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Methods Inf Med 2007; 46(05): 516-522
DOI: 10.1160/ME0374
Paper
Schattauer GmbH

The Application of an Institutional Clinical Data Warehouse to the Assessment of Adverse Drug Reactions (ADRs)

Evaluation of Aminoglycoside and Cephalosporin Associated Nephrotoxicity
Q. Zhang
1   Department of Integrated Medicine, Medical Informatics, Graduated School of Medicine, Osaka University, Osaka, Japan
,
Y. Matsumura
1   Department of Integrated Medicine, Medical Informatics, Graduated School of Medicine, Osaka University, Osaka, Japan
,
T. Teratani
1   Department of Integrated Medicine, Medical Informatics, Graduated School of Medicine, Osaka University, Osaka, Japan
,
S. Yoshimoto
1   Department of Integrated Medicine, Medical Informatics, Graduated School of Medicine, Osaka University, Osaka, Japan
,
T. Mineno
1   Department of Integrated Medicine, Medical Informatics, Graduated School of Medicine, Osaka University, Osaka, Japan
,
K. Nakagawa
1   Department of Integrated Medicine, Medical Informatics, Graduated School of Medicine, Osaka University, Osaka, Japan
,
M. Nagahama
1   Department of Integrated Medicine, Medical Informatics, Graduated School of Medicine, Osaka University, Osaka, Japan
,
S. Kuwata
2   Medical Informatics Division, Tottori University Hospital, Tottori, Japan
,
H. Takeda
1   Department of Integrated Medicine, Medical Informatics, Graduated School of Medicine, Osaka University, Osaka, Japan
› Author Affiliations
Further Information

Publication History

Publication Date:
22 January 2018 (online)

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Summary

Objectives: To apply an institutional clinical data warehouse (CDW) to the assessment of adverse drug reactions (ADRs) and demonstrate its utility through a specific example.

Methods: We modeled the process for assessing ADRs through retrospective cohort design by using CDW at the Osaka University Hospital as follows: 1) We defined a drug X, an adverse drug reaction (ADR) Y, and a laboratory measurement Z to assess Y during a given study period; 2) we excluded those whose Z value exceeded the defined criteria or were not available at the inception of the cohort; 3) we divided the patients into two groups based on exposure or non-exposure to X; 4) we matched the patient characteristics between the two groups through stratification and randomization; and 5) we compared the frequency of patients who presented Y during the study period between the two groups. Aminoglycoside and Cephalosporin associated nephrotoxicity in pediatric inpatients was used as an example to demonstrate the usefulness of this approach.

Results: Our evaluation indicates that there is an increased risk of nephrotoxicity for pediatric inpatients who were prescribed cephalosporin either alone or in combination with aminoglycoside; further, aminoglycoside tends to increase the cephalosporin-associated nephrotoxicity.

Conclusions: Our findings are consistent with those drawn from other studies, indicating thatthe method of a pplying an institutional CDW is useful for assessing ADRs.

Keywords

Clinical data warehouse - relational database - retrospective cohort study - adverse drug reactions
 

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