{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T04:29:39Z","timestamp":1792211379837,"version":"4.4.0"},"reference-count":46,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2022,8,8]],"date-time":"2022-08-08T00:00:00Z","timestamp":1659916800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brit J Clinical Pharma"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>Automated checks for medication\u2010related problems have become a cornerstone of medication safety. In many clinical settings medication checks remain confined to drug\u2013drug interactions because only medication data are available in an adequately coded form, leaving possible contraindicated drug\u2013disease combinations unaccounted for. Therefore, we devised algorithms that identify frequently contraindicated diagnoses based on medication patterns related to these diagnoses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We identified drugs that are associated with diseases constituting common contraindications based on their exclusive use for these conditions (such as allopurinol for gout or salbutamol for bronchial obstruction). Expert\u2010based and machine learning algorithms were developed to identify diagnoses based on highly specific medication patterns. The applicability, sensitivity and specificity of the approach were assessed by using an anonymized real\u2010life sample of medication and diagnosis data excerpts from 3506 discharge records of geriatric patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Depending on the algorithm, the desired focus (i.e., sensitivity <jats:italic>vs<\/jats:italic>. specificity) and the disease, we were able to identify the diagnoses gout, epilepsy, coronary artery disease, congestive heart failure and bronchial obstruction with a specificity of 44.0\u201399.8% (95% CI 41.7\u2013100.0%) and a sensitivity of 3.8\u201383.1% (95% CI 1.0\u201386.1%). Using only medication data, we were able to identify 123 (51.3%) of 240 contraindications identified by experts with access to medication data and diagnoses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study provides a proof of principle that some key diagnosis\u2010related contraindications can be identified based on a patient's medication data alone, while others cannot be identified. This approach offers new opportunities to analyse drug\u2013disease contraindications in community pharmacy or clinical routine data.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bcp.15469","type":"journal-article","created":{"date-parts":[[2022,7,25]],"date-time":"2022-07-25T18:08:48Z","timestamp":1658772528000},"page":"5399-5411","source":"Crossref","is-referenced-by-count":6,"title":["Use of medication data alone to identify diagnoses and related contraindications: Application of algorithms to close a common documentation gap"],"prefix":"10.1111","volume":"88","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4885-9864","authenticated-orcid":false,"given":"Wahram","family":"Andrikyan","sequence":"first","affiliation":[{"name":"Institute of Experimental and Clinical Pharmacology and Toxicology Friedrich\u2010Alexander\u2010Universit\u00e4t Erlangen\u2010N\u00fcrnberg  Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie I.","family":"Then","sequence":"additional","affiliation":[{"name":"Institute of Experimental and Clinical Pharmacology and Toxicology Friedrich\u2010Alexander\u2010Universit\u00e4t Erlangen\u2010N\u00fcrnberg  Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2884-7986","authenticated-orcid":false,"given":"Karl\u2010G\u00fcnter","family":"Ga\u00dfmann","sequence":"additional","affiliation":[{"name":"Geriatrics Centre Erlangen Malteser Waldkrankenhaus St. Marien  Erlangen Germany"},{"name":"Geriatrics in Bavaria\u2010Database  N\u00fcrnberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"T\u00fcmena","sequence":"additional","affiliation":[{"name":"Geriatrics in Bavaria\u2010Database  N\u00fcrnberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5772-4956","authenticated-orcid":false,"given":"Pauline","family":"D\u00fcrr","sequence":"additional","affiliation":[{"name":"Institute of Experimental and Clinical Pharmacology and Toxicology Friedrich\u2010Alexander\u2010Universit\u00e4t Erlangen\u2010N\u00fcrnberg  Erlangen Germany"},{"name":"Pharmacy Department Erlangen University Hospital  Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0334-7478","authenticated-orcid":false,"given":"Martin F.","family":"Fromm","sequence":"additional","affiliation":[{"name":"Institute of Experimental and Clinical Pharmacology and Toxicology Friedrich\u2010Alexander\u2010Universit\u00e4t Erlangen\u2010N\u00fcrnberg  Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5498-9761","authenticated-orcid":false,"given":"Renke","family":"Maas","sequence":"additional","affiliation":[{"name":"Institute of Experimental and Clinical Pharmacology and Toxicology Friedrich\u2010Alexander\u2010Universit\u00e4t Erlangen\u2010N\u00fcrnberg  Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,8,8]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"HIMSS: Healthcare Information and Management Systems Society.Annual European Digital Health Survey 2021. Accessed October 27 2021.https:\/\/www.himss.org\/resources\/himss-annual-european-digital-health-survey"},{"key":"e_1_2_10_3_1","unstructured":"European Commission.Benchmarking deployment of eHealth among general practitioners (2018). Accessed October 27 2021.https:\/\/op.europa.eu\/en\/publication-detail\/-\/publication\/d1286ce7-5c05-11e9-9c52-01aa75ed71a1"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/PTS.0000000000000358"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jep.12395"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2020.01176"},{"key":"e_1_2_10_7_1","unstructured":"OECD.Using Routinely Collected Data to Inform Pharmaceutical Policies (2019). Accessed October 27 2021.https:\/\/ec.europa.eu\/health\/sites\/default\/files\/policies\/docs\/2019_collecteddata_pharmaceuticalpolicies_report_en.pdf"},{"key":"e_1_2_10_8_1","unstructured":"Imigran\u00ae.Summary of Product Characteristics. GlaxoSmithKline UK. (2020). Accessed July 19 2021.https:\/\/www.medicines.org.uk\/emc\/product\/945\/smpc"},{"key":"e_1_2_10_9_1","unstructured":"Imigran\u00ae.Fachinformation. GlaxoSmithKline GmbH & Co. KG. (2020). Accessed July 19 2021.https:\/\/www.fachinfo.de\/api\/fachinfo\/pdf\/012361"},{"key":"e_1_2_10_10_1","unstructured":"Imitrex\u00ae.Prescribing Information. GlaxoSmithKline. (2017). Accessed October 27 2021.https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2017\/020132s029lbl.pdf"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.3414\/ME13\u201001\u20100053"},{"key":"e_1_2_10_12_1","first-page":"845","article-title":"Construction of a semi\u2010automated ICD\u201010 coding help system to optimize medical and economic coding","volume":"124","author":"Pereira S","year":"2006","journal-title":"Stud Health Technol Inform"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102458\u201013\u20101030"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-662-62168-4"},{"key":"e_1_2_10_15_1","unstructured":"Statistisches Bundesamt (Destatis).Tiefgegliederte Diagnosedaten der Krankenhauspatientinnen und \u2010patienten 2019. Accessed October 27 2021.https:\/\/www.destatis.de\/DE\/Themen\/Gesellschaft\u2010Umwelt\/Gesundheit\/Krankenhaeuser\/Publikationen\/Downloads\u2010Krankenhaeuser\/tiefgegliederte\u2010diagnosedaten\u20105231301197015.html"},{"key":"e_1_2_10_16_1","unstructured":"DGBS e.V. und DGPPN e.V.: S3\u2010Leitlinie zur Diagnostik und Therapie Bipolarer St\u00f6rungen. Langversion 2019. Accessed October 27 2021.https:\/\/www.awmf.org\/uploads\/tx_szleitlinien\/038\u2010019l_S3_Bipolare\u2010Stoerungen\u2010Diagnostik\u2010Therapie_2020\u201005.pdf"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz425"},{"key":"e_1_2_10_18_1","volume-title":"Nationale VersorgungsLeitlinie Chronische KHK: Langfassung","author":"Bundes\u00e4rztekammer (B\u00c4K), Kassen\u00e4rztliche Bundesvereinigung (KBV), Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF)"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab368"},{"key":"e_1_2_10_20_1","volume-title":"Nationale VersorgungsLeitlinie Chronische Herzinsuffizienz \u2010 Langfassung","author":"Bundes\u00e4rztekammer (B\u00c4K)","year":"2019"},{"key":"e_1_2_10_21_1","unstructured":"Corvaton\u00ae.Fachinformation. Sanofi\u2010Aventis Deutschland GmbH. (2016). Accessed October 27 2021.https:\/\/www.fachinfo.de\/api\/fachinfo\/pdf\/000470"},{"key":"e_1_2_10_22_1","unstructured":"Scikit\u2010learn developers. Decision Trees. Accessed October 27 2021.https:\/\/scikit-learn.org\/stable\/modules\/tree.html"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00391\u2010021\u20102004\u20104"},{"key":"e_1_2_10_24_1","volume-title":"Natural Language Annotation for Machine Learning: A Guide to Corpus\u2010building for Applications","author":"Pustejovsky J","year":"2012"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aci.2018.08.003"},{"key":"e_1_2_10_26_1","unstructured":"Fachinfo\u2010Service\u00ae.Fachinformationsverzeichnis Deutschland. Accessed October 27 2021.https:\/\/www.fachinfo.de"},{"key":"e_1_2_10_27_1","unstructured":"Bundesinstitut f\u00fcr Arzneimittel und Medizinprodukte.Arzneimittel\u2010Informationssystem (AMIce) f\u00fcr den Medizinischen Dienst. Accessed October 27 2021.https:\/\/portal.dimdi.de\/amguifree\/am\/search.xhtml"},{"key":"e_1_2_10_28_1","article-title":"Python: A dynamic, open source programming language","author":"Python Core Team","journal-title":"Python Software Foundation"},{"key":"e_1_2_10_29_1","first-page":"2825","article-title":"Scikit\u2010learn: machine learning in Python","volume":"12","author":"Pedregosa F","year":"2011","journal-title":"J Mach Learn Res"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586\u2010020\u20102649\u20102"},{"key":"e_1_2_10_31_1","unstructured":"BankS.Python interface for Graphviz (Graph Visualization Software). Accessed October 27 2021.https:\/\/graphviz.readthedocs.io\/en\/stable\/index.html"},{"key":"e_1_2_10_32_1","doi-asserted-by":"crossref","unstructured":"SeaboldS PerktoldJ.Statsmodels: Econometric and statistical modeling with Python. In: Proceedings of the 9th Python in Science Conference Austin TX 2010: 61.","DOI":"10.25080\/Majora-92bf1922-011"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1197\/jamia.M1809"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.3390\/app10155262"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.14801"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.3414\/ME16\u201001\u20100126"},{"key":"e_1_2_10_37_1","unstructured":"Isoptin\u00ae.Fachinformation. Mylan Healthcare GmbH (2020). Accessed October 27 2021.https:\/\/www.fachinfo.de\/api\/fachinfo\/pdf\/020976"},{"key":"e_1_2_10_38_1","unstructured":"SecuronSR.Summary of Product Characteristics. Mylan Products Ltd. Accessed October 27 2021.https:\/\/www.medicines.org.uk\/emc\/product\/6243\/smpc"},{"key":"e_1_2_10_39_1","unstructured":"Verapamil hydrochloride tablet.Prescribing Information. AvKARE. (2020). Accessed October 27 2021.https:\/\/www.drugs.com\/pro\/verapamil.html"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000426"},{"key":"e_1_2_10_41_1","unstructured":"Drugs.com.Drug Interaction Report.https:\/\/www.drugs.com\/interactions-check.php?drug_list=2297-0 3637-0. Accessed October 27 2021."},{"key":"e_1_2_10_42_1","unstructured":"Medscape.Drug Interaction Checker.https:\/\/reference.medscape.com\/drug-interactionchecker. Accessed October 27 2021."},{"key":"e_1_2_10_43_1","unstructured":"mediQ.Interaktions\u2010Checker.https:\/\/www.mediq.ch. Accessed October 27 2021."},{"key":"e_1_2_10_44_1","volume-title":"Stockley's Drug Interactions: A Source Book of Interactions, their Mechanisms, Clinical Importance and Management","author":"Preston CL","year":"2019"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1183\/20734735.0344\u20102018"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.2196\/13008"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0155649"}],"container-title":["British Journal of Clinical Pharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bcp.15469","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/bcp.15469","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/bpspubs.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bcp.15469","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,19]],"date-time":"2023-08-19T13:45:50Z","timestamp":1692452750000},"score":1,"resource":{"primary":{"URL":"https:\/\/bpspubs.onlinelibrary.wiley.com\/doi\/10.1111\/bcp.15469"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,8]]},"references-count":46,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["10.1111\/bcp.15469"],"URL":"https:\/\/doi.org\/10.1111\/bcp.15469","archive":["Portico"],"relation":{},"ISSN":["0306-5251","1365-2125"],"issn-type":[{"value":"0306-5251","type":"print"},{"value":"1365-2125","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,8]]}}}