Skip to main content
Log in

Population Pharmacokinetic Modeling: The Importance of Informative Graphics

  • Published:
Pharmaceutical Research Aims and scope Submit manuscript

Abstract

Purpose. The usefulness of several modelling methods were examined in the development of a population pharmacokinetics model for cefepime.

Methods. The analysis was done in six steps: (1) exploratory data analysis to examine distributions and correlations among covariates, (2) determination of a basic pharmacokinetic model using the NON-MEM program and obtaining Bayesian individual parameter estimates, (3) examination of the distribution of parameter estimates, (4) multiple linear regression (MLR) with case deletion diagnostics, generalized additive modelling (GAM), and tree-based modelling (TBM) for the selection of covariates and revealing structure in the data, (5) final NONMEM modelling to determine the population PK model, and (6) the evaluation of final parameter estimates.

Results. An examination of the distribution of individual clearance (CL) estimates suggested bimodality. Thus, the mixture model feature in NONMEM was used for the separation of subpopulations. MLR and GAM selected creatinine clearance (CRCL) and age, while TBM selected both of these covariates and weight as predictors of CL. The final NONMEM model for CL included only a linear relationship with CRCL. However, two subpopulations were identified that differed in slope and intercept.

Conclusions. The findings suggest that using informative graphical and statistical techniques enhance the understanding of the data structure and lead to an efficient analysis of the data.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

REFERENCES

  1. Beal SL, Sheiner LB. NONMEM Users Guide, Parts I–VI, Division of Clinical Pharmacology, University of California, San Francisco, 1979–1992.

    Google Scholar 

  2. Barbhaiya RH, Forgue ST, Shyu WC, Papp EA, Pittman KA. High pressure liquid chromatography of BMY-28142 in plasma and urine. Antimicrob. Agents Chemother. 31:55–59 (1987).

    Google Scholar 

  3. Cockroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron 16:31–41 (1976).

    CAS  PubMed  Google Scholar 

  4. Dechaux M, Gonzalez G, Broyer M. Creatinine plasmatique, clearance et excretion urinaire de la creatinine chez l'enfant. Arch. Fr. Ped. 35:53–62 (1978).

    Google Scholar 

  5. Maitre PO, Buhrer M, Stanski DR, Thompson D. A three step population pharmacokinetic analysis using NONMEM and bayesian regression: an application to midazolam. J. Pharmacokinet. Biopharm. 19:377–384 (1991).

    Google Scholar 

  6. Mandema JW, Verotta D, Sheiner LB. Building population pharmacodynamic models. I. Models for covariates. J. Pharmacokinet. Biopharm. 20:511–528 (1992).

    Google Scholar 

  7. Davidian M, Gallant AR. Smooth nonparametric maximum likelihood estimation for population pharmacokinetics, with application to quinidine. J. Pharmacokinet. Biopharm. 20:529–556 (1992).

    Google Scholar 

  8. Burtin P, Jacqz-Aigrain E, Girard P, Lenclen R, Magny JF, Betremieux P, Tehiry C, Desplanques L, Mussat P. Population pharmacokinetics of midazolam in neonates. Clin. Pharmacol. Ther. 56:615–625 (1994).

    Google Scholar 

  9. S-PLUS (version 3.1). Seattle, Washington: Statistical Sciences, Inc., 1992.

  10. Shapiro SS, Francia RS. An approximate analysis of variance test for normality. J. Am. Stat. Assoc. 67:215–216 (1972).

    Google Scholar 

  11. Cook RD. Detection of influential observations in linear regression. Technometrics 19:15–18 (1977).

    Google Scholar 

  12. Obenchain RL. Letters to the editor. Technometrics 19:348–351 (1977).

    Google Scholar 

  13. Cook RD, Weisberg S. Criticism and influence analysis in regression. In: Leinhardt S. (ed). Sociological Methodology. San Francisco: Jossey-Bass, 1982, pp 313–316.

    Google Scholar 

  14. Hastie TJ, Tibshirani RJ. Generalized Additive Models. New York: Chapman and Hall, 1990, pp 82–103.

    Google Scholar 

  15. Hastie TJ. Generalized additive models. In: Chambers JM, Hastie TJ., eds. Statistical Models in S. Pacific Grove, California: Wadsworth & Brooks/Cole Advanced Books & Software, 1992, pp 249–307.

    Google Scholar 

  16. Brieman L, Friedman JH, Olshen RA, Stone CJ. Classification and Regression Trees. Belmont, California: Wadsworth International Group, 1984, pp 216–265.

    Google Scholar 

  17. Sheiner LB, Rosenberg B, Marathe VV. Estimation of population characteristics of pharmacokinetic parameters from routine clinical data. J. Pharmacokinet. Biopharm. 5:445–479 (1977).

    Google Scholar 

  18. Drapper NR, Smith H. Applied Regression Analysis. New York: Wiley, 1966, pp 263–304.

    Google Scholar 

  19. Quenouille MH. Notes on bias estimation. Biometrika 43:353–360 (1956).

    Google Scholar 

  20. Miller RG. The jackknife—a review. Biometrika 61:1–15 (1974).

    Google Scholar 

  21. Mosteller F, Tukey JW. Data analysis, including statistics. In: Handbook of Social Psychology Vol 2, Lindzey O, Aronson E, eds. Reading, MA.: Addison-Wesley, 1964, pp 144–145.

    Google Scholar 

  22. Hinkley DV. Jackknife confidence limits using Student approximations. Biometrika 64:21–28 (1977).

    Google Scholar 

  23. Tukey JW. Exploratory Data Analysis. Reading, MA.: Addison-Wesley, 1977.

    Google Scholar 

  24. Barbhaiya RH, Knupp CA, Pittman K. Effects of age and gender on pharmacokinetics of cefepime. Antimicrob. Agents Chemother. 36:1181–1185 (1992).

    Google Scholar 

  25. Barbhaiya RH, Knupp CA, Forgue ST, Matzke GR, Guay RP, Pittman K. Pharmacokinetics of cefepime in subjects with renal insufficiency. Clin. Pharmcol. Ther. 48:268–276 (1990).

    Google Scholar 

  26. Hardin TC, Jennings TS. Cefepime. Pharmacotherapy 14:657–668 (1994).

    Google Scholar 

Download references

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ette, E.I., Ludden, T.M. Population Pharmacokinetic Modeling: The Importance of Informative Graphics. Pharm Res 12, 1845–1855 (1995). https://doi.org/10.1023/A:1016215116835

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1016215116835

Navigation