3.2 Active surveillance programs and performance
After using Boolean logic programming to integrate the trigger entries
and optimizing the rules, the final surveillance programs were obtained
(Table 3). The programs ran for about 3 minutes, 238,194 discharge
medical records from 2018 to 2021 were automatically monitored, and 309
cases were positive for triggers, with a positive rate of 0.13%. After
the manual screening, 94 cases of anaphylaxis were obtained, and the PPV
was 30.42%. 76 patients with 79 cases of anaphylaxis were finally
obtained after removing the duplicates, including 37 cases of
anaphylactic shock and 42 none shock anaphylaxis. The incidence of
anaphylaxis detected by the active surveillance programs was 0.03%.
During the same period (2018-2021), 14 cases of anaphylaxis were
reported to the National Adverse Drug Reaction Monitoring System in our
hospital, and 7 cases could be detected by the active surveillance
programs. The number of anaphylaxis detected by the active surveillance
programs was 5.64 times higher than that by the spontaneous reporting
system, and the under-reporting rate of the spontaneous reporting system
was 83.72%.