Improving Online Access to Drug-Related Information
Improving Online Access to Drug-related Information Jiao Li, Ph.D., Ritu Khare, Ph.D., Zhiyong Lu, Ph.D. National Center for Biotechnology Information (NCBI) National Library of Medicine, National Institutes of HealthIntroduction Linking drug monographs to diseases of interest Seeking drug-related information is one of the major activities of today’s Identifying diseases of Ranking diseases of interest online health consumers. In this work, our goals are: interest from drug monographs • Evidence confidence (1) To facilitate health consumers to access trustworthy drug information online θ sg (2) To provide consumers with integrated access to other health resources Resources containing drug-disease relationships = α ∗ pM s g + β ∗ pF s g + γ ∗ pQ s g + 𝛿 ∗ 𝑝 𝐿 (𝑠|𝑔) Drug monograph 𝑛 𝑀 𝑔,𝑠 𝑛 𝐹 𝑔,𝑠 𝑛 𝑄 𝑔,𝑠 𝑛 𝐿 𝑔,𝑠 e.g., the [Drug] is used for treating [Disease] = 𝛼∗ + 𝛽∗ + 𝛾∗ + 𝛿∗ Disease 𝑛 𝑀 𝑔 𝑛𝐹 𝑔 𝑛𝑄 𝑔 𝑛𝐿 𝑔 · Search drug names Drug monograph Disease monograph • Search trends 𝑓 𝑔, 𝑠 e.g., the [Disease] can be treated by [Drug] § Active ingredients Compound 𝑞 𝑠 𝑔 𝑓 𝑔 𝑓 𝑔, 𝑠 ∗ 𝑁 𝜏 𝑠 𝑔 = = = ( e.g., Ibuprofen) Search query 𝑞 𝑠 𝑓 𝑠 𝑓 𝑔 ∗ 𝑓 𝑠 § Brand names Gene e.g., [Drug] [Disease] 𝑁 (e.g., Advil, Motrin) Literature • Relevant score Health Consumer (1) (2) Protein e.g., study [Drug] in [Disease] 𝑟 𝑠|𝑔 = 𝜃 𝑠 𝑔 ∗ 𝑒 𝜏 𝑠|𝑔 𝒑 𝑀 𝑠 𝑔 : drug-disease in disease Literature where, monographs s: Disease 𝒑 𝑠 𝑔 : drug-disease in drug monographs 𝑭 Clinical Trial Fig 3. Resources containing g: Drug 𝒑 𝑸 𝑠 𝑔 : drug-disease searched by users drug-disease relationships 𝒑 𝑳 𝑠 𝑔 : drug-disease in scientific literature Fig 1. Health consumers’ behaviors of seeking drug-related information Filtering drug-disease M Results Output: rankedEnriching drug monographs relationships Q Q0.1 Q0.05 Q0.01 L0.01 L0.05 L0.1 L Input: a drug monograph diseases of interestby automatically assigning brand names Statistics-based filter: Tamsulosin (tam soo loe sin) Enlarged prostate F Prostatitis - bacterial Drug Monographs RxNorm Hypergeometric p-value is used to Why is this medication prescribed? Tamsulosin is used in men to treat the symptoms of an enlarged prostate (benign prostatic hyperplasia or BPH) which include chronic Ingredient (IN) has_ingredient Brand Name (BN) difficulty urinating (hesitation, dribbling, weak stream, and Prostatitis - nonbacterial• Each monograph is subject to a drug’s • A standardized Ibuprofen ingredient_of Advil measure the significance of relationships incomplete bladder emptying), painful urination, and urinary frequency and urgency. Tamsulosin is in a class of medications called alpha blockers. It works by relaxing the muscles in the - chronic generic name/active ingredient (e.g., nomenclature has_tradename tradename_of identified from queries and literature. prostate and bladder so that urine can flow easily. Cataract ‘Ibuprofen’) rather than its specific drug for clinical drugs Dosage Form (DF) has_dose_form Branded Drug or Package (SBD) product (e.g., ‘Advil®’) Oral Tablet Advil 100 MG Oral Tablet • Drug brand dose_form_of [Obsolete=N] [Veterinary=N] Domain knowledge based filter:• Drugs with same ingredients but related concepts Search query Literature Drugs in specific physical forms should be in RxNorm Q_ID Q_Term different dosage forms may be applied in specific categories of diseases. Q831368 flomax cataract described in different monographs. Drug dose form Disease category Q1129241 tamsulosin cataract Diclofenac (Transdermal) Ingredient (IN) has_ingredient Brand Name (BN) Ophthalmic Cream Ophthalmology Q952568 flomax and cataract Diclofenac (Ophthalmic) Guaifenesin Allfen ingredient_of surgery Diclofenac (Topical) Otic Solution Otolaryngology Q235052 flomax cataract reformulation_of has reformulation Vaginal Cream Obstetrics & Gynecology surgery Brand name vs. Ingredient name Ingredient (IN) has_ingredient Brand Name (BN)• When searching for drug information, Guaifenesin Guaiacolsulfonate ingredient_of Allfen Reformulated Mar 2007 Conclusions consumers use brand names rather than generic names. Our study has several practical implications in real-world medical informatics: • Facilitating consumers to access drug information through brand name search Assigning brand names to a given Assignment Result • Facilitating consumers to access drug-related disease monographs, and rankingdrug monograph • Our method is applicable to 957 drug diseases based on evidence confidence and user interest monographs (1095 in total). • Helping drug monograph editors update drug information such as brand names • Our method can help human editors update • Accurately characterizing monographs using features like ingredients & dosage forms Input: A full-text drug monograph and revise drug information. References Identify ingredients and dosage forms 1. Islamaj DR, Murray GC, Neveol A, and Lu Z: Understanding PubMed user search behavior through Map to RxNorm  log analysis. Database (Oxford) 2009, 2009:bap018. 2. Li J. and Lu Z. Automatic Identification and Normalization of Dosage Forms in Drug Monographs. Identify brand names in RxNorm BMC Medical Informatics and Decision Making 2012, 12:9. (1) Ingredient Consistency 3. Li J. and Lu Z. Assigning Brand Names to Drug Monographs in PubMed Health. The AMIA 2011 (2) Dosage Form Consistency Annual Symposium. 2011. Washington DC, USA 4. MedlinPlus® http://www.nlm.nih.gov/medlineplus/ (3) Obsolescence 5. American Hospital Formulary Service® (AHFS) drug information (4) Reformulation http://www.ahfsdruginformation.com/ (5) Veterinary 6. A.D.A.M. Medical Encyclopedia http://www.adam.com/MutlimediaEncyclopedia.aspx 7. RxNorm http://www.nlm.nih.gov/research/umls/rxnorm/ 8. PubMed® http://www.ncbi.nlm.nih.gov/pubmed/ Output: Brand Names 9. PubMed Health http://www.ncbi.nlm.nih.gov/pubmedhealth/ Acknowledgements This research was supported by the Intramural Research Program of the National Institutes of Health,Fig 2. Flowchart for determining brand names National Library of Medicine. We would like to thank our colleagues Dr. Stuart J. Nelson, Dr. John Kilbourne, and Dr. Olivier Bodenreider for discussing the meaningful use of RxNorm.