Hybrid Method Incorporating a Rule-Based Approach and Deep Learning for Prescription Error Prediction

Drug Saf. 2022 Jan;45(1):27-35. doi: 10.1007/s40264-021-01123-6. Epub 2021 Nov 12.

Abstract

Introduction: Recently, automated detection has been a new approach to address the risks posed by prescribing errors. This study focused on prescription errors and utilized real medical data to supplement the Drug Utilization Review (DUR)-based rules, the current prescription error detection method. We developed a new hybrid method through artificial intelligence for prescription error prediction by utilizing actual detection accuracy improvement to reduce 'warning fatigue' for doctors and improve medical care quality.

Object: This study was conducted in the Department of Pediatrics, targeting children sensitive to drugs to develop a prescription error detection system. Based on the DUR prescription history, 15,281 patient-level observations of children from Konyang University Hospital (KYUH)'s common data model (CDM) and DUR were collected and analyzed retrospectively.

Method: Among the CDM data, inspection information was interlocked with DUR and reflected as standard information for model development; this included outpatient prescriptions from January 1 to December 31, 2018. Through consultation with pediatric clinicians, rule definitions and model development were conducted for 35 drugs, with 137,802 normal and 1609 prescription errors.

Results: We developed a novel hybrid method of error detection in the form of an advanced rule-based deep neural network (ARDNN), which showed the expected performance (precision: 72.86, recall: 81.01, F1 score: 76.72) and reduced alarm pop-up alert fatigue to below 10%. We also created an ARDNN-based comprehensive dashboard that allows doctors to monitor prescription errors with alarm pop-ups when prescribing medications.

Conclusion: These results can advance the existing rule-based model by developing a prescription error detection model using deep learning. This method can improve overall medical efficiency and service quality by reducing doctors' fatigue.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Artificial Intelligence
  • Child
  • Deep Learning*
  • Drug Prescriptions
  • Humans
  • Medication Errors / prevention & control
  • Retrospective Studies