NextDose: A web-based Bayesian dose forecasting tool

 

Getting Started

 

Patient details such a patient identifier, sex and genotype that do not change with time may be entered here. Age at entry or date of birth are entered as well so that patient age can be calculated. If age is less than 1 year then you will be asked to enter gestation age (enter 40 weeks if you donít know).

 

After selecting a medicine you can then enter basic observations to calculate an initial dosing scheme then enter dose and response observations to calculate a follow up dosing scheme. Basic observations include things like weight, height, serum creatinine that may change with time. They are not response observations like drug concentration or INR. Basic observations are also known as covariates and response observations are also known as dependent variables.

 

There are two fundamental steps (FirstDose, NextDose) when using NextDose. A quick start overview of the process is shown here:

 

1.           Add a patient by clicking on the + at the side of the Find Patient box.

2.           Enter patient details.

3.           Add a medicine by clicking on the + at the side of the Add a new medicine box.

4.           Add weight as an observation. Weight is a basic observation that is always required.

5.           The FirstDose step -- predict an initial dosing scheme by clicking on Results (top menu) and Calculate (blue button) (use the default choices until you get more comfortable).

a.      You will see dosing recommendations (loading dose and maintenance dose) and a graph of predicted values such as concentrations.

b.     The dosing recommendations and graph are based on the patient details and basic observations you entered.

6.           Return to the Doses and Observations page.

7.           Enter one or more doses.

8.           Enter one or more response observations such as drug concentration or INR.

9.           The NextDose step -- predict a follow up dosing scheme by clicking on Results (top menu) and Calculate (blue button) (use the default choices until you get more comfortable).

a.      You will see dosing recommendations (loading dose and maintenance dose) and a graph of predicted values such as concentrations.

b.     The dosing recommendations and graph are based on the doses and the response observations you entered.

10.         Each time you change the doses, basic or response observations a new instance of the patient data is created. These can be accessed through the menu of dates and times on the left hand side of the NextDose window.

 

 

Getting Started with Pictures

 

There are two fundamental steps (FirstDose, NextDose) when using NextDose. An overview of the process is shown here with screen images:

 

1.    Add a patient by clicking on the + at the side of the Find Patient box.

 


2.           Enter patient details. When finished click Save Changes.

 


 

3.           Add a medicine by clicking on the + at the side of the Add a new medicine box.

 


4.           Add weight as an observation. Weight is a basic observation that is always required.

 


5.           The FirstDose step -- predict an initial dosing scheme by clicking on Results (top menu)

 


and Calculate (blue button) (use the default choices until you get more comfortable).

 


a.      You will see dosing recommendations (loading dose and maintenance dose) and a graph of predicted values such as concentrations.

 


b.     The dosing recommendations and graph are based on the patient details and basic observations you entered.

 

6.           Return to the Doses and Observations page.

 


7.           Enter one or more doses. Be sure to enter a suitable date and time for each dose. When given by infusion you should enter the infusion duration.

 


8.           Enter one or more response observations such as drug concentration or INR. It is important that you enter the date and time of the observations correctly relative to the previous dose(s).

 



9.           The NextDose step -- predict a follow up dosing scheme by clicking on Results (top menu) and Calculate (blue button) (use the default choices until you get more comfortable).

 


a.      You will see dosing recommendations (maintenance dose) and a graph of predicted values such as concentrations.

 


b.     The dosing recommendations and graph are based on the doses and the response observations you entered.

 

 

10.         Each time you change the doses, basic or response observations a new instance of the patient data is created. Each instance can be accessed through the menu of dates and times on the left hand side of the NextDose window.

 

 

Copyright All rights reserved | Developed by Sam Holford & Nick Holford 2012-2019