Evidence map›Paper›PMID 38503008›Full record

ArticleJournal of critical care2024

Determining steady-state trough range in vancomycin drug dosing using machine learning.

M Samie Tootooni, Erin F Barreto, Phichet Wutthisirisart, Kianoush B Kashani, Kalyan S Pasupathy

Open access · greenAbstract read
In one paragraph

Article in Journal of critical care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
6.6field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 17 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 1 country.

M Samie TootooniDepartment of Health Informatics and Data Science, Loyola University Chicago, Maywood, IL, United States of America. Electronic address: mtootooni@luc.edu.
Erin F BarretoDepartment of Pharmacy, Mayo Clinic, Rochester, MN, United States of America.
Phichet WutthisirisartDepartment of Health Sciences Research, Mayo Clinic, Rochester, MN, United States of America.
Kianoush B KashaniDivision of Nephrology and Hypertension, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, United States of America. Electronic address: Kashani.Kianoush@mayo.edu.
Kalyan S PasupathyDepartment of Biomedical and Health Information Sciences, University of Illinois Chicago, Chicago, IL, United States of America. Electronic address: kap@uic.edu.
Mayo Clinic in Florida · USLoyola University Chicago · USMayo Clinic · USUniversity of Illinois Urbana-Champaign · US

Funding

The Institute for Translational MedicineUL1TR002389 · NCATS · UNIVERSITY OF CHICAGO · PI Joshua J Jacobs, DAVID O MELTZER · 2017 to 2026
$71.6M
Institutional Career Development Core (Chapter 1)KL2TR002387 · NCATS · UNIVERSITY OF CHICAGO · PI ERIC C BEYER, Lisa L Barnes · 2017 to 2026
$7.6M
NCATS NIH HHS KL2 TR002387NCATS NIH HHS UL1 TR002389
6 · The paper itself

Abstract

backgroundVancomycin is a renally eliminated, nephrotoxic, glycopeptide antibiotic with a narrow therapeutic window, widely used in intensive care units (ICU). We aimed to predict the risk of inappropriate vancomycin trough levels and appropriate dosing for each ICU patient.

methodsObserved vancomycin trough levels were categorized into sub-therapeutic, therapeutic, and supra-therapeutic levels to train and compare different classification models. We included adult ICU patients (≥ 18 years) with at least one vancomycin concentration measurement during hospitalization at Mayo Clinic, Rochester, MN, from January 2007 to December 2017.

resultThe final cohort consisted of 5337 vancomycin courses. The XGBoost models outperformed other machine learning models with the AUC-ROC of 0.85 and 0.83, specificity of 53% and 47%, and sensitivity of 94% and 94% for sub- and supra-therapeutic categories, respectively. Kinetic estimated glomerular filtration rate and other creatinine-based measurements, vancomycin regimen (dose and interval), comorbidities, body mass index, age, sex, and blood pressure were among the most important variables in the models.

conclusionWe developed models to assess the risk of sub- and supra-therapeutic vancomycin trough levels to improve the accuracy of drug dosing in critically ill patients.

Indexed as

Anti-Bacterial AgentsIntensive Care UnitsMachine LearningVancomycinAdultAgedCritical IllnessDrug MonitoringFemaleHumansMaleMiddle AgedRetrospective StudiesAnti-Bacterial AgentsVancomycinArtificial intelligenceIntensive care unitVancomycin dosing

Identifiers

PMID38503008
PMCPMC11139571
OpenAlexW4392900986

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.