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Background  Adverse drug events (ADEs) detection and assessment is at the center of pharmacovigilance. Data mining of systems, such as FDA’s Adverse Event Reporting System (AERS) and more recently, Electronic Health Records (EHRs), can aid in the automatic detection and analysis of ADEs. Although different data mining approaches have been shown to be valuable, it is still crucial to improve the quality of the generated signals.    Objective  To leverage structural similarity by developing molecular fingerprint-based models (MFBMs) to strengthen ADE signals generated from EHR data.    Methods  A reference standard of drugs known to be causally associated with the adverse event  pancreatitis  was used to create a MFBM. Electronic Health Records (EHRs) from the New York Presbyterian Hospital were mined to generate structured data.  Disproportionality Analysis  (DPA) was applied to the data, and 278 possible signals related to the ADE  pancreatitis  were detected. Candidate drugs associated with these signals were then assessed using the MFBM to find the most promising candidates based on structural similarity.    Results  The use of MFBM as a means to strengthen or prioritize signals generated from the EHR significantly improved the detection accuracy of ADEs related to  pancreatitis . MFBM also highlights the etiology of the ADE by identifying structurally similar drugs, which could follow a similar mechanism of action.    Conclusion  The method proposed in this paper provides evidence of being a promising adjunct to existing automated ADE detection and analysis approaches.

Enhancing Adverse Drug Event Detection in Electronic Health Records Using Molecular Structure Similarity: Application to Pancreatitis