ReviewEuropean journal of epidemiology2017
Sequence symmetry analysis in pharmacovigilance and pharmacoepidemiologic studies.
Review in European journal of epidemiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
57 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Prescribing Cascades: An Umbrella Review and Updated Systematic Review.Drugs & aging · 2026Pooled it
- Methods for drug safety signal detection using routinely collected observational electronic health care data: A systematic review.Pharmacoepidemiology and drug safety · 2023Pooled it
- Control yourself: ISPE-endorsed guidance in the application of self-controlled study designs in pharmacoepidemiology.Pharmacoepidemiology and drug safety · 2021Pooled it
- Prescription Sequence Symmetry Analysis of Glucagon-Like Peptide-1 Receptor Agonists and Neuropsychiatric Conditions.Clinical pharmacology and therapeutics · 2026Article
- Signal Detection of Adverse Events Associated with PCSK9 Inhibitors: A Nationwide Sequence Symmetry and Combined Worldwide Disproportionality Analysis.Drug safety · 2026Article
- Dose-dependent relationships in potential prescribing cascades: a cohort study using community pharmacy dispensing data.International journal of clinical pharmacy · 2026Article
- Prescription cascades associated with acetylcholinesterase inhibitors use: a high-throughput sequence symmetry analysis.Age and ageing · 2026Article
- Unsuspected Adverse Drug Reactions to Dermatologic Medications: An Epidemiological Hypothesis-Free Screening Study of Real-World Data in Denmark.Drug safety · 2026Article
- Investigating Potential Prescribing Cascades Resulting in Prochlorperazine Prescription: An Exploratory Analysis of Antihypertensives and NSAIDs.Drugs & aging · 2026Article
- Association Discovery Approach in Healthcare Big Data to Identify Drug Safety and Drug Repurposing Signals.Clinical pharmacology and therapeutics · 2026Article
- Association between coronavirus disease 2019 and new-onset autoimmune diseases during the early phase of the pandemic.PloS one · 2026Article
- Prescription Sequence Symmetry Analysis for Detection of Chronic Opioid Use Adverse Event Signals Using Administrative Claims Data.Pharmacotherapy · 2025Article
- High-Throughput Screening for Prescribing Cascades Among Real-World Angiotensin-II Receptor Blockers (ARBs) Initiators.Pharmacotherapy · 2025Article
- Loop diuretics and subsequent use of urinary symptom medications in older adults: evaluation of a possible prescribing cascade.The journals of gerontology. Series A, Biological sciences and medical sciences · 2025Article
- High Throughput Pharmacovigilance Screening for Roflumilast Adverse Effects in Real-World Settings: A Sequence Symmetry Analysis.Basic & clinical pharmacology & toxicology · 2025Article
- Evaluation of dipeptidyl peptidase-4 inhibitor-associated gastrointestinal symptoms using the prescription claims database.Scientific reports · 2025Article
- High-Throughput Screening for Prescribing Cascades Among Real-World Angiotensin-II Receptor Blockers (ARBs) Initiators.medRxiv : the preprint server for health sciences · 2025Article
- High-Throughput Screening for Prescribing Cascades Among Real-World Angiotensin-Converting Enzyme Inhibitor Initiators.Pharmacoepidemiology and drug safety · 2025Article
- Core Concepts: Self-Controlled Designs in Pharmacoepidemiology.Pharmacoepidemiology and drug safety · 2025Review
- Pharmacovigilance - Technological Advancements, Recent Developments and Innovations.Current drug safety · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Sequence symmetry analysis (SSA) is a method for detecting adverse drug events by utilizing computerized claims data. The method has been increasingly used to investigate safety concerns of medications and as a pharmacovigilance tool to identify unsuspected side effects. Validation studies have indicated that SSA has moderate sensitivity and high specificity and has robust performance. In this review we present the conceptual framework of SSA and discuss advantages and potential pitfalls of the method in practice. SSA is based on analyzing the sequences of medications; if one medication (drug B) is more often initiated after another medication (drug A) than before, it may be an indication of an adverse effect of drug A. The main advantage of the method is that it requires a minimal dataset and is computationally efficient. By design, SSA controls time-constant confounders. However, the validity of SSA may be affected by time-varying confounders, as well as by time trends in the occurrence of exposure or outcome events. Trend effects may be adjusted by modeling the expected sequence ratio in the absence of a true association. There is a potential for false positive or negative results and careful consideration should be given to potential sources of bias when interpreting the results of SSA studies.
Indexed as
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.