title: Postmarketing safety surveillance : where does signal detection using electronic healthcare records fit into the big picture?
abstract: The safety profile of a drug evolves over its lifetime on the market; there are bound to be changes in the circumstances of a drug's clinical use which may give rise to previously unobserved adverse effects, hence necessitating surveillance postmarketing. Postmarketing surveillance has traditionally been carried out by systematic manual review of spontaneous reports of adverse drug reactions. Vast improvements in computing capabilities have provided opportunities to automate signal detection, and several worldwide initiatives are exploring new approaches to facilitate earlier detection, primarily through mining of routinely-collected data from electronic healthcare records (EHR). This paper provides an overview of ongoing initiatives exploring data from EHR for signal detection vis-à-vis established spontaneous reporting systems (SRS). We describe the role SRS has played in regulatory decision making with respect to safety issues, and evaluate the potential added value of EHR-based signal detection systems to the current practice of drug surveillance. Safety signal detection is both an iterative and dynamic process. It is in the best interest of public health to integrate and understand evidence from all possibly relevant information sources on drug safety. Proper evaluation and communication of potential signals identified remains an imperative and should accompany any signal detection activity.
authors: Ee-2116, Department of Medical Informatics, Erasmus Medical Centre, PO Box 2040, 3000 CA, Rotterdam, The Netherlands. p.coloma@erasmusmc.nl
authors: Preciosa M
authors: PM
authors: Coloma
authors: Gianluca
authors: G
authors: Trifirò
authors: Vaishali
authors: V
authors: Patadia
authors: Miriam
authors: M
authors: Sturkenboom
mesh_terms: D016907:Adverse Drug Reaction Reporting Systems / Q000706:statistics & numerical data*; D057225:Data Mining / Q000379:methods*; D016208:Databases, Factual / Q000706:statistics & numerical data*; D003695:Delivery of Health Care / Q000379:methods; D064420:Drug-Related Side Effects and Adverse Reactions; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D006801:Humans; D060735:Pharmacovigilance; D011358:Product Surveillance, Postmarketing
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