ARTICLE Risk of Drug Interactions among Children Accessing Drugs through Health Canada’s Special Access Programme
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Bibliographic record
Abstract
Objective: To evaluate if children treated with unlicensed medications obtained through Health Canada’s Special Access Programme (SAP) are at risk of undetected drug interactions. Methods: This case series reports on all ambulatory patients between 0 and 18 years of age who were treated at a mother-and-child tertiary care teaching hospital, who received an unlicensed medication through the SAP for at least 4 months, and for whom the authors had access to the community pharmacist. All potential level I, II, and III drug interactions, as determined by 2 frequently used references, were identified from the patients ’ files. Results: From January 7 to June 25, 2003, 65 (90%) of the 72 eligible patients agreed to take part in the study. The subjects were receiving the following medications: cisapride (n = 25), nitisinone (n = 10), hydroxocobalamin (n = 8), cysteamine (n = 5), melatonin (n = 4), divalproex sodium (n = 4), interferon-gamma (n = 4), stiripentol (n = 2), phenylbutyrate (n = 2), or methylcobalamin (n = 1). In total, 474 (35%) of 1351 months of treatment (for 39 patients) involved an unlicensed medication known to be associated with potential drug interactions. Three of the 39 patients (8%) actually experienced an interaction: these exposures, all involving cisapride, occurred during a total of 4 months (0.8%). Only 11 (17%) of the 66 community pharmacists noted use of an unlicensed medication in the patient’s file. Conclusion: Three of the 39 patients exposed to unlicensed medications known to have potential drug interactions did in fact have an interaction (in 4 different months). Measures should be taken to decrease the risk associated with the use of unlicensed medications available through Health Canada’s SAP.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
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 it