一个可扩展的自然语言处理框架,用于从临床叙事记录中对化疗诱导的不良事件进行药物重新定位
Masami Tsuchiya1, Mari Inoue1, Yoshimasa Kawazoe2
1Division of Drug Informatics, Keio University Faculty of Pharmacy, 1-5-30 Shibakoen, Minato-ku, Tokyo 105-8512, Japan.
概括
这项研究使用了电子健康记录 (EHR) 上的自然语言处理 (NLP) 来验证药物重定向以防止化疗副作用. ангиотензинII受体阻断剂 (ARBs) 显示出对口腔粘膜炎的显著保护作用.
科学领域:
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
- 医疗信息学 医疗信息学
背景情况:
- 化疗诱导的不良事件 (AE) 是一个重大的临床挑战.
- 将临床前药物重定向发现转化为人类证据是有限的.
- 开发了一个基于自然语言处理 (NLP) 的新型框架,以将临床前数据与使用电子健康记录 (EHR) 叙述的临床验证相结合.
研究的目的:
- 建立用于预防化疗相关副作用的药物重用概念证明 (PoC).
- 使用可扩展的NLP-流行病学框架对现实世界EHR数据进行临床前发现的验证.
- 确定可以减轻特定化疗毒性的现有药物.
主要方法:
- 从2004年到2023年,对56326名癌症患者的电子健康记录进行了回顾性分析.
- 一个基于变压器的NLP模型从临床笔记中提取了症状性AE.
- 倾向性得分匹配和Cox比例危险模型评估了候选药物,包括用于治疗口腔粘膜炎的血管新生素II受体抑制剂 (ARB) 和用于治疗外围神经病变的ramelteon.
主要成果:
- 该NLP模型实现了高精度 (精度为0.81-0.83;回忆为0.95-0.97).
- 同时服用ARB显著降低了口腔粘膜炎的发生率 (HR0.58,P<0.001),证实了临床PoC.
- 拉梅尔显示出对诱导的神经病变的潜在保护作用 (HR 0.60,P = 0.024).
结论:
- 一个可扩展的NLP-流行病学框架使药物重用候选人的非侵入性,现实世界的验证成为可能.
- ARB的发现为预防口腔粘膜炎提供了人类水平的PoC,支持临床试验.
- 该方法有效地使用EHR叙述进行翻译性研究,优先考虑安全药物,以提高癌症治疗耐受性.
相关概念视频
Pharmacovigilance
1.6K
Post-marketing surveillance is a critical component of pharmaceutical regulation, often uncovering unanticipated adverse drug reactions (ADRs) once a drug is widely used over an extended period.
This process, termed pharmacovigilance, aims to detect, evaluate, and minimize harmful effects related to medication use. The data collection for pharmacovigilance depends on spontaneous reporting systems, where healthcare professionals or patients voluntarily report suspected ADRs.
In some cases, there...
This process, termed pharmacovigilance, aims to detect, evaluate, and minimize harmful effects related to medication use. The data collection for pharmacovigilance depends on spontaneous reporting systems, where healthcare professionals or patients voluntarily report suspected ADRs.
In some cases, there...
1.6K
Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists
524
Neurokinin 1 (NK1) receptors are distributed across the GI tract, vagal afferents, and key CNS regions including the central vomiting center and chemoreceptor trigger zone (CTZ) Chemotherapy agents stimulate enterochromaffin cells in the gastrointestinal (GI) tract to release large amounts of substance P (SP). SP is a neuropeptide released by specific sensory nerves in response to many different stressors, including those in the GI mucosa affected by chemotherapy. SP binds and activates...
524
Structure-Activity Relationships and Drug Design
1.7K
Drug design is a dynamic field that involves discovering and developing new medications based on specific biological targets. This process heavily relies on structure-activity relationships (SAR) and quantitative structure-activity relationships (QSAR) to guide the design and optimization of efficient drugs.
SAR studies the intricate relationship between a drug's chemical structure and biological activity. It focuses on understanding how modifications to a drug's structure can influence...
SAR studies the intricate relationship between a drug's chemical structure and biological activity. It focuses on understanding how modifications to a drug's structure can influence...
1.7K
Drug Discovery: Overview
10.9K
Drug discovery is a multifaceted process involving extensive screening, testing, and optimization of lead compounds to identify potential new drugs for therapeutic use. It combines several approaches, including screening large numbers of natural products, chemical modification of known active molecules, identification of new drug targets, and rational design based on biological mechanisms and drug-receptor structure. These approaches are carried out in both academic research laboratories and...
10.9K
Drug Biotransformation: Overview
3.5K
Pharmaceutical substances known as xenobiotics are predominantly lipophilic and nonionized. This enables them to permeate lipid bilayers, such as cell membranes, and interact with intracellular target receptors. Lipophilic drugs have an advantage in crossing biological barriers and reaching their intended sites of action. However, lipophilic drugs often have a restricted capacity for renal expulsion or elimination from the body. When these drugs enter the kidneys and undergo glomerular...
3.5K
Drug Nomenclature
3.0K
During the development of a new pharmaceutical, the manufacturer initially assigns a code name to the drug. Once approved, the drug receives a United States Adopted Name (USAN)—a generic, nonproprietary designation. Upon being listed in the United States Pharmacopeia, this nonproprietary name becomes the drug's official name. Additionally, the manufacturer assigns a proprietary name or trademark, which serves as the brand name under which the drug is marketed. It is worth noting that...
3.0K


