Mean Exposure Does Not Validate Target Attainment Predictions in Children [Response to Letter]

Dear editor

We thank the author for the thoughtful comments on our article.1 We agree that mean prediction accuracy alone does not establish threshold attainment probabilities, which depend on the predictive distribution near decision thresholds. The requested distributional validation is limited by the scarcity of pediatric real-world data, particularly repeated individual trough concentrations stratified by age and meal intake. As noted in our article, the simulated 90% intervals were wider than observed variability. Accordingly, we agree that the reported attainment rates and statements that specific meals are necessary or sufficient should be considered simulation-based hypotheses pending validation in independent pediatric datasets. We also acknowledge that further data are needed to validate the practical application of the model, as we have stated in the Discussion and Conclusion sections of our article. We appreciate the opportunity to clarify this point.

Disclosure

The author has no conflicts of interest to declare regarding the content of this communication.