Reporting Modeling Results
I would like to get some feedback from the group concerning the reporting of
modeling results. I have a Pop PK model developed from data arising from 124
pediatric patients, age 1 to 48 months. All of the structural parameters have
been scaled allometrically, with the median body weight used as the reference
value. After accounting for body size, a covariate model was incorporated to
describe maturational changes in CL for young children. The maturation of
clearance was modeled using an exponential model proposed in:
Andersen et al. Population clinical pharmacology of children: modelling
covariate effects. Eur J Pediatr. 2006
Two parameters are estimated as part of this model * the fractional change in
CL for a typical one month old patient (beta - estimated to be 0.76 (0.589,
0.96) for this analysis) and a maturational half-life (TCL - 3.82 (1.57, 6.95)
months). CI’s are from the bootstrap.
The problem that I am running into is how to report the modeling results. It
seems very natural to me to report the model results normalized to median body
weight (L/h/10.4 kg^0.75). One of the study investigators disagrees with me and
would like to report the results on a per kg basis (L/h/kg^0.75). This seems
to be counterintuitive to me, as I tend to think about what represents the
“typical patient.” It also makes no sense to me to represent the CL in a one
kg child. The argument is that reporting in this manner makes more sense to
clinicians and that there is no such thing as a typical child.
So in an attempt to appease the investigator, I fit the same model with no
weight normalization. The estimated parameters are equivalent to what would be
scaled from the weight-normalized model, but there is no covariance matrix (not
surprising). It becomes problematic when the bootstrap results are considered
* beta = 0.78 (0.005, 0.995), TCL = 3.90 (0.001, 6.018). Again, this is not
surprising given that the covariate model is not centered.
I have attempted to make several compromises, including reporting the parameter
estimates in both median weight-normalized terms and normalized per kg. I have
also included scaled CL estimates for typical patients at several ages and body
weights. This hasn’t met the approval of the investigator, who is now insisting
that I report the model building procedure from the median weight model, but
report scaled parameters only on a per kg basis. This is wrong in my opinion
and is actually more confusing to someone who is trying to understand the model.
Can I get the group’s opinion on this? Am I being stubborn looking at the world
through a modeler’s point of view?
Thanks,
John Mondick PhD
Research Assistant Professor
Division of Clinical Pharmacology and Therapeutics
The Children's Hospital of Philadelphia
Tel (267) 426-2292
FAX (215) 590-7544
Email: [EMAIL PROTECTED]