Distinguishing drug toxicity syndromes from medical diseases: a QMR computer-based approach

Drug effects can mimic a wide variety of diseases. Experts note that adverse drug reactions (ADRs) have become the 'greatest imitator' of disease in clinical medicine. Quick Medical Reference (QMR) is a decision support system providing diagnostic data about more than 600 medical diseases. Currently, QMR contains only limited drug information. Just as physicians have difficulty diagnosing ADRs, QMR has similar problems in differentiating natural disease manifestations from drug toxicity syndromes. To remedy this problem, two prototype Drug Syndromes (DS), Carbamazepine Toxicity and Penicillin Toxicity, were incorporated into the QMR Knowledge Base (KB). Using detailed case reports, we demonstrated that a DS-augmented version of QMR was successful in discriminating these DS from the other diseases in QMR's KB. The addition of DS significantly improves QMR's diagnostic performance in cases in which some of the pathologic features are the consequence of drugs.