In this episode, I’ll discuss Monte Carlo simulations.
A Monte Carlo Simulation in the context of healthcare uses software to simulate thousands of patients from smaller sample sizes to provide a more robust prediction of an event. The term Monte Carlo is taken from a casino in Monaco and was used as a code word for the technique as it was used during the Manhattan Project.
Monte Carlo Simulations are commonly employed in pharmacokinetic studies of antibiotics in critical illness when data from large numbers of patients can be hard to obtain. In one study, 8 patients with cystic fibrosis being treated with ceftaroline each had two blood levels of ceftaroline drawn. From these 16 blood levels, patient-specific pharmacokinetic properties were estimated. From these properties, 10,000 simulated patients were evaluated to determine the pharmacodynamic probability of target attainment for ceftaroline in adults with cystic fibrosis.
It is not as hard as it sounds to create your own Monte Carlo simulation. Simple Monte Carlo Simulations can be performed using Microsoft Excel, Apple Numbers or Google Sheets. I have used Monte Carlo Simulations in two previous episodes: In episode 195 to evaluate the probability of allometric vancomycin dosing achieving a target AUC:MIC ratio, and episode 186 to evaluate the risk of anesthetic awareness when giving rocuronium before ketamine (rocketamine) in rapid sequence intubation.
I have a template for running your own Monte Carlo simulations in my free download area. You can access this template at pharmayjoe.com/free, it’s number 12 on the list.
If you like this post, check out my book – A Pharmacist’s Guide to Inpatient Medical Emergencies: How to respond to code blue, rapid response calls, and other medical emergencies.