Int. J. Pharm. Sci. Rev. Res., 28(2), September – October 2014; Article No. 18, Pages: 95-100 ISSN 0976 – 044X
International Journal of Pharmaceutical Sciences Review and Research
Available online at www.globalresearchonline.net
© Copyright protected. Unauthorised republication, reproduction, distribution, dissemination and copying of this document in whole or in part is strictly prohibited. © Copyright pro
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Satish Chandel* , Nidhi Jain, Abhay Joshi, Rakesh Sonawane, Arvind Sharma, Satish Chandel
Department of Pharmacology, Gandhi Medical College, Bhopal, India.
* Corresponding author’s E-mail: dr.satishchandel@gmail.com
Accepted on: 24-07-2014; Finalized on: 30-09-2014.
ABSTRACT
Signal detection is important and core activity of pharmacovigilance. The primary aims of pharmacovigilance are to collect, monitor,
assess and evaluate information regarding adverse effects, especially those which are serious or unexpected; and also involve
providing information about potential and investible hazards. The signal detection and its dissemination seem to be important utility
of pharmacovigilance database. It has power to prevent the epidemics of serious adverse drug reaction before gross damage to
community. The historical medical calamities could have been prevented if technique like signal detection and pharmacovigilance
would have been practiced since that time.
Keywords: Adverse drug reaction, Pharmacovigilance, Signal, Bayesian Confidence Propagation Neural Network, Information
component.
INTRODUCTION
rugs are among the miracles of this era. They have
saved billions of life and will continue to do same
in future. They have helped to bring improved
health and longer life to the human. The practice
of medicine should be assessable, available, affordable,
and most importantly ‘safe’. But we must understand that
they are not without risk. Drugs do not always benefit the
recipients instead they can harm some times. The
damage done by the drugs can range from mild,
moderate to severe or life threatening. This harm and
damage done by drugs when it is given in dose normally
used in men is called adverse drug reaction (ADR).
Practically each and every drug can cause adverse drug
reaction. World health organization (WHO) has defined
adverse drug reaction as “A response to a drug which is
noxious and unintended, and which occurs at doses
normally used for the prophylaxis, diagnosis or therapy of
disease, or for the modification of physiological function”.
An adverse event is defined as harmful and inadvertent
medical occurrence which may present during treatment,
but does not have proven causal relation with drugs.
1
Adverse drug reactions are serious matter concern as it
considerably affects morbidity and mortality. Adverse
Drug Reactions are the 4
th
to 6
th
leading cause of
mortality in the USA. More than 10% of hospital
admissions are concerned with drug related events. More
than 20% budget is spent on drug related events.
2
Hence
it is very important to identify, monitor and assess and
prevent ADRs. The discipline concerned with
identification, monitoring and then prevention of ADR is
called as pharmacovigilance. WHO defined
pharmacovigilance as “The science and activities relating
to the detection, evaluation, understanding and
prevention of adverse drug reactions or any other drug-
related problems”.
3
The aims of pharmacovigilance are
early detection of unknown safety problems,
identification of risk factors, quantifying risks and
ultimately preventing patients from being affected
unnecessarily.
4
One of the most important activities of
pharmacovigilance is signal detection. The importance of
signal detection was recognized after thalidomide
disaster in early 1950s, then various efforts were started
to prevent such tragedy. The primary function of
pharmacovigilance is to recognize early warning with
regard to previous adverse effects of drugs. The signal in
pharmacovigilance is information of particular ADR with
causal relation to a drug which is not reported previously.
The WHO has defined a signal as: “Reported information
on a possible causal relationship between an adverse
event and a drug, the relationship being unknown or
incompletely documented previously”.
5
The
interpretation that a signal should be seen as a first hint
that there is a need to look more closely at a drug and its
associated reported ADR was given by Finney in 1974;
according to him “A signal is a basis of communication
between WHO and national centres; only rarely will it
carry the force of a proven danger” and, “Signals are
intended to arouse suspicions and to stimulate deeper
investigation”.
6
Amery in 1999 also stated that: “A signal
may be defined as new information pointing to a
previously unknown causal relationship between an
adverse event, or its incidence, and a drug: the
information must be such that if confirmed, it may lead to
action regarding the medicine.
7
Signal is not a
confirmatory finding, it require further evaluation and
may get approved or neglected. Thus signal generation
aims at timely identification of previously unsuspected
adverse effects, but any signals require further evaluation
Signal Detection - An Imperative Activity of Pharmacovigilance
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Research Article