Linking laboratory and medication data: new opportunities for pharmacoepidemiological research

Abstract

Transfer of automated laboratory data collected during routine clinical care from the laboratory information system into a database format that enables linkage to other administrative (e.g., patient characteristics) or clinical (e.g., medication, diagnoses, procedures) data provides a valuable tool for clinical epidemiological research. It allows the investigation of biochemical characteristics of diseases, therapeutic effects and diagnostic and/or prognostic markers for disease with easy access and at relatively low cost. To this end, the Utrecht Patient Oriented Database (UPOD), an infrastructure of relational databases comprising data on patient characteristics, laboratory test results, medication orders, hospital discharge diagnoses and medical procedures for all patients treated at the University Medical Centre Utrecht since January 2004, was established. Current research within UPOD is focused on the innovative linkage of laboratory and medication data, which, for example, makes it possible to assess the quality of pharmacotherapy in clinical practice, to investigate interference between laboratory tests and drugs, to study the risk of adverse drug reactions, and to develop diagnostic and prognostic markers or algorithms for adverse drug reactions. Although recently established, we believe that UPOD broadens the opportunities for clinical pharmacoepidemiological research and can

Automated Detection of External Ventricular and Lumbar Drain-Related Meningitis Using Laboratory and Microbiology Results and Medication Data

“…The use of anonymous data through the UPOD has been exempted from review by the Institutional Review Board of the University Medical Center Utrecht as described previously [19].…”

“…the Utrecht patient-oriented database, UPOD [19]) to retrospectively identify the presence of infection. In order to increase sensitivity for culture-negative infections while maintaining specificity and enable surveillance without the need for manual confirmation, an alternative approach to the classification algorithm was sought and data sources were extended to include not only microbiology results and antibiotic use but also results of clinical chemistry analysis.…”

Testing bias in clinical databases: methodological considerations

“…UPOD data acquisition and data management is in accordance with current Dutch privacy and ethical regulations. A more complete description of UPOD has been published elsewhere [15]. …”

“…UPOD is a unique clinical database as it contains results of hematological blood tests measured with Cell-Dyn Sapphire automated blood cell analyzers (Abbott Diagnostics, St. Clara, California, USA) [15]. A feature of this analyzer is that it measures all hematological parameters irrespective of whether these are requested or not [15].…”

“…A feature of this analyzer is that it measures all hematological parameters irrespective of whether these are requested or not [15]. The non-requested parameters are measured because one hematological test is technically linked to the other hematological tests and conducted automatically when one of these tests is requested.…”