S14, after the first round of investigation, expert ratings were collected, and triggers were deleted based on the rating results. Meanwhile, in this study, the modification suggestions proposed by experts were also fully considered, and triggers were modified or added accordingly; for the second round, based on the results of the first round, another round of rating was conducted to determine the final results.

S15, the selection of triggers was carried out by using the threshold method to screen evaluation indicators, and based on the suitability score of each indicator, the full-score frequency, arithmetic mean, and coefficient of variation were calculated. The threshold calculation method for the full-score frequency and arithmetic mean is: the threshold=mean−standard deviation, and the indicators with scores higher than the threshold were selected; the threshold calculation method for the coefficient of variation is: the threshold=mean+standard deviation, and the indicators with scores lower than the threshold were selected. To avoid important indicators being eliminated, only indicators that failed to meet the requirements in all three measurement scales were eliminated. For indicators that failed to meet the requirements in one or two measurement scales, the research team made decisions after discussion based on principles such as directionality, scientificity, and availability.

S16, based on the results of the Delphi expert consultation, a preliminary version of the ADR trigger list for elderly patients, containing 42 triggers, was ultimately obtained. Details are provided in Table 1.

TABLE 1

ADR trigger entries for elderly patients (preliminary version).

No.
Triggers
Annotation

Laboratory results

1
The time for activating partial
Related to anticoagulant drugs,

thromboplastin exceeds 100 s.
identified as an ADE, accompanied by

symptoms related to bleeding.

2
International normalized ratio (INR)
The same as above.

exceeds 5.

3
Blood glucose is lower than 2.8
Identified as ADE, accompanied by

mmol/L.
symptoms related to hypoglycemia.

4
Urea nitrogen or creatinine levels are
Drug-induced renal dysfunction.

more than twice the baseline.

5
ALT (or AST) ≥3 ULN and/or ALP ≥2
Drug-induced liver dysfunction.

ULN, T-BIL >2.5 ULN, which may be

accompanied by abnormal INR.

6
Blood platelet <75 × 109/L
Drug-induced thrombocytopenia.

7
White blood cell <3.0 × 109/L
Drug-induced leukopenia.

8
Hemoglobin, male >175 g/L;
The use of EPO in CKD patients can

female >150 g/L
lead to an increase in hemoglobin.

9
Hemoglobin decreases by more than
Drug-related anemia or bleeding.

25%.

10
Blood potassium <3.5 mmol/L
Drug-related hypokalemia.

11
Blood potassium >5.5 mmol/L
Drug-related hyperkalemia.

12
Blood calcium >2.62 mmol/L
Drug-induced hypercalcemia.

13
Thyroid-stimulating hormone <0.27
Use of drugs that may cause

mU/L (or thyroid hormone >22.40
hyperthyroidism.

pmol/L).

14
Thyroid-stimulating hormone >4.2
Use of drugs that may cause

mU/L (or thyroid hormone <12.0
hypothyroidism.

pmol/L).

15
Positive Clostridium difficile.
Dysbiosis caused by antibiotics.

Plasma concentration

16
Digoxin blood concentration >2 ng/ml.
Excessive use of digoxin.

17
Peak plasma concentration of
Excessive use of gentamicin or

gentamicin or tobramycin >10 mg/L
tobramycin.

or trough concentration >2 mg/L.

18
Peak plasma concentration of
Excessive use of cyclosporine.

cyclosporine >300 ng/ml.

19
Theophylline >20 mg/L
Excessive use of theophylline.

20
Tacrolimus blood concentration >20 ng/ml
Excessive use of tacrolimus.

21
Voriconazole blood concentration >5.5
Excessive use of Voriconazole.

mg/L, Blurred vision, hallucinations.

Administration of rescue drugs

22
Administration of vitamin K
Counteracting bleeding caused by

anticoagulant drugs.

23
Administration of anti-allergic drugs
Combating drug-induced allergies; the

(such as loratadine, diphenhydramine,
type of medication can be determined

cetirizine, glucocorticoids, calcium
based on the specific situation of our

gluconate injection, etc.).
hospital.

24
Administration of flumazenil.
Counteracting benzodiazepine

poisoning.

25
Administration of naloxone.
Counteracting opioid poisoning

(excluding cases of opioid abuse).

26
Administration of antiemetic drugs
Combating drug-induced vomiting.

(ondansetron, granisetron,

metoclopramide, aprepitant, etc.).

27
Administration of antidiarrheal drugs,
Treating diarrhea caused by antibiotic-

intestinal flora microbial preparations,
resistant bacteria, as well as drugs for

or oral vancomycin and metronidazole,
treatment of constipation or gastric

etc.
motility drugs.

28
Administration of drugs for treating
Addressing drug-induced constipation.

constipation (such as glycerine enema,

polyethylene glycol, lactulose, etc.).

29
Administration of 50% glucose.
To combat hypoglycemia symptoms, it

is necessary to have hypoglycemia

symptoms as a condition for

identifying an ADE.

30
Administration of protamine.
Counteracting heparin-induced

bleeding.

31
Administration of adrenaline.
Rescue of anaphylactic shock caused

by medication.

32
Intravenous infusion of glucose
Drug-induced hyperkalemia.

injection + regular insulin.

33
Blood transfusion.
Combating drug(chemotherapy)-

related anemia or (anticoagulants)

bleeding.

34
Temporary intravenous or
Drug-induced hyperglycemia.

subcutaneous insulin for non-diabetics.

Symptoms

35
Excessive sedation or hypotension or
Sedation caused by medication and

falls (determined based on the patient's
other related conditions.

condition on the day and physical

examination results recorded in the

patient's medical history).

36
Rash
Drug-related rash.

37
Dehydration
Related to the use of diuretics.

38
Insane
Drug-induced mental disorders.

39
Bradycardia <60 beats/min
Bradycardia caused by drugs.

40
Respiratory rate <12 breaths/min
Respiratory depression caused by

opioids such as morphine.

Disposal measures

41
Sudden cessation of medication (which
Sudden drug withdrawal due to ADE.

can be indicated in medical advice, as

normal drug withdrawal is not

considered sudden).

Other

42
Other rare adverse events (such as
Other ADEs identified during the

interstitial pneumonia, fever,
review of medical records.

psychiatric disorders, etc.).

- S17, the elderly patients in the research medical institution of the Example (West China Hospital of Sichuan University) were selected as the research subjects. Information was collected from the electronic medical record system, including personal details, disease information, and medication data.

A certain number of cases were randomly selected, and the aforementioned ADR trigger entries for elderly patients (preliminary version) were used to conduct research on real cases. Based on the ADR monitoring results of these real cases, a total of 28 ADR trigger entries (final version) were obtained. Details are shown in Table 2.

TABLE 2

ADR trigger entries for elderly patients (final version).

No
Trigger
No
Trigger

Laboratory results
15
Blood transfusion

1
The time for activating partial
Symptoms

thromboplastin exceeds 100 s.

2
International normalized ratio (INR)
16
Excessive sedation or

exceeds 5.

hypotension or falls

3
Blood glucose is lower than
17
Rash

2.8 mmol/L

4
Urea nitrogen or creatinine levels
18
Bradycardia <60 beats/min

have increased by more than 2 times

compared to those upon admission.

5
ALT (or AST) ≥3 ULN and/or ALP ≥2
Plasma concentration

ULN, T-BIL >2.5 ULN (ULN: the

highest value)

6
Blood platelet <75 × 10{circumflex over ( )}9/L
19
The plasma concentration of

vancomycin is higher than the

upper limit of normal range.

7
White blood cell <3.0 × 10{circumflex over ( )}9/L
20
The plasma concentration of

phenytoin is higher than the

upper limit of normal range.

8
Hemoglobin decreased by more than
21
The plasma concentration of

25% compared to admission.

valproic acid is higher than the

upper limit of normal range.

9
Blood potassium <3.5 mmol/L
22
The plasma concentration of

phenobarbital is higher than the

upper limit of normal range.

110
Blood potassium >5.5 mmol/L
23
The plasma concentration of

carbamazepine is higher than the

upper limit of normal range.

Administration of rescue drugs
24
The plasma concentration of

vancomycin is higher than the

upper limit of normal range.

111
Administration of anti-allergic drugs
25
The plasma concentration of

lithium carbonate is higher than the

upper limit of normal range

112
Administration of antiemetic drugs
26
The plasma concentration of

tacrolimus capsules is higher than the

upper limit of normal range.

113
Administration of antidiarrheal drugs
27
The plasma concentration of

or intestinal flora microbial preparations.

voriconazole is higher than the

upper limit of normal range.

114
Administration of drugs for treatment
28
The plasma concentration of

of constipation

mycophenolic acid is higher than the

upper limit of normal range.

- S2, based on the aforementioned R trigger entries (final version or elderly patients in line with the medical institution (West China Hospital of Sichuan University), combined with evidence-based evidence and drug instructions, a dataset of ADR risk factors for elderly patients was constructed.

Specifically, based on the ADR types involved in the ADR trigger entries (final version), we retrieved literature related to a specific ADR, information from domestic and international ADR monitoring databases, as well as ADR information from existing hospital drug instructions. We established a dataset of ADR risk factors for elderly patients. The features in the dataset include non-drug factors (including patient's basic information, disease conditions, symptoms and signs, laboratory tests) and drug factors (medication use). Specifically, the features used in this example include:

- 1. Basic patient information: gender, age, height, weight, surgical history, infectious disease history, allergy history, smoking history, admission method, admission condition;
- 2. Disease conditions: main diagnostic categories (infectious diseases or parasitic diseases, tumor diseases, blood or hematopoietic organ diseases, immune system diseases, endocrine or metabolic diseases, neurological or psychiatric diseases, eye or ear diseases, circulatory system diseases, respiratory system diseases, digestive system diseases, skin diseases, musculoskeletal or connective tissue diseases, urogenital system diseases, injuries or poisoning), number of admission diagnoses, department of admission, level of nursing care upon admission, number of hospitalizations before admission, whether surgery was performed, type of surgery;
- 3. Symptoms and signs: admission temperature, respiration, pulse, heart rate, blood pressure, and mental status;
- 4. Admission laboratory tests: alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, total bilirubin, creatinine, creatinine clearance rate, white blood cell count and percentage, red blood cell count, hemoglobin, platelet count, lymphocyte count, eosinophil count, neutrophil count, international normalized ratio, D-dimer, blood glucose, and glycosylated hemoglobin;
- 5. Medication situation, including the number of medication types, the frequency of medication administration (referring to the total number of administrations within a certain period of time, for example, 3 times a day, which means a total of 30 administrations in 10 days), and the categories of medications, as shown in Table 3. It should be noted that for ease of understanding, Table 3 categorizes the types of medications into 4 levels. Level 1 includes Western medicine or Chinese patent drugs, Level 2 includes anti-infective drugs under Western medicine, Level 3 includes antibiotics under anti-infective drugs, and Level 4 includes penicillins under antibiotics. Patients should use this table as a standard to determine the category of the specific medications they use, and for those containing Level 4 classification, the drug category at Level 4 was used as the input feature. For medications that are not classified into Level 4, the category of Level 3 should be used as the input feature. Pharmaceutical professionals could use their professional knowledge to determine the category of medications based on this table.

TABLE 3

Level 1
Level 2
Level 3
Level 4

Western
Anti-infective
Antibiotics
penicillin antibiotics, cephalosporin antibiotics,

medicines
agents

β-lactamase inhibitors and their compound

formulations with β-lactam antibiotics,

carbapenems and other β-lactam antibiotics,

aminoglycoside antibiotics, tetracycline

antibiotics, macrolide antibiotics, lincomycin

antibiotics, glycopeptide antibiotics

Chemically
sulfonamide antibiotics, trimethoprim

synthesized
antibacterial drugs, nitrofuran antibacterial

antibacterial agents
drugs, quinolone antibacterial drugs,

nitroimidazole antibacterial drugs,

oxazolidinone antibacterial drugs

Antitubercular
bactericidal drugs for Mycobacterium

agents
tuberculosis, bacteriostatic drugs for

Mycobacterium tuberculosis

Antifungal agents
polyene antifungal drugs, azole antifungal

drugs, allylamine antifungal drugs,

echinocandin antifungal drugs, pyrimidine

antifungal drugs

Antiviral agents
broad-spectrum antiviral drugs, antiretroviral

drugs, anti-herpes virus drugs, anti-influenza

virus drugs, anti-hepatitis virus drugs

Antiparasitic agent
drugs for controlling malaria symptoms, drugs

for preventing the spread and prevention of

malaria, anti-amoebic drugs, anti-trichomonas

drugs, anti-leishmaniasis drugs, other

antiprotozoal drugs, anti-schistosomiasis

drugs, drugs against other trematodes, anti-

filarial drugs, anthelmintics, broad-spectrum

anthelmintics and insecticides, anlitapeworm,

other anthelmintics

Agents
Central nervous
resuscitative central nervous system stimulants,

primarily
system stimulants
psychostimulant central nervous system

acting on the

stimulants, central nervous system stimulants

central

promoting brain metabolism

nervous
Analgesic drugs
opioid analgesics, non-opioid analgesics

system
Antipyretic-
formic acid antipyretic-analgesic and anti-

analgesic and anti-
inflammatory drugs, acetic acid antipyretic-

inflammatory drugs
analgesic and anti-inflammatory drugs,

propionic acid antipyretic-analgesic and anti-

inflammatory drugs, fenamic acid antipyretic-

analgesic and anti-inflammatory drugs,

pyrazolone antipyretic-analgesic and anti-

inflammatory drugs, aniline-based antipyretic-

analgesic, and anti-inflammatory drugs,

sulfonylanilide antipyretic-analgesic and anti-

inflammatory drugs, oxicam antipyretic-

analgesic and anti-inflammatory drugs, coxib

antipyretic-analgesic and anti-inflammatory

drugs, other antipyretic-analgesic and anti-

inflammatory drugs

Anti-gout agents
anti-gout drugs inhibiting granulocyte

infiltration, anti-gout drugs promoting uric acid

excretion, anti-gout drugs inhibiting uric acid

production

Antiepileptic agents
anti-epileptic drugs regulating sodium

channels, anti-epileptic drugs regulating γ-

aminobutyric acid, anti-epileptic drugs for

absence seizures, other anti-epileptic drugs

Sedative, hypnotic,
benzodiazepine sedative hypnotics and

and anticonvulsant
anticonvulsants, barbiturate sedative hypnotics

agents
and anticonvulsants, aldehyde sedative

hypnotics and anticonvulsants,

cyclopyrrolidone sedative hypnotics and

anticonvulsants, other sedative hypnotics and

anticonvulsants

Antiparkinsonian
DA precursor antiparkinsonian drugs,

agents
peripheral dopamine decarboxylase inhibitor

antiparkinsonian drugs, catechol-O-

methyltransferase inhibitor antiparkinsonian

drugs, central DA receptor agonist

antiparkinsonian drugs, anticholinergic

antiparkinsonian drugs, monoamine oxidase-B

inhibitor antiparkinsonian drugs, other

antiparkinsonian drugs

Antipsychotic
phenothiazine antipsychotics, butyrophenone

agents
antipsychotics, thioxanthene antipsychotics,

benzamide antipsychotics, novel structural

antipsychotics, long-acting antipsychotics

Antianxiety agents
benzodiazepine anxiolytics, non-

benzodiazepine anxiolytics

Antimanic agents
lithium salt antimanic drugs, other antimanic

drugs

Antidepressants
tricyclic antidepressants, monoamine oxidase

inhibitor antidepressants, selective 5-

hydroxytryptamine reuptake inhibitor

antidepressants, selective norepinephrine

reuptake inhibitor antidepressants, selective 5-

hydroxytryptamine and norepinephrine

reuptake inhibitor antidepressants,

norepinephrine and specific serotoninergic

antidepressants, selective serotonin reuptake

activator antidepressants, central nervous

system stimulant antidepressants, other types of

antidepressants

Anti-
thrombolytic cerebrovascular drugs, anti-

cerebrovascular
platelet aggregation cerebrovascular drugs, free

agents
radical scavenging cerebrovascular drugs,

calcium antagonist cerebrovascular drugs,

vasodilator cerebrovascular drugs acting

directly on vascular smooth muscle,

cerebrovascular drugs improving

microcirculation and reducing blood viscosity,

cerebrovascular drugs improving brain

metabolism, other types of cerebrovascular

drugs

Anti-senile
cholinesterase inhibitor anti-senile dementia

dementia agents and
and brain metabolism improvement agents,

cerebral metabolism
NMDA receptor antagonist anti-senile

improving agents
dementia and brain metabolism improvement

agents, pyrrolidone brain metabolism

activators, agents enhancing brain oxygen or

glucose or energy metabolism for anti-senile

dementia and brain metabolism improvement,

other types of anti-senile dementia and brain

metabolism improvement agents

Anesthetics and
inhalational general anesthetics, intravenous

their adjuvant drugs
general anesthetics, ester local anesthetics,

amide local anesthetics, other types of local

anesthetics, skeletal muscle relaxants

Agents
Cholinergic agents
direct-acting cholinomimetic agents, anti-

primarily
and anticholinergic
cholinesterase cholinomimetic agents,

acting on the
agents
muscarinic receptor antagonist anticholinergic

autonomic

agents, nicotinic receptor antagonist

nervous

anticholinergic agents

system
Adrenergic agents
adrenergic drugs, αβ-receptor antagonists, α-

and anti-adrenergic
receptor antagonists, β-receptor antagonists

agents

Agents
Calcium channel
selective calcium channel blockers, non-

primarily
blocker
selective calcium channel blockers

acting on the
Agents for treating
cardiac glycosides, non-glycoside positive

cardiovascular
chronic cardiac
inotropic agents, enkephalin inhibitors

system
insufficiency

Antiarrhythmic
sodium channel blocker antiarrhythmic agents,

agents
β-receptor blockers, action potential

prolongation antiarrhythmic agents, calcium

channel blockers

Agents for the
nitrate anti-anginal agents, nitrite anti-anginal

prevention and
agents, other anti-anginal agents

treatment of angina

pectoris

Peripheral
calcium channel blocker peripheral vasodilator,

vasodilators
peripheral vasodilators by directly dilating

small vascular smooth muscles

Antihypertensive
renin inhibitor antihypertensive agents, ACEI

agents
antihypertensive agents, ARB antihypertensive

agents, diuretics antihypertensive agents,

calcium channel blocker antihypertensive

agents, peripheral vasodilator antihypertensive

agents, calcium channel opener

antihypertensive agents, central

antihypertensive agents, adrenergic receptor

antagonist antihypertensive agents,

antihypertensive agents affecting sympathetic

neurotransmitters, ganglionic blocker

antihypertensive agents

Anti-shock
adrenergic anti-shock vasoactive agents, other

vasoactive agents
anti-shock vasoactive agents

Blood lipid
agents affecting cholesterol synthesis, agents

regulating agents
affecting cholesterol absorption and transport,

and anti-
agents affecting lipoprotein transport and

atherosclerosis
decomposition, antioxidant lipid-regulating

agents
agents, polyunsaturated fatty acid lipid-

regulating agents

Agents
Expectorant agents
nauseating expectorants and irritating

primarily

expectorants, mucolytic agents, mucus diluents

acting on the
Antitussive agents
central cough suppressants, peripheral cough

respiratory

suppressants

system
Antiasthmatic
β-adrenergic receptor agonist bronchodilators,

agents
M-cholinergic receptor antagonist

bronchodilators, xanthine bronchodilators,

histamine release inhibitor bronchodilators,

adrenocortical hormone bronchodilators, anti-

leukotriene bronchodilators

Agents
Agents for treating
antacids, H2 receptor antagonist gastric acid

primarily
peptic ulcer and
secretion inhibitors, proton pump inhibitor

acting on the
gastroesophageal
gastric acid secretion inhibitors, selective

digestive
reflux disease
anticholinergic gastric acid secretion inhibitors,

system

gastrin receptor antagonist gastric acid

secretion inhibitors, colloidal bismuth gastric

mucosal protectants, prostaglandins and their

derivatives gastric mucosal protectants, other

agents for treating peptic ulcers, agents for

eradicating Helicobacter pylori,

gastrointestinal motility drugs

Gastrointestinal
M-receptor antagonist gastrointestinal

antispasmodic
spasmolytics, other types of gastrointestinal

agents
spasmolytics

Digestants
digestants

Gastrointestinal
gastro-kinetic agents, thiazide antiemetic

prokinetic agents,
agents, antihistamine antiemetic agents,

antiemetic agents,
dopamine or 5-hydroxytryptamine receptor

and emetic agents
antiemetic agents, other types of antiemetic

agents, emetics

Laxatives and
bulking laxatives, irritant laxatives, lubricating

antidiarrheal agents
laxatives, softening laxatives, antidiarrheal

agents

Microbial
probiotics, prebiotics, synbiotics

ecological agents

Adjunctive drugs
cell regeneration-promoting agents,

for hepatobiliary
transaminase-lowering and hepatoprotective

diseases
agents, choleretic and hepatoprotective agents,

basic metabolic agents for hepatic and cholalic

diseases, detoxification and hepatoprotective

agents, anti-inflammatory and hepatoprotective

agents, antiviral agents for hepatic and cholalic

diseases

Agents for treating
5-aminosalicylic acids for inflammatory bowel

inflammatory bowel
diseases, other agents for inflammatory bowel

disease
diseases

Other drugs for
Other drugs for digestive system

digestive system

Agents
Procoagulant agents
agents for promoting blood coagulation system

primarily

function, coagulation factor preparations,

acting on the

agents for inhibiting fibrinolytic system,

blood and

hemostatic agents acting on blood vessels,

hematopoietic

agents for promoting thrombocytopoiesis,

system

other coagulants

Anticoagulant
heparin anticoagulants, vitamin K antagonist

agents
anticoagulants, citrate anticoagulants,

fibrinolytic agents, direct factor IIa inhibitors,

direct factor Xa inhibitors, antiplatelet agents,

other anticoagulants

Plasma and plasma
plasma and plasma substitutes

substitutes

Antianemic agents
iron anti-anemia agents, folic acid anti-anemia

agents, other anti-anemia agents

Leukocyte
traditional leukocyte growth-promoting agents,

stimulating agents
biological products for leukocyte growth

promotion, plant extracts for leukocyte growth

promotion

Antiplatelet agents
antiplatelet agents

Agents
Drugs for the
loop diuretics, thiazine diuretics, potassium-

primarily
urinary system
sparing diuretics and carbonic anhydrase

acting on the

inhibitors, acidic salt diuretics, xanthine

urinary and

compound diuretics, agents for the treatment of

reproductive

diabetes insipidus, α receptor antagonists for

systems

the treatment of benign prostatic hyperplasia,

5α reductase inhibitors for the treatment of

benign prostatic hyperplasia, androgen receptor

antagonist drugs for the treatment of benign

prostatic hyperplasia

Drugs for the
posterior pituitary uterotonic agents, ergot

reproductive system
uterotonic agents, prostaglandin uterotonic

agents, agents promoting cervical ripening,

anti-preterm labor agents, dopamine receptor

agonist lactation-reducing agents, estrogen

lactation-reducing agents

Agents
Pituitary hormones
pituitary hormones and related agents

primarily
and related drugs

acting on the
Adrenocortical
glucocorticoid agents, mineralocorticoid

endocrine
hormones and
agents, weak androgenic agents

system
adrenocorticotropic

hormone

Sex hormones and
androgenic and anabolic agents, estrogenic

gonadotropins
agents, progestogenic agents, estrogen receptor

modulators, gonadotropin agents

Contraceptive drugs
short-acting oral contraceptives, long-acting

contraceptives, external contraceptives, male

contraceptives

Insulin and other
glucagon, ultra-short-acting insulin, short-

drugs that affect
acting insulin, medium-acting insulin, long-

blood sugar
acting insulin, ultra-long-acting insulin,

premixed insulin, sulfonylurea hypoglycemic

agents, insulin secretagogue hypoglycemic

agents, α-glucosidase inhibitor hypoglycemic

agents, biguanide hypoglycemic agents,

thiazolidinedione hypoglycemic agents, DDP-

4 inhibitor hypoglycemic agents, SGLT-2

inhibitor hypoglycemic agents, GLP-1

inhibitor hypoglycemic agents

Anti-obesity drugs
anti-obesity drugs

Thyroid hormone
thyroid hormone agents, anti-thyroid agents

drugs and

antithyroid drugs

Drugs affecting
bone resorption inhibitors, bone formation

bone metabolism
promoters, drugs for hyperosteogeny

Agents
Anti-allergic agents
antihistamines, agents for blocking histamine

primarily

release, other anti-allergic agents

affecting
Immunosuppressive
calcineurin inhibitors, anti-proliferative agents,

allergic
agents
polyclonal or monoclonal antibody

reactions and

immunosuppressants, traditional Chinese

immune

medicine immunosuppressants

function
Immunopotentiating
Immunopotentiating agents

agents

Antineoplastic
Antineoplastic
alkylating agents, anti-metabolic anti-tumor

drug
agents
agents, anti-tumor antibiotics, plant-derived

anti-tumor agents and their derivatives, anti-

tumor hormone agents, anti-tumor targeted

drugs, other anti-tumor agents and adjuvant

therapy agents

Vitamins,
Vitamins
vitamin A or vitamin D agents, vitamin B

nutritional

agents, vitamin C and other vitamins

agents,
Enzymes and other
enzyme agents, other biochemical preparations

enzyme-
biochemical

inhibiting
preparations

agents, and
Drugs used to
electrolyte balance regulators, acid-base

agents used to
regulate water,
balance regulators, other agents for regulating

regulate
electrolyte, and
water or electrolyte or acid-base balance,

water,
acid-base balance
compound electrolyte infusion and dialysis

electrolyte,

solution

and acid-base
Nutritional drugs
general enteral nutrition agents, disease-

balance

specific enteral nutrition agents, amino acid

parenteral nutrition agents, fat emulsion

parenteral nutrition agents, other types of

parenteral nutrition agents

Five sense
Drugs in ear, nose
agents for the treatment of glaucoma, agents for

organs, skin,
and throat diseases
the treatment of dry eye, vascular endothelial

and external

growth factor inhibitor ophthalmic agents,

medications

agents for the treatment of cataract, other

ophthalmic agents, otorhinolaryngological and

dental agents

Dermatologic
anti-infective dermatological agents,

agents
disinfectant and antiseptic dermatological

agents, skin cleansers, corticosteroid

dermatological agents

Disinfectant,
disinfectant, antiseptic, and astringent agents

antiseptic, and

astringent agents

Other types of
Detoxification
detoxification agents for metal poisoning,

drugs
agents
detoxification agents for organophosphate

poisoning, detoxification agents for cyanide

poisoning, detoxification agents for organic

fluorine poisoning, detoxification agents for

benzodiazepine poisoning, detoxification

agents for morphine poisoning, detoxification

agents for acetaminophen poisoning and other

detoxification agents

Drugs for the
drugs for the prevention and treatment of

prevention and
radiation sickness

treatment of

radiation sickness

Diagnostic
Diagnostic agents
tract contrast media and intravascular drug

agents

delivery enhancement contrast media,

gastrointestinal contrast media, bronchial

contrast media, lymph contrast media, MRI

contrast media, ultrasound contrast media,

organ function examination and other

diagnostic agents

Biological
Biological products
biological products for prevention, biological

products

products for treatment, in vivo diagnostic

reagents

Chinese
Internal
Formula for
formula for relieving superficies syndrome

patent
medicine
relieving superficies
with pungent and warm natured drugs in

drugs
medication
in internal medicine
internal medicine, formula for relieving

superficies syndrome with pungent and cool

natured drugs in internal medicine, formula for

relieving both superficial and internal disorders

in internal medicine, formula for strengthening

body resistance and relieving superficies in

internal medicine

Formula for
formula for dispelling summer heat to relieve

dispelling summer
exterior syndrome in internal medicine,

heat in internal
formula for clearing summer-heat and

medicine
removing damp in internal medicine, formula

for strengthening stomach and relieving

summer heat in internal medicine

Formula for
formula for clearing fire and promoting bowel

promoting bowel
movements in internal medicine, formula with

movements in
purgative action in internal medicine, formula

internal medicine
for eliminating fullness and promoting bowel

movements in internal medicine

Formula for heat-
formula for heat-clearing and purging

clearing in internal
pathogenic fire in internal medicine, formula

medicine
for clearing heat and detoxicating in internal

medicine, formula for clearing heat in viscerae

in internal medicine, formula for clearing heat

and sedating in internal medicine

Formula for
formula for warming interior to disperse cold in

warming interior in
internal medicine, formula for warming interior

internal medicine
to eliminate dampness in internal medicine,

formula for restoring yang and rescuing patient

from collapse in internal medicine

Formula for
formula for dissolving cold phlegm with

resolving phlegm,
warmth in internal medicine, formula for

relieving cough,
astringing lung to relieve cough in internal

preventing asthma
medicine, formula for clearing heat and

in internal medicine
resolving phlegm in internal medicine, formula

for moistening lung to remove phlegm in

internal medicine, anti-asthmatic agents for

internal medicine, formula for eliminating

stagnation and resolving phlegm in internal

medicine

Formula for
formula for clearing heat and resuscitation in

inducing
internal medicine, formula for aromatic or

resuscitation in
phlegm-reducing resuscitation in internal

internal medicine
medicine

Astringent formula
formula for astringing spermatorrhea in

in internal medicine
internal medicine, formula for arresting

discharges and antidiarrheal in internal

medicine, formula for tonifying kidney to

reduce urination in internal medicine

formula for
formula for supplementing qi in internal

strengthening the
medicine, formula for nourishing blood in

body resistance in
internal medicine, formula for nourishing yin in

internal medicine
internal medicine, formula for warming yang in

internal medicine, formula for benefiting both

yin and yang in internal medicine, formula for

benefiting both qi and blood in internal

medicine, formula for boosting qi and

nourishing yin in internal medicine, formula for

boosting qi and restoring pulse in internal

medicine

Formula for
formula for tranquilizing by nourishing the

tranquilizing in
heart in internal medicine, formula for boosting

internal medicine
qi and nourishing blood for tranquillization in

internal medicine, formula for removing heat

from the liver for tranquillization in internal

medicine, formula for tonifying kidney for

tranquillization in internal medicine, formula

for tranquilization with heavy material in

internal medicine

Hemostatic agents

for internal

medicine

Formula for clearing
formula for benefiting qi and activating blood

stasis in internal
circulation in internal medicine, formula for

medicine
activating qi flowing and activating blood

circulation in internal medicine, formula for

nourishing blood and activating blood

circulation in internal medicine, formula for

warming yang and promoting blood circulation

in internal medicine, formula for nourishing yin

and activating blood circulation in internal

medicine, formula for nourishing kidney and

activating blood circulation in internal

medicine, formula for resolving phlegm and

relaxing chest in internal medicine, formula for

removing blood stasis and promoting qi

circulation in internal medicine, formula for

invigorating blood circulation and eliminating

symptoms in internal medicine, formula for

clearing stasis and sputum in internal medicine

Formula for
formula for dispersing stagnated liver qi and

regulating qi flow in
relieving qi stagnation in internal medicine,

internal medicine
formula for soothing liver and regulating

stomach in internal medicine

Formula for

resolving food

stagnancy in

internal medicine

Formula for wind
formula for dispersing external wind in internal

disorder in internal
medicine, formula for calming liver to stop

medicine
endogenous wind in internal medicine, formula

for suppressing hyperactive liver and subsiding

yang in internal medicine, formula for

eliminating phlegm and calming wind in

internal medicine, formula for removing blood

stasis and dispelling wind in internal medicine,

formula for nourishing blood to expel wind in

internal medicine, formula for dispelling wind

and removing obstruction in the meridians in

internal medicine

Formula for
formula for dispelling cold and removing

eliminating
dampness in internal medicine, formula for

dampness in internal
dispelling wind and dampness in internal

medicine
medicine, formula for removing blood stasis

and dispelling dampness in internal medicine,

formula for inducing diuresis to remove edema

in internal medicine, formula for clearing heat

and freeing strangury in internal medicine,

formula for removing blood stasis and freeing

strangury in internal medicine, formula for

tonifying the body's righteousness and

eliminating dampness in internal medicine

Formula for

resolving turbidity

and lowering lipid

in internal medicine

Surgical
Formula for clearing
formula for purging liver and gallbladder in

medication
heat in surgical
surgical medicine, formula for clearing heat

medicine
and removing toxicity in surgical medicine,

formula for clearing heat and eliminating

dampness in surgical medicine, formula for

freeing strangury and dispersing stone in

surgical medicine

Formula for

warming meridians,

regulating qi,

promoting blood

circulation, and

dispersing lumps in

surgical medicine

Tumor
Anti-tumor Chinese

medication
patent drugs

Adjuvant Chinese

patent drugs for

tumor

Gynecological
Formula for
formula for regulating qi and nourishing blood

medication
regulating blood in
in gynecological medicine, formula for

gynecological
activating blood and removing stasis in

medicine
gynecological medicine, gynecological

hemostatic agent

Formula for clearing
oral formula for clearing away heat in

away heat in
gynecological medicine, external formula for

gynecological
clearing away heat in gynecological medicine

medicine

Formula for

tonifying the body's

righteousness in

gynecological

medicine

Formula for

dissipating

detumescence and

lump in

gynecological

medicine

Ophthalmic
Formula for clearing

medication
away heat in

ophthalmological

medicine

Formula for

tonifying the body's

righteousness in

ophthalmological

medicine

Formula for

removing blood

stasis in

ophthalmological

medicine

Formula for clearing

away heat in

ophthalmological

medicine

Orthopedic
Formula for

medication
activating blood and

removing stasis in

orthopedic medicine

Formula for

promoting blood

circulation to

remove obstruction

in collaterals in

orthopedic medicine

Formula for

tonifying kidney

and strengthening

bone in orthopedic

medicine

National
Tibetan medicines

medicines
Mongolian

medicines

Uyghur medicines

- S3, based on the above dataset of ADR risk factors in elderly patients, and grounded in the medical institution's case records, experienced clinical pharmacists completed the identification and risk factor (feature) annotation of ADR in elderly patients, thereby constructing an ADR dataset for elderly patients.

Specifically, it comprised the following steps:

- S31, the constructed ADR dataset for elderly patients had reached tens of thousands of cases, and the ADR discrimination was carried out according to the judgment criteria established by the National Center for ADR Monitoring, China.
- S32, the judgment criteria established by the National Center for ADR Monitoring, China was followed. The specific judgment criteria were: 1) Definitely; 2) Very likely; 3) Possible; 4) Possibly unrelated; 5) To be evaluated; 6) Unable to evaluate. Medical records determined as definitely, very likely, and possibly were considered to have experienced ADRs.
- S33, ADR was manually identified and annotated by many clinical pharmacists with over ten years of work experience.
- S4, the ADR dataset of elderly patients was learned about to construct an ADR risk prediction model for them. Specifically, the data of ADR datasets for tens of thousands of elderly patients were used, and after removing features with missing values of >2000, M types of missing value handling methods were applied, including but not limited to no imputation, mean imputation, regression imputation, or missForest methods. Classification was performed based on the above localized trigger entries, which were randomly divided into independent training and testing sets at a ratio of 8:2, and N types of machine learning models were used to conduct ADR prediction training, feature importance evaluation, and screening for elderly patients based on data from various categories

It should be noted that in the prior art, those skilled in this field (such as doctors, pharmacists, researchers, etc.) were aware of the relationship between certain characteristics and ADRs in patients with aid of research and professional knowledge. However, due to factors such as the wide variety of drugs, individual differences among patients, and advancements in related medical research, it was impossible for them to provide a complete and optimal combination of features for each type of drug. Therefore, the way of inputting features in this example was to input all the features listed in step S2 into the model (for example, for the drug categories listed in step S2, based on whether the patient used the drug category, “Yes” or “No” could be used as the input value for input). During the model training process, the model algorithm determined the impact of various features on the prediction results.

The model training step employed a 10-fold cross-validation method to perform internal model validation on the training set and adjust model parameters, aiming to achieve the maximum AUC value for the training set. Using the 10-fold cross-validation method, each model obtained 10 different sets of machine learning evaluation metrics based on the training set. The best-performing models, totaling N×M, were selected for the test set. The superiority of each model was determined based on metrics such as AUC, accuracy, precision, recall, and F1 scores for the test set.

Example 2

The system of this example includes:

Feature data acquisition module, used for inputting the ADR-related feature data of the elderly patients and sending the ADR-related feature data of the elderly patients to the data acquisition and storage module;

- data acquisition and storage module, used for acquiring and storing ADR-related characteristic data of elderly patients;
- prediction module, used for integrating the ADR prediction model for elderly patients trained in Example 1, which was used to calculate the ADR-related feature data of elderly patients and obtain the prediction results of ADR occurrence in elderly patients;
- result output module, used for outputing the real-time prediction results from the prediction module, and forming an auxiliary decision-making tool for medication schemes.

The technical solution of the present invention was further illustrated with reference to the following experimental examples. The models in the following experimental examples were trained according to the method of Example 1, with the difference being the selection of some features (risk factors) or the choice of specific machine learning algorithms. Steps or parameters not specifically described in the following experimental examples were executed according to the records of Example 1.

Experimental Example 1 Screening Study on the Importance of Non-Drug Influencing Factors in Input Features
1. Experimental Methods

This experimental example was pre-tested among thousands of patients treated with medication. After incorporating 23 non-drug influencing factors (see the left column of Table 5 for details), eXtreme Gradient Boosting (XGBoost), AdaBoost, CatBoost, Gradient Boosting Decision Tree (GBDT), Light Gradient Boosting Machine (LightGBM), Tree-based Pipeline Optimization Tool (TPOT), and Random Forest (RF) were used for analysis.

2. Experimental Results

As shown in FIG. 1 and Table 4, the results indicate that RF achieves the best performance. Therefore, RF was employed to rank the impact of non-drug influencing factors on ADR prediction. The ranking results are presented in Table 5, revealing that age, number of admission diagnoses, number of pre-admission hospitalizations, tumor disease, admission nursing level, and gender exerted the greatest influence on ADR prediction, while skin disease had the least impact.