SoftComputingMethodsforDrugDosinginRenalAnemia：对肾性贫血的药物剂量的软计算方法.pptVIP

Soft Computing Methods for Drug Dosing in Renal Anemia Adam E. Gaweda Kidney Disease Program University of Louisville Louisville, KY Overview Anemia in End Stage Renal Disease Soft Computing in Anemia Treatment Intelligent modeling and control for drug dosing Perception-based computing in clinical decision support Summary Mechanism of Red Blood Cell Production Anemia Management in End Stage Renal Disease Clinical Practice Dialysis Outcome Quality Initiative (DOQI) guideline: Maintain hematocrit between 33-36 Vol.% Protocol driven Anemia Management Protocol Frequent dosing changes Dose adjusted in 53% of patients / month Mean dose adjustment 1390±2648 units Challenges Target guidelines very narrow: Only 30% of healthy population would meet range comparable to DOQI guideline ( ±1.5 Vol. % ) Erythropoietin administration: Non-physiological dosing: Discrete and intermittent Different routes of administration: SC vs. IV Soft Computing Methods in Anemia Treatment Intelligent Modeling and Control Computing with Perceptions Intelligent Modeling and Control The existence of data records allows for incorporation of data-driven learning: Neural Networks for dose-response modeling Direct Inverse Neuro-Control for Erythropoietin administration Control Theoretic Approach to Anemia Treatment Patient Model Neuro-Controller Development of Plant Model and Controller Direct Inverse Neuro-Control Simulation Results – Anemia Management Protocol Simulation Results –Neuro-Control Simulation Results – Neuro-Control vs. Protocol Computing with Perceptions Imprecision exists due to the complexity of human body as well as the quality of data, i.e. laboratory data Perception-based Fuzzy System Prediction of approximate response to Erythropoietin treatment Perception-based Fuzzy System Computing with Perceptions – Perception as Fuzzy Number Computing with Perceptions – Imprecise Input Computing with Perceptions –Mutual Subsethood Computing with Perceptions –Imprecise Outpu