139: Standards for Creating a Paediatric Drug Monograph
Bibliographic record
Abstract
Adherence to a formulary is essential for rational use of pharmaceuticals. Children represent a unique and challenging population: while efforts toward adult drug monograph formation have been successful, currently many countries lack a standardized formulary for drug therapy in children. Off-label drug use has been associated with an increased risk for adverse drug reactions. Furthermore, paediatric dosing is subject to a high rate of medication errors. Drug monographs (DMs) convey dosing recommendations and evidence supporting therapeutic use in specific populations. The lack of standardized paediatric DMs creates a problem for health care providers, researchers and parents as missing information often results in clinicians choosing the drug, dose and duration of therapy based on personal experience and Institutional recommendations rather than evidence. Current developmental pharmacology indicates that many paediatric subgroups require special dosing considerations, such as premature infants, neonates and obese children. Data on dosing in these populations is very rarely displayed in DMs tailored to the adult population. To develop international standards for developing a paediatric DMs. Following an international environmental scan of existing national formularies a committee of experts in paediatric therapeutics was established. It established a survey of essential items to be included in a paediatric DM to be completed via an International Delphi process. The survey covered areas including search criteria, age groups, adverse drug reactions and overdose, drug-drug interactions, dosing, precautions, formulation, drug properties, and lactation/breastfeeding. Participants from 36 countries spanning six continents were invited to participate in the first round of the Delphi in December 2014. Preliminary results include only the first 11 complete responses received. The majority of participants first consult a paediatric formulary (60%) when searching for information to select, prescribe, dispense, administer, monitor and advise on medicines for children. The remaining participant's first source of information was the hospital formulary or a generic search engine (such as google). The most frequently consulted resource for consult was the British National Formulary for Children followed by Paediatric and Neonatal Lexi-drugs, Kinderformularium, NeoFax and the New Zealand formulary for Children. Further DM content specific results will be available at a later date. Preliminary results support the importance of developing standards for paediatric DMs as they are most frequently a first point of contact for information regarding paediatric dosing.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.128 | 0.178 |
| Meta-epidemiology (narrow) | 0.001 | 0.002 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.007 | 0.004 |
| Science and technology studies | 0.004 | 0.004 |
| Scholarly communication | 0.008 | 0.008 |
| Open science | 0.004 | 0.011 |
| Research integrity | 0.011 | 0.008 |
| Insufficient payload (model declined to judge) | 0.030 | 0.036 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".