{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T05:29:42Z","timestamp":1786685382380,"version":"build-2736575974"},"reference-count":18,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["R35GM15641"],"award-info":[{"award-number":["R35GM15641"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bpspubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacology Res &amp;amp; Perspec"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Rare adverse drug reactions (ADRs) are underrecognized and underreported in the electronic medical record (EMR). These events often require clinical review, making systematic identification challenging. The study aim was to develop an approach to prioritize identification and validation of a rare ADR to trimethoprim\u2010sulfamethoxazole causing acute respiratory distress syndrome (TMP\u2010SMX ARDS) across medical institutions. We developed a clinical phenotype based on 2 local TMP\u2010SMX ARDS cases mapped to standardized elements of a national comparative healthcare database (PHIS). We validated identification of TMP\u2010SMX ARDS at scale across medical institutions. A set of scoring criteria was created to prioritize cases and generate a center\u2010specific top 10 list of candidate encounters. External validation at 3 PHIS contributing hospitals with a known TMP\u2010SMX ARDS case was performed by reviewing the top 10 candidate list for the known case. The review period was January 1, 2012\u2013January 1, 2025. EMR data extracted from 2 TMP\u2010SMX ARDS cases included patients that both required extracorporeal membrane oxygenation for &gt;\u2009100\u2009days, experienced air leak early in hospital presentation, required tracheostomy placement, and were hospitalized for &gt;\u2009440\u2009days. Based on the TMP\u2010SMX ARDS phenotype, the local cases ranked 1st and 3rd on the PHIS generated top 10 candidate list for internal validation. For external validation, known cases were identified on their respective hospital top 10 lists, ranking 3rd, 3rd, and 5th. Applying a TMP\u2010SMX ARDS phenotype to a national health care database paired with clinical review of candidate cases may be an effective approach to identify underrecognized ADRs.<\/jats:p>","DOI":"10.1002\/prp2.70289","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T04:27:39Z","timestamp":1781756859000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Leveraging Administrative Health Data to Capture Rare Adverse Drug Reactions: Identifying Pediatric Patients With Trimethoprim\u2010Sulfamethoxazole Acute Respiratory Distress Syndrome"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6935-5844","authenticated-orcid":false,"given":"Keith","family":"Feldman","sequence":"first","affiliation":[{"name":"Department of Learning Health Sciences University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenna O.","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Missouri \u2013 Kansas City  Kansas City Missouri USA"},{"name":"Division of Critical Care Medicine Children's Mercy Kansas City  Kansas City Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Doane","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Critical Care Medicine Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Loftis","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Critical Care Medicine Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6188-2658","authenticated-orcid":false,"given":"James W.","family":"Antoon","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Hospital Medicine Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5015-8146","authenticated-orcid":false,"given":"Kevin J.","family":"Downes","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania, Division of Infectious Diseases Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6628-8949","authenticated-orcid":false,"given":"Jennifer L.","family":"Goldman","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Missouri \u2013 Kansas City  Kansas City Missouri USA"},{"name":"Divisions of Infectious Diseases and Clinical Pharmacology Children's Mercy Kansas City  Kansas City Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2023.1211786"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpt.2172"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40264\u2010023\u201001302\u20107"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40272\u2010022\u201000540\u2010z"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2022.08.020"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.12474"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jid.2017.01.031"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000006002"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202009\u20103421LE"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2018\u20103242"},{"key":"e_1_2_12_12_1","unstructured":"Children Hospital Association \u201cLeverage Your Data With CHA's Pediatric Health Information System \u201d(2025) https:\/\/www.childrenshospitals.org\/content\/analytics\/product\u2010program\/pediatric\u2010health\u2010information\u2010system."},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/14740338.2022.2131770"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/14604582221136712"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/10600280251320690"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.15892"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2020.09.011"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2023.1183491"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41397\u2010022\u201000266\u20108"}],"container-title":["Pharmacology Research &amp; 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