应用神经 ODEs 推导基于机制的模型,描述早产新生儿与成熟相关的血清肌酸酐动态。

Dominic Stefan Bräm MSc, Gilbert Koch PhD, Karel Allegaert MD, PhD, John van den Anker MD, PhD, FCP, Marc Pfister MD, FCP
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摘要

新生儿的血清肌酐因成熟过程而呈现复杂的动态变化,这在出生后的头几周最为明显。要开发一个基于机制的模型来描述复杂的动态变化,需要很高的药物计量学(PMX)建模专业知识和大量的模型开发时间。最近发表的一种低维神经常微分方程(NODE)机器学习(ML)方法能够自动为新生儿的此类数据建模。然而,这种高效的数据驱动方法本身并不能产生临床上可解释的模型。在这项工作中,介绍了一种利用合理的 PMX 类型函数推导可解释模型的方法。这种 "翻译 "被应用于推导新生儿血清肌酐的 PMX 模型,其中考虑到了成熟过程和协变量。将所建立的模型与之前发表的基于机理的 PMX 模型进行了比较,发现两个模型具有相似的机理结构。然后,利用所开发的模型模拟了出生后最初几周的血清肌酐浓度,其中考虑到了胎龄和出生体重的不同协变量值。这些模拟得出的血清肌酐参考值与观察到的血清肌酐值和之前公布的参考值一致。因此,本文介绍的基于 NODE 的 ML 方法可以模拟新生儿血清肌酐的复杂动态变化,并得出与传统 PMX 模型类似的可解释的数学统计成分,这展示了一种新颖可行的方法,可用于促进临床环境和儿科药物开发中复杂动态变化的建模。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Applying Neural ODEs to Derive a Mechanism-Based Model for Characterizing Maturation-Related Serum Creatinine Dynamics in Preterm Newborns

Serum creatinine in neonates follows complex dynamics due to maturation processes, most pronounced in the first few weeks of life. The development of a mechanism-based model describing complex dynamics requires high expertise in pharmacometric (PMX) modeling and substantial model development time. A recently published machine learning (ML) approach of low-dimensional neural ordinary differential equations (NODEs) is capable of modeling such data from newborns automatically. However, this efficient data-driven approach in itself does not result in a clinically interpretable model. In this work, an approach to deriving an interpretable model with reasonable PMX-type functions is presented. This “translation” was applied to derive a PMX model for serum creatinine in neonates considering maturation processes and covariates. The developed model was compared to a previously published mechanism-based PMX model whereas both models had similar mechanistic structures. The developed model was then utilized to simulate serum creatinine concentrations in the first few weeks of life considering different covariate values for gestational age and birth weight. The reference serum creatinine values derived from these simulations are consistent with observed serum creatinine values and previously published reference values. Thus, the presented NODE-based ML approach to model complex serum creatinine dynamics in newborns and derive interpretable, mathematical-statistical components similar to those in a conventional PMX model demonstrates a novel, viable approach to facilitate the modeling of complex dynamics in clinical settings and pediatric drug development.

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