BACKGROUND: Alert fatigue could potentially be improved if physicians agreed on which alerts were clinically significant. We conducted a study to determine the extent to which physicians agree on which drug-drug interactions are clinically significant. METHODS: Two groups of eight generalist physicians reviewed 100 randomly selected drug-drug interactions from the Medi-Span® Drug Therapy Monitoring System™ database and indicated whether they thought each interaction was clinically significant based on the full-text clinical discussion contained within each interaction monograph and their clinical experience. RESULTS: The Fleiss Kappa measure of inter-rater agreement was 0.19 (0.12, 0.26) for one group, 0.22 (0.14, 0.29) for the second group and 0.21 (0.15, 0.27) for the combined group. CONCLUSION: We found poor agreement among generalist physicians on which drug-drug interactions are clinically significant. Use of a feature to allow physicians to tailor alerts to their needs may be an important component in reducing alert fatigue.
BACKGROUND: Alert fatigue could potentially be improved if physicians agreed on which alerts were clinically significant. We conducted a study to determine the extent to which physicians agree on which drug-drug interactions are clinically significant. METHODS: Two groups of eight generalist physicians reviewed 100 randomly selected drug-drug interactions from the Medi-Span® Drug Therapy Monitoring System™ database and indicated whether they thought each interaction was clinically significant based on the full-text clinical discussion contained within each interaction monograph and their clinical experience. RESULTS: The Fleiss Kappa measure of inter-rater agreement was 0.19 (0.12, 0.26) for one group, 0.22 (0.14, 0.29) for the second group and 0.21 (0.15, 0.27) for the combined group. CONCLUSION: We found poor agreement among generalist physicians on which drug-drug interactions are clinically significant. Use of a feature to allow physicians to tailor alerts to their needs may be an important component in reducing alert fatigue.
Authors: Shobha Phansalkar; Amrita A Desai; Douglas Bell; Eileen Yoshida; John Doole; Melissa Czochanski; Blackford Middleton; David W Bates Journal: J Am Med Inform Assoc Date: 2012-04-26 Impact factor: 4.497
Authors: Jeannette E F Zwart-van Rijkom; Esther V Uijtendaal; Maarten J ten Berg; Wouter W van Solinge; Antoine C G Egberts Journal: Br J Clin Pharmacol Date: 2009-08 Impact factor: 4.335