Transcript No Slide Title

HL7 Vocabulary TC:
Dose Form Analysis
Timothy McNamara, MD, MPH&TM
Multum Information Services, Inc.
September 29, 1999
ROI
Background
• Analysis of dose form terminology
• Data provided by Jim Cimino
• Based on data submitted to Jim for analysis
during an earlier study of congruence of drug
terminologies
• The original data set included all “clinical
drug data” submitted from each provider for
each of 1000 arbitrarily selected NDCs (listed
in the FDA NDC list)
Data
• 593 records
• Each record contained five fields:
• 1st provider name
• 2nd provider name
• 1st form description
• 2nd form description
• count
Data Sample
fdb/stl|medispan|TABLET EC CR|ENTERIC COATED TABLET|1|
fdb/stl|medispan|TABLET ULTR MCR|TABLET|1|
fdb/stl|medispan|TABLET|TABLET|153|
fdb/stl|medispan|TABLET|TABLET CR|1|
fdb/stl|multum|AEROSOL|AEROSOL|1|
fdb/stl|multum|CAPSULE CR 12HR|CAPSULE CR|1|
fdb/stl|multum|CAPSULE CR 24HR|CAPSULE CR|1|
fdb/stl|multum|CAPSULE CR|CAPSULE CR|2|
fdb/stl|multum|CAPSULE EC|CAPSULE CR|1|
fdb/stl|multum|CAPSULE|CAPSULE|26|
fdb/stl|multum|CHEWABLE TABLET|CHEWABLE TABLET|2|
fdb/stl|multum|CREAM|CREAM|7|
fdb/stl|multum|DRESSING|OINTMENT|1|
fdb/stl|multum|ELIXIR|CONCENTRATE|1|
Methodology
• Imported raw data into Microsoft Access 97
• Appended “reverse” of each record to master
table
• Queried table to find list of records where:
1st provider name = X
2nd provider name = Y
• Analyzed congruence of dose form
descriptions for a subset of records:
• 1st provider name = “mdx”
• 2nd provider name = “multum”
Results
• 3 drug list providers submitted 6 lists for
comparison resulting in 15
X possible pairwise
10
comparisons
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
fdb/sb
fdb/sb
fdb/sb
fdb/sb
fdb/sb
fdbstl
fdb/stl
fdb/stl
fdb/stl
med
med
med
medispan
medispan
mdx
X
X
X
-
fdb/stl
med
medispan
mdx
multum
med
medispan
mdx
multum
medispan
mdx
multum
mdx
multum
multum
X
X
Results
25 mdx terms had exactly one Multum term across the
data submitted:
AEROSOL
CAPSULE
CAPSULE CR
CHEWABLE TABLET
CREAM
GEL
GRANULE FOR RECONSTITUTION
IRRIGATION SOLUTION
KIT, MISCELLANEOUS ROUTES
LOTION
OINTMENT
ORAL SUSPENSION
PATCH
POWDER FOR INJECTION
POWDER FOR SUSPENSION, ORAL
RECTAL SUPPOSITORY
SOLUTION FOR DROPS, OTIC
SOLUTION INHALATION, ORAL
SOLUTION, MUCOUS MEMBRANES (ORAL)
SOLUTION, OPHTHALMIC (NON-SYSTEMIC)
SOLUTION, OTIC
SUBLINGUAL TABLET
SUSPENSION FOR DROPS, OPTHALMIC
TABLET
TABLET CR
Results
15 Multum terms had exactly one mdx term across the
data submitted:
AEROSOL
CAPSULE
CAPSULE CR
CHEWABLE TABLET
CONCENTRATE
CREAM
ELIXIR
ENTERIC COATED TABLET
GRANULE FOR RECONSTITUTION
LOTION
OINTMENT
PATCH
POWDER FOR INJECTION
POWDER FOR RECONSTITUTION
SUPPOSITORY
Results
12 Multum and mdx terms were used exactly the
same way across the data submitted:
AEROSOL
CAPSULE
CAPSULE CR
CHEWABLE TABLET
CREAM
GRANULE FOR RECONSTITUTION
LOTION
OINTMENT
PATCH
POWDER FOR INJECTION
POWDER FOR SUSPENSION, ORAL
RECTAL SUPPOSITORY
AEROSOL
CAPSULE
CAPSULE CR
CHEWABLE TABLET
CREAM
GRANULE FOR RECONSTITUTION
LOTION
OINTMENT
PATCH
POWDER FOR INJECTION
POWDER FOR RECONSTITUTION
SUPPOSITORY
“Functional Synonyms”
Conclusions
• Mdx and Multum appear to apply 12 dose form
terms (18.5% of Multum’s 65 dose form terms)
in an editorially-consistent way
• This estimate likely overcalls the actual level
of congruence since it is based on a small
sample of NDCs
• The “meaning” of dose form terms tends to
be different and there appear to be
substantially different editorial rules for
creation of dose form terms and assignment
of dose form terms
Conclusions
• Further progress in this narrow activity would
be facilitated by:
• Open availability of all dose forms for all
NDCs
• Review of editorial rules from each drug
list provider for creation of dose form
terms and their assignment
• Contribution of one dose form set per drug
list provider
Conclusions
• The value of isolated dose form congruence
(even if it can be achieved) without an explicit
goal of broader congruence (regarding
ingredients, strengths, routes, etc…) is topic
worthy of further discussion