Discovering prescription patterns in pediatric acute-onset neuropsychiatric syndrome patients
| Autor: | Genevieve L. Wojcik, Arturo Lopez Pineda, Jennifer Frankovich, Collin Mc Closkey Leibold, Armin Pourshafeie, Carlos Bustamante, Alexander G. Ioannidis, Avis L. Chan |
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| Rok vydání: | 2020 |
| Předmět: |
Pediatrics
medicine.medical_specialty Obsessive-Compulsive Disorder Pediatric acute-onset neuropsychiatric syndrome Health Informatics Autoimmune Diseases Cohort Studies 03 medical and health sciences 0302 clinical medicine Streptococcal Infections medicine Humans 030212 general & internal medicine Medical prescription Child 030304 developmental biology Polypharmacy 0303 health sciences business.industry Cognition medicine.disease Computer Science Applications Prescriptions Concomitant Cohort Etiology business Cohort study |
| Zdroj: | Journal of biomedical informatics. 113 |
| ISSN: | 1532-0480 |
| Popis: | Objective Pediatric acute-onset neuropsychiatric syndrome (PANS) is a complex neuropsychiatric syndrome characterized by an abrupt onset of obsessive-compulsive symptoms and/or severe eating restrictions, along with at least two concomitant debilitating cognitive, behavioral, or neurological symptoms. A wide range of pharmacological interventions along with behavioral and environmental modifications, and psychotherapies have been adopted to treat symptoms and underlying etiologies. Our goal was to develop a data-driven approach to identify treatment patterns in this cohort. Materials and methods In this cohort study, we extracted medical prescription histories from electronic health records. We developed a modified dynamic programming approach to perform global alignment of those medication histories. Our approach is unique since it considers time gaps in prescription patterns as part of the similarity strategy. Results This study included 43 consecutive new-onset pre-pubertal patients who had at least 3 clinic visits. Our algorithm identified six clusters with distinct medication usage history which may represent clinician’s practice of treating PANS of different severities and etiologies i.e., two most severe groups requiring high dose intravenous steroids; two arthritic or inflammatory groups requiring prolonged nonsteroidal anti-inflammatory drug (NSAID); and two mild relapsing/remitting group treated with a short course of NSAID. The psychometric scores as outcomes in each cluster generally improved within the first two years. Discussion and conclusion Our algorithm shows potential to improve our knowledge of treatment patterns in the PANS cohort, while helping clinicians understand how patients respond to a combination of drugs. |
| Databáze: | OpenAIRE |
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