PK-RNN-V E: A deep learning model approach to vancomycin therapeutic drug monitoring using electronic health record data.

Journal: Journal of biomedical informatics
Published Date:

Abstract

Vancomycin is a commonly used antimicrobial in hospitals, and therapeutic drug monitoring (TDM) is required to optimize its efficacy and avoid toxicities. Bayesian models are currently recommended to predict the antibiotic levels. These models, however, although using carefully designed lab observations, were often developed in limited patient populations. The increasing availability of electronic health record (EHR) data offers an opportunity to develop TDM models for real-world patient populations. Here, we present a deep learning-based pharmacokinetic prediction model for vancomycin (PK-RNN-V E) using a large EHR dataset of 5,483 patients with 55,336 vancomycin administrations. PK-RNN-V E takes the patient's real-time sparse and irregular observations and offers dynamic predictions. Our results show that RNN-PK-V E offers a root mean squared error (RMSE) of 5.39 and outperforms the traditional Bayesian model (VTDM model) with an RMSE of 6.29. We believe that PK-RNN-V E can provide a pharmacokinetic model for vancomycin and other antimicrobials that require TDM.

Authors

  • Masayuki Nigo
    Division of Infectious Diseases, Department of Internal Medicine, The University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX, United States; School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, TX, United States. Electronic address: masayuki.nigo@uth.tmc.edu.
  • Hong Thoai Nga Tran
    Landmark Health, Huntington Beach, CA, United States.
  • Ziqian Xie
    Department of Biomedical Engineering, University of Miami, Coral Gables, FL, United States of America.
  • Han Feng
    Department of Mathematics, City University of Hong Kong, Kowloon, Hong Kong. Electronic address: hanfeng@cityu.edu.hk.
  • Bingyu Mao
    School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, TX, United States.
  • Laila Rasmy
    School of Biomedical Informatics, University of Texas Health Science Center at Houston (UTHealth), Houston, TX, United States.
  • Hongyu Miao
  • Degui Zhi
    School of Biomedical Informatics, the University of Texas Health Science Center at Houston, Houston, TX, USA.