title: Informatics tools for the development of action-oriented triggers for outpatient adverse drug events.
abstract: 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.
authors.affiliation: Boston University School of Public Health, Boston, MA, USA.
authors.forename: Hillary J
authors.initials: HJ
authors.lastname: Mull
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Nebeker
authors.forename: Jonathan Rich
authors.initials: JR
authors.lastname: Nebeker
mesh_terms: 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