The DLE knowledge base is a product for hospitals and clinical laboratories which includes information about the effect of drugs on laboratory test results.
It has several unique features:
The effect of drugs on laboratory tests can make the interpretation of the test difficult. In some cases the drug can have a drastic effect on a laboratory test result. Clinicians don’t always have time or opportunity to check the possible effects of drugs on the results of laboratory tests. This may lead to erroneous conclusions, unnecessary additional laboratory tests and examinations, and even unnecessary drug treatments. In many handbooks and databases there is information about drug effects on laboratory tests, but this information does not always reach clinicians.
At Turku University Central Hospital a knowledge base of drug effects on laboratory test results has been developed for several years. During the process a coding scheme to summarise the information of each drug effect on laboratory test was developed.
This Drug Laboratory Effect code (DLE code) was fixed following the type developed in Karolinska Hospital, Sweden. The coding of information according to this code was started in 1996.
Seven features of each drug effect on a laboratory test are coded:
1. Route of administration (oral, parenteral)
2. Direction and strength of effect
3. Level of documentation
4. Sex of patient (males, females, or both)
5. Age of patient (children, adults, or both)
6. Frequency of effect
7. Clinical significance of effect
The DLE coding scheme has turned out to be a very suitable way to describe the knowledge of drug effects on laboratory tests in a format used by computer software. Drugs are coded using both the ATC code, which is the international standard for drug coding, and generic drug name in English.
The first laboratory tests to be coded were the ones which most often are subject to misinterpretations. The most important of those are hormones, enzymes and proteins. Most emphasis has been put on the biological effects which are valid in all laboratories.
The work will never be finished, as new information about drug effects on laboratory tests as well as information about totally new drugs is collected continuously. The previously coded laboratory tests are continuously updated as new information about drug effects is obtained.
The coding of the DLE knowledge base is carried out by experts in laboratory medicine. Each coded drug effect on a laboratory test is based on a consensus of at least two independent experts.
The DLE knowledge base also includes a list of the references which have been used in the coding process.
The DLE knowledge base is unique in Europe.
The aim is to develop a language independent knowledge base which could be
included in any laboratory information system. The approach has been tested
successfully when the knowledge base was implemented for example in a
Spanish hospital.
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