1. Drug utilization forms an important aspect of many research initiatives. It helps researchers to examine the effectiveness of pharmacotherapy applied in the inpatient, outpatient and various other settings. In the arena of pediatric pharmacotherapy, drug utilization can be used to examine various outcomes and the extent to which best practices in children differ from labeling, adult dosing guidance etc. The Children’s Hospital of Philadelphia (CHOP) and its satellite locations handle more than 15,000 inpatient admissions and more than 200,000 emergency and outpatient visits each year. CHOP has 304 beds, 20% of which are allocated to intensive care. Physicians at CHOP administer drugs based on the CHOP formulary. The entire CHOP formulary consists of 998 drugs with 7,553 formulation-dose entries (unique formulations and dosage strengths) at present. As part of the continuous review of the therapeutic standards committee, the formulary is periodically re-evaluated and drugs are added or removed from the list. The Hospital Drug Utilization (HDU): HDU was created at CHOP using the accounting data from the SIEMENs' accounting system. The raw data extracted from the accounting system is in the form of text files running to 80,000 rows. The database that hosts the HDU is a relational database running on Oracle 9i. Data is loaded into Oracle database based on a “star schema” data model. This data model enables easy analysis, retrieval, and reporting. The central table, commonly referred to as the “fact table,” is where all key facts, measurements, or results are stored. This table is connected to a set of attribute tables, commonly referred to as “dimension tables,” through which the fact tables are indexed or defined. The data that resides on the HDU spans 6 years – from 2001 to 2006 and contains over a million records. The main fact tables are diagnosis, treatment, admission and procedure related to patients. These tables get appended every year. The other dimension tables get appended or updated as and when there is a change in the diagnosis code or treatment code or a procedure code. The number of records in a single fact table is about 500,000 and sometimes exceeds that - for e.g.. Patient Treatment has about 11,700,000 rows. Usage at CHOP: Over the years, HDU has been used for various purposes. To name a few, we have queried the database to get information regarding utilization of various drugs at CHOP across various age groups, utilization of drug for various diagnosis/treatment, comparison of drug utilization across hospitals. For all the above analysis, data was collected from the database through SQL queries. The data analysis, data summarizations, statistical analysis and graphs were done using SAS. SAS is an excellent data management and statistical analysis tool. SAS/Access, SAS/ODS and other graphical utilities are used in this interface and this is explained in detail in the methods section. Objectives: Our objective was to design an interface that would allow both advanced programmers and non-programmers to exploit the utility of SAS for specific projects. BACKGROUND CONCLUSIONS METHODS and RESULTS REFERENCES A SAS-Based Query and Exploitation Interface to Hospital Drug Utilization Bhuvana Jayaraman and Jeffrey S. Barrett Laboratory for Applied PK/PD, Division of Clinical Pharmacology, The Children’s Hospital of Philadelphia, SAS GUI to build SQL queries: SAS GUI has the power to build SQL queries. Under the Solutions  Desktop  Reporting  Query Data, SQL Queries can be constructed by users who have good grip on SQL commands. This tool helps user to create new SAS datasets. After creation of SAS datasets, they can run their own program or can use the macros available to create customized report/graph. The overall ranking of top 25 drugs from the HDU across all years with the inclusion of Methotrexate (MTX) and Tacrolimus (TAC). MTX and TAC were chosen as the dashboard drugs for the Pediatric Knowledge Base – a chair’s initiative project at CHOP. The PDF output from SAS using the SAS ODS (Output Delivery System) shows the summary statistics for the SMA patients treated at CHOP. SAS is powerful data analysis tool. The ease of using SAS is exploited in this interface. This tool aids researchers to utilize the Drug Utilization data for future research. This tool has been used for the following: To prioritize choice of agents for a Pharmacotherapy clinical application – Pediatric Knowledge Base, in development at CHOP. Recommendation to do a clinical trial of Acetaminophen IV based on the administration and usage of Acetaminophen at CHOP. To work on a disease progression model for Spinal Muscular Atrophy patients. The future plan is to make this interface a web interface using SAS IntrNet. Base SAS, SAS Macros, SAS/ACCESS and SAS GUI were used to achieve the objective. Connection to the Oracle database was done using the LIBNAME statement which uses the Oracle engine to provide direct and dynamic access to the oracle data. libname mydblib oracle user=username password=password path=‘schema'; (Note: The values for user, password and path are specific to Oracle. The value for path= statement is the Oracle alias name in the Oracle TNSNAMES.ORA file.) Zuppa AF, Vijayakumar S, Mondick JT, Pavlo P, Jayaraman B, Patel D, Narayan M, Boneva T, Vijayakumar K, Adamson PC, Barrett JS. Design and implementation of a web-based hospital drug utilization system. J Clin Pharmacol: 47(9): 1172-1180, 2007. Barrett JS, Patel D, Jayaraman B, Narayan M, Zuppa A. Key Performance Indicators for the Assessment of Pediatric Pharmacotherapeutic Guidance. J Pediatr Pharmacol Ther 13:141- 155, 2008. Zuppa AF, Jayaraman B, Blumer J, Reed M, Barrett JS. Cross-Institutional Drug Utilization In Pediatric Intensive Care Units.The Journal of Clinical Pharmacology 2006: 46 (9): 1061. ACKNOWLEDGMENTS Intek Partners – provided resources for building the database The flowchart describing the process of the data flow from the Siemens system to Oracle database to SAS. Screen shot of the SAS GUI SQL query builder Customized user input and output: A user interface was designed to solicit user input. %Windows was used to collect the user input. This acts similar to a HTML form. The variables are collected as a macro variables and are then used in SAS code to get data from the SAS datasets. Based on the user input, necessary tables are merged and results/graphs are designed. User can ask for summary data, year specific data, drug specific data etc. Complexity arises when user requests more than one drug or would like to see only seasonal changes in the data. Depending on the user request, the window will be displayed again to collect more data. Screen shot of the view of the SAS user interface SAS reporting and Graphing functions are extremely versatile. The SAS Output Delivery System (ODS) has the capability to print data in an HTML or PDF or RTF file format. The PROC GPLOT can create a JPEG or WMF file as is required by the user. With both the GUI interface and the user interface, users have the opportunity to get their data in the format that they desire. Proficient SAS programmers can create and run their own code. Other users can almost get all the data that they require using the user interface. Users can also input more than one drug or more than a year. The code utilizes PROC SQL capability to merge the datasets. The code also has the functionality to check for errors such that no empty dataset is returned. The above table represents the administration of Acetaminophen across different diagnosis for the year 2001 and 2002.