ArticleClinical pharmacokinetics2026
Evaluation and Improvement of Specialized Vancomycin Pharmacokinetic Models for Pediatric Cardiovascular Intensive Care Unit and Pediatric Oncology Patients.
Article in Clinical pharmacokinetics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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.
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.
Who cites it
1 citing paper in PubMed.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectiveDose optimization of vancomycin in distinct pediatric subpopulations is inherently complex due to altered vancomycin pharmacokinetics associated with certain conditions or circumstances, such as cancer or postoperative cardiac surgery. Numerous population pharmacokinetic models have been developed that aim to capture these alterations; however, it is currently unclear whether these specialized models are necessary, or if covariates in a well-specified general model can adequately capture pharmacokinetic variation between special subpopulations. Here, we conduct an external evaluation comparing the predictive performance of published general and specialized population pharmacokinetic models in pediatric oncology and pediatric cardiovascular intensive care unit (CVICU) patients in order to address this question, and guide model selection decisions for model-informed precision dosing of vancomycin in these subpopulations.
methodsThe predictive error, bias, and accuracy of two general, six oncology-supporting, and three CVICU-supporting pharmacokinetic models were compared in two multi-site data sets of pediatric oncology (N = 371, 1392 drug levels, 20 sites) and pediatric CVICU (N = 219, 1136 drug levels, 11 sites) patients, respectively. The best performing model(s) in each subpopulation were refit to evaluate whether predictive performance could be further improved over the published models.
resultsWe find that although specialized models performed better than general population models for pediatric CVICU patients, a general model (Colin 2019) performed better than all specialized models for pediatric oncology patients. We additionally report a refit version of the Shimamoto 2024 model for pediatric CVICU patients, which performed better than all published CVICU-supporting models in our data set.
conclusionPopulation pharmacokinetic models developed on distinct pediatric subpopulations are not necessarily more fit-for-purpose than models developed on a general population. Both well-specified general models and specialized models may be capable of achieving suitable clinical performance in these subpopulations, and this assessment of model fit-for-purpose must be made on a case-by-case basis.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.