An automated technique to identify potential inappropriate traditional Chinese medicine (TCM) prescriptions

Yang, Hsuan-Chia; Iqbal, Usman; Nguyễn, Phụng Anh; Lin, Shen-Hsien; Huang, Chih-Wei; Jian, Wen-Shan; Li, Yu-Chuan

doi:10.1002/pds.3976

Cited by 8 publications

(9 citation statements)

References 38 publications

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“…However, although some significant challenges of TCM have currently faced from both the application of modern medicine and social development, the clinical practice of TCM still accounts for about 20% of all health care delivered in China [ 8 ]. Additionally, much attention has been captured on patient safety and quality of care to TCM users [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Application of Prescription Reviews for Traditional Chinese Medicine to Improve Medical Disputes and Patient Satisfaction

Cai¹,

Xu²

2022

Evidence-Based Complementary and Alternative Medicine

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Objective. Medical disputes and patient satisfaction are related to inappropriate prescribing practices. We aim to investigate the clinical application of prescription reviews for traditional Chinese medicine (TCM). Method. TCM prescriptions performed prescription reviews in 372 patients from the year 2019 to 2020 were set as the observation group and those from the year 2017 to 2018 without prescription reviews as the control group (n = 341). According to the Criteria for Assessing Prescription Quality in Chinese Hospitals (CAPQCH) items, “Irrational” and “Rational” TCM prescriptions were determined mainly based on the following category: nonstandard prescriptions, inappropriate prescriptions, and hypernormal prescriptions. The incidence of medical disputes and the degree of patient satisfaction were compared between the two groups. Result. No difference was found in age and gender between the control group and the observation group. The number of irrational TCM prescriptions from the year 2017 to 2020 was 6, 8, 2, and 3, respectively, with the percentage of 3.725%, 4.480%, 1.201%, and 1.446%. The irrational rate in the observation group (1.344%) was significantly lower than that in the control group (4.106%). Specifically, a higher rate of nonstandard prescriptions was revealed in the control group as compared with the observation group. Moreover, a reduced incidence of medical disputes was revealed in the observation group relative to the control group accompanying with the increased degree of patient satisfaction. Conclusion. Prescription reviews have high application value in the management of Chinese pharmacies, which can improve the rationality of prescriptions, increase patient satisfaction, and reduce medical disputes.

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Section: Introductionmentioning

confidence: 99%

Application of Prescription Reviews for Traditional Chinese Medicine to Improve Medical Disputes and Patient Satisfaction

Cai¹,

Xu²

2022

Evidence-Based Complementary and Alternative Medicine

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“…However, data mining techniques are customizable and can identify inappropriate prescriptions. For example, association rule mining has been used to find inappropriate prescriptions by calculating the co-occurrence of medications and diseases, resulting in a sensitivity of 75.9% and a specificity of 89.5% [ 42 , 43 ]. These methods however do have disadvantages, including inefficiency in the generation of candidate item sets because they require vast data sources and the frequent scanning of databases.…”

Section: Discussionmentioning

confidence: 99%

“…For model evaluation, considering the sensitivity and specificity (71.5% and 68.8%, respectively) of the Apriori algorithm in previous work [ 42 , 43 ], we set both the expected sensitivity and specificity at 80%. By setting a significance level of .05 and an allowable error of 0.05, we needed at least 14,471 prescriptions given 1.7% prevalence [ 44 ] of prescription misuse according to equation 1.…”

Section: Methodsmentioning

confidence: 99%

A Multiview Model for Detecting the Inappropriate Use of Prescription Medication: Machine Learning Approach

et al. 2020

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Background The inappropriate use of prescription medication has recently garnered worldwide attention, but most national policies do not effectively provide for early detection or timely intervention. Objective This study aimed to develop and assess the validity of a model that can detect the inappropriate use of prescription medication. This effort combines a multiview and topic matching method. The study also assessed the validity of this approach. Methods A multiview extension of the latent Dirichlet allocation algorithm for topic modeling was chosen to generate diagnosis-medication topics, with data obtained from the Chinese Monitoring Network for Rational Use of Drugs (CMNRUD) database. Topic mapping allowed for calculating the degree to which diagnoses and medications were similarly distributed and, by setting a threshold, for identifying prescription misuse. The Beijing Regional Prescription Review Database (BRPRD) database was used as the gold standard to assess the model’s validity. We also conducted a sensitivity analysis using random samples of validated prescriptions and evaluated the model’s performance. Results A total of 44 million prescriptions were used to generate topics using the diagnoses and medications from the CMNRUD database. A random sample (15,000 prescriptions) from the BRPRD was used for validation, and it was found that the model had a sensitivity of 81.8%, specificity of 47.4%, positive-predictive value of 14.5%, and negative-predictive value of 96.0%. The model showed superior stability under different sampling proportions. Conclusions A method that combines multiview topic modeling and topic matching can detect the inappropriate use of prescription medication. This model, which has mediocre specificity and moderate sensitivity, can be used as a primary screening tool and will likely complement and improve the process of manually reviewing prescriptions.

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“…Reference standards in herbal medicine 3 11.11 (24,27,37) Regulation of herbal medicinal products 8 30 (13,24,25,28,30,31,43,45) Toxicity evaluation in herbal products 7 26 (23,25,27,28,30,38,46) Quality control of herbal medicine 11 40.75 (4,7,9,11,27,(31)(32)(33)39,42,44) Efficacy in herbal medicine 9 33.33 (3,4,11,13,25,29,33,39,40) Adverse effects of herbal medicine 7 26 (7,32,36,38,41,43,46) Safety in herbal medicine 12 44.45 (3,11,13,…”

Section: Factors Number = 27 Percentage (%) Referencesmentioning

confidence: 99%

The role of herbal medicines in health care quality and the related challenges

Mirzaeian

Sadoughi

Tahmasebian

et al. 2021

J Herbmed Pharmacol

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In recent years, there has been a renewed interest in the use of herbal medicines. Quality control and safety are two critical principles to be considered in the production process of herbal medicines. This review study aimed to investigate the condition of the countries other than Iran in terms of observing the safety principles, quality control, and meeting the standard of herbal drug use. In this systematic review, references were selected using the search terms "health-care quality" and "challenges of herbal medicine usage" from the databases "Web of Science" and "PubMed" published between 2000 and 2019. To select the resources among the selected literature, confirmation was accomplished by two researchers and Cohen’s kappa coefficient (κ). The selected papers were classified based on publication year, journal, country, reference standards, regulation, toxicity evaluation, quality control, efficacy, safety, and adverse effects in herbal medicine. From 1532 retrieved papers, 27 papers with an estimated Cohen’s kappa coefficient of 0.81 were confirmed and included in the study. Based on the analysis, the main findings of the papers were thematically classified into seven subcategories as follows: reference standards in herbal medicine, regulation of herbal medicinal products, toxicity evaluation for herbal products, quality control of herbal medicine, efficacy, adverse effects of herbal medicine, and safety. Given the significance of the effects of herbal medicines on health care quality, it is essential to codify guidelines on the proper use of these drugs.

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An automated technique to identify potential inappropriate traditional Chinese medicine (TCM) prescriptions

Abstract: We successfully applied the AOP model to automatically identify potential inappropriate TCM prescriptions. This model could be a potential TCM clinical decision support system in order to improve drug safety and quality of care.

Cited by 8 publications

References 38 publications

Application of Prescription Reviews for Traditional Chinese Medicine to Improve Medical Disputes and Patient Satisfaction

Application of Prescription Reviews for Traditional Chinese Medicine to Improve Medical Disputes and Patient Satisfaction

A Multiview Model for Detecting the Inappropriate Use of Prescription Medication: Machine Learning Approach

The role of herbal medicines in health care quality and the related challenges

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