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Published on: September 19, 2012
[Quantitative evaluation method of the informational value of initial symptoms based on Bayesian theory]
Shigeru Ohshima1, Mayuko Ieda, Midori Yamamoto
1Department of Analytical Pharmaceutics and Informatics, Faculty of Pharmaceutical Sciences, Josai University, Sakado, Saitama, Japan.
Summary
Pharmacists provide crucial information on adverse drug reaction (ADR) initial symptoms. This study introduces a quantitative method using posterior probability (PP) and incidence of nonspecific initial symptoms (NIS) to evaluate information usefulness for patients.
Area of Science:
- Pharmacology
- Patient Safety
- Drug Information Dissemination
Background:
- Pharmacists are mandated to inform patients about initial symptoms of adverse drug reactions (ADRs).
- Quantitative evaluation of the usefulness of this pharmacist-provided information has been lacking.
- Accurate assessment of ADR symptom information is vital for patient safety and effective drug use.
Purpose of the Study:
- To develop and present a theory for quantitatively evaluating the usefulness of information on initial ADR symptoms.
- To introduce posterior probability (PP), positive likelihood ratio (LR(+)), and incidence of nonspecific initial symptoms (NIS) as evaluation metrics.
- To assess the practical utility of ADR symptom information considering patients' inability to distinguish specific symptoms from general bodily changes.
Main Methods:
- Utilized clinical trial data to calculate PP, LR(+), and NIS for specific drug-induced liver damage scenarios.
- Calculated LR(+) and PP for rash as an initial symptom of liver damage from loxoprofen sodium hydrate and voriconazole.
- Incorporated NIS into calculations to reflect realistic patient symptom perception and evaluate information utility.
Main Results:
- For loxoprofen sodium hydrate-induced liver damage, rash had a high LR(+) of 27.9 but a low PP of 0.002067.
- For voriconazole-induced liver damage, rash showed an LR(+) of 5 and a PP of 0.2, suggesting potentially useful information.
- Considering NIS significantly reduced PP, indicating that general symptoms often mask specific ADR indicators for patients.
Conclusions:
- The developed theory using PP and NIS offers a novel quantitative method for evaluating the usefulness of ADR initial symptom information.
- Information about rash as an initial symptom for liver damage may be more useful for voriconazole than loxoprofen sodium hydrate.
- Further research is needed to enhance the value of pharmacist information services by accounting for NIS in evaluations.
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