Three patients. Three different calulations. Three different answers.
In 2022, Dr. Lena Hartmann was running PK modeling for a carboplatin re-dosing study at Dana-Farber. The protocol called for individualized AUC targeting using Calvert's formula. What she found was that three different clinical pharmacologists at the same institution were applying different creatinine clearance estimation methods, resulting in dose recommendations that varied by as much as 22% for the same patient.
None of the three answers was wrong by the letter of the protocol. All three were defensible. But two of them put the patient outside the target AUC band. When she looked at the published literature on Calvert-derived dosing in relapsed ovarian cancer, the average AUC target attainment rate in TDM-naive sites was 61.4%.
She built a spreadsheet. Then a MATLAB script. Then, in late 2023, she co-founded DoseMind with two colleagues from the clinical pharmacology team at HMS to replace the spreadsheet with something a clinical research coordinator could actually use.
