Drug Info Systems Content Exam

Identify the type of literature:

Aronoff GR, Bennett WM, Berns JS, et al. Drug Prescribing in Renal

Failure: Dosing Guidelines for Adults and Children. 5th ed. Philadelphia,

PA: American College of Physicians; 2007; 100.

tertiary

Identify the type of literature: OVID

secondary

Identify the type of literature:

Risperdal (risperidone) [package insert].Titusville, NJ: Janssen

Pharmaceutical Companies; 2019

tertiary

Identify the type of literature:

Epidemiology of severe hypoglycemia in the diabetes control and

complications trial. The DCCT Research Group. Am J Med 1991;90(4):450-

459.

primary

Recognize 6 sections (article anatomy) of a published journal article:

1. Abstract

2. Introduction (background)

3. Methods

4. Results

5. Discussion

6. Conclussion

What's an incidence?

the number of new events (instances of illness)

ex. how many people received their first diagnosis with social anxiety disorder in 2024?

What's prevalence?

the number of events (instances of a given disease or other condition) in a given population at a single point in time

ex. how many people have a diagnosis of social anxiety disorder in 2024?

What is a primary resource?:

includes clinical research studies and reports, both published and unpublished

- randomized controlled trials (experimental designs)

- cohort studies, case control studies/reports (observational designs)

What is a secondary resource?:

mainly in the form of searchable databases that enable location and retrieval of primary (clinical trials) or tertiary (narrative reviews) resources

What is a tertiary resource?:

they contain info that has been filtered and summarized by the author or editor to provide a quick and concise overview of a topic

What is systemic review & meta analysis?:

purpose: summarize published literature on a particular topic

value: efficient way to stay current on whats been published on the topic

problems: outdated as soon as new data is published. subject to inaccuracies based on search design

1. What is randomization? (aka random allocation)

Predetermines and planned allocation of individuals to groups using chance. Involves at least 2 groups, (experimental and control groups) but may have more.

- should make the participants similar at the start of the experiment

3. What are cohort studies?

investigators select a group of exposed individuals & non-exposed

- follow up with both groups to compare incidence of disease (or other outcome)

- explanatory, observation, non-randomized

-prospective or retrospective

4. What are case control studies?

Subjects selected by outcome

cases: those with the outcome of interest (disease, adverse effect)

controls: those without the outcome

- useful for examining rare or slowly developing adverse effects

always retrospective!!

5. What is a case report?

description of a clinical observation in a single patient (aka case)

- observations are novel or new disease presentation, adverse event or treatment outcome

A narrative review has ______ data produced and produces ______ types of results

no new

descriptive/qualitative

A systemic review has ______ data produced and produces _____ types of results

no new

qualitative

Meta-analysis has ____ data produced and produces _____ types of results

new

quantitative

What is blinding (aka masking)?

prevents bias in understanding of intervention effects

whats a single blind?

only participants are ignorant

whats a double blind?

researchers and participants are ignorant

whats a triple blind?

statisticians are also ignorant

whats a double dummy?

use of 2 different placebos when study treatments are different dosage forms

2. What are randomized control trials (RCT)?

goal: comparison of the effects of an intervention with a control group

- qualified participants are randomized into the groups

- groups are followed in time for effects

- data/results/outcomes between groups are compared at the end of the study

- gold-standard study design to measure and quantify effect differences between an intervention and control

Whats the basic study design of a RCT?

study population -> randomly assigned to current treatment or new treatment -> study population either improves or does not improve

cohort studies are useful for:

examining medication adverse effects (harm)

5. What is a case series?:

Description of a clinical observation with several patients

- observations are often made assessing new treatments or procedures

Case series and case reports are descriptive with ______ comparison or _____

NO

intervention

What can be found in an abstract?:

a short summary of the study located at the start of an article & have a strict word limit of 200-400 words

What can be found in an introduction?:

background on a topic, brief literature review of what has been published on the topic. Includes a rationale for the study, study objectives, and sometimes a hyptheses

What can be found in the methods section?:

section details the study design, population, and procedures—including randomization, blinding, and statistical analysis—to provide a transparent blueprint of how the research was conducted.

What is found in the results section?:

Subject characteristics, subject dropouts, endpoints quantifies, statistical significance, and safety assessments

What is found in the discussion section?

interpretation of results, clinical significance, other study results compared, and limitations

What is found in the conclusion?

how the findings apply to clinical practice, what the results add to the current body of knowledge, and what future studies should come next

Why is plagiarism considered academic dishonesty?

because it is taking credit for someone's original words or ideas as if they were your own

Whats the OUHSC academic policy on plagiarism?

0% on that paper/assignment

potential failing grade

reported to academic dean

Why do you need to cite reference sources?

It credits the original source of information, adds credibility to your arguments, and enables reader to find original work for more information

What does OUHSC consider plagarism?

- direct quote without quotation marks

- paraphrasing without providing source

- paraphrasing but wording is almost exactly the same

- using your own words but not giving credit to where the original idea/work was learned (& is not common knowledge)

What format should we utilize when citing written work?

American Medical Association (AMA)

When should you cite sources?

when reporting facts and data, when information is obtained verbatim from a source, and when paraphrasing info that is not common knowledge

What is common knowledge?

Information known by the average educated person

Why is informatics in health professions education important?

The Institute of Medicine requires informatics because all health professionals must be able to deliver patient-centered care as part of an interdisciplinary team, using technology to support evidence-based practice and quality improvement. For pharmacy specifically, ACPE standards require students to recall and apply knowledge of technology-based systems (like EHRs) to safely capture, analyze, and share health data

How have federal laws like HIPAA, HITECH, and MACRA impacted the adoption of electronic health records (EHR)?

HIPAA (1996): Defined Protected Health Information (PHI) and established patient privacy and data access rights.

HITECH (2009): Promoted the adoption of Health Information Technology (HIT) and established the "Meaningful Use" program, which provided financial incentives for using EHRs to improve quality and exchange data.

MACRA (2015): Shifted focus from "volume to value," using a Quality Payment Program (MIPS/APMs) to reward providers for improved healthcare quality and reduced spending.

Identify informatics tools that may be used in each step of the

medication use process:

Prescribe/Transcribe: CPOE, Electronic Prescribing (eRX), and Clinical Decision Support (CDS).

Dispense: Barcode verification, robotics, automated dispensing cabinets, and automated compounding.

Administer: Electronic Medication Administration Records (MAR), barcode verification, and smart pumps.

Monitor: CDS, data analytics, and wearable devices

Identify ways an individual may learn more about pharmacy informatics:

Experience: Pursue IPPE/APPE rotations and shadow informatics pharmacists.

Formal Training: Seek a pharmacy residency or specialized certification.

Networks: Engage with organizations like ASHP, HIMSS, AMIA, or AHIMA, and utilize resources from HealthIT.gov

How can interoperability be used to optimize patient care?

Uses standardized languages (like USCDI) to allow the secure, effortless exchange of health information across different institutions and providers.

How can a computerized provider order entry be used to optimize patient care?

Reduces errors by eliminating illegible handwriting and integrating with CDS for safety

How can a medication dispensing system be used to optimize patient care?

Provides clinicians with intelligently filtered, person-specific information (like allergy alerts or guidelines) at appropriate times to enhance decision-making.

How may clinical decision support be used to optimize patient care?

CDS optimizes care by providing "intelligently filtered" information to clinicians at the point of care through:

Safety Alerts: Providing automated warnings for drug allergies, drug-drug interactions, and drug-disease state interactions.

Standardization: Using condition-specific order sets and clinical guidelines to ensure best practices.

Decision Tools: Offering diagnostic support, documentation templates, and contextually relevant reference information.

Medication Safety: Acting as a critical informatics element during the Prescribe, Transcribe, and Monitor stages of the medication use process.

How do you differentiate between medical websites for healthcare professionals versus those for patients?

Professional Sites: Focus on an objective presentation of facts/data, do not promote specific therapies, discuss both benefits and adverse effects (including theoretical ones), and are extensively referenced with monographs.

Patient/Consumer Sites: Often use biased language, may promote recipes or specific "benefits" while limiting discussion of adverse events or risks, and frequently lack formal references or citations.

What types of medical information are available to healthcare professionals within specific .gov domains?

FDA: Drug approvals, safety alerts, and regulatory information.

NIH: Research studies, clinical trials, and general health information.

CDC: Vaccine recommendations (e.g., flu vaccine and pregnancy), disease outbreaks, and public health toolkits.

Medline Plus: Trusted health information intended for patients but used for reference.

AHRQ: Research to improve the quality and safety of healthcare.

What characteristic determines if an online medical source is credible?

Authoritative authorship (qualifications/credentials), up-to-date content, accuracy that can be verified by other sites, and inclusion of citations from peer-reviewed publications.

What characteristic determines if an online medical source is biased?

Promotion/advertising prioritized over serious content, claims that do not match the cited studies, and lack of discussion regarding risks or adverse effects.

What is the DISCERN instrument?

It is a questionnaire used to assess the quality of information about treatment choices. It uses a Likert scale (1-5) across three sections

How is the DISCERN instrument applied?

Section 1: Reliability of the publication (aims, relevance, sources, bias).

Section 2: Quality of information on treatment choices (benefits, risks, "no treatment" outcomes).

Section 3: Overall quality rating of the publication.

How do you formulate a response to a drug information question using online sources?

1. Identify a credible evidence resource (e.g., CDC or ACOG for pregnancy questions).

2. Verify the information across multiple reputable sites.

3. Ensure the evidence supports the specific claim (e.g., "Pregnant women should get a flu shot, NOT the live attenuated nasal spray").

What are the limitations of AI in a healthcare context?

Requires human oversight; output must be critically evaluated and verified against credible resources.

What is selection bias?

Training data is not representative of the real world.

What is confirmation bias?

AI prioritizes patterns already in data, overlooking other possibilities.

What is recall bias?

Subjective interpretations during data labeling.

What is implicit bias?

Unconscious prejudices from developers or data

What does P stand for in PICO?

Population/Patient: Includes age, disease/condition, gender, or ethnicity.

What does I stand for in PICO?

Intervention/Exposure: Can be pharmacologic, non-pharmacologic, a diagnostic test, or an exposure.

What does C stand for in PICO?

Comparator/Control: Another medication, placebo, or diagnostic test (note: not all questions require this)

What does O stand for in PICO?

Outcome(s): What you hope will happen and how you will measure it.

Why must you define unknown information before starting a systematic search?

- To ensure you have enough background knowledge on the drug, disease, or test.

- To identify specific vocabulary for the search; vague terms like "beneficial" are unmeasurable and hinder the search.

- To determine if the question is too broad (e.g., failing to specify the stage of a disease).

When is a tertiary resource used for a clinical question?

Used for background information, defining a disease state (e.g., "What is HF?"), or understanding drug mechanisms and adverse effects.

When is a secondary/primary resource used for a clinical question?

Used for specific clinical questions or to find recent studies evaluating a treatment's use in specific populations.

What are the three steps in the systematic search process?

1. Define Unknowns: Gather background info prior to searching.

2. Prioritize Resources: Decide which type of literature and specific sources to use first.

3. Initiate Search: Use specific terms (like MEDLINE search terms) and refine the strategy based on initial results.

What are the pros of searching for every single PICO element in a clinical question?

Comprehensive retrieval, increased specificity, and thoroughness.

What are the cons of searching for every single PICO element in a clinical question?

Overly restrictive searches (potential to miss relevant data), reduced sensitivity, and increased complexity

What is Evidence-Based Medicine? (EBM)

Delivery of optimal patient care by integrating the best research evidence, clinical expertise, and patient values.

What is the first step of Evidence-Based Medicine (EBM)?

Translate a clinical problem into an answerable question that is clear and focused.