InterRater Agreement Among Physicians on the Clinical Significance ofDrugDrug Interactions

AMIA 2013 Annual Symposium

Howard R. Strasberg ; MD ; MS1 ; Albert Chan ; MD ; MS2 ; Stephen J. Sklar ; PharmD1

PID  :  122560

来源: CEUR

【 摘 要 】

Background:Alert fatigue could potentially be improved if physicians agreed on which alerts wereclinically significant.We conducted a study to determine the extent to which physicians agree on which drugdruginteractions are clinically significant.Methods: Two groups of eight generalist physicians reviewed 100 randomlyselected drugdrug interactions from the MediSpan Drug Therapy Monitoring System database and indicatedwhether they thought each interaction was clinically significant based on the fulltext clinical discussion containedwithin each interaction monograph and their clinical experience.Results:The Fleiss Kappa measure of interrateragreement was 0.19 (0.12, 0.26) for one group, 0.22 (0.14, 0.29) for the second group and 0.21 (0.15, 0.27) for thecombined group.Conclusion: We found poor agreement among generalist physicians on which drugdruginteractions are clinically significant.Use of a feature to allow physicians to tailor alerts to their needs may be an