比较 Mw\Pharm 3.30 和 Mw\Pharm++，一款用于万古霉素 PK/PD 监测的 Windows 版药代动力学软件。第 1 部分：事后建模。
Comparison of Mw\Pharm 3.30 and Mw\Pharm ++, a Windows version of pharmacokinetic software for PK/PD monitoring of vancomycin. Part 1: A-posteriori modelling.
机构信息
Department of Clinical Pharmacology, Faculty of Medicine, University of Ostrava, Czechia.
Department of Clinical Pharmacology, Faculty of Medicine, University of Ostrava, Czechia; Department of Clinical Pharmacology, Department of Laboratory Medicine, University Hospital Ostrava, Czechia.
出版信息
Comput Methods Programs Biomed. 2022 Feb;214:106552. doi: 10.1016/j.cmpb.2021.106552. Epub 2021 Dec 1.
BACKGROUND AND OBJECTIVES
For a long time, the Mw\Pharm software suite (MEDI\WARE, Prague, Czech Republic/ Groningen, Netherlands) has been used for PK/PD modelling in therapeutic drug monitoring (TDM). The aim of this study was to find the best model in the newer Windows Mw\Pharm++ 1.3.5.558 version (WIN).
METHODS
25 patients were repeatedly examined for vancomycin (mean age 63±14 years, body weight 88±21 kg, median dose 1 g/12 h). Trough concentrations predicted a-posteriori by WIN models "vancomycin_adult_k_C2", "#vancomycin_adult_C2", "vancomycin_adult_C2" were compared with the measured value and "vancomycin adult" DOS 3.30 model (DOS).
STATISTICS
Percentage prediction error (%PE) calculated as (predicted-measured)/measured values, or WIN-DOS/DOS - data presented as mean±SD, RMSE, Blandt-Altman plot - data presented as bias±SD (95% limits of agreement), Pearson's coefficient of rank correlation (R), Student's t-test. Statistical analysis was performed using GraphPad Prism version 5.00 for Windows.
RESULTS
The mean%PE in vancomycin predicted values varied from -4.5% ± 33.6 to -8.2% ± 39.3. The%PE between WIN and DOS models varied from -0.2% ± 24.5% to 4.4 ± 21.4%. Model "vancomycin_adult_C2" was closest both to measured vancomycin trough concentration and DOS model:%PE -4.5 ± 33.6% vs +4.2 ± 20.3%, RMSE 33.7 vs 20.6, Blandt-Altman bias +2.19 ± 6.17 (-9.9 - 14.3) vs -0.29 ± 3.25 (-6.7 - 6.1), resp. "#vancomycin_adult_C2" model produced largest%PE (-8.2%), RMSE (40.0) as well as Blandt-Altman bias +2.82 ± 6.76 (-10.4 - 16.1). The Pearson's R of predicted and measured vancomycin concentration, and of values predicted by WIN and DOS models, varied from 0.5135 to 0.5854, P<0.0001 and from 0.7869 to 0.8462, P<0.0001, resp.
CONCLUSIONS
Three Windows vancomycin models and one DOS model in the Mw\Pharm software were compared. The best outcomes, i.e. lowest%PE, RMSE and highest Pearson's R, were reached with "vancomycin_adult_C2" model.
背景与目的
长期以来，MW\Pharm 软件套件（捷克共和国布拉格的 MEDI\WARE 和荷兰格罗宁根的）一直用于治疗药物监测（TDM）中的 PK/PD 建模。本研究的目的是在较新的 Windows Mw\Pharm++1.3.5.558 版本（WIN）中找到最佳模型。
方法
25 名患者被反复检查万古霉素（平均年龄 63±14 岁，体重 88±21kg，中位数剂量 1g/12h）。通过 WIN 模型“vancomycin_adult_k_C2”、“#vancomycin_adult_C2”和“vancomycin_adult_C2”预测的万古霉素谷浓度与实测值进行比较，与 DOS 3.30 模型（DOS）的“vancomycin adult”进行比较。
统计学
%PE 计算为（预测值-实测值）/实测值，或 WIN-DOS/DOS-数据表示为均值±SD、RMSE、Blandt-Altman 图-数据表示为偏差±SD（95%置信区间）、Pearson 秩相关系数（R）、Student t 检验。统计分析使用 GraphPad Prism 版本 5.00 for Windows 进行。
结果
万古霉素预测值的平均%PE 从-4.5%±33.6%到-8.2%±39.3%。WIN 和 DOS 模型之间的%PE 从-0.2%±24.5%到 4.4±21.4%不等。“vancomycin_adult_C2”模型与实测万古霉素谷浓度和 DOS 模型最为接近：%PE-4.5%±33.6%与+4.2%±20.3%，RMSE 为 33.7 与 20.6，Blandt-Altman 偏差为+2.19±6.17（-9.9-14.3）与-0.29±3.25（-6.7-6.1）。“#vancomycin_adult_C2”模型产生最大的%PE（-8.2%）、RMSE（40.0）以及 Blandt-Altman 偏差（+2.82±6.76）（-10.4-16.1）。预测和实测万古霉素浓度之间以及 WIN 和 DOS 模型预测值之间的 Pearson R 值从 0.5135 到 0.5854，P<0.0001 不等，从 0.7869 到 0.8462，P<0.0001 不等。
结论
在 MW\Pharm 软件中比较了三个 Windows 万古霉素模型和一个 DOS 模型。“vancomycin_adult_C2”模型达到了最低的%PE、RMSE 和最高的 Pearson R，效果最佳。
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