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

Computerized Surveillance for Adverse Drug Events in a Pediatric Hospital

Table 3

ADE Rules: Positive Predictive Value (Rules with No ADEs Not Listed)

Rule Description ADEs Alerts PPV
Carbamazepine > 14 4 4 1.00
Digoxin > 2.5 2 2 1.00
Flumazenil administered 2 2 1.00
Hypoglycemia: glucose < 40 and insulin 1 1 1.00
Naloxone administered 9 14 0.64
Clostridium difficile infection 7 14 0.50
Phenobarbital > 50 2 6 0.33
INR > 4.5 5 16 0.31
Hypokalemia: potassium < 3 66 223 0.30
Tacrolimus > 20 1 4 0.25
Tobramycin trough > 3 1 4 0.25
Hypomagnesemia: Mg2+ < 1.6 19 80 0.24
Vancomycin trough elevated 5 24 0.21
Phenytoin > 20 3 17 0.18
Nephrotoxicity: (Scr 2× increase over past 2 days) or (Scientific Review > 1.5x ULN) 18 149 0.12
Metabolic acidosis: anion gap > 11 with drug cause 1 9 0.11
Hyperkalemia: potassium > 6.5 and age > 1 yr 2 25 0.08
Hepatotoxicity: elevated liver function test (2.5x ULN) 9 159 0.06
Neutropenia: ANC < lower limit of normal 2 67 0.03
Hypophosphatemia: phosphorus < lower limit of normal 1 85 0.01
  • ADE = adverse drug event; INR = international normalized ratio; ULN = upper level of normal.

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