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Medical and academic leadership is needed for clinical decision support systems.

In a medical comment in Läkartidningen, Lars L Gustafsson, describes the rationale of using good decision support prac­tice when developing and implementing clinical decision support systems. Unfortunately, this is not the case today and many of the rather few systems that are available are not usable, effective and safe. At least part of the problem is lack of medical leadership and anchoring in health care and academia. The whole article (in Swedish) can be found at

Vinnova supports the development of open data sources

VINNOVA, the Swedish Governmental Agency for Innovation Systems has announced a call for proposal for open data sources. The aim of the call is to support the start of new innovations by making data openly availiable and to increase both the knowledge and the systematics regarding open access. The announcement by this Swedish authority is a very positive initiative for the future of open data sources. This initiative is in line with the aims of SIDI.  Link


Comparison of drug-drug interaction systems for both pharmacy and health care

The journalist Fredrik Hedlund describes competing decision support systems for
drug-drug interaction control systems in Swedish healthcare and for dispensing of drugs at pharmacy
offices in Sweden. The draw-backs with two different systems in pharmacies and in healthcare
are described as well as costs for development of the two systems
(EES-Elektroniskt Expertstöd) and SFINX. The article is written in Swedish.

Video recording of the eSPC Workshop at EMA

On October 5, took place in London a workshop within the project electronic SPC (e-SPC). e-SPC is a cooperative project between the EMA and the Karolinska Institute. The meeting was chaired by Dr. Lars L Gustafsson, and an audio and video recording of it has been published at the link:

New Project: Swedish reference model for drug information

SIDI is launching a new project based on the preliminary work from Seibo Software Studios:

Swedish reference model for drug information

The purpose of this project is the creation of a conceptual model of drug information to be used as a reference primarily in Sweden in EDS systems on drugs in health care.

More info: Projects page 

Unique evaluation of two drug-drug interaction databases for expert support in healthcare and in pharmacy

by Prof. Dr. Lars L. Gustafsson

A few days ago Swedish Medical Products Agency (MPA) published a unique comparison of two drug-drug interaction databases called EES (Drug-Drug interactions in the Electronic Expert Support provided by The Information Service Board for Swedish Pharmacies) and SFINX

The Drug-Drug Interaction Function in EES is originally developed by the US Company First Databank and intended to be used as an Electronic Decision Support for pharmacists when dispensing drugs at pharmacies. SFINX is developed primarily for use as a decision support system for physicians and nurses in drug prescribing by clinical pharmacologists and pharmacists at Karolinska Institutet in Stockholm, at the Finnish Company Medbase and by experts at Stockholm Healthcare Region (1-3).

The responsible officer for the evaluation is Anders Carlsten in collaboration with internal and external experts at Swedish Medical Products Agency. The Swedish Ministry of Health has ordered this comparative study ( ). This is initiated by discussions in Sweden about risks to have two different knowledge databases for drug-drug interactions but also a firm commitment by the Minister of Health to provide a number of EES functions not only at pharmacies but also at Swedish healthcare institutions ( It is quite amazing that this comparison between EES interaction function and SFINX was initiated by a Ministry led by a politician, Göran Hägglund, and not by the National Board of Health and Welfare ( in charge of providing Swedish Healthcare Institutions with guidelines on best practices.

The evaluation is in Swedish but of great interest for everyone interested in how healthcare staff should be supported with scientifically based advice at point of care in future. The evaluation recommends SFINX to be used preferably as decision support in pharmacies and in healthcare institutions . The advantage is that SFINX has drug-drug interaction alerts based on each substance in comparison with the EES drug-drug interaction function that mostly has shared drug-drug interaction alerts for a class of drugs. In addition, EES drug-drug interaction function lacks information for about 22% of available drug substances in Sweden. Dr Anders Carlsten also comment that it is not optimal if two different knowledge databases with different classification systems (3 for EES drug-drug interaction function and 4 for SFINX) are used simultaneously in the country.

A thrilling time is in front of us. The intention from the Minister has been to provide the whole contents of EES, including the drug-drug interaction function, to all Swedish physicians ( but this evaluation recommends SFINX to be used at all pharmacies in Sweden. How will the decision be taken on what drug-drug interaction database should be used be used electronically at point of care and at pharmacies when dispensing drugs in Sweden? Is the minister to take the decision or is it the National Board of Health and Welfare making the decision based on recommendations from their scientific experts? I do hope that the evaluation of MPA is published in English. This evaluation shows that the question on what knowledge databases should be used in healthcare is hot. In my mind, it is self-evident that we only need knowledge databases that are based on scientific findings and developed in an open matter and freely available in the public domain. The risks to use different drug-drug interaction information in pharmacies and in healthcare institutions in the same country is not known but is likely not negligible.


1. Tillgängliggörande av EES för vårdgivare. Rapport: Utvärdering och införande av ESS. 2011-03-17. Apotekens Service AB.

2. Böttiger Y, Laine K, Andersson ML, Korhonen T, Molin B, Ovesjö ML, Tirkkonen T, Rane A, Gustafsson LL, Eiermann B. SFINX-a drug-drug interaction database designed for clinical decision support systems. Eur J Clin Pharmacol 2009;65:627-33 (

3. Eiermann B, Bastholm-Rahmner P, Korkmaz S, Lilja B, Veg A, Wettermark B, Gustafsson LL. Knowledge databases for clinical decision support in drug prescribing- development, quality assurance, management, integration, implementation and evaluation of clinical value. Decision Support Systems, Book edited by: Chiang S. Jao, ISBN 978-953-7619-64-00, January 2010, INTECH,

PRESS RELEASE 2011-06-14

New Swedish institute to promote free access to reliable information about medicines

Printable pdf: English Svenska

Despite constant information overload, there is a surprising lack of readily available and reliable information about medicines, in Sweden, as well as globally. Drug industry, pharmacies, health care institutions, authorities, and sources on the internet - they do all provide information in different ways, with varying degrees of clarity and objectivity. It is difficult to tell facts from fiction and advertising! The newly established ”Swedish Institute for Drug Informatics” promotes free access to evidence based and objective information about medicines; their use, benefit and risks, for health care, academy and the general public, nationally and globally. The Institute will use open protocols and support the development of and open access to clever and simple IT tools!


The use of medicines is increasing all over the world, and the global drug expenditure is now approximately 800 billion Euros yearly. Add the costs for misuse of medicines, which amounts to at least as much! Access to unbiased, readily available and well structured drug information is a prerequisite for all forms of safe and effective drug treatment. This is as true in a rural African health centre, as in a Swedish university hospital.

A patient needs an antibiotic to treat an infection. Which drug is most effective? Is this drug available locally? Under what brand names are the drug sold? Can this antibiotic be used together with other drugs? What dose is suitable for my patient? What side-effects are to be expected? These questions arise daily to patients and health care providers all over world.

- Today, there is a huge amount of information about drugs available to both patients and health care workers. However, it is nearly impossible to sort out what is reliable information, says Lars L Gustafsson, professor of clinical pharmacology. We believe that clever IT tools can help both the general public and health care workers to keep correct information at hand.

- In poor countries, the cost for medicines represents 40-60 percent of the total health care expenditure. Health care providers are often at loss, even concerning the most basic drug information. The access to correct information can make a difference between life and death in this context, says Anders Wijkman.

The Institute is based on a broad experience in the area of drug information and information technology. SIDI has been founded by Paul Cohen and Lars L Gustafsson, both of which have worked within the area for many years. Together with the other board members, they represent a life-long commitment to questions concerning drug treatment and health care, development of information technology, social sciences, politics, research and industry.


  • Professor Lars L Gustafsson, M.D., Clinical Pharmacology, Karolinska University Hospital and the Department of Laboratory Medicine, Karolinska Institutet, chairman.

  • Associate professor Ylva Böttiger, M.D., Clinical Pharmacology, Karolinska University Hospital, Stockholm.

  • Professor emeritus Björn Pehrson, Telecommunications Systems Laboratory, KTH Royal Institute of Technology, Stockholm.

  • Computer scientist Daniel Rodriguez, Seibo-Studios, Stockholm

  • Former EU parliamentarian Anders Wijkman, Stockholm

Contact and information:

Lars L Gustafsson, +46-706012614,

Ylva Böttiger, +46-8 5858 1193,

Daniel Rodriguez, +46-730787036,



SIDI's site is launched

As a first step in SIDI's life its website is launched! We hope to develop it as an important tool to communicate our message and  to keep the Foundation in touch with its audience.

The Foundation is approved

2011-05-11 - The County Administrative Board of Stockholm (Länstyrelsen i Stockholms Län) registered Swedish Institute for Drug Informatics (SIDI) as a Foundation in its Register of Foundations.

This is an important milestone in SIDIs existence that means that from now on, SIDI can get out and spread its message without formal impediment. We are pleased for that!

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