title: Adequacy of representation of the National Drug File Reference Terminology Physiologic Effects reference hierarchy for commonly prescribed medications.
abstract: The National Drug File Reference Terminology contains a novel reference hierarchy to describe physiologic effects (PE) of drugs. The PE reference hierarchy contains 1697 concepts arranged into two broad categories; organ specific and generalized systemic effects. This investigation evaluated the appropriateness of the PE concepts for classifying a random selection of commonly prescribed medications. Ten physician reviewers classified the physiologic effects of ten drugs and rated the accuracy of the selected term. Inter reviewer agreement, overall confidence, and concept frequencies were assessed and were correlated with the complexity of the drug's known physiologic effects. In general, agreement between reviewers was fair to moderate (kappa 0.08-0.49). The physiologic effects modeled became more disperse with drugs having and inducing multiple physiologic processes. Complete modeling of all physiologic effects was limited by reviewers focusing on different physiologic processes. The reviewers were generally comfortable with the accuracy of the concepts selected. Overall, the PE reference hierarchy was useful for physician reviewers classifying the physiologic effects of drugs. Ongoing evolution of the PE reference hierarchy as it evolves should take into account the experiences of our reviewers.
authors.affiliation: Vanderbilt University, USA.
authors.forename: S Trent
authors.initials: ST
authors.lastname: Rosenbloom
authors.forename: Joseph
authors.initials: J
authors.lastname: Awad
authors.forename: Ted
authors.initials: T
authors.lastname: Speroff
authors.forename: Peter L
authors.initials: PL
authors.lastname: Elkin
authors.forename: Russell
authors.initials: R
authors.lastname: Rothman
authors.forename: Anderson
authors.initials: A
authors.lastname: Spickard
authors.forename: Josh
authors.initials: J
authors.lastname: Peterson
authors.forename: Brent A
authors.initials: BA
authors.lastname: Bauer
authors.forename: Dietland L
authors.initials: DL
authors.lastname: Wahner-Roedler
authors.forename: Mark
authors.initials: M
authors.lastname: Lee
authors.forename: William M
authors.initials: WM
authors.lastname: Gregg
authors.forename: Kevin B
authors.initials: KB
authors.lastname: Johnson
authors.forename: Jim
authors.initials: J
authors.lastname: Jirjis
authors.forename: Mark S
authors.initials: MS
authors.lastname: Erlbaum
authors.forename: John S
authors.initials: JS
authors.lastname: Carter
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Lincoln
authors.forename: Steven H
authors.initials: SH
authors.lastname: Brown
mesh_terms: D004358:Drug Therapy; D006801:Humans; D008954:Models, Biological; D004364:Pharmaceutical Preparations; D010600:Pharmacology; D010827:Physiology; D018875:Vocabulary, Controlled
chemical_list: D004364:Pharmaceutical Preparations