作者
David W Uster, Sophie L Stocker, Jane E Carland, Jonathan Brett, Deborah JE Marriott, Richard O Day, Sebastian G Wicha
发表日期
2021/1
期刊
Clinical Pharmacology & Therapeutics
卷号
109
期号
1
页码范围
175-183
简介
Many important drugs exhibit substantial variability in pharmacokinetics and pharmacodynamics leading to a loss of the desired clinical outcomes or significant adverse effects. Forecasting drug exposures using pharmacometric models can improve individual target attainment when compared with conventional therapeutic drug monitoring (TDM). However, selecting the “correct” model for this model‐informed precision dosing (MIPD) is challenging. We derived and evaluated a model selection algorithm (MSA) and a model averaging algorithm (MAA), which automates model selection and finds the best model or combination of models for each patient using vancomycin as a case study, and implemented both algorithms in the MIPD software “TDMx.” The predictive performance (based on accuracy and precision) of the two algorithms was assessed in (i) a simulation study of six distinct populations and (ii) a clinical …
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