A machine learning approach to personalized dose adjustment of lamotrigine using noninvasive clinical parameters
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Abstract The pharmacokinetic variability of lamotrigine (LTG) plays a significant role in its dosing requirements. Our goal here was to use noninvasive clinical parameters to predict the dose-adjusted concentrations (C/D ratio) of LTG based on machine learning (ML) algorithms. A total of 1141 therapeutic drug-monitoring measurements were used, 80% of which were randomly selected as the "derivation cohort" to develop the prediction algorithm, and the remaining 20% constituted the "validation cohort" to test the finally selected model. Fifteen ML models were optimized and evaluated by tenfold cross-validation on the "derivation cohort,” and were filtered by the mean absolute error (MAE). On the whole, the nonlinear models outperformed the linear models. The extra-trees’ regression algorithm delivered good performance, and was chosen to establish the predictive model. The important features were then analyzed and parameters of the model adjusted to develop the best prediction model, which accurately described the C/D ratio of LTG, especially in the intermediate-to-high range (≥ 22.1 μg mL−1 g−1 day), as illustrated by a minimal bias (mean relative error (%) = + 3%), good precision (MAE = 8.7 μg mL−1 g−1 day), and a high percentage of predictions within ± 20% of the empirical values (60.47%). This is the first study, to the best of our knowledge, to use ML algorithms to predict the C/D ratio of LTG. The results here can help clinicians adjust doses of LTG administered to patients to minimize adverse reactions.
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ML algorithms analyze data from wearable devices such as accelerometers and gyroscopes to monitor motor symptoms and allow healthcare providers to adjust medication dosages.
“They analyze data from wearable devices, such as accelerometers and gyroscopes, to monitor motor symptoms and allow healthcare providers to adjust medication dosages [189,190].”
From The emergence of AI-based wearable sensors for digital health technology: a review (2023) · cites this paper as [190]
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- Authors
- Zhu, X., Huang, W., Lu, H., Wang, Z., Ni, X., Hu, J., Deng, S., Tan, Y., Li, L., Zhang, M., Qiu, C., Luo, Y., Chen, H., Huang, S., Xiao, T., Shang, D., & Wen, Y.
- Affiliations
- Guangzhou Medical University (CN)
- Guangzhou Psychiatric Hospital (CN)
- Corresponding author
- Shang, Dewei
- Wen, Yuguan
- ORCID
- Venue
- Scientific Reports
- Published
- 2021-03-10
- Volume
- 11
- Issue
- 1
- Pages
- 5568-5568
- ISSN
- 2045-2322 (ISSN-L)
- PMC
- PMC7946912
- OpenAlex
- W3133517216
- Cited by
- 46
- References
- 59
- Citations by year
- 2026: 6 · 2025: 9 · 2024: 10 · 2023: 13 · 2022: 6 · 2021: 2
- FWCI
- 2.73
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Scientific Reports (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Guangzhou Municipal Science and Technology Project for Medicine and Healthcare (20201A011047)
- Natural Science Foundation of Guangdong Province (2018A0303130074, 2019A1515010265)
- National Natural Science Foundation of China (81701319)
- Topics
- Physical Sciences › Computer Science › Artificial Intelligence › Machine Learning in Healthcare
- Physical Sciences › Computer Science › Computational Theory and Mathematics › Computational Drug Discovery Methods
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmaceutical studies and practices
- Keywords
- lamotrigine, pharmacokinetic variability, therapeutic drug monitoring, extra trees regression, antiepileptic drugs, adverse drug reactions
- MeSH terms
- Machine Learning, Lamotrigine, Female, Humans, Male, Middle Aged, Models, Biological, Retrospective Studies, Drug Monitoring
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