title: Monitoring of anticoagulant therapy applying a dynamic statistical model.
abstract: 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 predictive models that can predict International Normalised Ratio (INR) values enables for a 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 values 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 optimise 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.
authors.affiliation: Department of Cardiology, Aalborg AF Study Group, Cardiovascular Research Centre, Aalborg Hospital, Srd. Skovvej 15, Denmark. pbn@rn.dk
authors.forename: Peter Brønnum
authors.initials: PB
authors.lastname: Nielsen
authors.forename: Søren
authors.initials: S
authors.lastname: Lundbye-Christensen
authors.forename: Torben Bjerregaard
authors.initials: TB
authors.lastname: Larsen
authors.forename: Søren Risom
authors.initials: SR
authors.lastname: Kristensen
authors.forename: Ole Kristian
authors.initials: OK
authors.lastname: Hejlesen
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D003198:Computer Simulation; D004305:Dose-Response Relationship, Drug; D016903:Drug Monitoring / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D015233:Models, Statistical; D017711:Nonlinear Dynamics; D057285:Precision Medicine; D012189:Retrospective Studies; D014812:Vitamin K / Q000037:antagonists & inhibitors; D014859:Warfarin / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D000925:Anticoagulants; D014812:Vitamin K; D014859:Warfarin