Evidence map›Paper›PMID 36124058›Full record

ArticleCommunications medicine2022

Medication history-wide association studies for pharmacovigilance of pregnant patients.

Anup P Challa, Xinnan Niu, Etoi A Garrison, Sara L Van Driest, Lisa M Bastarache, Ethan S Lippmann, Robert R Lavieri, Jeffery A Goldstein, David M Aronoff

Open access · goldAbstract read
In one paragraph

Article in Communications medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.5field-weighted citation impact, top 16% 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

4 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Review
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

9 authors at 5 institutions in 2 countries.

Anup P ChallaVanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN 37203 USA.ORCID 0000-0002-8886-7308
Xinnan NiuDepartment of Biomedical Informatics, Vanderbilt University, Nashville, TN 37203 USA.
Etoi A GarrisonDepartment of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN 37203 USA.
Sara L Van DriestDepartment of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37232 USA.ORCID 0000-0003-2580-1405
Lisa M BastaracheDepartment of Biomedical Informatics, Vanderbilt University, Nashville, TN 37203 USA.
Ethan S LippmannDepartment of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, TN 37212 USA.
Robert R LavieriVanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN 37203 USA.
Jeffery A GoldsteinDepartment of Pathology, Northwestern University, Chicago, IL 60611 USA.
David M AronoffDepartment of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN 37203 USA.ORCID 0000-0003-4587-6121
Vanderbilt University · USVanderbilt University Medical Center · USHarvard University · USIndiana University – Purdue University Indianapolis · USNorthwestern University · US

Funding

Vanderbilt Institute for Clinical and Translational Research (VICTR) -Identifying correlates of functional immunity in SARS-CoV-2 convalescent plasmaUL1TR002243 · NCATS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Paul A. Harris, Wesley H Self · 2017 to 2026
$130.7M
Clinical trial emulation to assess drug safety in pregnant patientsR21HD105304 · NICHD · VANDERBILT UNIVERSITY MEDICAL CENTER · PI ARONOFF, DAVID M, CHALLA, ANUP PRASANT ARON · 2021 to 2021
$260k
NCATS NIH HHS UL1 TR002243NICHD NIH HHS R21 HD105304
6 · The paper itself

Abstract

Background: Systematic exclusion of pregnant people from interventional clinical trials has created a public health emergency for millions of patients through a dearth of robust safety data for common drugs. Methods: We harnessed an enterprise collection of 2.8 M electronic health records (EHRs) from routine care, leveraging data linkages between mothers and their babies to detect drug safety signals in this population at full scale. Our mixed-methods signal detection approach stimulates new hypotheses for post-marketing surveillance agnostically of both drugs and diseases-by identifying 1,054 drugs historically prescribed to pregnant patients; developing a quantitative, medication history-wide association study; and integrating a qualitative evidence synthesis platform using expert clinician review for integration of biomedical specificity-to test the effects of maternal exposure to diverse drugs on the incidence of neurodevelopmental defects in their children. Results: We replicated known teratogenic risks and existing knowledge on drug structure-related teratogenicity; we also highlight 5 common drug classes for which we believe this work warrants updated assessment of their safety. Conclusion: Here, we present roots of an agile framework to guide enhanced medication regulations, as well as the ontological and analytical limitations that currently restrict the integration of real-world data into drug safety management during pregnancy. This research is not a replacement for inclusion of pregnant people in prospective clinical studies, but it presents a tractable team science approach to evaluating the utility of EHRs for new regulatory review programs-towards improving the delicate equipoise of accuracy and ethics in assessing drug safety in pregnancy.

Indexed as

Adverse effectsDrug development

Identifiers

PMID36124058
PMCPMC9481638
OpenAlexW4296057249

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.