Methods and systems for evaluating interaction of medical products and dependence on demographic variables

• US 8,170,889 B2
• Filed: 09/22/2006
• Issued: 05/01/2012
• Est. Priority Date: 09/22/2005
• Status: Active Grant

• Current Assignee: UBC Late Stage, Inc. (The Cigna Group)
• Original Assignee: UBC Late Stage, Inc. (The Cigna Group)
• Inventors: Pearson, Ronald K., Hochberg, Alan M.
• Primary Examiner(s): O'Connor, Gerald J.
• Assistant Examiner(s): PAULS, JOHN A
• Application Number:
  US12/065,631
• Publication Number:
  US 20080215402A1
• Time in Patent Office: 2,048 Days
• Field of Search: 705/2, 705/3, 705/19, 1/1, 395/613, 435/6
• US Class Current: 705/3
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 30/0204 Market segmentation
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 70/40 relating to drugs, e.g. their side effects or intended usage

Abstract

A computer implemented method of evaluating interaction two or more medical products or conditions, in the context of a reference condition, based on a dataset of patient records includes developing a reference contingency lattice of lattice subsets from a subset of the patient records containing the reference condition, wherein the lattice subsets correspond to the number of patient records that contain each of the two or more medical products or conditions and combinations thereof. A plurality of comparison contingency lattices are developed, each of the comparison contingency lattices developed from a respective random subset of patient records not containing the reference condition, where each of the comparison contingency lattices include lattice subsets that correspond to the number of patient records that contain each of the two or more medical products or conditions and combinations thereof. The lattice subsets of the reference contingency lattice are compared to the corresponding lattice subsets of the comparison contingency lattices to determine whether a lattice subset is indicative of an interaction between the medical products or conditions with respect to the reference condition.

Claims

1. A computer implemented method of evaluating interaction of two or more medical products or conditions, in the context of a reference condition, based on a dataset of patient records, comprising:

developing a reference contingency lattice of reference lattice subsets from a subset of the patient records containing the reference condition, wherein each reference lattice subset corresponds to the patient records that contain the reference condition and that contain a respective medical product or condition, or combination of medical products or conditions, of the two or more medical products or conditions;

developing a plurality of comparison contingency lattices, each of the comparison contingency lattices developed from a respective random subset of the patient records not containing the reference condition, wherein each of the respective random subsets is of a same size as the subset of patient records containing the reference condition, and wherein each of the comparison contingency lattices includes comparison lattice subsets, wherein each comparison lattice subset is associated with a respective reference lattice subset and corresponds to the patient records containing the respective medical product or condition, or combination of medical products or conditions, of the associated reference lattice subset; and

comparing, via a processor, the reference lattice subsets of the reference contingency lattice to the associated comparison lattice subsets of the comparison contingency lattices to determine a difference in one of the reference lattice subsets of the reference contingency lattice from the associated comparison lattice subsets of the comparison contingency lattices, wherein the difference is indicative of an interaction between the medical products or conditions with respect to the reference condition.

2. The method of claim 1, wherein the step of comparing the reference lattice subsets of the reference contingency lattice to the associated comparison lattice subsets of the comparison contingency lattices comprises calculating a z-score for at least one reference lattice subset of the reference contingency lattice based on the associated comparison lattice subsets in the comparison contingency lattices.

3. The method of claim 2, wherein a significance level of any of the z-scores is adjusted by a Bonferroni correction based on a plurality of comparisons.

4. The method of claim 1, wherein the medical products comprise drugs, medications or vaccines.

5. The method of claim 1, wherein the medical products comprise medical devices.

6. The method of claim 1, further comprising displaying the reference contingency lattice with subsets highlighted based on the indication of the interaction between the medical products or conditions.

7. The method of claim 1, wherein the reference contingency lattice and the comparison contingency lattices each comprise subsets having a partial order such that between any two subsets there exists a least upper bound subset and a greatest lower bound subset.

8. A computer implemented method of evaluating interaction of two or more medical products or conditions, in the context of a reference condition, based on a dataset of patient records, comprising:

developing a reference orthogonal contingency lattice of reference lattice subsets from a subset of the patient records containing the reference condition, wherein each reference lattice subset corresponds to the patient records that contain the reference condition and that contain a respective medical product or condition, or combination of medical products or conditions, of the two or more medical products or conditions, and wherein each reference lattice subset excludes the medical products or conditions, or combination of medical products or conditions, that correspond to other reference lattice subsets;

developing a plurality of comparison contingency lattices, each of the comparison contingency lattices developed from a respective random subset of the patient records not containing the reference condition, wherein each of the respective random subsets is of a same size as the subset of patient records containing the references condition, and wherein each of the comparison contingency lattices includes comparison lattice subsets, wherein each comparison lattice subset is associated with a respective reference lattice subset and corresponds to the patient records containing the respective medical product or condition, or the combination of medical products or conditions, of the associated reference lattice subset, and wherein each comparison lattice subset excludes the medical products or conditions, or combination of medical products or conditions, that correspond to the reference subsets with which the comparison lattice subset is not associated; and

comparing, via a processor, the reference lattice subsets of the reference orthogonal contingency lattice to the associated comparison lattice subsets of the comparison contingency lattices to determine a difference in one of the reference lattice subsets of the reference orthogonal contingency lattice from the associated comparison lattice subsets of the comparison contingency lattices, wherein the difference is indicative of an interaction between the medical products or conditions with reference to the reference condition.

9. The method of claim 8, wherein the step of comparing the reference lattice subsets of the reference orthogonal contingency lattice to the associated comparison lattice subsets of the comparison contingency lattices comprises calculating a z-score for at least one reference lattice subset of the reference orthogonal contingency lattice based on the corresponding subsets in the comparison contingency lattices.

10. The method of claim 9, wherein a significance level of any of the z-scores is adjusted by a Bonferroni correction based on a plurality of comparisons.

11. The method of claim 8, wherein the medical products comprise drugs, medications or vaccines.

12. The method of claim 8, wherein the medical products comprise medical devices.

13. The method of claim 8, further comprising displaying the reference orthogonal contingency lattice with subsets highlighted based on the indication of the interaction between the medical products or conditions.

14. The method of claim 8, wherein the reference orthogonal contingency lattice and the comparison contingency lattices each comprise subsets having a partial order such that between any two subsets there exists a least upper bound subset and a greatest lower bound subset.

15. The method of claim 8, further comprising:

determining, via a processor, a number, N, of patient records in the dataset containing indications of each of the two or more medical products;

of patient records in the dataset containing indications of each of the two or more medical products, determining a number, Nx, of patient records containing indications of the reference condition;

within each of a plurality of random samples of size N of patient records of the dataset, the patient records of the respective random samples containing indications of each of the two or more medical products and combinations thereof but that exclude all the other medical products and combinations thereof, determining a number of such patient records of each random sample containing the reference condition; and

determining whether a second-order bystander effect exists between the reference condition and any of the two or more medical products or combinations thereof based on a comparison of Nx to the number of the patient records of each random sample.

16. The method of claim 15, further comprising graphically displaying the number of patient records containing indications of each of the two or more medical products and combinations thereof but that exclude all the other medical products and combinations thereof of each random sample.

17. A computer implemented method of evaluating interaction of two or more medical products, in the context of a reference condition, based on a dataset of patient records, comprising:

determining a number, N, of patient records in the dataset containing indications of a medical product A and a medical product B;

of patient records in the dataset containing indications of the medical product A and the medical product B, determining a number, Nx, of patient records containing indications of the reference condition;

among patient records of a first random sample of size N of patient records of the dataset, the patient records of the first random sample containing the medical product A and not the medical product B, determining a number of the patient records of the first random sample containing the reference condition;

among patient records of a second random sample of size N of patient records of the dataset, the patient records of the second random sample containing the medical product B and not the medical product A, determining a number of the patient records of the second random sample containing the reference condition;

among patient records of a third random sample of size N of patient records of the dataset, the patient records of the third random sample containing neither the medical product A nor the medical product B, determining a number of the patient records of the third random sample containing the reference condition; and

determining, via a processor, whether a second-order bystander effect exists between the reference condition and either of the medical product A or the medical product B based on a comparison of Nx to the number of the patient records of the first random sample containing the reference condition, the number of the patient records of the second random sample containing the reference condition, and the number of the patient records of the third random sample containing the reference condition.

18. The method of claim 17, wherein the comparison comprises comparing at least 100 of the first random samples, at least 100 of the second random samples and at least 100 of the third random samples.

19. The method of claim 18, further comprising graphically displaying the number of patient records of each of the first random sample, second random sample and third random sample containing indications of the reference condition.

20. The method of claim 17, wherein the two or more medical products comprise drugs, medications or vaccines.

21. The method of claim 17, wherein the two or more medical products comprise medical devices.

22. A computer implemented method of evaluating dependence on demographic variables, in the context of a medical product and a reference condition, based on a dataset of patient records, comprising:

determining a number, N, of patient records in the dataset containing indications of both the medical product and the reference condition;

determining an average demographic variable of the patient records in the dataset containing indications of both the medical product and the reference condition;

for a continuous demographic variable, determining an average of the demographic variable of patient records in a first random sample of size N, the patient records of the first random sample containing an indication of the medical product and not containing an indication of the reference condition;

for the continuous demographic variable, determining an average of the demographic variable of patient records in a second random sample of size N, the patient records of the second random sample containing an indication of the reference condition and not containing an indication of the medical product;

for the continuous demographic variable, determining an average of the demographic variable of patient records in a third random sample of size N, the patient records of the third random sample containing neither an indication of the medical product nor an indication of the reference condition; and

determining, via a processor, whether the continuous demographic variable, affects an association between the reference condition and the medical product,

wherein the determining step is based on a comparison of the average demographic variable of the patient records in the dataset containing indications of both the medical product and the reference condition, the average of the demographic variable of patient records in a first random sample, the average of the demographic variable of patient records in a second random sample, and the average of the demographic variable of patient records in a third random sample.

23. The method of claim 22, wherein the respective acts of determining an average include determining averages of at least 100 first random samples, at least 100 second random samples and at least 100 third random samples.

24. The method of claim 23, further comprising graphically displaying the averages of the at least 100 first random samples, the averages of the at least 100 second random samples and the averages of the at least 100 third random samples.

25. A computer readable data storage means, the computer readable data storage means not being a transitory signal, and the computer readable data storage means containing program code recorded thereon for implementing the following steps:

developing a reference contingency lattice of reference lattice subsets from a subset of the patient records containing the reference condition, wherein each reference lattice subset corresponds to the patient records that contain the reference condition and that contain a respective medical product or condition, or combination of medical products or conditions, of the two or more medical products or conditions;

developing a plurality of comparison contingency lattices, each of the comparison contingency lattices developed from a respective random subset of the patient records not containing the reference condition, wherein each of the respective random subsets is of a same size as the subset of patient records containing the reference condition, and wherein each of the comparison contingency lattices includes comparison lattice subsets, wherein each comparison lattice subset is associated with a respective reference lattice subset and corresponds to the patient records containing the respective medical product or condition, or combination of medical products or conditions, of the associated reference lattice subset; and

comparing, via a processor, the reference lattice subsets of the reference contingency lattice to the associated comparison lattice subsets of the comparison contingency lattices to determine a difference in one of the reference lattice subsets of the reference contingency lattice from the associated comparison lattice subsets of the comparison contingency lattices, wherein the difference is indicative of an interaction between the medical products or conditions with respect to the reference condition.

26. A computing system comprising:

a processor; and

a system memory containing program code recorded thereon that when executed by the processor performs the following steps;

developing a reference contingency lattice of reference lattice subsets from a subset of the patient records containing the reference condition, wherein each reference lattice subset corresponds to the patient records that contain the reference condition and that contain a respective medical product or condition, or combination of medical products or conditions, of the two or more medical products or conditions;

developing a plurality of comparison contingency lattices, each of the comparison contingency lattices developed from a respective random subset of the patient records not containing the reference condition, wherein each of the respective random subsets is of a same size as the subset of patient records containing the reference condition, and wherein each of the comparison contingency lattices includes comparison lattice subsets, wherein each comparison lattice subset is associated with a respective reference lattice subset and corresponds to the patient records containing the respective medical product or condition, or combination of medical products or conditions, of the associated reference lattice subset; and

comparing, via a processor, the reference lattice subsets of the reference contingency lattice to the associated comparison lattice subsets of the comparison contingency lattices to determine a difference in one of the reference lattice subsets of the reference contingency lattice from the associated comparison lattice subsets of the comparison contingency lattices, wherein the difference is indicative of an interaction between the medical products or conditions with respect to the reference condition.

27. A computer implemented method of evaluating dependence on demographic variables, in the context of a medical product and a reference condition, based on a dataset of patient records, comprising:

determining a number, N, of patient records in the dataset containing indications of both the medical product and the reference condition;

determining a fraction of the patient records in the dataset containing indications of both the medical product and the reference condition;

for a categorical demographic variable, among patient records in a first random sample of size N, determining a fraction of patient records for which the categorical demographic variable has a specified value, the patient records of the first random sample containing an indication of the medical product and not containing an indication of the reference condition;

for the categorical demographic variable, among patient records in a second random sample of size N, determining a fraction of patient records for which the categorical demographic variable has a specified value, the patient records of the second random sample containing an indication of the reference condition and not containing an indication of the medical product;

for the categorical demographic variable, among patient records in a third random sample of size N, determining a fraction of patient records for which the categorical demographic variable has a specified value, the patient records of the third random sample containing neither an indication of the medical product or an indication of the reference condition; and

determining, via a processor, whether the categorical demographic variable affects an association between the reference condition and the medical product,

wherein the determining step is based on a comparison of the fraction of the patient records in the dataset containing indications of both the medical product and the reference condition, the fraction of patient records for which the categorical demographic variable has the specified value.

28. The method of claim 27, wherein the respective acts of determining a fraction include determining fractions of patient records for which the categorical demographic variable has the specified value in at least 100 fourth random samples, at least 100 fifth random samples and at least 100 sixth random samples.

29. The method of claim 28, further comprising graphically displaying the fractions of patient records for which the categorical demographic variable has the specified value for the at least 100 first random samples, the fractions of patient records for which the categorical demographic variable has the specified value for the at least 100 second random samples and the fractions of patient records for which the categorical demographic variable has the specified value for the at least 100 third random samples.