Optimal sampling schedule design for populations of patients
Abstract
Generation of pharmacodynamic relationships in the clinical arena requires estimation of pharmacokinetic parameter values for individual patients. When the target population is severely ill, the ability to obtain traditional intensive blood sampling schedules is curtailed. Population modeling guided by optimal sampling theory has provided robust estimates of individual patient pharmacokinetic parameter values. Because of the wide range of parameter values seen in this circumstance, it is important to know how the range of parameter values in the population affects the timing of the optimal samples. We describe a new, simple technique to obtain optimal samples for a population of patients. This technique uses the nonparametric distribution associated with a nonparametric adaptive grid population pharmacokinetic analysis. We used the distribution from an analysis of 58 patients receiving levofloxacin for nosocomial pneumonia at a dose of 750 mg. The collection of parameter vectors and their associated probabilities were entered into a D-optimal design evaluation by using ADAPT II. The sampling times, weighted for their probabilities, were displayed in a frequency histogram (an expression of how system information varies with time for the population). Such an explicit expression of the time distribution of information allows rational sampling design that is robust not only for the population mean vector, as in traditional D-optimal design theory, but also for large portions of…
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Evidence Hub reads this as a clinical trial, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 58 participants or records.
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