背景:文拉法辛剂量方案在个体之间差异很大,需要个性化的剂量。
目的:本研究旨在通过真实世界数据分析确定文拉法辛的剂量相关影响因素,并使用先进的人工智能技术构建个性化剂量模型。
方法:我们对使用文拉法辛治疗的抑郁症患者进行了回顾性研究。通过单变量分析选择重要变量。随后,七个模型的预测性能(XGBoost,LightGBM,CatBoost,GBDT,ANN,TabNet,和DT)进行了比较。选择性能最优的算法建立剂量预测模型。模型验证使用混淆矩阵和ROC分析。此外,进行了剂量亚组分析.
结果:共纳入298例患者。选择TabNet建立文拉法辛剂量预测模型,表现出最高的性能,精度为0.80。分析确定了与文拉法辛日剂量相关的七个关键变量,包括文拉法辛的血药浓度,总蛋白质,淋巴细胞,年龄,球蛋白,胆碱酯酶,和血小板计数.预测文拉法辛剂量为75mg的曲线下面积(AUC),150毫克,和225mg分别为0.90、0.85和0.90。
结论:我们成功开发了一个TabNet模型,利用真实世界数据预测文拉法辛剂量。该模型显示出相当高的预测准确性,提供文拉法辛的个性化给药方案。这些发现为临床用药提供了有价值的指导。
BACKGROUND: Venlafaxine dose regimens vary considerably between individuals, requiring personalized dosing.
OBJECTIVE: This study aimed to identify dose-related influencing factors of
venlafaxine through real-world data analysis and to construct a personalized dose model using advanced artificial intelligence techniques.
METHODS: We conducted a retrospective study on patients with depression treated with
venlafaxine. Significant variables were selected through a univariate analysis. Subsequently, the predictive performance of seven models (XGBoost, LightGBM, CatBoost, GBDT, ANN, TabNet, and DT) was compared. The algorithm that demonstrated optimal performance was chosen to establish the dose prediction model. Model validation used confusion matrices and ROC analysis. Additionally, a dose subgroup analysis was conducted.
RESULTS: A total of 298 patients were included. TabNet was selected to establish the venlafaxine dose prediction model, which exhibited the highest performance with an accuracy of 0.80. The analysis identified seven crucial variables correlated with
venlafaxine daily dose, including blood venlafaxine concentration, total protein, lymphocytes, age, globulin, cholinesterase, and blood platelet count. The area under the curve (AUC) for predicting
venlafaxine doses of 75 mg, 150 mg, and 225 mg were 0.90, 0.85, and 0.90, respectively.
CONCLUSIONS: We successfully developed a TabNet model to predict venlafaxine doses using real-world data. This model demonstrated substantial predictive accuracy, offering a personalized dosing regimen for venlafaxine. These findings provide valuable guidance for the clinical use of the drug.