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Background: The enzymatic system of cytochrome P450 (CYP450) is a group of enzymes involved in the metabolism of drugs present in the liver. Literature records instances of underdosing of drugs due to the concurrent administration of another drug that strongly induces the same cytochrome for which the first drug is a substrate and overdosing due to strong inhibition. IT solutions have been proposed to raise awareness among prescribers to mitigate these interactions., Objective: This study aimed to develop a drug interaction dashboard for Cytochrome-mediated drug interactions (DIDC) using a health care data warehouse to display results that are easily readable and interpretable by clinical experts., Methods: The initial step involved defining requirements with expert pharmacologists. An existing model of interactions involving the (CYP450) was used. A program for the automatic detection of cytochrome-mediated drug interactions (DI) was developed. Finally, the development and visualization of the DIDC were carried out by an IT engineer. An evaluation of the tool was carried out., Results: The development of the DIDC was successfully completed. It automatically compiled cytochrome-mediated DIs in a comprehensive table and provided a dedicated dashboard for each potential DI. The most frequent interaction involved paracetamol and carbamazepine with CYP450 3A4 (n=50 patients). The prescription of tacrolimus with CYP3A5 genotyping pertained to 675 patients. Two experts qualitatively evaluated the tool, resulting in overall satisfaction scores of 6 and 5 out of 7, respectively., Conclusions: At our hospital, measurements of molecules that could have altered concentrations due to cytochrome-mediated DIs are not systematic. These DIs can lead to serious clinical consequences. The purpose of this DIDC is to provide an overall view and raise awareness among prescribers about the importance of measuring concentrations of specific drugs and metabolites. Ultimately, the tool could lead to an individualized approach and become a prescription support tool if integrated into prescription assistance software., (© Laura Gosselin, Alexandre Maes, Kevin Eyer, Badisse Dahamna, Flavien Disson, Stefan Darmoni, Julien Wils, Julien Grosjean. Originally published in JMIR Medical Informatics (https://medinform.jmir.org).)

Objective: A comprehensive understanding of professional and technical terms is essential to achieving practical results in multidisciplinary projects dealing with health informatics and digital health. The medical informatics multilingual ontology (MIMO) initiative has been created through international cooperation. MIMO is continuously updated and comprises over 3700 concepts in 37 languages on the Health Terminology/Ontology Portal (HeTOP). Methods: We conducted case studies to assess the feasibility and impact of integrating MIMO into real-world healthcare projects. In HosmartAI, MIMO is used to index technological tools in a dedicated marketplace and improve partners' communication. Then, in SaNuRN, MIMO supports the development of a "Catalog and Index of Digital Health Teaching Resources" (CIDHR) backing digital health resources retrieval for health and allied health students. Results: In HosmartAI, MIMO facilitates the indexation of technological tools and smooths partners' interactions. In SaNuRN within CIDHR, MIMO ensures that students and practitioners access up-to-date, multilingual, and high-quality resources to enhance their learning endeavors. Conclusion: Integrating MIMO into training in smart hospital projects allows healthcare students and experts worldwide with different mother tongues and knowledge to tackle challenges facing the health informatics and digital health landscape to find innovative solutions improving initial and continuous education., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Access to reliable and accurate digital health web-based resources is crucial. However, the lack of dedicated search engines for non-English languages, such as French, is a significant obstacle in this field. Thus, we developed and implemented a multilingual, multiterminology semantic search engine called Catalog and Index of Digital Health Teaching Resources (CIDHR). CIDHR is freely accessible to everyone, with a focus on French-speaking resources. CIDHR has been initiated to provide validated, high-quality content tailored to the specific needs of each user profile, be it students or professionals., Objective: This study's primary aim in developing and implementing the CIDHR is to improve knowledge sharing and spreading in digital health and health informatics and expand the health-related educational community, primarily French speaking but also in other languages. We intend to support the continuous development of initial (ie, bachelor level), advanced (ie, master and doctoral levels), and continuing training (ie, professionals and postgraduate levels) in digital health for health and social work fields. The main objective is to describe the development and implementation of CIDHR. The hypothesis guiding this research is that controlled vocabularies dedicated to medical informatics and digital health, such as the Medical Informatics Multilingual Ontology (MIMO) and the concepts structuring the French National Referential on Digital Health (FNRDH), to index digital health teaching and learning resources, are effectively increasing the availability and accessibility of these resources to medical students and other health care professionals., Methods: First, resource identification is processed by medical librarians from websites and scientific sources preselected and validated by domain experts and surveyed every week. Then, based on MIMO and FNRDH, the educational resources are indexed for each related knowledge domain. The same resources are also tagged with relevant academic and professional experience levels. Afterward, the indexed resources are shared with the digital health teaching and learning community. The last step consists of assessing CIDHR by obtaining informal feedback from users., Results: Resource identification and evaluation processes were executed by a dedicated team of medical librarians, aiming to collect and curate an extensive collection of digital health teaching and learning resources. The resources that successfully passed the evaluation process were promptly included in CIDHR. These resources were diligently indexed (with MIMO and FNRDH) and tagged for the study field and degree level. By October 2023, a total of 371 indexed resources were available on a dedicated portal., Conclusions: CIDHR is a multilingual digital health education semantic search engine and platform that aims to increase the accessibility of educational resources to the broader health care-related community. It focuses on making resources "findable," "accessible," "interoperable," and "reusable" by using a one-stop shop portal approach. CIDHR has and will have an essential role in increasing digital health literacy., (©Julien Grosjean, Arriel Benis, Jean-Charles Dufour, Émeline Lejeune, Flavien Disson, Badisse Dahamna, Hélène Cieslik, Romain Léguillon, Matthieu Faure, Frank Dufour, Pascal Staccini, Stéfan Jacques Darmoni. Originally published in JMIR Medical Education (https://mededu.jmir.org), 04.03.2024.)

Introduction: The cytochrome P450 (CYP450) enzyme system is involved in the metabolism of certain drugs and is responsible for most drug interactions. These interactions result in either an enzymatic inhibition or an enzymatic induction mechanism that has an impact on the therapeutic management of patients. Detecting these drug interactions will allow for better predictability in therapeutic response. Therefore, computerized solutions can represent a valuable help for clinicians in their tasks of detection., Objective: The objective of this study is to provide a structured data-source of interactions involving the CYP450 enzyme system. These interactions are aimed to be integrated in the cross-lingual multi-terminology server HeTOP (Health Terminologies and Ontologies Portal), to support the query processing of the clinical data warehouse (CDW) EDSaN (Entrepôt de Données de Santé Normand)., Material and Methods: A selection and curation of drug components (DCs) that share a relationship with the CYP450 system was performed from several international data sources. The DCs were linked according to the type of relationship which can be substrate, inhibitor, or inducer. These relationships were then integrated into the HeTOP server. To validate the CYP450 relationships, a semantic query was performed on the CDW, whose search engine is founded on HeTOP data (concepts, terms, and relations)., Results: A total of 776 DCs are associated by a new interaction relationship, integrated in HeTOP, by 14 enzymes. These are CYP450 1A2, 2A6, 2B6, 2C8, 2C9, 2C18, 2C19, 2D6, 2E1, 3A4, 3A7, 11B1,11B2 mitochondrial and P-glycoprotein, constituting a total of 2,088 relationships. A general modelling of cytochromic interactions was performed. From this model, 233,006 queries were processed in less than two hours, demonstrating the usefulness and performance of our CDW implementation. Moreover, they showed that in our university hospital, the concurrent prescription that could cause a cytochromic interaction is Bisoprolol with Amiodarone by enzymatic inhibition for 2,493 patients., Discussion: The queries submitted to the CDW EDSaN allowed to highlight the most prescribed molecules simultaneously and potentially responsible for cytochromic interactions. In a second step, it would be interesting to evaluate the real clinical impact by looking for possible adverse effects of these interactions in the patients' files. Other computational solutions for cytochromic interactions exist. The impact of CYP450 is particularly important for drugs with narrow therapeutic window (NTW) as they can lead to increased toxicity or therapeutic failure. It is also important to define which drug component is a pro-drug and to considerate the many genetic polymorphisms of patients., Conclusion: The HeTOP server contains a non-negligible number of relationships between drug components and CYP450 from multiple reference sources. These data allow us to query our Clinical Data Warehouse to highlight these cytochromic interactions. It would be interesting in the future to assess the actual clinical impact in hospital reports., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

The aim of this paper is to present the use of Medical Informatics Multilingual Ontology (MIMO) to index digital health resources that are (and will be) included in SaNuRN (project to teach digital health). MIMO currently contains 1,379 concepts and is integrated into HeTOP, which is a cross-lingual multiterminogy server. Existing teaching resources have been reindexed with MIMO concepts and integrated into a dedicated website. A total of 345 resources have been indexed with MIMO concepts and are freely available at https://doccismef.chu-rouen.fr/dc/#env=sanurn. The development of a multilingual MIMO for enhancing the quality and the efficiency of international projects is challenging. A specific semantic search engine has been deployed to give access to digital health teaching resources.