Artificial Intelligence and Machine Learning Approaches to Facilitate Therapeutic Drug Management and Model-Informed Precision Dosing.
Artificial Intelligence and Machine Learning Approaches to Facilitate Therapeutic Drug Management and Model-Informed Precision Dosing.
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DOI：
10.1097/ftd.0000000000001078
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发表时间：
2023-04-01
影响因子：
2.5
通讯作者：
Mizuno, Tomoyuki
中科院分区：
文献类型：
--
作者：
Poweleit, Ethan A.;Vinks, Alexander A.;Mizuno, Tomoyuki
关键词：
治疗药物监测（TDM）和模型信息精确给药（MIPD）在过去60年里从计算和数学的进步中受益匪浅。此外，人工智能（AI）和机器学习（ML）方法用于支持临床研究和支持的使用正在增加。然而，人工智能和机器学习在精确计量方面的应用直到最近才得到评估。考虑到机器学习处理多维数据（例如来自电子健康记录的数据）的能力，人工智能和机器学习应用程序促进TDM和MIPD的机会可能是有利的。本文总结了支持TDM和MIPD的相关AI和ML方法，并特别关注了最近的应用。本文还讨论了与此集成相关的机遇和挑战。各种AI和ML应用已被评估用于精确给药，包括与浓度或暴露预测、剂量优化、群体药代动力学和药效学、定量系统药理学以及MIPD系统开发和支持相关的应用。这些应用为ML和药物计量学提供了一个机会，以一种集成的方式操作，为精确给药提供临床决策支持。尽管人工智能与精确给药的整合仍处于早期阶段，并在不断发展，但人工智能和机器学习有可能与药物计量方法和谐协作，以支持TDM和MIPD。由于数据越来越多地在机构和临床网络之间共享，并汇总到大型数据库中，这些应用将继续增长。这些方法的成功实施将取决于临床医生和信息学、ML、药物计量学、临床药理学和TDM专家之间的跨领域合作。
Therapeutic drug monitoring (TDM) and model-informed precision dosing (MIPD) have greatly benefitted from computational and mathematical advances over the past 60 years. Furthermore, the use of artificial intelligence (AI) and machine learning (ML) approaches for supporting clinical research and support is increasing. However, AI and ML applications for precision dosing have been evaluated only recently. Given the capability of ML to handle multidimensional data, such as from electronic health records, opportunities for AI and ML applications to facilitate TDM and MIPD may be advantageous. This review summarizes relevant AI and ML approaches to support TDM and MIPD, with a specific focus on recent applications. The opportunities and challenges associated with this integration are also discussed. Various AI and ML applications have been evaluated for precision dosing, including those related to concentration or exposure prediction, dose optimization, population pharmacokinetics and pharmacodynamics, quantitative systems pharmacology, and MIPD system development and support. These applications provide an opportunity for ML and pharmacometrics to operate in an integrated manner to provide clinical decision support for precision dosing. Although the integration of AI with precision dosing is still in its early stages and is evolving, AI and ML have the potential to work harmoniously and synergistically with pharmacometric approaches to support TDM and MIPD. Because data are increasingly shared between institutions and clinical networks and aggregated into large databases, these applications will continue to grow. The successful implementation of these approaches will depend on cross-field collaborations among clinicians and experts in informatics, ML, pharmacometrics, clinical pharmacology, and TDM.