The EU-ADR Project: Preliminary Results
and Perspective
Gianluca TRIFIRO
a, b, 1
, Annie FOURRIER-REGLAT
c
, Miriam C.J.M.
STURKENBOOM
a
, Carlos DÍAZ ACEDO
d
and Johan VAN DER LEI
a
, on behalf of
the EU-ADR Group
a
Department of Medical Informatics, Erasmus University Medical Center, Rotterdam,
The Netherlands
b
IRCCS Centro Neurolesi ‘‘Bonino-Pulejo’’, Messina, Italy
c
Inserm U 657, Pharmacology Department, Bordeaux, France
d
Fundació IMIM - European Projects Management Office, Barcelona, Spain.
Abstract. The EU-ADR project aims to exploit different European electronic
healthcare records (EHR) databases for drug safety signal detection. In this paper
we describe the project framework and the preliminary results. Methods: As first
step we created a ranked list of the events that are deemed to be important in
pharmacovigilance as mining on all possible events was considered to unduly
increase the number of spurious signals. All the drugs that are potentially
associated to these events will be detected via data mining techniques. Data
sources are eight 8 databases in four countries (Denmark, Italy, the Netherlands,
and the United Kingdom) that are virtually linked through harmonisation of input
data followed by local elaboration of input data through custom-built software
(Jerboa©). All the identified drug-event associations (signals) will be thereafter
biologically substantiated and epidemiologically validated. To date, only Upper
gastrointestinal bleeding (UGIB) event has been used to test the ability of the
system in signal detection. Results: An initial ranked list comprising 23 adverse
events was identified. The top-ranking events were: cutaneous bullous eruptions,
acute renal failure, acute myocardial infarction, anaphylactic shock, and
rhabdomyolysis. Regarding the UGIB test, a total of 48,016 first-ever episodes
were identified. The age-standardized incidence rates of UGIB varied between 40-
100/100,000 person-years depending on country and type of healthcare database.
A statistically significant association between use of NSAIDs and UGIB was
detected in all of the databases. Conclusion: a dynamic ranked list of 23 adverse
drug events judged as important in pharmacovigilance was created to permit
focused data mining. Preliminary results on the UGIB event detection demonstrate
the feasibility of harmonizing various health care databases in different European
countries through a distributed network approach.
Keywords: Pharmacovigilance, electronic health records, biomedical knowledge,
signal generation, signal substantiation
Introduction
In pharmacovigilance, a signal is defined by the World Health Organization as
information on a possible causal relationship between an adverse event and a drug,
1 Corresponding Author: trifirog@unime.it
Detection and Prevention of Adverse Drug Events
R. Beuscart et al. (Eds.)
IOS Press, 2009
© 2009 The authors and IOS Press. All rights reserved.
doi:10.3233/978-1-60750-043-8-43
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