Introduction - Uppsala Monitoring Centre

c) Sources of true helpful advice addressed to prescribers. Many of these are herbal
recipe books, dispensatories or pharmacopoeias which describe drugs/herbs and
the methods for preparing them for use; but frequently without giving the indications
for use or their adverse effects. The flood of publications after the widespread
introduction of printing contained a lot of dross, which had accumulated over the
centuries, as well as the helpful publications (Ring, 1972).
d) Scientific papers giving details of individual cases, which often contain the first
reports of new ADRs.
Translation was vital for the transmission of information. The knowledge
acquired by the Greeks and Romans was carried into Persia via Constantinople
by the Nestorians and then from the Arab world back to Europe via Spain, Sicily
and Salerno:
Greek and Roman into Arabic via Pahlawi and Syriac:
a) Jundishapur School – Nestorian Christians (c379)
b) Baghdad School – c832 AD Hunayn ibn Ishaq ( d 873)
Arabic and Greek to Latin
c) Toledo School – Gerard of Cremona (fl 1150- 1187)
d) Salerno School – Constantinus Africanus (1020 – 1087)
These latter translations spread throughout Europe until the advent of printing
when fresh translations were done.
Bayes’ 3 theorem can be applied in Pharmacovigilance as:
Prior probability of adverse reactions + Human experience = Posterior probability of
adverse reactions
The prior probability consists of the total information known about the drug
before its first use in humans. Historically, the early evidence of toxicity would
have been its effect on animals. Since the early users were aware of the potential
toxicity of herbs/minerals they are likely to have to have been more alive to that
possibility when the new herb was similar in any way to a known toxic
herb/mineral.
Ideal knowledge of an adverse drug reaction
The information on an adverse drug reaction that should be available in order to give
the maximum help to the prescriber is:
The manifestation (clinical or laboratory) both subjective and objective
Graded both for severity and seriousness
Frequency or incidence, both absolute and relative to similar drugs with
confidence intervals
3 Bayes = Thomas Bayes ( 1702-1761) was an English clergyman who proposed a theory of probabilities; his
work was published posthumously in 1774