Prednisone as an Indicator of Severe Asthma

In clinical practice, certain medications are reserved only for those patients who do not respond to first-line therapies, often because second- or third-line therapies carry additional safety risks and/or are supported by weaker evidence of efficacy.

DBP is a physician who specializes in the treatment of respiratory conditions. He wishes to determine if medication usage, as exposed by the complex study design used in ICEES, can be used as a surrogate marker or indicator of patients with severe disease. In his clinic practice, he typically reserves prednisone for patients with severe asthma who are unresponsive to first- and second-line therapies and considered difficult to manage.

To determine whether prednisone usage can be considered an indicator of severe asthma, DBP submitted a query to ICEES that asked: what is the association between prednisone administration/prescription and emergency department (ED) or inpatient visits for respiratory issues among patients with ‘asthma-like’ conditions? The results indicated that 9.84% of patients were prescribed or administered prednisone at least one time over a one-year period (N = 22,810; calendar year 2010). Moreover, 16.67% of those patients who were administered/prescribed prednisone (N = 2,244) had two or more annual ED or inpatient visits for respiratory issues compared to 5.58% of patients who were not administered/prescribed prednisone (N = 20,566; P < 0.0001).

While these results confirm DBP’s clinic experience, and thus perhaps are not surprising, they are remarkable in that they suggest that medication usage, as revealed by ICEES, can be used as a surrogate marker or indicator of patients with severe diseas

These results are included in a manuscript that is under review as a Special Communication in Journal of Biomedical Informatics.

Translator-enabled insights into medication indicators of severe disease!

References:

Fecho K, Hadlock J, Ta C, Xu H, Zhu R, Zhu Q, Arunachalum S, Champion J, Chute CG, Gersing K, Glusman G, Lee J, Pfaff E, Robinson M, Sid E, Peden DB and The Biomedical Data Translator Consortium. Sex, obesity, diabetes, and exposure to particulate matter: scientific insights revealed by analysis of open clinical data sources during a five day hackathon. *Journal of Biomedical Informatics, submitted for consideration as a Special Communication. *Apart from the first/lead and last/senior authors, all other authors are listed in alphabetical order.