Towards a Clinical Decision Support System for Drug Allergy Management: Are Existing Drug Reference Terminologies Sufficient for Identifying Substitutes and Cross-Reactants?
Drug allergy cross-reactivity checking is an important component of electronic health record systems. Currently, a single, open-source medication dictionary that can provide this function does not exist. In this study, we assessed the feasibility of using RxNorm and NDF-RT (National Drug File--Reference Terminology) for allergy management decision support. We evaluated the performance of using the Pharmacological Class, Mechanism of Action and Chemical Structure NDF-RT classifications in discriminating between safe and cross-reactive alternatives to a sample of common drug allergens. The positive predictive values for the three approaches were 96.3%, 99.3% and 96.2% respectively. The negative predictive values were 94.7%, 56.8% and 92.6%. Our findings suggest that in the absence of an established medication allergy classification system, using the Pharmacologic Class and Chemical Structure classifications in NDF-RT may still be effective for discriminating between safe and cross-reactive alternatives to potential allergens.
Department of Biomedical Informatics, Columbia University, New York, USA.
William
W
Ogallo
Department of Biomedical Informatics, Columbia University, New York, USA.
Andrew S
AS
Kanter
D016303:Clinical Pharmacy Information Systems / Q000458:organization & administration*; D003429:Cross Reactions; D020000:Decision Support Systems, Clinical / Q000458:organization & administration*; D004342:Drug Hypersensitivity / Q000175:diagnosis / Q000188:drug therapy*; D057915:Drug Substitution / Q000592:standards*; D006801:Humans; D009323:Natural Language Processing; D012016:Reference Values; D015203:Reproducibility of Results; D062245:RxNorm; D012680:Sensitivity and Specificity; D009626:Terminology as Topic