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Drug Safety
Published in: Drug Safety 4/2018

01-04-2018 | Original Research Article

An Automated System Combining Safety Signal Detection and Prioritization from Healthcare Databases: A Pilot Study

Authors: Mickael Arnaud, Bernard Bégaud, Frantz Thiessard, Quentin Jarrion, Julien Bezin, Antoine Pariente, Francesco Salvo

Published in: Drug Safety | Issue 4/2018

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Abstract

Introduction

Signal detection from healthcare databases is possible, but is not yet used for routine surveillance of drug safety. One challenge is to develop methods for selecting signals that should be assessed with priority.

Aim

The aim of this study was to develop an automated system combining safety signal detection and prioritization from healthcare databases and applicable to drugs used in chronic diseases.

Methods

Patients present in the French EGB healthcare database for at least 1 year between 2005 and 2015 were considered. Noninsulin glucose-lowering drugs (NIGLDs) were selected as a case study, and hospitalization data were used to select important medical events (IME). Signal detection was performed quarterly from 2008 to 2015 using sequence symmetry analysis. NIGLD/IME associations were screened if one or more exposed case was identified in the quarter, and three or more exposed cases were identified in the population at the date of screening. Detected signals were prioritized using the Longitudinal-SNIP (L-SNIP) algorithm based on strength (S), novelty (N), and potential impact of signal (I), and pattern of drug use (P). Signals scored in the top 10% were identified as of high priority. A reference set was built based on NIGLD summaries of product characteristics (SPCs) to compute the performance of the developed system.

Results

A total of 815 associations were screened and 241 (29.6%) were detected as signals; among these, 58 (24.1%) were prioritized. The performance for signal detection was sensitivity = 47%; specificity = 80%; positive predictive value (PPV) 33%; negative predictive value = 82%. The use of the L-SNIP algorithm increased the early identification of positive controls, restricted to those mentioned in the SPCs after 2008: PPV = 100% versus PPV = 14% with its non-use. The system revealed a strong new signal with dipeptidylpeptidase-4 inhibitors and venous thromboembolism.

Conclusion

The developed system seems promising for the routine use of healthcare data for safety surveillance of drugs used in chronic diseases.
Appendix
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Metadata
Title
An Automated System Combining Safety Signal Detection and Prioritization from Healthcare Databases: A Pilot Study
Authors
Mickael Arnaud
Bernard Bégaud
Frantz Thiessard
Quentin Jarrion
Julien Bezin
Antoine Pariente
Francesco Salvo
Publication date
01-04-2018
Publisher
Springer International Publishing
Published in
Drug Safety / Issue 4/2018
Print ISSN: 0114-5916
Electronic ISSN: 1179-1942
DOI
https://doi.org/10.1007/s40264-017-0618-y

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