Adverse drug events prevention rules: multi-site evaluation of rules from various sources

Abstract

Adverse drug events are a public health issue (98,000 deaths in the USA every year). Some computerized physician order entry (CPOEs) coupled with clinical decision support systems (CDSS) allow to prevent ADEs thanks to decision rules. Those rules can come from many sources: academic knowledge, record reviews, and data mining. Whatever their origin, the rules may induce too numerous alerts of poor accuracy when identically applied in different places. In this work we formalized rules from various sources in XML and enforced their execution on several medical departments to evaluate their local confidence. The article details the process and shows examples of evaluated rules from various sources. Several needs are enlightened to improve confidences: segmentation, contextualization, and evaluation of the rules over time.