Evidence map›Paper›PMID 29725942›Full record

ArticleDrug safety2018

Exploring the Potential Routine Use of Electronic Healthcare Record Data to Strengthen Early Signal Assessment in UK Medicines Regulation: Proof-of-Concept Study.

Katherine Donegan, Rebecca Owen, Helena Bird, Brian Burch, Alex Smith, Phil Tregunno

Abstract read
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In one paragraph

Article in Drug safety, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Katherine DoneganVigilance and Risk Management of Medicines, MHRA, 151 Buckingham Palace Road, London, SW1W 9SZ, UK. katherine.donegan@mhra.gov.uk.ORCID http://orcid.org/0000-0002-3488-9130
Rebecca OwenVigilance and Risk Management of Medicines, MHRA, 151 Buckingham Palace Road, London, SW1W 9SZ, UK.
Helena BirdVigilance and Risk Management of Medicines, MHRA, 151 Buckingham Palace Road, London, SW1W 9SZ, UK.
Brian BurchVigilance and Risk Management of Medicines, MHRA, 151 Buckingham Palace Road, London, SW1W 9SZ, UK.
Alex SmithVigilance and Risk Management of Medicines, MHRA, 151 Buckingham Palace Road, London, SW1W 9SZ, UK.
Phil TregunnoVigilance and Risk Management of Medicines, MHRA, 151 Buckingham Palace Road, London, SW1W 9SZ, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionElectronic healthcare record (EHR) databases are used within pharmacoepidemiology studies to confirm or refute safety signals arising from spontaneous adverse event reports. However, there has been limited routine use of such data earlier in the signal management process, to help rapidly contextualise signals and strengthen preliminary assessment or to inform decisions regarding action including the need for further studies. This study explores the value of EHR used in this way within a regulatory environment via an automated analysis platform.

methodsSafety signals raised at the UK Medicines and Healthcare products Regulatory Agency (MHRA) between July 2014 and June 2015 were individually reviewed by a multi-disciplinary team. They assessed the feasibility of identifying the exposure and event of interest using primary care data from the Clinical Practice Research Datalink (CPRD) within the Commonwealth Vigilance Workbench (CVW) Longitudinal Module platform, which was designed to facilitate routine descriptive analysis of signals using EHR. Three signals, where exposure and event could be well identified, were retrospectively analysed using the platform.

resultsOf 69 unique new signals, 20 were for drugs prescribed predominately in secondary care or available without prescription, which would not be identified in primary care. A further 17 were brand, formulation, or dose-specific issues, were related to mortality, were relevant only to a subgroup of patients, or were drug interactions, and hence could not be reviewed using the platform given its limitations. Analyses of exposure and incidence of the adverse event could be produced using CPRD within the CMV Longitudinal Module for 32 (46%) signals. The case studies demonstrated that the data provided supporting evidence for confirming initial assessment of the signal and deciding upon the need for further action.

conclusionsCPRD can routinely provide useful early insights into clinical context when assessing a large proportion of safety signals within a regulatory environment provided that a flexible approach is adopted within the analysis platform.

Indexed as

Proof of Concept StudyAdverse Drug Reaction Reporting SystemsDatabases, FactualDrug-Related Side Effects and Adverse ReactionsElectronic Health RecordsFemaleHumansMalePharmacoepidemiologyPilot ProjectsUnited Kingdom

Identifiers

What Socratic holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.