FreeToolBox Roadmap

This is the roadmap for FreeToolBox. It can be also concidered as a part of the changelog between main stable versions.

Where possible, kindly avoid multiple small edits.

FreeToolBox will allow users to:

• create drugs databases
• review/add/remove interactions
• create the final interactions database

The FreeToolBox interaction's knowlegde database will be XML encoded. The final interaction database will be SQLite based.
The XML based database will be added to the SVN, as a text file: additions, versionning… can be easily manage by SVN.

• we can not directly use ATC codes as interactors. We must use the interacting classes and interacting molecules names from the AFSSAPS. This list can be extended. Each interacting molecules can refer to one or many ATC codes. One interacting class can refer to one or many interacting molecules.
• we can easily add/remove/review new interacting molecules and classes
• we can easily add/remove/review/define new interactions

An interaction is:

• a main interactor (class or molecule)
• that interacts with an 'interactor' (class or molecule)

The set MainInteractor/Interactor does have the following informations:

• a level of interaction
• a risk and management text in two languages: English, French (we need translators for German, Spanish…)
• can have multiple sources (gov agencies, journals, web references)
• can have multiple reviews (reviewer, comment, dateOfReview, completed)

  <MainInteractor name="ACIDE ACETYLSALICYLIQUE">
    <MainInformation lang="fr">Text information about the main interactor.</MainInformation>
    <MainInformation lang="en">Text information about the main interactor.</MainInformation>
    <Interactor name="ANTAGONISTES DES RECEPTEURS DE L'ANGIOTENSINE II" level="P">
      <Risk text="Risk text of interaction MainInteractor with Interactor" lang="fr"/>
      <Management text="Management text of interaction MainInteractor with Interactor" lang="fr"/>
      <Risk text="Risk text of interaction MainInteractor with Interactor" lang="fr"/>
      <Management text="Management text of interaction MainInteractor with Interactor" lang="fr"/>
 
      <!-- Work in progress: risks can be set for specific dose/route or in general -->
      <FormalizedRisk 
          mainDailyDoseFrom=""
          mainDailyDoseTo="" 
          mainWeeklyDoseFrom=""
          mainWeeklyDoseTo=""
          interactorDailyDoseFrom=""
          interactorDailyDoseTo="" 
          interactorWeeklyDoseFrom=""
          interactorWeeklyDoseTo="" 
          mainRoute=""
          interactorRoute=""
          bleeding="" 
          renalFailure="" 
          pulmonaryFailure="" 
          hepaticFailure="" 
          heartFailure="" 
          heartRythmFailure=""
          mainADEPotentialisation=""
          interactorADEPotentialisation="" />
      <FormalizedRisk [...] />
      <!-- End -->
 
      <!-- Not yet implemented -->
      <Reviews>
        <Reviewer name="" uid="" dateofreview="" comment="" completed=""/>
        <Reviewer name="" uid="" dateofreview="" comment="" completed=""/>
      </Reviews>
      <References>
        <Reference comitter="" reviewer="" source="" web="" journal=""/>
        <Reference comitter="" reviewer="" source="" web="" journal=""/>
      </References>
      <!-- End -->
 
    </Interactor>
  </MainInteractor>

• PIM are related to patient age and comorbidities
  • Appropriate prescribing in elderly people: How well can it be measured and optimised? Lancet2007
  • Geriatric Pharmacotherapy Resource List

• Several PIM lists exists:
  • US, US, US, US (need update ? 2008)
  • FR
  • CA, CA
  • DE, DE,

• Some list describe the lack of treatment as well as the misuse:
  • STOPP-START, STOPP-START french

• PIMs are calculated on the basis of the ATC codes of MOLECULES (not drugs ATC code - which is NOT the same)
• Use can choice the source of the PIM
• PIM are processed:
  • Before the prescription beeing done (drugs to avoid with the elderly)
  • During the prescription (dosages to adapat to the elderly - a panel show the warnings)
  • After each drugs prescription (associations avoid with the elderly)
  • When a patient data change (active pathology, medical history…) (manage misuse, underuse drugs regarding the patien physiology/comorbidities)
  • When a chronic treatment is analyzed (duration adaptation)
• Level of warnings can be defined in the preferences application
• When possible, an alternative list of drug is proposed to the practitioner

<PIM genericSource="Beers,Priscus..." pmid="" type="" level="" country="">
  <Molecule class="" atc="" />
  <MoleculeAssociation>
    <Molecule class="" atc="" />
  </MoleculeAssociation>
  <DoseAlert higherThan="" lowerThan="" />
  <Risk lang="" value=""/>
  <Management lang="" value=""/>
  <RelatedDiagnosis>
    <ICD value="" />
  </RelatedDiagnosis>
  
</PIM>

• First release

• Drugs Database Creators
  • Tools::moleculeLinker → some problems when comparing names with :
    • automatic removal of the parenthesis content (eg in the french db : POTASSIUM (CHLORURE DE) → POTASSIUM ACETATE)
    • create for these a new tag: “proposedAtc”
    • add to the proposedAtc more automatic calculations
    • Sometimes on molecule name as multiple codes… (Ca:SODIUM CHLORIDE)
  • ZA drugs database
    • create a XML file which allow users to add composition to drugs according their uids (generate the ui too)
  • FR drugs database
    • Some missing molecule names in the compo.txt (UID=60982364) got molecule_code
  • CA drugs database
    • Better management of molecule strength

• Interaction Database Management
  • Add English translations of AFSSAPS interacting class in the ATC codes feeder
  • Verify the management of the : One AFSSAPS interacting molecule ↔ N ATC codes
  • InteractionDatabase → Add the information text of the interacting class to
    • the reviewers view,
    • the SQLite feeder
  • XML Tree must be reviewed (some missing ATC)
  • Transform XML Tree MoleculeName to ATC to avoid missing links du to typos
  • PROMACAÏNE is not classified in the interacting classes

• PIM database
  • Create first XML structure for the PIM knownledge

• General application
  • Add possiblity to reviewers to send via mail their recent reviews to the dev list
  • Management of authorized reviewers

• Documentation
  • Write application documentation

• Enroll participants