PMID- 23845189
OWN - NLM
STAT- MEDLINE
DCOM- 20140519
LR  - 20130905
IS  - 1365-2710 (Electronic)
IS  - 0269-4727 (Linking)
VI  - 38
IP  - 5
DP  - 2013 Oct
TI  - An algorithm for the identification of heparin-induced thrombocytopenia using a 
      medical information database.
PG  - 423-8
LID - 10.1111/jcpt.12083 [doi]
AB  - WHAT IS KNOWN AND OBJECTIVE: Using effective algorithms for extracting relevant 
      drug and patient information from electronic medical information data systems is 
      likely to form an increasingly important aspect of pharmacovigilance. To this 
      end, we aimed to develop and validate a novel algorithm for detecting 
      heparin-induced thrombocytopenia (HIT) using a medical information database (MID) 
      and for identifying possible risk factors for HIT. METHODS: We developed a new 
      algorithm for detecting HIT based on platelet count at distinct time-points and 
      diagnostic information from patients treated with unfractionated heparin (UFH) 
      from April 2008 through March 2012 at Hospital of Hamamatsu University School of 
      Medicine, Japan. Definitive diagnoses of HIT were made through reviews of the 
      medical records by a skilled haematologist. The performance of the algorithm was 
      assessed using the positive predictive value (PPV). Multivariate logistic 
      regression analysis was used to identify possible risk factors for HIT. RESULTS 
      AND DISCUSSION: This algorithm detected 47 patients with suspected HIT in the 
      source population (n = 2875). Of these, 41 were identified as patients with 
      definitive HIT after review of the medical records. The PPV for the algorithm was 
      87.2%, and the frequency of definitive HIT was 1.4%. Longer-term treatment (>/=4 
      days) with UFH was identified as a risk factor for HIT, with an odds ratio of 
      5.38 (95% CI: 2.35-12.32) for definitive HIT. WHAT IS NEW AND CONCLUSION: We 
      developed a novel, high-PPV detection algorithm for HIT and identified 
      longer-term treatment with UFH as a risk factor for HIT. Our results support the 
      utility of MIDs for improving pharmacovigilance.
CI  - (c) 2013 John Wiley & Sons Ltd.
FAU - Hanatani, T
AU  - Hanatani T
AD  - Division of Medicinal Safety Science, National Institute of Health Sciences, 
      Tokyo, Japan.
FAU - Sai, K
AU  - Sai K
FAU - Tohkin, M
AU  - Tohkin M
FAU - Segawa, K
AU  - Segawa K
FAU - Kimura, M
AU  - Kimura M
FAU - Hori, K
AU  - Hori K
FAU - Kawakami, J
AU  - Kawakami J
FAU - Saito, Y
AU  - Saito Y
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20130712
PL  - England
TA  - J Clin Pharm Ther
JT  - Journal of clinical pharmacy and therapeutics
JID - 8704308
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Aged
MH  - *Algorithms
MH  - *Databases, Factual
MH  - Female
MH  - Heparin/*adverse effects
MH  - Humans
MH  - Male
MH  - Pharmacovigilance
MH  - Risk Factors
MH  - Thrombocytopenia/*chemically induced/epidemiology
OTO - NOTNLM
OT  - detection algorithm
OT  - heparin-induced thrombocytopenia
OT  - medical information database
OT  - pharmacovigilance
OT  - risk factor
OT  - validation
EDAT- 2013/07/13 06:00
MHDA- 2014/05/20 06:00
CRDT- 2013/07/13 06:00
PHST- 2013/04/30 00:00 [received]
PHST- 2013/06/12 00:00 [accepted]
PHST- 2013/07/13 06:00 [entrez]
PHST- 2013/07/13 06:00 [pubmed]
PHST- 2014/05/20 06:00 [medline]
AID - 10.1111/jcpt.12083 [doi]
PST - ppublish
SO  - J Clin Pharm Ther. 2013 Oct;38(5):423-8. doi: 10.1111/jcpt.12083. Epub 2013 Jul 
      12.