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Δευτέρα 13 Φεβρουαρίου 2017

Identification of adverse drug-drug interactions through causal association rule discovery from spontaneous adverse event reports

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Publication date: Available online 10 February 2017
Source:Artificial Intelligence in Medicine
Author(s): Ruichu Cai, Mei Liu, Yong Hu, Brittany L. Melton, Michael E. Matheny, Hua Xu, Lian Duan, Lemuel R. Waitman
ObjectiveDrug-drug interaction (DDI) is of serious concern, causing over 30% of all adverse drug reactions and resulting in significant morbidity and mortality. Early discovery of adverse DDI is critical to prevent patient harm. Spontaneous reporting systems have been a major resource for drug safety surveillance that routinely collects adverse event reports from patients and healthcare professionals. In this study, we present a novel approach to discover DDIs from the Food and Drug Administration's adverse event reporting system.MethodsData-driven discovery of DDI is an extremely challenging task because higher-order associations require analysis of all combinations of drugs and adverse events and accurate estimate of the relationships between drug combinations and adverse event require cause-and-effect inference. To efficiently identify causal relationships, we introduce the causal concept into association rule mining by developing a method called Causal Association Rule Discovery (CARD). The properties of V-structures in Bayesian Networks are utilized in the search for causal associations. To demonstrate feasibility, CARD is compared to the traditional association rule mining (AR) method in DDI identification.ResultsBased on physician evaluation of 100 randomly selected higher-order associations generated by CARD and AR, CARD is demonstrated to be more accurate in identifying known drug interactions compared to AR, 20% vs. 10% respectively. Moreover, CARD yielded a lower number of drug combinations that are unknown to interact, i.e., 50% for CARD and 79% for AR.ConclusionEvaluation analysis demonstrated that CARD is more likely to identify true causal drug variables and associations to adverse event.



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