Digital Patient

A modern guide to computational models and constructive simulation for personalized patient care using the Digital Patient

The healthcare industry's emphasis is shifting from merely reacting to disease to preventing disease and promoting wellness. Addressing one of the more hopeful Big Data undertakings, The Digital Patient: Advancing Healthcare, Research, and Education presents a timely resource on the construction and deployment of the Digital Patient and its effects on healthcare, research, and education. The Digital Patient will not be constructed based solely on new information from all the "omics" fields, which includes systems analysis, Big Data, as well as the various efforts to model the human physiome and represent it virtually. The Digital Patient will be realized through the purposeful collaboration of patients as well as scientific, clinical, and policy researchers, from both their own research and through the development of an effective framework into which their research will fit.

The Digital Patient: Advancing Healthcare, Research, and Education addresses the international research efforts that are leading to the development of the Digital Patient, the wealth of ongoing research in systems biology and multi-scale simulation, and the imminent applications within the domain of personalized healthcare. Chapter coverage includes:

The visible human
The physiological human
The virtual human
Research in systems biology
Multi-scale modeling
Personalized medicine
Self-quantification
Visualization
Computational modeling
Interdisciplinary collaboration
The Digital Patient: Advancing Healthcare, Research, and Education is a useful reference for simulation professionals such as clinicians, medical directors, managers, simulation technologists, faculty members, and educators involved in research and development in the life sciences, physical sciences, and engineering. The book is also an ideal supplement for graduate-level courses related to human modeling, simulation, and visualization.

Auteur

C. Donald Combs, PhD, is Vice President and Dean of the School of Health Professions at Eastern Virginia Medical School and is also a senior faculty member in the Department of Modeling, Simulation, and Visualization Engineering at Old Dominion University.

John A. Sokolowski, PhD, is Associate Professor and Executive Director of the Virginia Modeling, Analysis, and Simulation Center at Old Dominion University.

Catherine M. Banks, PhD, is Research Associate Professor at the Virginia Modeling, Analysis, and Simulation Center at Old Dominion University.

Échantillon de lecture
1
THE DIGITAL PATIENT

C. Donald Combs

School of Health Professions, Eastern Virginia Medical School, Norfolk, VA, USA

Whatever we do together is pure invention,
The maps they gave us were out of date by years.

-Adrienne Rich, 21 Love Poems

"Men's courses will foreshadow certain ends, to which, if persevered in, they must lead," said
Scrooge."But if the courses be departed from, the ends will change."

-Charles Dickens, A Christmas Carol

It is, perhaps, odd to begin a book about a highly technical subject, the Digital Patient, with quotations from a poem and a book that, in very different ways, confront the vagaries of relationships. Then again, perhaps it is not so odd after all. Rich identifies the reality that relationships change and head in unexpected directions and that, often, what we thought was settled turns out to be in flux. Dickens describes the inevitable intertwining of past, present, and future in a hopeful homily. Imagine if we could all, without the ghosts, have the opportunity to revisit our past, understand clearly how it affects the present, and realize that the future can be changed into a more rounded, healthier human experience. In its essence, that is what the Digital Patient entails-the development of an evolving foundation for a better future in terms of personal and population health, in the validity of biological and social research, and in the development of more effective drugs and devices.

Dickens' story is a useful metaphor because it invokes the passage of time and describes that passage within a social context. Incorporating those two factors, time and social context, into the discussion of the Digital Patient foreshadows the emergence of an infinite array of applications that will advance our understanding of health and the factors affecting its realization. This introductory chapter provides some historical context for the concept of a Digital Patient, refines the definition to reflect explicitly the impact of the emerging fields of systems biology and computational physiology, and provides a rationale for the chapters that follow. The chapter draws heavily from the writings of Vanessa Díaz-Zuccarini, Peter Hunter, Robert Hester, Leroy Hood, Richard Satava, Peter M. A. Sloot, and other chapter authors. It draws as well from the research conducted by hundreds of international researchers who address topics important to the Digital Patient as diverse as Big Data, the human physiome, systems biology, human behavior, multiscale modeling and simulation, ontologies in healthcare, and Bayesian analysis.
HEALTH, THE GOAL

The most widely accepted definition of health is the one developed by the World Health Organization: Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity [1]. The definition applies to individuals and to populations. From a societal perspective, achieving the goal of health, both individually and as a whole, is why we fund (through both public and private sources) research and development efforts in the domains related to the Digital Patient.
PERSONALIZED MEDICINE

Historically, understanding in detail and with certainty what is going on within the human body has been an elusive quest. Partial glimpses and general understanding are the best we have been able to do with the data we have at our disposal and within the limitations of population-normed theories of what the data mean for the diagnosis and treatment of individuals. In the not-too-distant future, however, that will change as the Digital Patient is developed. The capacity to measure one's personal physiological and social metrics, compare those metrics with the metrics of millions of other humans, personalize needed therapeutic interventions, and measure the resultin

Contenu
List of Contributors xiii Preface xvii

Part 1 The Vision: The Digital PatientImproving Research, Development, Education, and Healthcare Practice 1

1 The Digital Patient 3
C. Donald Combs

Health, The Goal, 4

Personalized Medicine, 4

The Best Outcomes, 5

The Emergence of the Digital Patient, 5

The Human Physiome, 6

Enabling the Digital Patient, 8

P4 Medicine, 11

Conclusion, 11

References, 12

2 Reflecting on Discipulus and Remaining Challenges 15
Vanessa Díaz?]Zuccarini, Mona Alimohammadi, and César Pichardo?]Almarza

Introduction, 15

A Brief Contextual Background and a Call for Integration: Personalized Medicine is Holistic, 16

The Many Versions of the Digital Patient: On the Road to Medical Avatars, 18

Discipulus: The Digital Patient Technological Challenges and Main Conclusions, 19

The Remaining Challenges and Big Data, 24

Conclusion, 25

References, 26

3 Advancing the Digital Patient 27
Catherine M. Banks

Introduction, 27

The Digital Patient: Its Early Start, 28

Engaging the Digital Patient, 30

Conclusion, 31

4 The Significance of Modeling and Visualization 33
John A. Sokolowski and Hector M. Garcia

Introduction, 33

Modeling a Complex System: Human Physiology, 34

Medical Modeling, Simulation, and Visualization, 35

Modes and Types of Visualization, 40

Visu…