Modeling longitudinal data in acute illness.
Biomarkers of sepsis could allow early identification of high-risk patients, in whom aggressive interventions can be life-saving. Among those interventions are the immunomodulatory therapies, which will hopefully become increasingly available to clinicians. However, optimal use of such interventions will probably be patient specific and based on longitudinal profiles of such biomarkers. Modeling techniques that allow proper interpretation and classification of these longitudinal profiles, as they relate to patient characteristics, disease progression, and therapeutic interventions, will prove essential to the development of such individualized interventions. Once validated, these models may also prove useful in the rational design of future clinical trials and in the interpretation of their results. However, only a minority of mathematicians and statisticians are familiar with these newer techniques, which have undergone remarkable development during the past two decades. Interestingly, critical illness has the potential to become a key testing ground and field of application for these emerging modeling techniques, given the increasing availability of point-of-care testing and the need for titrated interventions in this patient population.
Clermont
Gilles
G
D000208:Acute Disease / Q000453:epidemiology*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D006801:Humans; D008137:Longitudinal Studies; D015233:Models, Statistical; D018805:Sepsis / Q000097:blood* / Q000453:epidemiology
D015415:Biomarkers; D002097:C-Reactive Protein
Crit Care Med. 2004 Oct;32(10):2061-70
15483415
Ann Intern Med. 2003 Mar 18;138(6):502-5
12639085
Crit Care Med. 2003 May;31(5):1560-7
12771633
Crit Care Med. 2004 Mar;32(3):858-73
15090974
Nat Rev Immunol. 2004 Jun;4(6):445-56
15173833
Crit Care Med. 2004 Oct;32(10):2050-60
15483414
Crit Care. 2007;11(3):R70
17598889
Shock. 2005 Jul;24(1):74-84
15988324
Am J Respir Cell Mol Biol. 2005 Nov;33(5):476-82
16014897
J Virol. 2006 Aug;80(15):7590-9
16840338
Shock. 2006 Sep;26(3):235-44
16912648
J Crit Care. 2007 Mar;22(1):77-84
17371750
Crit Care Med. 2007 Apr;35(4):1061-7
17334246