Improving Online Access to Drug-Related Information
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Transcript of Improving Online Access to Drug-Related Information
Improving Online Access to Drug-related Information
Acknowledgements
Jiao Li, Ph.D., Ritu Khare, Ph.D., Zhiyong Lu, Ph.D.
National Center for Biotechnology Information (NCBI)
National Library of Medicine, National Institutes of Health
Linking drug monographs to diseases of interest Introduction
Drug Monographs
• Each monograph is subject to a drug’s
generic name/active ingredient (e.g.,
‘Ibuprofen’) rather than its specific drug
product (e.g., ‘Advil®’)
• Drugs with same ingredients but
different dosage forms may be
described in different monographs.
Diclofenac (Transdermal)
Diclofenac (Ophthalmic)
Diclofenac (Topical)
Brand name vs. Ingredient name
• When searching for drug information,
consumers use brand names rather
than generic names.
Seeking drug-related information is one of the major activities of today’s
online health consumers. In this work, our goals are:
(1) To facilitate health consumers to access trustworthy drug information online
(2) To provide consumers with integrated access to other health resources
Fig 1. Health consumers’ behaviors of seeking drug-related information
Fig 3. Resources containing
drug-disease relationships
References 1. Islamaj DR, Murray GC, Neveol A, and Lu Z: Understanding PubMed user search behavior through
log analysis. Database (Oxford) 2009, 2009:bap018.
2. Li J. and Lu Z. Automatic Identification and Normalization of Dosage Forms in Drug Monographs.
BMC Medical Informatics and Decision Making 2012, 12:9.
3. Li J. and Lu Z. Assigning Brand Names to Drug Monographs in PubMed Health. The AMIA 2011
Annual Symposium. 2011. Washington DC, USA
4. MedlinPlus® http://www.nlm.nih.gov/medlineplus/
5. American Hospital Formulary Service® (AHFS) drug information
http://www.ahfsdruginformation.com/
6. A.D.A.M. Medical Encyclopedia http://www.adam.com/MutlimediaEncyclopedia.aspx
7. RxNorm http://www.nlm.nih.gov/research/umls/rxnorm/
8. PubMed® http://www.ncbi.nlm.nih.gov/pubmed/
9. PubMed Health http://www.ncbi.nlm.nih.gov/pubmedhealth/
Enriching drug monographs
by automatically assigning brand names
Fig 2. Flowchart for determining brand names
Conclusions
RxNorm
• A standardized
nomenclature
for clinical drugs
• Drug brand
related concepts
in RxNorm
Assigning brand names to a given
drug monograph
Assignment Result
• Our method is applicable to 957 drug
monographs (1095 in total).
• Our method can help human editors update
and revise drug information.
Identifying diseases of
interest from drug monographs
Ranking diseases of interest
θ s g = α ∗ pM s g + β ∗ pF s g + γ ∗ pQ s g + 𝛿 ∗ 𝑝𝐿(𝑠|𝑔)
= 𝛼 ∗𝑛𝑀 𝑔,𝑠
𝑛𝑀 𝑔+ 𝛽 ∗
𝑛𝐹 𝑔,𝑠
𝑛𝐹 𝑔+ 𝛾 ∗
𝑛𝑄 𝑔,𝑠
𝑛𝑄 𝑔+ 𝛿 ∗
𝑛𝐿 𝑔,𝑠
𝑛𝐿 𝑔
𝜏 𝑠 𝑔 =𝑞 𝑠 𝑔
𝑞 𝑠=
𝑓 𝑔, 𝑠𝑓 𝑔
𝑓 𝑠𝑁
=𝑓 𝑔, 𝑠 ∗ 𝑁
𝑓 𝑔 ∗ 𝑓 𝑠
• Search trends
• Evidence confidence
𝑟 𝑠|𝑔 = 𝜃 𝑠 𝑔 ∗ 𝑒𝜏 𝑠|𝑔
• Relevant score
s: Disease
g: Drug
𝒑𝑀 𝑠 𝑔 : drug-disease in disease
monographs
𝒑𝑭 𝑠 𝑔 : drug-disease in drug monographs
𝒑𝑸 𝑠 𝑔 : drug-disease searched by users
𝒑𝑳 𝑠 𝑔 : drug-disease in scientific literature
where,
Filtering drug-disease
relationships
Statistics-based filter:
Hypergeometric p-value is used to
measure the significance of relationships
identified from queries and literature.
Domain knowledge based filter:
Drugs in specific physical forms should be
applied in specific categories of diseases.
Drug dose form Disease category
Ophthalmic Cream Ophthalmology
Otic Solution Otolaryngology
Vaginal Cream Obstetrics & Gynecology
Our study has several practical implications in real-world medical informatics:
• Facilitating consumers to access drug information through brand name search
• Facilitating consumers to access drug-related disease monographs, and ranking
diseases based on evidence confidence and user interest
• Helping drug monograph editors update drug information such as brand names
• Accurately characterizing monographs using features like ingredients & dosage forms
Results Input: a drug
monograph Enlarged prostate
Prostatitis - bacterial
chronic
Prostatitis - nonbacterial
- chronic
Cataract
Output: ranked
diseases of interest
Search query
Q_ID Q_Term
Q831368 flomax cataract
Q1129241 tamsulosin cataract
Q952568 flomax and cataract
surgery
Q235052 flomax cataract
surgery
Literature
Health Consumer
· Search drug names
§ Active ingredients
( e.g., Ibuprofen)
§ Brand names
(e.g., Advil, Motrin)
(1)
Drug monograph
Disease
Compound
Gene
Protein
Literature
Clinical Trial
(2)
Advil
Brand Name (BN)
Ibuprofen
Ingredient (IN)
Advil 100 MG Oral Tablet
[Obsolete=N]
[Veterinary=N]
Branded Drug or Package (SBD)
Oral Tablet
Dosage Form (DF)
has_ingredient
ingredient_of
has_dose_form
dose_form_of
has_tradename tradename_of
Allfen
Brand Name (BN)
Guaifenesin
Ingredient (IN)
Allfen Reformulated Mar 2007
Brand Name (BN)
has_ingredient
ingredient_of
has_ingredient
ingredient_of Guaifenesin
Guaiacolsulfonate
Ingredient (IN)
reformulation_of has reformulation
Input: A full-text drug monograph
Identify ingredients and dosage forms
Map to RxNorm [2]
Identify brand names in RxNorm
(1) Ingredient Consistency
(2) Dosage Form Consistency
(3) Obsolescence
(4) Reformulation
(5) Veterinary
Output: Brand Names
Resources containing drug-disease relationships
Literature
e.g., study [Drug] in [Disease]
Drug monograph
e.g., the [Drug] is used for treating [Disease]
Disease monograph
e.g., the [Disease] can be treated by [Drug]
Search query
e.g., [Drug] [Disease]
LL0.01 L0.05L0.1
M
F
Q Q0.01Q0.05Q0.1
Tamsulosin(tam soo' loe sin)
Why is this medication prescribed?Tamsulosin is used in men to treat the symptoms of an enlarged prostate (benign prostatic hyperplasia or BPH) which include difficulty urinating (hesitation, dribbling, weak stream, and incomplete bladder emptying), painful urination, and urinary frequency and urgency. Tamsulosin is in a class of medications called alpha blockers. It works by relaxing the muscles in the prostate and bladder so that urine can flow easily.
This research was supported by the Intramural Research Program of the National Institutes of Health,
National Library of Medicine. We would like to thank our colleagues Dr. Stuart J. Nelson, Dr. John
Kilbourne, and Dr. Olivier Bodenreider for discussing the meaningful use of RxNorm.