Information Systems Developments to Detect and Analyze Chemotherapy-associated Adverse Drug Events

A dificult balance exists in the use of cancer chemotherapy in which the cytotoxic medicine must act on the cancer without causing neutropenic fever, a condition that is caused by over-suppression of the immune system. An improved understanding of dosing strategies as well as the use ofmedications to support the immune system has helped to reduce the likelihood of an admission for neutropenic fever following cancer chemotherapy. Therefore, as with any drug therapy, chemotherapy administration that is temporally associated with an unexpected hospitalization for neutropenia is an adverse drug event (ADE). Analogous to other informatics research to monitor and address the occurrence of ADEs, this work develops and validates the information systems infrastructure necessary to detect the occurrence of and analyze the factors contributing to chemotherapy associated ADEs. INTRODUCTION As with ADEs in general, the presence of a chemotherapy-associated ADE is often not recorded directly as a discharge diagnosis. Therefore, the occurrence of an ADE must be inferred indirectly using available clinical and administrative information. While manual chart review could be used to search for ADEs, it is personnel-intensive. We therefore developed a more efficient system that leverages the information from administrative records pertaining to the patient's characteristics, the nature of the cancer, the timing and types of chemotherapy used, and the diagnostic and other details of the associated hospital admission. Once detected, the same administrative data can suggest etiological factors that may predict the occurrence of an ADE.