Article
Computer Science, Information Systems
Joshua M. Inglis, Stephen Bacchi, Alexander Troelnikov, William Smith, Sepehr Shakib
Summary: This study utilized machine learning natural language processing to classify and assess the risk of penicillin ADRs with high accuracy. The artificial neural network model performed best in categorizing allergy or intolerance and evaluating true allergy risk, outperforming simpler algorithms and achieving high sensitivity and specificity. The findings suggest that automated evaluation using machine learning models may improve the specificity of prescribing alerts and facilitate delabelling in real-time risk stratification.
INTERNATIONAL JOURNAL OF MEDICAL INFORMATICS
(2021)
Article
Medicine, General & Internal
Joshua M. Inglis, Gillian E. Caughey, William Smith, Sepehr Shakib
Summary: This study examined the documentation of opioid adverse drug reactions in electronic health records of four public hospitals in South Australia. The majority of the recorded reactions were suggestive of pharmacological intolerance rather than true allergic reactions. A dedicated clinical service for systematic review of adverse drug reactions is needed to improve the accuracy of documentation.
INTERNAL MEDICINE JOURNAL
(2021)
Review
Allergy
Neil Powell, Shuayb Elkhalifa, Autumn Guyer, Tomaz Garcez, Jonathan Sandoe, Li Zhou
Summary: Allergy labels are common, often incorrect, and potentially harmful. Clinical decision support (CDS) tools integrated in electronic health records (EHR) and mobile apps can provide solutions for drug allergy management, including penicillin allergy delabeling (PADL). Improving the infrastructure and relevance of drug allergy alerts is important to reduce alert fatigue and facilitate appropriate antibiotic use.
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE
(2023)
Article
Allergy
Santiago Alvarez-Arango, Sharmitha Yerneni, Olive Tang, Li Zhou, Christian M. Mancini, Suzanne V. Blackley, Corinne Allison Keet, Kimberly G. Blumenthal
Summary: This study described the epidemiology of vancomycin hypersensitivity reactions documented in electronic health records, showing a wide range of reactions including common and severe reactions. The documentation of Red Man Syndrome was more likely for males and less likely for blacks, suggesting a demographic association.
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE
(2021)
Article
Immunology
Matas Griskaitis, Luis Furuya-Kanamori, Kasim Allel, Richard Stabler, Patrick Harris, David L. Paterson, Laith Yakob
Summary: This study aimed to determine whether the temporal dynamics of resistance emergence at the individual-patient level were predictable for specific pathogen-drug classes. It was found that beta-lactam-resistant Streptococcus pneumoniae peaked 4 days after treatment completion. The decline of resistance was slower compared to its emergence, returning to preexposure levels 1 month after treatment. Based on this finding, resistance surveillance should target this temporal peak.
CLINICAL INFECTIOUS DISEASES
(2022)
Article
Immunology
Bernardo Sousa-Pinto, Kimberly G. Blumenthal, Eric Macy, Ana Margarida Pereira, Luis Filipe Azevedo, Luis Delgado, Joao Almeida Fonseca
Summary: The study projected that penicillin allergy testing is cost-saving in both inpatient and outpatient settings, with potential average savings in United States dollars for patients. Probabilistic sensitivity analysis showed that testing was the less costly option in 75% of simulations, supporting policies promoting widespread testing of patients with a penicillin allergy label.
CLINICAL INFECTIOUS DISEASES
(2021)
Article
Medicine, General & Internal
Joshua M. Inglis, Stephen Bacchi, Alexander Troelnikov, William Smith, Sepehr Shakib
Summary: Machine learning models developed by the research team were able to classify penicillin adverse drug reaction (ADR) labels using free-text reaction descriptions, and their effectiveness was validated externally and practically. These models performed comparably to expert criteria in categorizing allergy or intolerance and identifying high-risk allergies. They have practical applications in identifying individuals suitable for penicillin ADR evaluation. Implementation studies are needed.
INTERNAL MEDICINE JOURNAL
(2023)
Article
Pharmacology & Pharmacy
Mona Al-Ahmad, Jusufovic Edin, Fardous Musa, Tito Rodriguez-Bouza
Summary: The study analyzed data from a national drug allergy registry over a 12-year period, focusing on common drugs associated with clinical reactions, diagnostic methods used, and outcomes of allergic evaluations. Results showed that anti-inflammatory drugs, analgesics, and antibiotics, particularly beta-lactam antibiotics, were the major contributors to confirmed drug allergies. Skin tests and drug provocation tests were key diagnostic methods, with respiratory symptoms and urticaria being the most common presenting symptoms among patients with confirmed hypersensitivity reactions.
FRONTIERS IN PHARMACOLOGY
(2021)
Article
Pharmacology & Pharmacy
Md Muntasir Zitu, Shijun Zhang, Dwight H. H. Owen, Chienwei Chiang, Lang Li
Summary: This study evaluated the generalizability of machine learning methods, specifically natural language processing (NLP) techniques, for detecting adverse drug events (ADEs) in electronic medical records (EMRs). The researchers constructed a new corpus and utilized data from Harvard's National Clinical Challenge (n2c2) to compare the performance of different machine learning methods in detecting drug-ADE relationships. They found that ClinicalBERT showed superior performance compared to other methods, demonstrating its potential for accurately detecting drug-ADE relationships in clinical narratives in EMRs.
FRONTIERS IN PHARMACOLOGY
(2023)
Article
Allergy
Lauren W. Kaminsky, Sarah Al-Obaydi, Rezhan H. Hussein, Alexandra A. Horwitz, Taha Al-Shaikhly
Summary: This study investigated the impact of penicillin allergy label on clinical outcomes in children with pneumonia. The results showed that the allergy label was associated with higher risk of hospitalization, acute respiratory failure, and need for intensive care. The label also resulted in overutilization of broader-spectrum antibiotics and increased complications.
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE
(2023)
Article
Computer Science, Interdisciplinary Applications
Sara Santiso, Alicia Perez, Arantza Casillas
Summary: This work focuses on extracting ADRs from EHRs in Spanish using a deep neural network approach. The system shows the ability to handle cross-hospital predictions and has a certain tolerance to external variations. However, errors in entity recognition can lead to a decrease in performance in the ADR detection stage.
COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE
(2021)
Article
Medicine, General & Internal
Silabhakta Livirya, Alan Pithie, Ignatius Chua, Niall Hamilton, Matthew Doogue, Heather Isenman
Summary: Careful assessment of ADR history allows for de-labelling of many patients. An oral amoxicillin challenge without prior skin testing is safe and feasible for low-risk penicillin allergic patients while in hospital.
INTERNAL MEDICINE JOURNAL
(2022)
Article
Allergy
Autumn C. Guyer, Eric Macy, Andrew A. White, Merin E. Kuruvilla, Rachel G. Robison, Santhosh Kumar, David A. Khan, Elizabeth J. Phillips, Allison Ramsey, Kimberly Blumenthal
Summary: The allergy section of the electronic health record plays a crucial role in clinical decision-making and treatment planning, but current allergy modules do not meet the requirements. We recommend collaboration between EHR vendors and allergists to optimize and modernize allergy documentation, providing meaningful, accurate, timely, and comprehensive allergy information.
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE
(2022)
Article
Public, Environmental & Occupational Health
Suehyun Lee, Hyunah Shin, Seon Choe, Min-Gyu Kang, Sae-Hoon Kim, Dong Yoon Kang, Ju Han Kim
Summary: This study aimed to improve the MetaLAB algorithm and validate its performance in detecting major adverse drug reactions, including drug-induced liver injury, with multicenter data. By considering demographic and clinical records, an optimized scenario for detecting adverse drug reactions was created based on MetaLAB. The MetaLAB-HOI algorithm was developed using common model-based multicenter electronic health record data to identify adverse drug reaction signals. The odds ratios of 101 drugs for health outcomes of interest were calculated in four medical centers.
PHARMACOEPIDEMIOLOGY AND DRUG SAFETY
(2023)
Article
Multidisciplinary Sciences
Martijn Sijbom, Karolina K. Braun, Frederike L. Buchner, Leti van Bodegom-Vos, Bart J. C. Hendriks, Mark G. J. de Boer, Mattijs E. Numans, Merel M. C. Lambregts
Summary: This study analyzed the completeness and correctness of antibiotic allergy registration in primary care practice and identified determinants for improvement through interviews with healthcare providers. The study found very low rates of completeness and correctness in registrations, with main barriers including insufficient knowledge, lack of priority, limitations of registration features in electronic medical records, fear of medical liability, and patients misinterpreting side-effects as allergies. Potential interventions to improve the quality of antibiotic allergy registrations include raising awareness through continued education and simplifying registration in electronic medical records with adequate ICT support.
Article
Public, Environmental & Occupational Health
Lynne Parkinson, Rachael Moorin, Geeske Peeters, Julie Byles, Fiona Blyth, Gillian Caughey, Michelle Cunich, Parker Magin, Lyn March, Dimity Pond
AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH
(2016)
Article
Health Care Sciences & Services
Jodie B. Hillen, Agnes Vitry, Gillian E. Caughey
AUSTRALIAN JOURNAL OF PRIMARY HEALTH
(2016)
Article
Endocrinology & Metabolism
G. E. Caughey, J. D. Barratt, S. Shakib, A. Kemp-Casey, E. E. Roughead
Article
Medicine, General & Internal
G. E. Caughey, A. I. Vitry, E. N. Ramsay, A. L. Gilbert, S. Shakib, P. Ryan, A. Esterman, R. A. McDermott, E. E. Roughead
INTERNAL MEDICINE JOURNAL
(2016)
Article
Medicine, General & Internal
Gillian E. Caughey, Nicole L. Pratt, John D. Barratt, Sepehr Shakib, Anna R. Kemp-Casey, Elizabeth E. Roughead
MEDICAL JOURNAL OF AUSTRALIA
(2017)
Article
Medicine, General & Internal
Gillian E. Caughey, Kirsty Tait, Agnes I. Vitry, Sepehr Shakib
PATIENT PREFERENCE AND ADHERENCE
(2017)
Review
Geriatrics & Gerontology
Nashwa Masnoon, Sepehr Shakib, Lisa Kalisch-Ellett, Gillian E. Caughey
Review
Geriatrics & Gerontology
Nashwa Masnoon, Sepehr Shakib, Lisa Kalisch-Ellett, Gillian E. Caughey
Article
Orthopedics
M. C. S. Inacio, K. Cashman, N. L. Pratt, M. H. Gillam, G. Caughey, S. E. Graves, E. E. Roughead
OSTEOARTHRITIS AND CARTILAGE
(2018)
Article
Pharmacology & Pharmacy
Nicholas Farinola, Gillian E. Caughey, J. Simon Bell, Sally Johns, Milka Hauta-aho, Sepehr Shakib
THERAPEUTIC ADVANCES IN DRUG SAFETY
(2018)
Article
Pharmacology & Pharmacy
Gillian E. Caughey, Lisa M. Kalisch Ellett, John D. Barratt, Sepehr Shakib
THERAPEUTIC ADVANCES IN DRUG SAFETY
(2017)
Article
Geriatrics & Gerontology
Jodie Belinda Hillen, Agnes Vitry, Gillian E. Caughey
AUSTRALASIAN JOURNAL ON AGEING
(2017)
Article
Pharmacology & Pharmacy
Gao-Jing Ong, Amy Page, Gillian Caughey, Sally Johns, Emily Reeve, Sepehr Shakib
PHARMACOLOGY RESEARCH & PERSPECTIVES
(2017)
Article
Pharmacology & Pharmacy
Esa Y. H. Chen, Basia Diug, J. Simon Bell, Kevin P. Mc Namara, Michael J. Dooley, Carl M. Kirkpatrick, John J. McNeil, Gillian E. Caughey, Jenni Ilomaki
THERAPEUTIC ADVANCES IN DRUG SAFETY
(2016)