J Am Med Inform Assoc 16:607-612 doi:10.1197/jamia.M3167
  • The Practice of Informatics
  • Application of Information Technology

Computerized Surveillance for Adverse Drug Events in a Pediatric Hospital

  1. Peter M Kilbridge, MDa,c,d,
  2. Laura A Noirotb,
  3. Richard M Reichley, RPhc,
  4. Kathleen M Berchelmann, MDa,
  5. Cortney Schneider, PharmDd,
  6. Kevin M Heardc,
  7. Miranda Nelson, MDd,
  8. Thomas C Bailey, MDb,c
  1. aDepartment of Pediatrics, Washington University School of Medicine, St Louis, MO
  2. bDepartment of Internal Medicine, Washington University School of Medicine, St Louis, MO
  3. cBJC Healthcare, Center for Healthcare Quality and Effectiveness, St Louis, MO
  4. dSt Louis Children's Hospital, St Louis, MO
  1. Correspondence: Peter M. Kilbridge, MD, St Louis Children's Hospital, One Children's Place, St Louis, MO 63110 (Email: kilbridge_p{at}
  • Received 3 February 2009
  • Accepted 29 May 2009


There are limited data on adverse drug event rates in pediatrics. The authors describe the implementation and evaluation of an automated surveillance system modified to detect adverse drug events (ADEs) in pediatric patients. The authors constructed an automated surveillance system to screen admissions to a large pediatric hospital. Potential ADEs identified by the system were reviewed by medication safety pharmacists and a physician and scored for causality and severity. Over the 6 month study period, 6,889 study children were admitted to the hospital for a total of 40,250 patient-days. The ADE surveillance system generated 1226 alerts, which yielded 160 true ADEs. This represents a rate of 2.3 ADEs per 100 admissions or 4 per 1,000 patient-days. Medications most frequently implicated were diuretics, antibiotics, immunosuppressants, narcotics, and anticonvulsants. The composite positive predictive value of the ADE surveillance system was 13%. Automated surveillance can be an effective method for detecting ADEs in hospitalized children.


  • Supported by AHRQ Grant 1R18HS017010.

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