Abstract
AbstractWrong dose, a common prescription error, can cause serious patient harm, especially in the case of high-risk drugs like oral corticosteroids. This study aims to build a machine learning model to predict dose-related prescription modifications for oral prednisolone tablets (i.e., highly imbalanced data with very few positive cases). Prescription data were obtained from the electronic medical records at a single institute. Cluster analysis classified the clinical departments into six clusters with similar patterns of prednisolone prescription. Two patterns of training datasets were created with/without preprocessing by the SMOTE method. Five ML models (SVM, KNN, GB, RF, and BRF) and logistic regression (LR) models were constructed by Python. The model was internally validated by five-fold stratified cross-validation and was validated with a 30% holdout test dataset. Eighty-two thousand five hundred fifty-three prescribing data for prednisolone tablets containing 135 dose-corrected positive cases were obtained. In the original dataset (without SMOTE), only the BRF model showed a good performance (in test dataset, ROC-AUC:0.917, recall: 0.951). In the training dataset preprocessed by SMOTE, performance was improved on all models. The highest performance models with SMOTE were SVM (in test dataset, ROC-AUC: 0.820, recall: 0.659) and BRF (ROC-AUC: 0.814, recall: 0.634). Although the prescribing data for dose-related collection are highly imbalanced, various techniques such as the following have allowed us to build high-performance prediction models: data preprocessing by SMOTE, stratified cross-validation, and BRF classifier corresponding to imbalanced data. ML is useful in complicated dose audits such as oral prednisolone.
Funder
Grant for Research Project of the Japanese Society of Drug Informatics in 2018
Publisher
Springer Science and Business Media LLC
Subject
Artificial Intelligence,Computer Science Applications,Health Informatics,Information Systems
Reference64 articles.
1. Dornan T, Ashcroft D, Heathfield H, Lewis P, Miles J, Taylor D, Tully M, Wass V (2009) Final report: An in depth investigation into causes of prescribing errors by foundation trainees in relation to their medical education - EQUIP study. General Medical Council. http://www.gmc-uk.org/FINAL_Report_prevalence_and_causes_of_prescribing_errors.pdf_28935150.pdf. Accessed 20 Jul 2022
2. Avery AJ, Ghaleb M, Barber N, Franklin BD, Armstrong SJ, Serumaga B, Dhillon S, Freyer A, Howard R, Talabi O, Mehta RL (2013) The prevalence and nature of prescribing and monitoring errors in English general practice: a retrospective case note review. Br J Gen Pract 63:e543-553. https://doi.org/10.3399/bjgp13X670679
3. Claesson CB, Burman K, Nilsson J, Vinge E (1995) Prescription errors detected by Swedish pharmacists. Int J Pharm Pract 3:151–156. https://doi.org/10.1111/j.2042-7174.1995.tb00809.x
4. Lustig A (2000) Medication error prevention by pharmacists–an Israeli solution. Pharm World Sci 22:21–25. https://doi.org/10.1023/A:1008774206261
5. Khaja KA, Al-ansari TM, Sequeira R (2005) An evaluation of prescribing errors in primary care in Bahrain. Int J Clin Pharmacol Ther 43:294–301. https://doi.org/10.5414/cpp43294