The Effect of Patient-Specific Drug-Drug Interaction Alerting on the Frequency of Alerts: A Pilot Study.

Background: False-positive drug-drug interaction alerts are frequent and result in alert fatigue that can result in prescribers bypassing important alerts. Development of a method to present patient-appropriate alerts is needed to help restore alert relevance. Objective: The purpose of this study was to assess the potential for patient-specific drug-drug interaction (DDI) alerts to reduce alert burden. Methods: This project was conducted at a tertiary care medical center. Seven of the most frequently encountered DDI alerts were chosen for developing patient-specific, algorithm-based DDI alerts. For each of the DDI pairs, 2 algorithms featuring different values for modifying factors were made. DDI alerts from the 7 drug pairs were collected over 30 days. Outcome measures included the number of DDI alerts generated before and after patient-specific algorithm application to the same patients over the same time period. Results: A total of 14 algorithms were generated, and each was evaluated by comparing the number of alerts generated by our existing, customized clinical decision support (CDS) software and the patient-specific algorithms. The CDS DDI alerting software generated an average of 185.3 alerts per drug pair over the 30-day study period. Patient-specific algorithms reduced the number of alerts resulting from the algorithms by 11.3% to 93.5%. Conclusion and Relevance: Patient-specific DDI alerting is an innovative and effective approach to reduce the number of DDI alerts, may potentially increase the appropriateness of alerts, and may decrease the potential for alert fatigue.

3D-SURFER: software for high-throughput protein surface comparison and analysis.

SUMMARY: We present 3D-SURFER, a web-based tool designed to facilitate high-throughput comparison and characterization of proteins based on their surface shape. As each protein is effectively represented by a vector of 3D Zernike descriptors, comparison times for a query protein against the entire PDB take, on an average, only a couple of seconds. The web interface has been designed to be as interactive as possible with displays showing animated protein rotations, CATH codes and structural alignments using the CE program. In addition, geometrically interesting local features of the protein surface, such as pockets that often correspond to ligand binding sites as well as protrusions and flat regions can also be identified and visualized. AVAILABILITY: 3D-SURFER is a web application that can be freely accessed from: http://dragon.bio.purdue.edu/3d-surfer CONTACT: dkihara@purdue.edu SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.