Translating human physiological mechanisms to predict clinical outcomes via computer simulation.
Published: 2005
Language: eng
Number of pages: 208
Description: 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.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.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 mug/L and 3 mug/L of the corresponding observed values, respectively. On QQ plots, the observed and predicted quantiles were within 5 g/L for Hb and 10 mug/L for SF concentrations. Similar results were observed for the Pakistan study.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.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.
Notes: Thesis (Ph.D.)--University of Toronto, 2005.

Electronic version licensed for access by U. of T. users.

Source: Dissertation Abstracts International, Volume: 66-06, Section: B, page: 3037.