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Document Type:Latin Dissertation
Language of Document:English
Record Number:54621
Doc. No:TL24575
Call number:‭NR02803‬
Main Entry:Waseem Sharieff
Title & Author:Translating human physiological mechanisms to predict clinical outcomes via computer simulationWaseem Sharieff
College:University of Toronto (Canada)
Date:2005
Degree:Ph.D.
student score:2005
Page No:208
Abstract:Background. Iron deficiency is the most common preventable nutrition problem in developing countries today. Enough is known about iron metabolism that a computer model should be able to predict individual responses to iron supplementation. If construction of such a valid model was possible, this could obviate the need for further large and expensive randomized clinical trials (RCTs) to determine effectiveness of various dosing schemes of iron. Objective. To accurately predict hemoglobin (Hb) and serum ferritin (SF) concentrations in individuals taking iron supplements, using knowledge of iron metabolism and data from previous studies. Methods. We used computer simulations and data from previous studies including 3 recently completed studies in Ghanaian children. Of these, two measured iron absorption from 30 and 45 mg of iron; the third measured change in Hb concentrations in a cohort which received 80 mg of iron for 2 months. We used summary statistics and quantile-quantile (QQ plots to compare model-predicted Hb and SF concentrations to actual values in two cohorts from a study in China. One cohort received 30 mg of iron five-days-a-week for 3 months; the other received 30 mg of iron weekly for 3 months. Finally, we tested the sensitivity of the model by comparing model-predicted Hb and SF concentrations to actual values of children with recurrent diarrhea in Pakistan; two cohorts in this study received 30 mg of iron daily for 2 months. Results. The model closely replicated values of the first three studies. For China, the model-predicted means for Hb and medians for SF were within 2 μg/L and 3 μg/L of the corresponding observed values, respectively. On QQ plots, the observed and predicted quantiles were within 5 g/L for Hb and 10 μg/L for SF concentrations. Similar results were observed for the Pakistan study. Conclusion. Our model of iron metabolism can accurately predict Hb and SF concentrations following iron supplementation in real life settings and is not sensitive to common childhood illnesses such as uncomplicated diarrhea; the model can thus obviate the need for repeating large and expensive RCTs in multiple settings to determine effectiveness of a given dosing scheme.
Subject:Health and environmental sciences; Applied sciences; Clinical outcomes; Health care; Biomedical research; Developing countries--LDCs; Simulation; Studies; 0541:Biomedical research; 0769:Health care
Added Entry:University of Toronto (Canada)