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A machine-learning guided method for predicting add-on and switch in secondary data sources: A case study on anti-seizure medications in Danish registries

Affiliation
Department of Drug Design and Pharmacology ,University of Copenhagen ,Copenhagen ,Denmark
Breitenstein, Peter Suhr;
Affiliation
Department of Drug Design and Pharmacology ,University of Copenhagen ,Copenhagen ,Denmark
Mahmoud, Israa;
Affiliation
Department of Drug Design and Pharmacology ,University of Copenhagen ,Copenhagen ,Denmark
Al-Azzawi, Fahed;
Affiliation
Department of Drug Design and Pharmacology ,University of Copenhagen ,Copenhagen ,Denmark
Shakibfar, Saeed;
Affiliation
Department of Drug Design and Pharmacology ,University of Copenhagen ,Copenhagen ,Denmark
Sessa, Maurizio

Purpose: There is a lack of available evidence regarding the treatment pattern of switches and add-ons for individuals aged 65 years or older with epilepsy during the first years from the time they received their first anti-seizure medication because of the lack of valid methods. Therefore, this study aimed to develop an algorithm for identifying switches and add-ons using secondary data sources for anti-seizure medication users. Methods: Danish nationwide databases were used as data sources. Residents in Denmark between 1996 and 2018 who were diagnosed with epilepsy and redeemed their first prescription for anti-seizure medication after epilepsy diagnosis were followed up for 730 days until the end of the follow-up period, death, or emigration to assess switches and add-ons occurred during the follow-up period. The study outcomes were the overall accuracy of the classification of switch or add-on of the newly developed algorithm. Results: In total, 15870 individuals were included in the study population with a median age of 72.9 years, of whom 52.0% were male and 48.0% were female. A total of 988 of the 15879 patients from the study population were present during the 730-day follow-up period, and 988 individuals (6.2%) underwent a total of 1485 medication events with co-exposure to two or more anti-seizure medications. The newly developed algorithmic method correctly identified 9 out of 10 add-ons (overall accuracy 92%) and 9 out of 10 switches (overall accuracy 88%). Conclusion: The majority of switches and add-ons occurred early during the first 2 years of disease and according to clinical recommendations. The newly developed algorithm correctly identified 9 out of 10 switches/add-ons.

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License Holder: Copyright © 2022 Breitenstein, Mahmoud, Al-Azzawi, Shakibfar and Sessa.

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