Objectives: To measure the reliability of data mining for indicators related to patient treatment at hospital discharge.\n\nMethods: Design: Retrospective cohort study. Population: Patients discharged alive after an admission for heart failure in a general internal medicine department from 2009 to 2010. Data: Key treatments at patient's discharge extracted from the clinical information system compared with data extracted manually from the medical records. Endpoint: Accuracy of data mining for treatment prescription. Analysis: Sensitivity, specificity, positive and negative predictive values (PPVs and NPVs) of data mining for angiotensin-converting enzyme (ACE) inhibitors and betablockers prescription discharge. The gold standard was manual data extraction. We then investigated causes of discrepancies between the two methods.\n\nResults: A total of 724 patients were included. At discharge, 85.2% received an ACE inhibitor and 72.4% a beta-blocker. For ACE inhibitors, data mining yielded a sensitivity of 90%, a specificity of 100%, a PPV of 100% and an NPV of 64%. Corresponding values for beta-blockers were 95%, 100%, 100% and 88%, respectively. Main causes for discrepancy were: omission of some molecules in the electronic query used; non-standard writing of a prescription in the clinical information system; formats incorrectly interpreted by the query.\n\nConclusion: Immediate reliance on data mining for drug prescription is currently unwarranted because this complex process is still prone to errors. Results should be manually checked before they can be used as quality indicators.
Several steps in the replicative cycle of human immunodeficiency virus (HIV) could be envisaged as targets for anti-AIDS drugs. The anionic compound PMEA [9-(2-phosphonyl-methoxyethyl)adenine], the 2'3'-dideoxynucleoside analogues D4T (2',3-deidehydro-2',3'-dideoxythymidine), AzddUrd 3'-azido-2',3'-dideoxyuridine), FddUrd (3'-fluoro-2',3-dideoxyuridine), AzddDAPR (3'-azido-2',3'-dideoxy-2,6' diaminopurine riboside) and the sulfated polysaccharides dextran sulfate and pentosan polysulfate are among the most promising candidate anit-AIDS drugs which have been recently described. They are targeted at either virus-cell binding (dextran sulfate, pentosan polysulfate) or virus-associated reverse transcriptase (PMEA, D4T, AzddUrd, FddUrd, AzddDAPR).
The antiherpes drugs, aciclovir and ganciclovir, are considered the standard treatments and prophylactic agents for infections caused by herpes simplex virus (HSV), varicella zoster virus (VZV) and cytomegalovirus (CMV). Until a decade ago, the impact of aciclovir on the control of severe and life-threatening herpesvirus infections was unprecedented. During the past few years, we have witnessed approval of new therapeutic drugs for infections caused by HSV and VZV (i.e. penciclovir and the oral prodrugs, valaciclovir and famciclovir), CMV (i.e. ganciclovir, cidofovir and fomivirsen) or HSV, VZV and CMV (i.e. foscarnet). A few agents, such as brivudin and benzimidavir, are in ongoing clinical development; others have been suspended because of safety concerns. New antiherpes agents are needed to face clinical issues such as drug resistance, increased use of antiherpes prophylaxis in transplantation and safety concerns in small children or pregnant women.