Informatics tools for the development of action-oriented triggers for outpatient adverse drug events.
BACKGROUND
Trigger tools are an important development in the identification and reduction of adverse drug events (ADEs). Most previously published triggers are simple, consisting of one or two conditions. Simple logic may lead to alerts for conditions not caused by a drug or already treated by the provider.


METHODS
We created a knowledge-encoding tool to develop outpatient ADE triggers to more specifically identify harm caused by a drug and which require further clinical intervention. The tool presented the user with data on similar triggers from the literature and a series of fields to facilitate the creation of algorithms based on epidemiological principles.


RESULTS
Using this tool, we created 23 triggers that addressed 55 high-harm outpatient drugs and ADEs.


CONCLUSIONS
Informatics tools can facilitate the design of clinically rich triggers. More investigation is needed to determine whether the performance characteristics of clinically rich triggers are better than those of simple triggers.
Mull
Hillary J
HJ
Boston University School of Public Health, Boston, MA, USA.
Nebeker
Jonathan R
JR
Nebeker
Jonathan Rich
JR
D000553:Ambulatory Care / Q000379:methods*; D001185:Artificial Intelligence; D020000:Decision Support Systems, Clinical / Q000458:organization & administration*; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000175:diagnosis* / Q000517:prevention & control*; D008404:Massachusetts; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012984:Software