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Computational Technology for Effective Health Care: Immediate Steps and Strategic Directions
5.2 OTHER REPRESENTATIVE RESEARCH CHALLENGES
In addition to patient-centered cognitive support, there are for the computer science community many other interesting research challenges relevant to health care. Several examples are provided to illustrate this main point, but there are indeed many more that are not covered in this report.
One aspect of the “virtual patient” in Section 5.1 involves modeling various subsystems within a real patient (e.g., different organs, digestive system, and so on) to show how they interact.9 Such models might operate on different or variable timescales—a model focusing on the absorption of nutrients through the digestive system might operate on a timescale of hours, whereas a model focusing on skeletal health, calcium depletion, osteoporosis, or particular bones might operate over years. Similarly, some models might represent molecular interactions, and others might represent particular cells, organs, or organisms.
To first order, the physiological subsystems of all human beings are identical. Thus, a sensible approach to modeling subsystems in a specific patient is to appropriately parameterize a generic model of those subsystems. But finding appropriate parameterizations for any given model and coupling the different models and the data to drive them pose significant intellectual challenges. Some insight into model interoperability can be gained through the use of ad hoc techniques (e.g., XML-based “mash-ups” [Web applications that combine data from multiple sources] used in Web 2.0 applications) or through other existing component frameworks, but the overall problem of model interoperability for health care purposes is vastly more complex than applications that have been tackled before.
Progress is being made in understanding specific metabolic pathways.10 The effects of a medication, as well as of some other treatments, are candidates for modeling. Such models will still require many of the parameters used to manage and classify the data.11 Genetic makeup,
The notion of a computational virtual human being that would provide a high-fidelity computational model of a human being that would respond realistically to various stimuli is not new. See, for example, “The Virtual Human Project: An Idea Whose Time Has Come?,” Oak Ridge National Laboratory Review 33(1), 2000.
See, for example, PharmGKB, a project to curate information that establishes knowledge about the relationships among drugs, diseases, and genes, including their variations and gene products, available at http://www.pharmgkb.org/.