Unraveling the impact of therapeutic drug monitoring via machine learning for patients with sepsis.

IF 11.7 1区 医学 Q1 CELL BIOLOGY Cell Reports Medicine Pub Date : 2024-08-20 Epub Date: 2024-08-09 DOI:10.1016/j.xcrm.2024.101681
H Ceren Ates, Abdallah Alshanawani, Stefan Hagel, Menino O Cotta, Jason A Roberts, Can Dincer, Cihan Ates
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Abstract

Clinical studies investigating the benefits of beta-lactam therapeutic drug monitoring (TDM) among critically ill patients are hindered by small patient groups, variability between studies, patient heterogeneity, and inadequate use of TDM. Accordingly, definitive conclusions regarding the efficacy of TDM remain elusive. To address these challenges, we propose an innovative approach that leverages data-driven methods to unveil the concealed connections between therapy effectiveness and patient data, collected through a randomized controlled trial (DRKS00011159; 10th October 2016). Our findings reveal that machine learning algorithms can successfully identify informative features that distinguish between healthy and sick states. These hold promise as potential markers for disease classification and severity stratification, as well as offering a continuous and data-driven "multidimensional" Sequential Organ Failure Assessment (SOFA) score. The positive impact of TDM on patient recovery rates is demonstrated by unraveling the intricate connections between therapy effectiveness and clinically relevant data via machine learning.

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通过机器学习了解治疗药物监测对败血症患者的影响。
对重症患者进行β-内酰胺类药物治疗药物监测(TDM)的临床研究,由于患者群体较小、研究之间存在差异、患者异质性以及 TDM 的使用不充分等因素而受到阻碍。因此,有关 TDM 疗效的确切结论仍然难以确定。为了应对这些挑战,我们提出了一种创新方法,利用数据驱动方法揭示通过随机对照试验(DRKS00011159;2016 年 10 月 10 日)收集的疗效与患者数据之间的隐性联系。我们的研究结果表明,机器学习算法可以成功识别出区分健康和疾病状态的信息特征。这些特征有望成为疾病分类和严重程度分层的潜在标记,并提供连续的、数据驱动的 "多维 "序贯器官衰竭评估(SOFA)评分。通过机器学习解开治疗效果与临床相关数据之间错综复杂的联系,证明了 TDM 对患者康复率的积极影响。
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来源期刊
Cell Reports Medicine
Cell Reports Medicine Biochemistry, Genetics and Molecular Biology-Biochemistry, Genetics and Molecular Biology (all)
CiteScore
15.00
自引率
1.40%
发文量
231
审稿时长
40 days
期刊介绍: Cell Reports Medicine is an esteemed open-access journal by Cell Press that publishes groundbreaking research in translational and clinical biomedical sciences, influencing human health and medicine. Our journal ensures wide visibility and accessibility, reaching scientists and clinicians across various medical disciplines. We publish original research that spans from intriguing human biology concepts to all aspects of clinical work. We encourage submissions that introduce innovative ideas, forging new paths in clinical research and practice. We also welcome studies that provide vital information, enhancing our understanding of current standards of care in diagnosis, treatment, and prognosis. This encompasses translational studies, clinical trials (including long-term follow-ups), genomics, biomarker discovery, and technological advancements that contribute to diagnostics, treatment, and healthcare. Additionally, studies based on vertebrate model organisms are within the scope of the journal, as long as they directly relate to human health and disease.
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