Re: 7 days left to comment (was Re: representing potential drug-drug interaction knowledge and evidence - Last commenting period for the W3C Community Group report

Dear Rich,

Thank you for taking the time to consider my comments and for making changes accordingly.

In your first change you describe the new text which says, "This example states NSAIDs generally and then refers to specific NSAID formulations in Contextual information/modifying factors..." but to my mind that still leaves the <Mechanism of Interaction>, <Clinical Consequences>, and <Seriousness> attributes carrying information that, rather than being "general" is actually specific to systemically available NSAID formulations.

My key point is that <Mechanism of Interaction>, <Clinical Consequences>, and <Seriousness> should provide clinically accurate information for the named <Drugs Involved>. If the PDDI is truly a class effect then it's fine to apply these attributes to the class-level interactants, but if not (as is the case with NSAIDs), then some more granular level of abstraction will be required to represent the interactants. I accept that the new text in Section 3.1 acknowledges this principle but I think there is still scope for implementations of your excellent model to be misleading since, as I've already mentioned, it could be argued that that content of the <Mechanism of Interaction>, <Clinical Consequences>, and <Seriousness> attributes in the standing text is actually specific to "systemic NSAIDs" rather than being applicable to "NSAIDs generally".

I wonder if this issue could be addressed by including a comment in Section 3.1 along the following lines:
"The drugs involved may be described at various levels of abstraction, from drug classes at one level to more closely defined medicinal product concepts at the other. The information carried by the following attributes must remain clinically accurate for the particular level of abstraction chosen for the interactants".

Finally, I note that the recent changes have introduced a consistent misspelling of "ophthalmic".

Kind regards
Colin

Colin Macfarlane
Medicines Optimisation Team Lead
ELSEVIER | Clinical Solutions
+44 (0)20 7424 4200 office
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