[Predictive performance of Smart Dose, PharmVan and JPKD on Vancomycin plasma concentration]

Area of Science:

• Pharmacokinetics and Therapeutic Drug Monitoring
• Clinical Pharmacology
• Computational Medicine

Background:

• Accurate Vancomycin plasma concentration prediction is crucial for effective treatment and minimizing toxicity.
• Individualized drug delivery decision-making systems aim to optimize dosing regimens.
• Evaluating the predictive performance of these systems is essential for clinical application.

Purpose of the Study:

• To assess the predictive accuracy of Smart Dose, PharmVan, and JPKD for Vancomycin plasma concentrations.
• To identify factors influencing the predictive performance of these individualized drug delivery systems.
• To compare the performance of these systems for initial versus adjustment Vancomycin regimens.

Main Methods:

• Retrospective analysis of clinical data from 185 patients receiving Vancomycin.
• Prediction of Vancomycin plasma concentrations using Smart Dose, PharmVan, and JPKD for initial and adjustment regimens.
• Statistical analysis including Mann-Whitney U test, logistic regression, and ROC curve analysis to evaluate predictive error and influencing factors.

Main Results:

• No significant difference in predictive performance was observed among Smart Dose, PharmVan, and JPKD for Vancomycin plasma concentration.
• Smart Dose demonstrated superior predictive accuracy for adjustment regimens compared to initial regimens.
• Hypertension was associated with improved Smart Dose prediction, while low body weight (<55.95 kg) negatively impacted JPKD prediction accuracy.

Conclusions:

• Smart Dose, PharmVan, and JPKD exhibit comparable predictive capabilities for Vancomycin plasma levels.
• Smart Dose shows enhanced performance for adjustment regimens and in hypertensive patients.
• JPKD's predictive accuracy is compromised in low-body weight individuals, highlighting the need for careful consideration of patient characteristics.