{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T03:09:33Z","timestamp":1776740973504,"version":"3.51.2"},"reference-count":28,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2019,8,13]],"date-time":"2019-08-13T00:00:00Z","timestamp":1565654400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>We validated an algorithm to detect frequency errors in computerized healthcare data and estimated the incidence of these errors in an integrated healthcare system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We applied Sentinel System analytic tools on the electronic health records of Kaiser Permanente, Northern California, January 1, 2010, through May 30, 2015,to identify rheumatoid arthritis (RA) patients with new use of methotrexate (365\u2010day baseline period). We identified potential methotrexate frequency errors using ICD\u20109 code 995.20 (adverse drug event), Current Procedural Terminology (CPT) code 96409 for injection of leucovorin and prescription refill patterns. We performed chart review to confirm the frequency errors, assessed performance for detecting frequency errors, and estimated the incidence of chart\u2010confirmed errors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study included 24,529 methotrexate dispensings among 3,668 RA patients. Among these, 722 (3%) had one dispensing and 23,807 (97.1%) had \u22652 dispensings during 1\u2010year follow\u2010up period. We flagged 653 (2.7%) with a potential medication error (46 with one dispensing and 607 with \u22652 dispensings). We sampled 94 for chart review, and confirmed three methotrexate errors. All three confirmed frequency errors involved a first methotrexate dispensing followed by injected rescue therapy, leucovorin, (positive predictive value, 60%; 95% confidence interval [CI], 15\u201095%). No potential errors were found among patients with \u22652 dispensings. We estimated the frequency error incidence among one methotrexate dispensing to be 0.4% (95%CI, 0.1% to 1.2%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Rescue therapy is a specific indicator of methotrexate overdose among first methotrexate dispensings. This method is generalizable to other medications with serious adverse events treated with antidotes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.4858","type":"journal-article","created":{"date-parts":[[2019,8,14]],"date-time":"2019-08-14T01:33:14Z","timestamp":1565746394000},"page":"1361-1368","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Development of an algorithm to detect methotrexate wrong frequency error using computerized health care data"],"prefix":"10.1002","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5702-7162","authenticated-orcid":false,"given":"Lisa J.","family":"Herrinton","sequence":"first","affiliation":[{"name":"Division of Research Kaiser Permanente Northern California  Oakland California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiffany S.","family":"Woodworth","sequence":"additional","affiliation":[{"name":"Department of Population Medicine Harvard Medical School and Harvard Pilgrim Health Care Institute  Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8971-9748","authenticated-orcid":false,"given":"Efe","family":"Eworuke","sequence":"additional","affiliation":[{"name":"Office of Surveillance and Epidemiology U.S. Food and Drug Administration  Silver Spring MD"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura B.","family":"Amsden","sequence":"additional","affiliation":[{"name":"Division of Research Kaiser Permanente Northern California  Oakland California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liyan","family":"Liu","sequence":"additional","affiliation":[{"name":"Division of Research Kaiser Permanente Northern California  Oakland California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jo","family":"Wyeth","sequence":"additional","affiliation":[{"name":"Office of Surveillance and Epidemiology U.S. Food and Drug Administration  Silver Spring MD"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Petrone","sequence":"additional","affiliation":[{"name":"Department of Population Medicine Harvard Medical School and Harvard Pilgrim Health Care Institute  Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Talia J.","family":"Menzin","sequence":"additional","affiliation":[{"name":"Department of Population Medicine Harvard Medical School and Harvard Pilgrim Health Care Institute  Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Population Medicine Harvard Medical School and Harvard Pilgrim Health Care Institute  Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Goldfien","sequence":"additional","affiliation":[{"name":"Division of Research Kaiser Permanente Northern California  Oakland California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Office of Surveillance and Epidemiology U.S. Food and Drug Administration  Silver Spring MD"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,8,13]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"ACR guideline.https:\/\/www.rheumatology.org\/Portals\/0\/Files\/ACR%202015%20RA%20Guideline.pdf. 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