Evaluation of a computer-based adverse-drug-event monitor.
OBJECTIVE
The performance of a computer-based adverse-drug-event (ADE) monitor is evaluated, and the characteristics of ADEs detected and undetected by the monitor are compared.


METHODS
A retrospective analysis was conducted to identify ADEs using pre-defined ADE alerts that were recognized by a computer-based ADE monitor in a 1300-bed, tertiary care, teaching hospital in Seoul, Korea. A subsequent chart review was conducted by a pharmacist to confirm the ADEs and identify ADEs unrecognized by the monitor. The performance of the monitor was evaluated for its sensitivity and positive predictive value in detecting an ADE. The differences in characteristics of ADEs were compared between computer-recognized ADEs and computer-unrecognized ADEs for severity, causality, preventability, associated clinical manifestations, and types of ADEs.


RESULTS
During a one-month period, a total of 598 patients from two intensive care units and five general wards were monitored to identify ADEs. The computer-based ADE monitor identified 148 ADEs, and the chart review identified 39 computer-unrecognized ADEs. The sensitivity of the computer-based ADE monitor was 79% (148 of 187). The computer-recognized ADEs were more severe than computer-unrecognized ADEs, but there were no statistically significant differences in the causality, preventability, and types of ADEs. The positive predictive value of the computer monitor was 21% (148 of 718).


CONCLUSIONS
The computer-based ADE monitor successfully identified most of the ADEs and almost all of the severe ADEs that occurred in the hospitalized patients. However, the accuracy of the computer-based ADE monitor needs to be improved.
Hwang
Soo-Hee
SH
Center for Interoperable Electronic Health Record, Seoul, Korea.
Lee
Sukhyang
S
Koo
Hyun-Kyung
HK
Kim
Yoon
Y
D016907:Adverse Drug Reaction Reporting Systems / Q000592:standards* / Q000706:statistics & numerical data; D016303:Clinical Pharmacy Information Systems / Q000592:standards*; D003199:Computer Systems / Q000592:standards; D016903:Drug Monitoring / Q000379:methods; D064420:Drug-Related Side Effects and Adverse Reactions; D006746:Hospital Bed Capacity, 500 and over; D006760:Hospitalization / Q000706:statistics & numerical data; D006784:Hospitals, Teaching; D006801:Humans; D007723:Korea; D008485:Medical Audit; D015203:Reproducibility of Results; D012189:Retrospective Studies