Development and evaluation of the comment aid system for therapeutic drug monitoring. I. Application to valproate

A comment aid system for therapeutic drug monitoring (TDM), which produces the primary comment on the dosage regimen of valproate, was developed. This system produces consulting comments with a fuzzy theory, by using the dosage regimen of valproate, pharmacokinetic parameters estimated by the Bayesian method, and therapeutic effect and toxicity of anticonvulsants evaluated by the physician. For nearly 90% in 42 cases, comments of the system were agreeable comparing with the notes of TDM technologists. There are a few disagreements between this system and experts, mainly because the system does not use enough information about combination therapy with other anticonvulsants. Developed comment aid system shows some clinical and educational utility, and suggests significance and possibility of more useful and allround TDM expert system. Then this system might be available as a prototype of the TDM expert system.