Background: In recent years, pharmacogenetic algorithms were developed for estimating the appropriate dose of vitamin K antagonists. Aim: To evaluate the performance of new generation artificial neural networks (ANNs) to predict the warfarin maintenance dose. Methods: Demographic, clinical and genetic data (CYP2C9 and VKORC1 polymorphisms) from 377 patients treated with warfarin were used. The final prediction model was based on 23 variables selected by TWIST^® system within a bipartite division of the data set (training and testing) protocol. Results: The ANN algorithm reached high accuracy, with an average absolute error of 5.7 mg of the warfarin maintenance dose. In the subset of patients requiring ≤21 mg and 21–49 mg (45 and 51% of the cohort, respectively) the absolute error was 3.86 mg and 5.45 with a high percentage of subjects being correctly identified (71 and 73%, respectively). Conclusion: ANN appears to be a promising tool for vitamin K antagonist maintenance dose prediction.

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References

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Published online 16 December 2013

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The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

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The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.

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Prediction of optimal warfarin maintenance dose using advanced artificial neural networks

Abstract

References