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The Intelligent Ventilator (INVENT) project:the role of mathematical models in translating physiological knowledge into clinical practice

Elsevier Ireland Ltd
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  • Medicine


Monitoring of anticoagulant therapy applying a dynamic statistical model c o m p u t e r m e t h o d s a n d p r o g r a m s i n b i o m e d i c i n e 1 1 0 ( 2 0 1 3 ) 380–388 j o ur na l ho me pag e: l .e lsev ierhea l th .com/ journa ls /cmpb Monit y a statis Peter Br ena Søren R a Departmen Centr b Departmen Hosp c Medical In borg a r t i c Article history: Received 10 February 2012 Received in revised form 14 October 2012 Accepted 19 Keywords: Anticoagula State-space Warfarin Internation Statistical m Patients with an increased risk of thrombosis may require treatment with vitamin K- antagonists such as warfarin. Treatment with warfarin has been reported difficult mainly due to high inter- and intraindividual variability in response to the drug [1]. Using pre- dictive models that can predict International Normalised Ratio (INR) values enables for a 1. In Several pat anticoagula with coum for prophy at increase patients wi venous thr serious ad attempts to over-treatm insufficient ing the Inte ∗ Correspon E-mail a 0169-2607/$ November 2012 tion treatment model al Normalised Ratio odel higher degree of individualised warfarin dosing regime. This paper reports the outcome of the development of a dynamic prediction model. It takes warfarin intake and INR val- ues as inputs, and uses an individual sensitivity parameter to model response to warfarin intake. The model is set on state-space form and uses Kalman filtering technique to opti- mise individual parameters. Retrospective test of the model proved robustness to choices of initial parameters, and feasible prediction results of both INR values and suggested warfarin dosage, which may prove beneficial for both patients and healthcare takers. © 2012 Elsevier Ireland Ltd. All rights reserved. troduction ients at risk of thrombosis will need some kind of tion therapy. Oral anticoagulation therapy (OAT) arins (vitamin K

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