Purpose: Electronic clinical decision support systems (CDSS) require drug information that can be processed by computers. The goal of this project was to determine and evaluate a compilation of variables that comprehensively capture the information contained in the summary of product characteristic (SmPC) and unequivocally describe the drug, its dosage options, and clinical pharmacokinetics.
Methods: An expert panel defined and structured a set of variables and drafted a guideline to extract and enter information on dosage and clinical pharmacokinetics from textual SmPCs as published by the European Medicines Agency (EMA). The set of variables was iteratively revised and evaluated by data extraction and variable allocation of roughly 7% of all centrally approved drugs.
Results: The information contained in the SmPC was allocated to three information clusters consisting of 260 variables. The cluster "drug characterization" specifies the nature of the drug. The cluster "dosage" provides information on approved drug dosages and defines corresponding specific conditions. The cluster "clinical pharmacokinetics" includes pharmacokinetic parameters of relevance for dosing in clinical practice. A first evaluation demonstrated that, despite the complexity of the current free text SmPCs, dosage and pharmacokinetic information can be reliably extracted from the SmPCs and comprehensively described by a limited set of variables.
Conclusion: By proposing a compilation of variables well describing drug dosage and clinical pharmacokinetics, the project represents a step forward towards the development of a comprehensive database system serving as information source for sophisticated CDSS.
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http://dx.doi.org/10.1007/s00228-017-2214-6 | DOI Listing |
Best Pract Res Clin Anaesthesiol
December 2023
Department of Anesthesia and Pain Management, Sinai Health System, Women's College Hospital, University Health Network, Toronto, Ontario, Canada; Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada; Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada; Interdepartmental Division of Critical Care, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Goal-directed administration of blood components including red cells, platelets, plasma, and factor concentrates plays a critical role in the management of intraoperative coagulopathy. Increasingly commonly used, purified and recombinant factor concentrates are being recognized for their logistical advantages and potentially superior efficacy. Three- and four-factor prothrombin concentrates, fibrinogen concentrates and activated factor VII have an evolving evidence base relative to frozen plasma and cryoprecipitate.
View Article and Find Full Text PDFBest Pract Res Clin Anaesthesiol
December 2023
Université d'Angers, Département Anesthésie Réanimation, CHU Angers, Angers, France; Université d'Angers, UMR CNRS 6015, Inserm U1083, Unité MitoVasc, Team Carme, Angers, France.
Preoperative anemia is frequent and is associated with poor patient outcomes and higher transfusion rates. Perioperative blood transfusion is also associated with poor outcomes. These observations justify efforts to increase hemoglobin levels in anemic patients before surgeries with a moderate to high bleeding risk.
View Article and Find Full Text PDFBest Pract Res Clin Anaesthesiol
December 2023
School of Medicine, The University of Western Australia, Perth, Western Australia, Australia.
Preoperative anemia affects one-third of patients undergoing major surgery and is associated with worse perioperative and postoperative outcomes; including length of hospital stay, allogeneic blood transfusion, morbidity, and mortality. Iron deficiency is the most common cause of anemia, and associative data suggests that preoperative correction of iron deficiency anemia could improve postoperative patient outcomes. However, data from randomized controlled trials (RCTs) do not appear to support the routine use of iron therapy to treat preoperative anemia.
View Article and Find Full Text PDFBest Pract Res Clin Anaesthesiol
March 2024
Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, Department of Anesthesia and Critical Care Medicine, 1275 York Avenue, New York, NY, 10028, USA. Electronic address:
The objectives of this minireview are two-fold. The first is to discuss the evolution of opioid analgesia in perioperative medicine in the context of thoracic non-cardiac surgery. Current standard-of-care, aiming to optimize analgesia and limit undesirable side effects, is discussed in the context of multimodal analgesia, specifically enhanced recovery after thoracic surgery pathways.
View Article and Find Full Text PDFAfr J Reprod Health
December 2024
Department of Cardiology, The First Affiliated Hospital,Hengyang Medical School, University of South China.
Anaemia is a common phenomenon in patients with malignant gynecological tumors. The occurrence of anaemia in the perioperative period leads to an increased probability of blood transfusion, increased surgical complications,poor wound healing, prolonged hospitalization, increased medical costs, and increased mortality. Intravenous iron, which is known for its rapid onset and lack of gastrointestinal side effects, has become increasingly prevalent in clinical practice.
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