Facilitating statistical and visual pattern detection in large databases of

electronic health records:

Introducing the vigiTrace analytics suite

Ola Caster

DSV Data Science Seminar, Kista 4th December 2014

Acknowledgement to Niklas Norén

Ola Caster, Uppsala Monitoring Centre

WHO Programme for International Drug Monitoring

Ola Caster, Uppsala Monitoring Centre

Ola Caster, Uppsala Monitoring Centre

Ola Caster, Uppsala Monitoring Centre

Longitudinal health records

Ola Caster, Uppsala Monitoring Centre

Ola Caster, Uppsala Monitoring Centre

Ola Caster, Uppsala Monitoring Centre

million

Ola Caster, Uppsala Monitoring Centre

UMC research timeline

Ola Caster, Uppsala Monitoring Centre

vigiTrace

Chronographs

(visualised temporal patterns)

Pattern detection

(screening based on calibrated self-controlled cohort analysis)

+

+

Chronograph example: Adverse effect

Chronograph example: Beneficial effect

Which chronographs to highlight?

Ola Caster, Uppsala Monitoring Centre

Calibrated self-controlled cohort analysis

Drug-event overview

Chronograph

Contrasts

Drug-event list (’screening’)

Event overview

Drug overview Patient list

Patient history

Patient overview

6

Nifedipine Flushing

7 20 x x

Sibutramine Oedema

assessors drugs per assessor

events per drug

509

127 Already known

382 25%

Results

509

127 Already known

382

291 Dismissed

91

Merit further evaluation

25% 76%

Results

Ola Caster, Uppsala Monitoring Centre

Take-home messages

• Databases of electronic health records hold promise as a complementary data source in pharmacovigilance

• UMC has been involved in this scientific development for a long time, contributing both broadly and deeply

• vigiTrace facilitates detection and visualisation of relevant temporal patterns, as well as in-depth expert assessment of the underlying data

Uppsala Monitoring Centre Box 1051 SE-751 40 Uppsala, Sweden Visiting address: Bredgränd 7, Uppsala Tel: +46 18 65 60 60 Fax: +46 18 65 60 88

Website: www.who-umc.org

Ola Caster, Uppsala Monitoring Centre

References

• Norén GN, Edwards IR. Modern methods of pharmacovigilance: detecting adverse effects of drugs. Clinical Medicine, Journal of the Royal College of Physicians, 2009. 9(5):486-489.

• Norén GN, Hopstadius J, Bate A, Star K, Edwards IR. Temporal pattern discovery in longitudinal electronic patient records. Data Mining and Knowledge Discovery, 2010. 20(3):361-387.

• Norén GN, Edwards IR. Opportunities and challenges of adverse drug reaction surveillance in electronic patient records. Pharmacovigilance Review, 2010. 4(1):17-20.

• Star K, Bate A, Meyboom RHB, Edwards IR. Pneumonia following antipsychotic prescriptions in electronic health records: a patient safety concern? British Journal of General Practice, 2010. 60(579):e385-e394.

• Cederholm S, Hill G, Asiimwe A, Bate A, Bhayat F, Brobert G, Bergvall T, Ansell D, Star K, Norén GN. Structured assessment for prospective identification of safety signals in electronic medical records: evaluation in The Health Improvement Network. Drug Safety, 2014. In press.