药物相互作用分析软件性能的量化评估与思考  

Quantitative analysis and reflection on performance of drug-drug interaction analysis software

作　　者：袁如月 刘岩 杨天绎 张力[4] 赵志刚[5] 李新辰[5] 李皎月 黄举凯 杨晓晖[2] YUAN Ruyue;LIU Yan;YANG Tianyi;ZHANG Li;ZHAO Zhigang;LI Xinchen;LI Jiaoyue;HUANG Jukai;YANG Xiaohui(Dongcheng Retired Cadre Recuperation Center,Beijing 100120,China;Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;Rutgers University,New Brunswick,NJ 08901,USA;Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China;Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]东城退休干部休养所,北京100120 [2]北京中医药大学东直门医院,北京100700 [3]罗格斯大学,美国新泽西州新布朗斯维克089014 [4]北京中医药大学东方医院,北京100078 [5]首都医科大学附属北京天坛医院,北京100070

出　　处：《药物评价研究》2025年第3期566-575,共10页Drug Evaluation Research

基　　金：中国药品监督管理研究会研究课题-基于多元证据体探索中成药安全性评价方法的研究(2024-Y-Y-006);临床研究和成果转化能力提升试点项目-中药制剂研发——治疗胃轻瘫中药复方佛香散(DZMG-ZJXY-23002)。

摘　　要：目的采用多维度定量评估国外5个常用药物相互作用(DDI)分析软件的性能,为我国DDI软件开发提供参考。方法对DDI分析软件的评估涵盖4个维度,即准确性、全面性、易用性、可靠性,准确性采用诊断性Meta分析方法对敏感度、特异度等数据进行定量合成,绘制集成受试者工作特征曲线(SROC)图并计算曲线下面积;全面性、易用性、可靠性通过访问软件平台进行量表评分,每个条目1分制进行评分,全面性总分7分,易用性总分3分,可靠性总分10分;最终将4个性能评分相加得到综合分数。结果通过既往系统综述文献选取研究频率较高的5个DDI分析软件为研究对象,包括Micromedex DrugReax^(®)、Lexicomp Interactions、Epocrates、Drug Interactions Checker(Drugs.com)、Medscape^(®)。准确性方面,Epocrates敏感度合并值最高,为0.71;Micromedex特异度合并值最高,为0.85;Epocrates阳性似然比合并值最高,为6.14;Lexicomp Interactions、Epocrates阴性似然比最低,为0.2;Epocrates曲线下面积最高,为0.9332。全面性得分排名为:Micromedex(7分)>Lexicomp Interactions(6分)>Drugs.com(5分)>Medscape(3.5分)>Epocrates(3分)。5个软件易用性得分均为3分,可靠性得分排名为:Lexicomp Interactions(9分)=Drugs.com(9分)>Micromedex(8分)>Medscape(7分)>Epocrates(5分)。最终综合得分排名为Lexicomp Interactions(8.5分)>Epocrates(7.75分)>Micromedex(7.5分)>Medscape(5.375分)>Drugs.com(5.25分)。结论国外DDI分析软件识别能力及信息质量参差不齐,对于DDI严重程度分类标准、参考文献及信息来源等重要信息有待完善,一些软件的易用性及可靠性也有待提升。Objective To quantitatively evaluate the performance of five commonly used foreign drug-drug interaction(DDI)analysis software from multiple dimensions,to provide a reference for the development of DDI software in China.Methods The DDI analysis software were evaluated from four dimensions:accuracy,comprehensiveness,usability,and reliability.The integrated receiver operating characteristic(SROC)curve was plotted,and the area under the curve was calculated.Comprehensiveness,usability,and reliability were scored by accessing the software platform.Each item was scored on a one-point scale,resulting in a total score of seven points for comprehensiveness,three points for usability,and 10 points for reliability.Finally,the scores for the four performance evaluations were added to obtain an overall score.Results Based on the previous literature of systematic review,five frequently used DDI analysis software was selected as the subjects of study.These software include Micromedex DrugReax^(®),Lexicomp Interactions,Epocrates,Drug Interactions Checker(Drugs.com),and Medscape^(®).In terms of accuracy,Epocrates had the highest combined sensitivity value at 0.71,while Micromedex had the highest combined specificity value at 0.85.Epocrates also had the highest combined positive likelihood ratio value at 6.14,and Lexicomp Interactions and Epocrates had the lowest combined negative likelihood ratio values at 0.2.Epocrates had the highest area under the curve value at 0.9332.In terms of comprehensive,Micromedex(seven points)>Lexicomp Interactions(six points)>Drugs.com(five points)>Medscape^(®)(3.5 points)>Epocrates(three points).All five software received a usability score of three.In terms of reliability,Lexicomp Interactions(nine points)=Drugs.com(nine points)>Micromedex(eight points)>Medscape(seven points)>Epocrates(five points).The final overall score rankings were as follows:Lexicomp Interactions(8.5 points)>Epocrates(7.75 points)>Micromedex(7.5 points)>Medscape^(®)(5.375 points)>Drugs.com(5.25 points).Conclusion The ident

关 键 词：药物相互作用 软件 性能评估 合理用药 Micromedex DrugReax^(®) Lexicomp Interactions Epocrates Drug Interactions Checker(Drugs.com) Medscape^(®) 

分 类 号：R969.2[医药卫生—药理学]