title: A similarity measure for case based reasoning modeling with temporal abstraction based on cross-correlation.
abstract: Adverse drug events (ADEs) are a major limitation of drug safety. They are often caused by inappropriate selection of dose and the concurrent use of drugs modulating each other (drug interaction). Risk assessment and prevention strategies must therefore consider co-administered drugs, individual doses, and their timing. In a new approach we evaluated the performance of cross correlation, commonly used in signal processing, to determine similarities in patient treatments. To achieve this, patient treatments were modeled as groups of vectors representing discrete time intervals. These vectors were cross-correlated and the results evaluated to find clusters in time courses indicating similarity in treatment of different patients. To evaluate our algorithm, we then created a number of test cases. The focus of this article is on each treatment, and its pattern in time and dosage. The algorithm successfully produces a relatively low similarity score for cases that are completely different with respect to their pattern of time and dosage but high scores when they are equal (score of 0.699) or similar (score of 0.528) in their therapies, and thus succeeds in having a relatively high specificity (27/30). Such an approach might help to considerably reduce the problem of false alarms which hampers most existing alerting systems for medication errors or impending ADEs.
authors.affiliation: Institute for Medical Biometry and Informatics, Department Medical Informatics, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany. florian.hartge@med.uni-heidelberg.de
authors.forename: Florian
authors.initials: F
authors.lastname: Hartge
authors.forename: Thomas
authors.initials: T
authors.lastname: Wetter
authors.forename: Walter E
authors.initials: WE
authors.lastname: Haefeli
mesh_terms: D016907:Adverse Drug Reaction Reporting Systems; D000465:Algorithms; D016303:Clinical Pharmacy Information Systems; D004347:Drug Interactions; D006801:Humans; D007202:Indicators and Reagents; D008508:Medication Errors; D008510:Medication Systems, Hospital; D015233:Models, Statistical; D004364:Pharmaceutical Preparations; D015203:Reproducibility of Results; D012107:Research Design; D012308:Risk Management; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted; D012984:Software; D013997:Time Factors; D014894:Weights and Measures
chemical_list: D007202:Indicators and Reagents; D004364:Pharmaceutical Preparations