Zellner D, Frankewitsch T, Keller F
Medical Department, University of Ulm, Germany.
Int J Clin Pharmacol Ther. 1998 Oct;36(10):554-60.
For the adjustment of individual vancomycin dosages, we estimate the important pharmacokinetic quantities half-life, clearance, and volume of distribution.
To obtain reliable information 293 observations from 244 patients were extracted from 23 published studies on vancomycin. Information about vancomycin's pharmacokinetics out of different sources represents an increase in sample size and, therefore, interpretive power.
Once the whole of the data had been stratified into a small number of homogeneous clusters based on cofactors, different (robust) estimators (mean, median, Winsorized, and trimmed mean) were calculated for the expected value of the pharmacokinetic parameters of vancomycin within the clusters. Measures of the statistical accuracy such as standard error, bias, mean square error, and confidence interval were estimated via bootstrap methods from large bootstrap sample sizes to compare the quality of the estimators.
Due to the homogenization of the data all individual estimator functions yield very similar results and the empirical mean works fairly well as an estimate. The most frequently used estimator with the smallest estimated mean square error was the Winsorized mean.
为了调整万古霉素的个体剂量，我们估算了重要的药代动力学参数，即半衰期、清除率和分布容积。
为了获取可靠信息，从23项已发表的关于万古霉素的研究中提取了244例患者的293份观察数据。来自不同来源的关于万古霉素药代动力学的信息代表了样本量的增加，因此也提高了解释力。
一旦根据辅助因子将所有数据分层为少量同质聚类，就会为聚类内万古霉素药代动力学参数的期望值计算不同的（稳健）估计量（均值、中位数、 Winsor化均值和截尾均值）。通过自抽样方法从大量自抽样样本中估计统计准确性的度量，如标准误差、偏差、均方误差和置信区间，以比较估计量的质量。
由于数据的同质化，所有个体估计函数都产生非常相似的结果，经验均值作为估计值效果相当好。估计均方误差最小的最常用估计量是Winsor化均值。
