A systematic approach for developing a corpus of patient reported adverse drug events: A case study for SSRI and SNRI medications.

"Psychiatric Treatment Adverse Reactions" (PsyTAR) corpus is an annotated corpus that has been developed using patients narrative data for psychiatric medications, particularly SSRIs (Selective Serotonin Reuptake Inhibitor) and SNRIs (Serotonin Norepinephrine Reuptake Inhibitor) medications. This corpus consists of three main components: sentence classification, entity identification, and entity normalization. We split the review posts into sentences and labeled them for presence of adverse drug reactions (ADRs) (2168 sentences), withdrawal symptoms (WDs) (438 sentences), sign/symptoms/illness (SSIs) (789 sentences), drug indications (517), drug effectiveness (EF) (1087 sentences), and drug infectiveness (INF) (337 sentences). In the entity identification phase, we identified and extracted ADRs (4813 mentions), WDs (590 mentions), SSIs (1219 mentions), and DIs (792). In the entity normalization phase, we mapped the identified entities to the corresponding concepts in both UMLS (918 unique concepts) and SNOMED CT (755 unique concepts). Four annotators double coded the sentences and the span of identified entities by strictly following guidelines rules developed for this study. We used the PsyTAR sentence classification component to automatically train a range of supervised machine learning classifiers to identifying text segments with the mentions of ADRs, WDs, DIs, SSIs, EF, and INF. SVMs classifiers had the highest performance with F-Score 0.90. We also measured performance of the cTAKES (clinical Text Analysis and Knowledge Extraction System) in identifying patients' expressions of ADRs and WDs with and without adding PsyTAR dictionary to the core dictionary of cTAKES. Augmenting cTAKES dictionary with PsyTAR improved the F-score cTAKES by 25%. The findings imply that PsyTAR has significant implications for text mining algorithms aimed to identify information about adverse drug events and drug effectiveness from patients' narratives data, by linking the patients' expressions of adverse drug events to medical standard vocabularies. The corpus is publicly available at Zolnoori et al. [30].

Identifying the Underlying Factors Associated With Patients' Attitudes Toward Antidepressants: Qualitative and Quantitative Analysis of Patient Drug Reviews.

BACKGROUND: Nonadherence to antidepressants is a major obstacle to deriving antidepressants' therapeutic benefits, resulting in significant burdens on the individuals and the health care system. Several studies have shown that nonadherence is weakly associated with personal and clinical variables but strongly associated with patients' beliefs and attitudes toward medications. Patients' drug review posts in online health care communities might provide a significant insight into patients' attitude toward antidepressants and could be used to address the challenges of self-report methods such as patients' recruitment. OBJECTIVE: The aim of this study was to use patient-generated data to identify factors affecting the patient's attitude toward 4 antidepressants drugs (sertraline [Zoloft], escitalopram [Lexapro], duloxetine [Cymbalta], and venlafaxine [Effexor XR]), which in turn, is a strong determinant of treatment nonadherence. We hypothesized that clinical variables (drug effectiveness; adverse drug reactions, ADRs; perceived distress from ADRs, ADR-PD; and duration of treatment) and personal variables (age, gender, and patients' knowledge about medications) are associated with patients' attitude toward antidepressants, and experience of ADRs and drug ineffectiveness are strongly associated with negative attitude. METHODS: We used both qualitative and quantitative methods to analyze the dataset. Patients' drug reviews were randomly selected from a health care forum called askapatient. The Framework method was used to build the analytical framework containing the themes for developing structured data from the qualitative drug reviews. Then, 4 annotators coded the drug reviews at the sentence level using the analytical framework. After managing missing values, we used chi-square and ordinal logistic regression to test and model the association between variables and attitude. RESULTS: A total of 892 reviews posted between February 2001 and September 2016 were analyzed. Most of the patients were females (680/892, 76.2%) and aged less than 40 years (540/892, 60.5%). Patient attitude was significantly (P<.001) associated with experience of ADRs, ADR-PD, drug effectiveness, perceived lack of knowledge, experience of withdrawal, and duration of usage, whereas oth age (F4,874=0.72, P=.58) and gender (χ24=2.7, P=.21) were not found to be associated with patient attitudes. Moreover, modeling the relationship between variables and attitudes showed that drug effectiveness and perceived distress from adverse drug reactions were the 2 most significant factors affecting patients' attitude toward antidepressants. CONCLUSIONS: Patients' self-report experiences of medications in online health care communities can provide a direct insight into the underlying factors associated with patients' perceptions and attitudes toward antidepressants. However, it cannot be used as a replacement for self-report methods because of the lack of information for some of the variables, colloquial language, and the unstructured format of the reports.