Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington.
Anesthesia Services, Harborview Medical Center; Departments of Anesthesiology & Pain Medicine and Neurological Surgery, University of Washington, Seattle, Washington.
Anesthesiology. 2022 Aug 1;137(2):137-150. doi: 10.1097/ALN.0000000000004282.
For the task of estimating a target benchmark dose such as the ED50 (the dose that would be effective for half the population), an adaptive dose-finding design is more effective than the standard approach of treating equal numbers of patients at a set of equally spaced doses. Up-and-down is the most popular family of dose-finding designs and is in common use in anesthesiology. Despite its widespread use, many aspects of up-and-down are not well known, implementation is often misguided, and standard, up-to-date reference material about the design is very limited. This article provides an overview of up-and-down properties, recent methodologic developments, and practical recommendations, illustrated with the help of simulated examples. Additional reference material is offered in the Supplemental Digital Content.
对于估计目标基准剂量（例如 ED50，即对一半人群有效的剂量）等任务，自适应剂量探索设计比标准方法更有效，标准方法是在一组等距剂量下治疗相等数量的患者。上下法是最受欢迎的剂量探索设计家族，在麻醉学中广泛使用。尽管它被广泛使用，但上下法的许多方面并不为人所知，实施往往存在误导，并且关于该设计的标准、最新参考资料非常有限。本文通过模拟示例提供了上下法特性、最近的方法学发展和实用建议的概述。补充数字内容中提供了其他参考资料。
