A fuzzy recognition-primed decision model-based causal association mining algorithm for detecting adverse drug reactions in postmarketing surveillance

The current approach to postmarketing surveillance primarily relies on spontaneous reporting. It is a passive surveillance system and limited by gross underreporting (<10% reporting rate), latency, and inconsistent reporting. We propose a new interestingness measure, causal-leverage, to signal potential adverse drug reactions (ADRs) from electronic health databases which are readily available in most modern hospitals. This measure is based on an experience-based fuzzy recognition-primed decision (RPD) model that we developed previously [1] which assesses the strength of association of a drug-ADR pair within each individual patient case. Using the causal-leverage measure, we develop a data mining algorithm to evaluate the associations between a given drug enalapril and all potential ADRs in a real-world electronic health database. The experimental results have shown that our approach can effectively shortlist some known ADRs. For example, the known ADR hyperkalemia caused by enalapril was ranked as top 1% among all the 3954 potential ADRs in our database.