Polypharmacy, most often defined as the simultaneous consumption of five or more drugs at once, is a prevalent phenomenon in the older population. Some of these polypharmacies, deemed inappropriate, may be associated with adverse health outcomes such as death or hospitalization. Considering the combinatorial nature of the problem as well as the size of claims database and the cost to compute an exact association measure for a given drug combination, it is impossible to investigate every possible combination of drugs. Therefore, we propose to optimize the search for potentially inappropriate polypharmacies (PIPs). To this end, we propose the OptimNeuralTS strategy, based on Neural Thompson Sampling and differential evolution, to efficiently mine claims datasets and build a predictive model of the association between drug combinations and health outcomes. We benchmark our method using two datasets generated by an internally developed simulator of polypharmacy data containing 500 drugs and 100 000 distinct combinations. Empirically, our method can detect up to 72% of PIPs while maintaining an average precision score of 99% using 30 000 time steps.
翻译:多重药物疗法,通常被定义为同时服用五种或更多药物,是老年人群中普遍存在的现象。其中一些被认为不当的多重药物疗法,可能与诸如死亡或住院等不良健康结果相关联。考虑到问题的组合性质以及索赔数据库的规模和计算给定药物组合的确切关联度的成本,因此无法研究每种可能的药物组合。因此,我们提出了OptimNeuralTS策略,基于神经汤普森抽样和差分进化,以有效地挖掘索赔数据集并建立药物组合与健康结果之间的预测模型,以优化寻找可能不当的多重药物疗法(PIPs)。我们使用内部开发的多重药物疗法数据模拟器生成了两个数据集,其中包含500种药物和100,000种不同的组合。经验性地,我们的方法可以在维持30,000个时间步长的情况下检测到高达72%的PIPs,并保持平均精度得分为99%。