fellow at the Regenstrief Institute and the Indiana University School of Medicine.
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As usual there were a lot of things that happened during the week, and not all of it was pharmacy or technology related. Here’s a quick look at some of the stuff I found interesting.

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Our facility is running a trial of  DynaMed, “an evidence based medicine point-of-care” database. It reminds me of UpToDate.

From the DynaMed site:

• According to the National Academy Press (2001) 44-98,000 American deaths per year occur due to preventable medical errors; medical errors are estimated to cost the U.S. $17 to $29 billion annually
• Using the “best available evidence” for clinical decision-making improves health outcomes and reduces health care costs
• Busy clinicians use “fast and easy” resources expected to answer most of their questions instead of resources designed to provide the best current evidence
• Clinicians sometimes turn to textbooks and online resources with substantial breadth, but these resources do not use the best available evidence
• Physicians and other health care professionals need a resource where they can reliably answer most questions quickly and accurately (i.e., with the best available evidence)

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The National Library of Medicine has a website know as Pillbox beta that allows anyone to use various identifiers on a tablet or capsule, i.e. imprint, shape, color, size and/or scoring, to quickly identify a medication. I’ve used systems like this many times for the emergency department when a patient would roll in the door with ten different medications all thrown together in a plastic baggie. The nurse would bring them to the pharmacy and say “I need you to tell me what these are”. I tried holding the baggie to my head like the Great Carnac on Carson, but most of the time I had to use other references to help me out.


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As usual there were a lot of things that happened during the week, and not all of it was pharmacy or technology related. Here’s a quick look at some of the stuff I found interesting.
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2009 brought many new and exciting changes not only in my personal life, but in the world of pharmacy and technology as well. I’ve learned many new things, gained some skills previously absent from my armamentarium, met some great new people, discovered the “real” internet for the first time, traveled more than ever before, discovered I don’t know diddly squat about a great many things, and am more excited about the next year than I can remember in recent history.

Below is a list of opinions about a great many things that I have seen and done over the past year. Some are pharmacy related, some are technology related, some are personal, and some are just random thoughts.
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Recently I was fortunate enough to be a beta tester for the new Android version of Lexi-Comp’s suite of medical information software. I was very excited for the opportunity as I’ve been using what I would consider inferior drug information resources since purchasing my Droid about a month ago. The installation was a problem initially as the databases wouldn’t install directly to the microSD card on the Droid. As you can imagine, the databases are large and immediately filled up the physical memory on the device. Within a couple of weeks of reporting the problem to Lexi-Comp they had corrected the issue and sent me a new build that installed seamlessly.
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I finally had an opportunity to roam around the exhibit hall at the ASHP Midyear today. Of course I had to sacrifice a session to attend, but it was worth it. If you’ve never been in the exhibit hall at one of these events you owe it to yourself to check it out.
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homer-simpson-dohThe Annals of Pharmacotherpy (Vol. 43, No. 11, pp. 1912-1913): “Approximately 80% of pharmacists use the Internet to obtain drug information.1 Wikipedia, often found at the top of Internet search results, is a free-access, collaborative, online encyclopedia that can be edited by anyone.2 Incidents of vandalism have occurred, since the site allows anyone to contribute. For example, an incident occurred in which a fake biography was created as a joke to implicate prominent writer and journalist John Seigenthaler for the assassination of John F Kennedy. It took about 4 months until the fake biography was detected and deleted by Wikipedia.3 Although Wikipedia does have an internal quality review, the ability of internal editors to find and correct erroneous information may not be timely. As reported by Clauson et al.,4 the information found on Wikipedia may not be complete and accurate, especially in regard to drug information. Published data regarding pharmacists’ use of Wikipedia to obtain drug information is lacking. Therefore, the objective of this study was to measure pharmacists’ use and perception of Wikipedia for obtaining drug information.” – This letter to the editor discusses the results of a questionnaire given to pharmacists regarding the use of Wikipedia for drug information. I was disturbed to read that 28% of respondents reported using Wikipedia for drug information. Strange that it doesn’t appear on any of my drug information resources lists, and never will. I expect better from pharmacists.

 

Below is a list of drug information resources for both mobile devices and online access. I’ve used most, but not all, of these resources and have found the mobile versions to be a valuable resource when you’re on the go. While it is possible to access the online versions of these resources via a smartphone, the mobile applications are designed with the smaller screen in mind and therefore, in my opinion, work better then the online versions when using a mobile device.

Let me know if I missed any. Also feel free to comment on your favorite.
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