Evidence map›Paper›PMID 30064519›Full record

ArticleBMC research notes2018

Use of power-law analysis to predict abuse or diversion of prescribed medications: proof-of-concept mathematical exploration.

Kathleen A Fairman, Alyssa M Peckham, Michael L Rucker, Jonah H Rucker, David A Sclar

Open access · goldAbstract read
In one paragraph

Article in BMC research notes, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.2field-weighted citation impact, top 36% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 1 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

Kathleen A FairmanCollege of Pharmacy-Glendale, Midwestern University, 19555 N 59th Ave, Glendale, AZ, 85308, USA. kfairm@midwestern.edu.
Alyssa M PeckhamNortheastern University School of Pharmacy and Massachusetts General Hospital, Boston, USA.
Michael L RuckerWood Environment & Infrastructure Solutions, Phoenix, USA.
Jonah H RuckerKathleen Fairman LTD, Phoenix, USA.
David A SclarCollege of Pharmacy-Glendale, Midwestern University, 19555 N 59th Ave, Glendale, AZ, 85308, USA.
Midwestern University · USNortheastern University · USPhoenix (United States) · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo conduct a proof-of-concept study comparing Lorenz-curve analysis (LCA) with power-law (exponential function) analysis (PLA), by applying segmented regression modeling to 1-year prescription claims data for three medications-alprazolam, opioids, and gabapentin-to predict abuse and/or diversion using power-law zone (PLZ) classification.

resultsIn 1-year baseline observation, patients classified into the top PLZ groups (PLGs) were demographically and diagnostically similar to those in Lorenz-1 (top 1% of utilizers) and Lorenz-25 (top 25%). For prediction of follow-up (6-month post-baseline) Lorenz-1 use of alprazolam and opioids (i.e., potential abuse/diversion), PLA had somewhat lower sensitivity compared with LCA (83.5-95.4% vs. 99.5-99.9%, respectively) but better specificity (98.2-98.8% vs. 75.5%) and much better positive predictive value (PPV; 34.5-45.3% vs. 4.0-4.6%). Of top-PLG alprazolam- and opioid-treated patients, respectively, 20.7 and 9.9% developed incident (new) Lorenz-1 in followup, compared with < 3% of Lorenz-25 patients. For gabapentin, neither PLA nor LCA predicted incident Lorenz-1 (PPV = 0.0-1.4%). For all three medications, PLA sensitivity for follow-up hospitalization was < 5%, but specificity was better for PLA (97.3-99.2%) than for LCA (74.3-75.4%). PLA better identified patients at risk of future controlled substance abuse/diversion than did LCA, but the technique needs refinement before widespread use.

Indexed as

Analgesics, OpioidModels, TheoreticalPrescription Drug DiversionAdolescentAdultAgedFemaleFentanylForecastingHumansMiddle AgedSubstance-Related DisordersYoung AdultAnalgesics, OpioidFentanylAbuseAlprazolamDiversionGabapentinLorenz-curve analysisOpioidsPower-law analysis

Identifiers

PMID30064519
PMCPMC6069871
OpenAlexW2886386077

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

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.