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Discovering prescription patterns in pediatric acute-onset neuropsychiatric syndrome patients.
Lopez Pineda, Arturo; Pourshafeie, Armin; Ioannidis, Alexander; Leibold, Collin McCloskey; Chan, Avis L; Bustamante, Carlos D; Frankovich, Jennifer; Wojcik, Genevieve L.
Afiliación
  • Lopez Pineda A; Department of Biomedical Data Science, Stanford University, CA, USA; Department of Data Science, Amphora Health, Morelia, Mexico.
  • Pourshafeie A; Department of Biomedical Data Science, Stanford University, CA, USA; Department of Physics, Stanford University, CA, USA.
  • Ioannidis A; Department of Biomedical Data Science, Stanford University, CA, USA.
  • Leibold CM; Department of Pediatrics, Division of Allergy, Immunology, and Rheumatology, Stanford University, CA, USA; Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA.
  • Chan AL; Department of Pediatrics, Division of Allergy, Immunology, and Rheumatology, Stanford University, CA, USA.
  • Bustamante CD; Department of Biomedical Data Science, Stanford University, CA, USA; Department of Genetics, Stanford University, CA, USA; Chan Zuckerberg Biohub, San Francisco, CA, USA. Electronic address: cdbustam@stanford.edu.
  • Frankovich J; Department of Pediatrics, Division of Allergy, Immunology, and Rheumatology, Stanford University, CA, USA. Electronic address: jfranko@stanford.edu.
  • Wojcik GL; Department of Biomedical Data Science, Stanford University, CA, USA; Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA. Electronic address: gwojcik1@jhu.edu.
J Biomed Inform ; 113: 103664, 2021 01.
Article en En | MEDLINE | ID: mdl-33359113
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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades Autoinmunes / Infecciones Estreptocócicas / Trastorno Obsesivo Compulsivo Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Child / Humans Idioma: En Revista: J Biomed Inform Asunto de la revista: INFORMATICA MEDICA Año: 2021 Tipo del documento: Article País de afiliación: México Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades Autoinmunes / Infecciones Estreptocócicas / Trastorno Obsesivo Compulsivo Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Child / Humans Idioma: En Revista: J Biomed Inform Asunto de la revista: INFORMATICA MEDICA Año: 2021 Tipo del documento: Article País de afiliación: México Pais de publicación: Estados Unidos