Individual dose-response models for levodopa infusion dose optimization.
Background and Objective: To achieve optimal effect with continuous infusion treatment in Parkinson's disease (PD), the individual doses (morning dose and continuous infusion rate) are titrated by trained medical personnel. This study describes an algorithmic method to derive optimized dosing sugges...
| Publicado en: | International Journal of Medical Informatics Vol. 112; pp. 137 - 143 |
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| Autores principales: | , , , , |
| Formato: | research Journal Article |
| Publicado: |
Elsevier B.V.
Apr2018
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=128227030&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 128227030 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 13865056 JR4 jtl: International Journal of Medical Informatics issn: 13865056 maglogo: N pubinfo: dt: Apr2018 vid: 112 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 128227030 128227030 NLM29500011 128227030 10.1016/j.ijmedinf.2018.01.018 NLM29500011 128227030 ppf: 137 ppct: 6 formats: tig: atl: Individual dose-response models for levodopa infusion dose optimization. aug: au: Thomas, Ilias Alam, Moudud Nyholm, Dag Senek, Marina Westin, Jerker affil: Department of Micro-data analysis, Dalarna University, Falun, 79 131, Sweden sug: subj: Parkinson Disease Drug Therapy Antiparkinson Agents Administration and Dosage Hospitalization Statistics and Numerical Data Levodopa Administration and Dosage Algorithms Computer Simulation Human Male Parkinson Disease Metabolism Levodopa Pharmacokinetics Antiparkinson Agents Pharmacokinetics Dose-Response Relationship, Drug Female Infusions, Parenteral Validation Studies Comparative Studies Evaluation Research Multicenter Studies Scales Male Female ab: Background and Objective: To achieve optimal effect with continuous infusion treatment in Parkinson's disease (PD), the individual doses (morning dose and continuous infusion rate) are titrated by trained medical personnel. This study describes an algorithmic method to derive optimized dosing suggestions for infusion treatment of PD, by fitting individual dose-response models. The feasibility of the proposed method was investigated using patient chart data.Methods: Patient records were collected at Uppsala University hospital which provided dosing information and dose-response evaluations. Mathematical optimization was used to fit individual patient models using the records' information, by minimizing an objective function. The individual models were passed to a dose optimization algorithm, which derived an optimized dosing suggestion for each patient model.Results: Using data from a single day's admission the algorithm showed great ability to fit appropriate individual patient models and derive optimized doses. The infusion rate dosing suggestions had 0.88 correlation and 10% absolute mean relative error compared to the optimal doses as determined by the hospital's treating team. The morning dose suggestions were consistency lower that the optimal morning doses, which could be attributed to different dosing strategies and/or lack of on-off evaluations in the morning.Conclusion: The proposed method showed promise and could be applied in clinical practice, to provide the hospital personnel with additional information when making dose adjustment decisions. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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