Screening of anticancer drugs to detect drug‐induced interstitial pneumonia using the accumulated data in the electronic medical record

Abstract

Because drug‐induced interstitial pneumonia (DIP) is a serious adverse drug reaction, its quantitative risk with individual medications should be taken into due consideration when selecting a medicine. We developed an algorithm to detect DIP using medical record data accumulated in a hospital. Chest computed tomography (CT) is mainly used for the diagnosis of IP, and chest X‐ray reports, KL‐6, and SP‐D values are used to support the diagnosis. The presence of IP in the reports was assessed by a method using natural language‐processing, in which IP was estimated according to the product of the likelihood ratio of characteristic keywords in each report. The sensitivity and the specificity of the method for chest CT reports were 0.92 and 0.97, while those for chest X‐ray reports were 0.83 and 1, respectively. The occurrence of DIP was estimated by the patterns of presence of IP before, during, and after the administration of the target medicine. The occurrence rate of DIP in cases administered Gefitinib; Methotrexate (MTX); Tegafur, Gimeracil, and Oteracil potassium (TS‐1); and Tegafur and Uracil (UTF) was 6.0%, 2.3%, 1.4%, and 0.7%, respectively. The estimated DIP cases were checked by having the medical records independently reviewed by medical doctors. By chart review, the positive predictive values of DIP against Gefitinib, MTX, TS‐1, and UFT were 69.2%, 44.4%, 58.6%, and 77.8%, respectively. Although the cases extracted by this method included some that did not have DIP, this method can estimate the relative risk of DIP between medicines.

Iridoid Glycosides From Morinda Officinalis F. C. How Alleviate Rheumatoid Arthritis and Its Associated Bone Deterioration and Protect Against Methotrexate-induced Toxicity in Collagen-induced Arthritic Rats

“…Furthermore, oxidative stress is one of the main causes of lung injury induced by MTX. Long-term administration of MTX can induce severe interstitial pneumonia [32] and lung injury [33]. In the other way, it was reported that MTX could also cause severe gastrointestinal reaction.…”

Stevens–Johnson syndrome associated with TS‐1 in a patient with gastric cancer: A case report

“…Several severe adverse reactions caused by TS‐1 have been reported. For instance, interstitial pneumonia caused by TS‐1, a serious complication, was first reported by Kurakawa in 2001, 16 followed by several articles on interstitial pneumonia induced by TS‐1, 17,18 suggesting that the quantitative risk of TS‐1 should be taken into account. Several reports reflect the potential risk of TS‐1 to patients, including a 44‐year‐old woman and a 66‐year‐old man with gastric cancer who developed acral lentiginosis associated with oral TS‐1 19 .…”

Applying Natural Language Processing to Textual Data From Clinical Data Warehouses: Systematic Review

“…In the included articles, named entity recognition (NER) primarily focuses on identifying entities such as protected health information (PHI) to deidentify clinical documents [206,207], as well as various clinical concepts. These concepts encompass diseases [20,25,40,41,45,47,49]; findings and symptoms [49,52,[116][117][118][119]121]; and medication names [49,52,[93][94][95]99,100,102,106,107,112,113,115], along with their associated details such as dose, frequency, and duration [52,[93][94][95]112,113,115] as well as potential adverse events [96][97][98]100,101,[106][107][108][109][110]114]. These medical concepts can be mapped to terminologies or ontol...…”