AN EVALUATION OF BAYESIAN MICROCOMPUTER PREDICTIONS OF THEOPHYLLINE CONCENTRATIONS IN NEWBORN-INFANTS

被引:8
|
作者
MURPHY, MG
PECK, CC
MERENSTEIN, GB
RODDEN, D
机构
[1] UNIFORMED SERV UNIV HLTH SCI,DEPT MED,BETHESDA,MD 20814
[2] US FDA,CTR DRUG EVALUAT & RES,ROCKVILLE,MD 20857
[3] UNIV COLORADO,HLTH SCI CTR,DENVER,CO 80262
关键词
Age factors; Asphyxia neonatorum; Disposition; Pharmacokinetics; Premature infant; Theophylline;
D O I
10.1097/00007691-199001000-00009
中图分类号
R446 [实验室诊断]; R-33 [实验医学、医学实验];
学科分类号
1001 ;
摘要
Determination of appropriate theophylline maintenance doses in preterm infants is confounded by interpatient variability. This study evaluated the performance of an IBM PC computer program applying Bayesian regression before and during steady state in 37 preterm infants. Prior population estimates of clearance and distribution volume in preterm infants and Bayesian estimates of clearance and distribution volume based on one to three theophylline plasma concentrations were used to predict subsequent concentrations (drawn 1–17 days later). We assessed the accuracy and precision of the predictive performance of the Bayesian program with the mean prediction error and the mean absolute prediction error. The absolute prediction error (mean absolute error ± SEM) significantly decreased with increasing feedback concentrations from 3.54 ± 0.45 μg/ml (population estimates) to 2.74 ± 0.42 (one feedback) and 2.02 ± 0.35 μg/ml (two feedback concentrations). Mean prediction errors (±SEM) based on one to three feedbacks (-1.5 ± 0.40 μ/ml) were significant improvements over population predictions (- 2.63 ± 0.72 μ/ml, p < 0.05), although a small but significant average overprediction remained. Absolute prediction error was correlated with postconceptional and postnatal age when zero or one but not two feedback concentrations were available. Computer program predictions based on one measured feedback concentration were more accurate and precise than population-based predictions. Refinement of population parameters or two feedback concentrations further improved performance. © 1990 Raven press, Ltd., New York.
引用
收藏
页码:47 / 53
页数:7
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