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Computerized Surveillance for Adverse Drug Events in a Pediatric Hospital -- Kilbridge et al. 16 (5): 607 -- Journal of the American Medical Informatics Association


The Practice of Informatics: Application of Information Technology

Computerized Surveillance for Adverse Drug Events in a Pediatric Hospital
Peter M. Kilbridge, MDa,c,d,*, Laura A. Noirotb, Richard M. Reichley, RPhc, Kathleen M. Berchelmann, MDa, Cortney Schneider, PharmDd, Kevin M. Heardc, Miranda Nelson, PharmD, MDd and Thomas C. Bailey, MDb,c
a Department of Pediatrics, Washington University School of Medicine, St Louis, MO
b Department of Internal Medicine, Washington University School of Medicine, St Louis, MO
c BJC Healthcare, Center for Healthcare Quality and Effectiveness, St Louis, MO
d St Louis Children's Hospital, St Louis, MO


* Correspondence: Peter M. Kilbridge, MD, St Louis Children's Hospital, One Children's Place, St Louis, MO 63110 (Email: kilbridge_p@kids.wustl.edu).
Received for publication: 02/03/09; accepted for publication: 05/29/09.

Abstract
There are limited data on adverse drug event rates in pediatrics. The authors describe the implementation and evaluation of an automated surveillance system modified to detect adverse drug events (ADEs) in pediatric patients. The authors constructed an automated surveillance system to screen admissions to a large pediatric hospital. Potential ADEs identified by the system were reviewed by medication safety pharmacists and a physician and scored for causality and severity. Over the 6 month study period, 6,889 study children were admitted to the hospital for a total of 40,250 patient-days. The ADE surveillance system generated 1226 alerts, which yielded 160 true ADEs. This represents a rate of 2.3 ADEs per 100 admissions or 4 per 1,000 patient-days. Medications most frequently implicated were diuretics, antibiotics, immunosuppressants, narcotics, and anticonvulsants. The composite positive predictive value of the ADE surveillance system was 13%. Automated surveillance can be an effective method for detecting ADEs in hospitalized children.

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Computerized Surveillance for Adverse Drug Events in a Pediatric Hospital -- Kilbridge et al. 16 (5): 607 -- Journal of the American Medical Informatics Association

First published June 30, 2009 as JAMIA PrePrint; doi:10.1197/jamia.M3167
This Article
J Am Med Inform Assoc. 2009;16:607-612. DOI 10.1197/jamia.M3167.
© 2009 American Medical Informatics Association

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