{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T09:19:51Z","timestamp":1787822391979,"version":"build-2784847793"},"reference-count":58,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","award":["848 018 004"],"award-info":[{"award-number":["848 018 004"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005622","name":"Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005622","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Clin Pharmacol"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Electronic triggers (e\u2010triggers) are used as screening signals to detect potential adverse drug events (ADEs) and offer an effective system level approach for medication safety surveillance. Their clinical utility is typically evaluated through time\u2010consuming manual chart review by experts, limiting implementation. Estimating associations between e\u2010triggers and relevant ICU patient outcomes may provide a rapid, data\u2010driven alternative. In this study, electronic supratherapeutic drug concentration triggers (eSDCT) were used as a use case.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Pseudonymized Electronic Health Record (EHR) data from adults admitted to 14 Dutch ICUs (2010\u20132020) were analysed. Patients with \u22651 therapeutic drug monitoring measurements were included. eSDCTs were selected based on literature, data availability and expert input. Associations with ICU Length of Stay (LOS), ICU mortality and hospital mortality were assessed using adjusted linear and logistic mixed\u2010effects models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 6006 ICU admissions, 49.5% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092973) had \u22651 of the five selected group\u2010level eSDCTs. Exposed admissions showed higher hospital mortality (38.2%\n                      <jats:italic>vs<\/jats:italic>\n                      . 27.9%), ICU mortality (30.6%\n                      <jats:italic>vs<\/jats:italic>\n                      . 20.3%) and longer ICU LOS (median 13.8 [IQR 5.6\u201328.1]\n                      <jats:italic>vs<\/jats:italic>\n                      . 7.5 [3.2\u201315.7] days) compared with unexposed admissions. After adjustment, antibiotic and immunosuppressive eSDCTs remained associated with increased ICU mortality (OR 1.47 [1.26\u20131.70] and 2.86 [1.56\u20135.24]), hospital mortality (OR 1.46 [1.27\u20131.68] and 1.81 [1.07\u20133.10]) and prolonged ICU LOS (expB 1.82 [1.71\u20131.94] and 2.99 [2.46\u20133.62]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our data\u2010driven approach shows that antibiotic and immunosuppressive eSDCTs are associated with worse ICU patient outcomes, supporting their implementation for ICU\u2010level medication safety surveillance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bcp.70610","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T08:50:08Z","timestamp":1779353408000},"page":"3191-3201","source":"Crossref","is-referenced-by-count":0,"title":["Supratherapeutic drug concentration triggers: A novel data\u2010driven approach to assess their value for medication safety surveillance in intensive care"],"prefix":"10.1002","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-6131-8229","authenticated-orcid":false,"given":"Anne Paulien","family":"Langermans","sequence":"first","affiliation":[{"name":"Department of Medical Informatics, Amsterdam Public Health research institute Amsterdam University Medical Centre  Amsterdam The Netherlands"},{"name":"ChipSoft  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Izak A. 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