Friday, November 30, 2012

Google Flu Trends

Flu Trends in Norfolk, Virginia.

The dark blue line is the Google "estimate" based upon evaluation of search terms.  The lighter colors represent past year efforts.

This is from the Google Flu Trends website.

The MedBiquitous Consortium

Just came across this organization, MedBiquitous.

The MedBiquitous Consortium develops IT standards for healthcare education and quality improvement.

According to their website:


Founded by Johns Hopkins Medicine and leading professional medical societies, MedBiquitous is a not-for-profit, international group of professional associations, universities, commercial, and governmental organizations seeking to develop and promote technology standards for the health professions that advance lifelong learning, continuous improvement, and better patient outcomes. MedBiquitous is accredited by the American National Standards Institute (ANSI) to develop information technology standards supporting the health professions.
MedBiquitous members are creating a technology blueprint for advancing the health professions. Based on XML and Web services standards, this blueprint will weave together the many activities, organizations, and resources that support the ongoing education and improvement of healthcare professionals. Ultimately, this blueprint will seamlessly support the learner in ways that will improve patient outcomes and simplify the administrative work associated with lifelong learning and continuous improvement.
  Their standards and development efforts include work in the following areas:
  • Activity Reporting
  • Competencies
  • Curriculum Inventory
  • Educational Achievement
  • Educational Trajectory
  • Healthcare Learning Object Metadata
  • Medical Education Metrics
  • Performance Framework
  • Professional Profile
  • SCORM for Healthcare
  • Virtual Patients

Friday, November 9, 2012

How Visualization Can Enable Understanding

The good folks at the Texas Advanced Computing Center (TACC) have developed an animation that helps to communicate the science of "vulnerable plaques" to the doctors, scientists, students, industry professionals and patients who need to understand it.

Two-thirds of all heart attacks are caused by something known as vulnerable plaques, which are fatty lipid pool deposits in the inner layer of the arterial wall.

This work was accomplished with the help of sophisticated visualization expertise and techniques from TACC and their Faculty Innovation Center.

"Modeling these very complicated systems involves solving millions of equations each time step, and for millions of time steps, so the computational burden is enormous," Hughes said. "For a computational institute like ICES, having an advanced computing center like TACC available is a platform for all of our research," said Thomas Hughes, a professor at The University of Texas at Austin's Institute for Computational and Engineering Sciences.

Read more here.

From http://www.tacc.utexas.edu/news/press-releases/2012/tacc-aids-cardiovascular-disease-research

Monday, November 5, 2012

Paul Boom: The Psychology of Everything

While there is no mention of medical modeling and simulation in this video, this quick but thorough introduction to psychology is definitely worth the 43 minutes it will take you to watch it.  I find it important to understand the base reasons behind why people like or dislike certain things, and what motivates people.  Dr. Bloom excels at reducing this information into layman's terms in this video.


Tuesday, October 23, 2012

Design is Problem Solving - Emphasizing the Problem

Puzzle piece
Puzzle piece (Photo credit: Joey Day)
Are we making "things" on purpose?

Here's a link to a post on Whitney Hess's Blog, "Pleasure and Pain", where she tells the story how important it is to understand what problem you are solving when you bring a new product into the workplace.  I suggest reading her article; however, the crux of the story is that the P&G engineers thought that they were solving a problem by creating a better floor cleaning chemical.  The real problem that people in the home were having, though, was that wet mopping was very messy.  P&G created the Swifter to solve the messiness problem.

Whitney's three principles of problem solving:


  • Process: Define the problem before trying to solve it.
  • People: Ask questions to root out the truth.
  • Purpose: Be obsessed with the problem, not the solution.
This approach is very relevant to the medical modeling and simulation community.  Unlike the Department of Defense (DoD) industry, there is neither a focused effort nor a process helping to derive the needs, or requirements, for new technologies.  While healthcare providers have both evidence-based and theoretical appreciation for the promise of medical modeling and simulation in their workplace, they don't quite yet know for sure what they need.  Even worse, they are challenged to state their needs in a way that can be translated into engineer-speak and made into a "thing".  

I propose that the healthcare community needs to create and embrace a process by which capability gaps are identified, categorized as addressable (or not) via modeling and simulation (because, clearly, all things are not), and codified into a need or requirement that can be used as a basis for discussions about design.

At some level, this will improve the advancement of medical modeling and simulation and the inevitable payoff in improved patient safety.  Making "things" on purpose is the intelligent approach, don't you think? 



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Monday, September 17, 2012

What about training transfer?


Recently published by Advances in Health Sciences Education, “Does training learners on simulators benefit real patients?”  reviews a body of research that has explored the effectiveness of simulator training with regard to training transfer of specific skill-based, rule-based, and knowledge-based clinical tasks. The authors point out that the simulation-based training strategy has been widely adopted in medical schools across Europe and North America without ample research support of both clinical skills transfer and measurable patient benefits.

What may be interesting to discuss here is a parallel line of speculation based on a conflicting premise: Why has it taken medicine so long to embrace simulation-based training in contrast to, for example, the military? In response to this hypothetical, one may venture that medicine requires a new practice to be evidence-based before it is adopted – after all, patient lives are at stake. Therefore, the previous lack of and the current limited body of research supporting clinical training transfer simply have not provided the level of evidence required to prompt widespread acceptance of simulation-based medical training.

That being said, there are fewer and fewer medical schools left that are not incorporating some form of simulation into the curriculum. In “Medical simulation gets real,” Voelker traces the progressive introduction and use of simulation in medical education and training, also highlighting that, “among the greatest challenges for simulation researchers is determining whether simulation training can translate into improved patient outcomes.”  

The papers cited here are only a small sample of those addressing the topic of clinical transfer of skills from simulation-based training. Weigh in below – do you think medicine is “catching up” to the simulation bandwagon?  Do you feel there is enough evidence to support the relatively recent increase in the use of simulation in medical education, perhaps with respect to a given clinical skillset in particular? What areas are particularly lacking when it comes to simulation-based training and studies on resultant patient benefits and why?  

Friday, August 24, 2012

The "Google" Collection of Chemical Reactions

From our friends at Northwestern University in Evanston, Illinois:  
Northwestern University scientists have connected 250 years of organic chemical knowledge into one giant computer network -- a chemical Google on steroids. (Called Chematica, t)his “immortal chemist” will never retire and take away its knowledge but instead will continue to learn, grow and share.

 A decade in the making, the software optimizes syntheses of drug molecules and other important compounds, combines long (and expensive) syntheses of compounds into shorter and more economical routes and identifies suspicious chemical recipes that could lead to chemical weapons.
The Chematica network is unique in that it connects approximately 7 million chemicals with a like number  of chemical reactions.  Essentially, they have linked all known chemical compounds with the reactions between them.  It is a monumental repository of chemical reactions/methods.

Another added value of the project is the development and use of algorithms to search and analyze the data.  This is a very useful capability for the research community.

Details of the system are published in the August 6 issue of Angewandte Chemie.

Chematica is being commercialized, which speaks to the relative maturity of the research and their trust in its capability.

While they are not characterizing Chematica as a model or a simulation, the ability to reference this data may one day be useful to modelers seeking to accurately represent physiological reactions within the human body.  Once again, it's all about the data.

Sunday, August 19, 2012

Digital Health

Why does a blog on medical modeling and simulation collaboration care about the various ways to track one's health via commonly available technology?  Why do we care about electronic health records and other historical information relative to one's health?

It's the data.

Models and simulations are data-hungry tools.  Data is sustenance to models and simulations -- without it, they have nothing to feed the algorithms and queries that make up most models and simulations. For those of us still wrapping our heads around M&S as a tool, think of data this way:

Algebraically, the polynomial X+Y=Z is not a terribly difficult problem -- assuming you have at least two numbers to substitute for X, Y, or Z.  Without at least two numbers - the data - this problem becomes unsolvable.

One of the great but mostly unspoken benefits of electronic health records is the potential to gather and use data from individuals, and in the aggregate, communities that physicians and health professionals can leverage in the increasingly complicated task of diagnosing and treating people accurately and with economy.  Electronic health records, as they exist today, are incomplete and not interoperable.  They certainly don't collect information such as "I felt like crud today" or "I ran six miles today and my left knee hurts and I'm running on 18 month old neutral last running shoes and ....." all which may be useful to a diagnosis.  Most people don't track themselves completely - I'm of the opinion that our personal health memories are mostly founded in personally catastrophic events.

Capturing personal data may appear fairly narcissistic or obsessive-compulsive, but it might play an important role in predicting potential health issues or elaborating upon historical indicators that contribute to issues.  As technology progresses, there is potential for much of the required narcissistic behavior to be replaced by an autonomous collection of much of this data.  I suppose we'll figure out whether we like that or not, down the road.

Photo by Karen Roe/flickr/CC
Wired recently published an interesting article out using technology to track your health.  The article presents a basic blueprint to tracking the things that may help you figure out why you're gaining weight or losing weight or tired or whatever.  Their article also outlines a number of websites that can assist with keeping track of yourself, health-wise.

Something I'm in the process of evaluating is HealthTap.  HealthTap is an online service that matches you with physicians in your area, as well as answers to personal health questions.  According to the site, "HealthTap is for people who want instant access to trusted health information from top doctors."  The site provides you with the opportunity to input a vast quantity of information about your health history as well as input daily information.

While Google Health tanked, the idea was consistent with many of the online or digital oriented health tracking businesses out there.  I would guess that Google will get back into this game further down the road.

What's the benefit of any of these sites, today?  The privilege of being an "early adopter" and digital access to your personal information.  At the NCCMMS, we see these as future assets that, with your permission, we can leverage to verify and validate the performance of analytic and predictive models that   will be used to educate as well as assist with diagnosis and treatment.

Tuesday, August 14, 2012

Healthcare Analytics

According to Wikipedia, Analytics is "the discovery and communication of meaningful patterns in data. Especially valuable in areas rich with recorded information, analytics rely on the simultaneous application of statistics, computer programming and operations research to quantify performance."

Medical modeling and simulation, as an analytic tool or capability, are an integral part of healthcare analytics.  Certainly, data analysis can be performed without models; however, models provide the flexibility to evaluate multiple threads, look for optimizing characteristics, or chase theories, for example.

In my mind, healthcare analytics is a natural extension of medical data analysis enabled by modeling and simulation.

The Promise of Healthcare Analytics article.

Free Report Download


Monday, August 13, 2012

NCCMMS in the News



Thursday, July 26, 2012

Which Airports are Most Contagious? Let's Model It!

The Big Minds at MIT built an interesting model to determine which airports are more likely to support the spread of disease.

Abstract:  The spread of infectious diseases at the global scale is mediated by long-range human travel. Our ability to predict the impact of an outbreak on human health requires understanding the spatiotemporal signature of early-time spreading from a specific location. Here, we show that network topology, geography, traffic structure and individual mobility patterns are all essential for accurate predictions of disease spreading. Specifically, we study contagion dynamics through the air transportation network by means of a stochastic agent-tracking model that accounts for the spatial distribution of airports, detailed air traffic and the correlated nature of mobility patterns and waiting-time distributions of individual agents. From the simulation results and the empirical air-travel data, we formulate a metric of influential spreading––the geographic spreading centrality––which accounts for spatial organization and the hierarchical structure of the network traffic, and provides an accurate measure of the early-time spreading power of individual nodes.

Link to the Journal Article titled "A Metric of Influential Spreading during Contagion Dynamics through the Air Transportation Network"

Monday, July 23, 2012

$2.54 Trillion Spent on Healthcare in 2010

Want to know how the U.S. stacks up against the rest of the world relative to health/healthcare?  Check out the information at the Organisation for Economic Co-operation and Development (link below).

For instance, in 2010, we spent 17.6% of our GDP on healthcare.  


Who else spent a lot?  The Netherlands (12%) -- and they mandate the purchase of at least basic health insurance.

In 2010, our GDP was $14.4471 Trillion.  That's $2.54 TRILLION spent on healthcare in the US in 2010.

For comparison, The Netherlands GDP in 2010 was $774.2289 Billion, so they spent $92 Billion on healthcare in 2010.


Graphical comparison of the GDPs.  Red is the US.  Blue is The Netherlands.




Data from here, here, and other publicly available sources.



Computational Biology Model of Mycoplasma genitalium

It is interesting to think that it is 2012 and researchers are just now finishing a computer model of an organism -- in this case, the tiny parasite Mycoplasma genitalium.  We are quite a way from a complete model of a human being - much less an individualized model.  That said, steps like these are critical to advancing the science to that level.


From Stanford University:

In a breakthrough effort for computational biology, the world's first complete computer model of an organism has been completed, Stanford researchers reported last week in the journal Cell.

By encompassing the entirety of an organism in silico, the paper fulfills a longstanding goal for the field. Not only does the model allow researchers to address questions that aren't practical to examine otherwise, it represents a stepping-stone toward the use of computer-aided design in bioengineering and medicine. Link to the original article.

Friday, July 20, 2012

Why Medical Modeling Has Skeptics




This is an insightful article that presents several key reasons why biologists are skeptical of biomedical models.  These same issues and factors can probably be applied to just about every other healthcare area.   The usage trends in medical modeling and simulation are towards training and education, rather than community or individual care (regressive and predictive  models) because (I believe) there is an inherent distrust in mathematical models of soft tissue systems.

"Though few biologists or physicians will admit to skepticism (we couldn’t get any card-carrying skeptics to go on record for this story), modelers claim that skepticism is near-universal—popping up in grant evaluations, paper reviews, and interactions with experimentalists. “I have encountered a tremendous amount of skepticism for modeling,” says Grace Peng, PhD, a program director at the National Institute of Biomedical Imaging and Bioengineering.



Modelers may assume that the problem of skepticism rests solely with experimentalists. But, in fact, modelers play an enabling role—in the way they treat non-modelers, present their results, and even build their models. Thus, overcoming skepticism is as much about changing the culture of modeling as it is about changing the minds of biomedical researchers.


It also turns out that skepticism is heterogeneous. The degree of skepticism varies greatly across different fields of biology and medicine; and skeptics themselves come in many different flavors. Different kinds of skepticism have diverse origins and may present unique obstacles for modelers. This article disentangles the different types of skeptics and suggests what modelers can learn from each."


Meet the Skeptics: Why Some Doubt Biomedical Models - and What it Takes to Win Them Over


Monday, July 16, 2012

MedGadget.com

Here's an interesting site for those of us who care about medical device development in the greater sense (not directly focused on modeling and simulation based tools).  It's MedGadget.com.  From the site:

Medgadget is an independent journal of the latest medical gadgets, technologies and discoveries.  Our website is written, edited and published by a group of MDs and biomed engineers.
This may be a helpful reference and review site for developers of medical modeling and simulation training and education tools.  Remember -- almost every tool and gadget requires some level of training in order to create a truly proficient user.  

Tuesday, June 12, 2012

NCCMMS Awarded $600,000 Grant

A $600,000 grant from the Commonwealth of Virginia's Office of Economic Adjustment (OEA) will help the National Center for Collaboration in Medical Modeling and Simulation (NCCMMS) – a joint venture of Eastern Virginia Medical School (EVMS) and Old Dominion University's Virginia Modeling, Analysis and Simulation Center (VMASC) – extend its partnership in medical modeling and simulation into vital new areas.

Link to original story.

Link to NCCMMS Website.


Founded in 2001 as a joint venture of EVMS and ODU, NCCMMS has worked in several areas of medical modeling and simulation collaboration, including creating an informational database specific to medical modeling and simulation available online at www.medicalmodsim.com. The Center has also helped encourage collaboration between the physicians of EVMS and the engineers of ODU and VMASC.

The Center is under the co-direction of C. Donald Combs, PhD, Vice President and Dean with the School of Health Professions at EVMS and John Sokolowski, PhD, Executive Director of VMASC.


"We are focused on making Hampton Roads, and specifically ODU and EVMS, the nationwide leaders in medical modeling and simulation technology, training and research," Dr. Sokolowski says. "The components to make this happen are already in place."


The opportunities are immense. "The U.S. spends over $2.7 trillion on healthcare," says Dr. Combs. "That's more than the rest of the world spends, combined, and our system isn't ranked number one." He noted that medical modeling and simulation is one technology that can help to reduce costs and improve patient safety by reducing medical errors and ensuring career-long procedural competence.


The NCCMMS recently established a Board of Advisors, which provides expert advice from nationally recognized, interdisciplinary leaders in medical M&S and related fields. The Board is focused on growing the capability, capacity and impact of NCCMMS, locally and nationally.


With this new OEA grant, NCCMMS is investing in two initiatives to help position Hampton Roads as the leader in medical modeling and simulation research and information sharing.


The first initiative is the Laboratory for Investigation, Validation and Verification of Emerging Simulators (LIVES). LIVES aims to be the "Consumer Reports" of medical modeling and simulation devices and software, providing independent testing and assessment so medical entities have an unbiased view of these kinds of tools. This is a service not currently provided within the medical community. The goal is for the users and purchasers of these devices to purchase the reports provided by LIVES.


"LIVES is critical to ensuring that medical simulator investment decisions are influenced by unbiased fact" says Dr. Combs. "Purchasing the right medical training simulator to meet your needs will ultimately result in improved patient safety, which is our main emphasis." NCCMMS is currently developing the testing process and protocols to evaluate medical simulators.


The grant funding also established The SimLab, a new research capability that aims to act as a hub for collaborative medical modeling and simulation research. It is modeled on The Media Lab at the Massachusetts Institute of Technology. The SimLab will conduct basic research in medical modelng and simulation in order to solve problems presented by the sponsoring membership of industry partners and the medical community at large. The SimLab will also seek to commercialize their research, further fostering partnerships between academia and the private sector.


The timing of the OEA grant was ideal. The modeling and simulation industry in Hampton Roads has for the past decade been focused on diversifying modeling and simulation research away from its beginning domain of military applications into a host of multidisciplinary fields – from transportation, to health care, to emergency preparedness.


With more than 10 years of collaboration already in place between researchers from ODU and EVMS, leading to numerous innovations such as the virtual operating room and virtual pathology stethoscope, this region is poised to play a significant role in the introduction of even more modeling and simulation innovations into the $2.7 trillion annually that the United States spends on health care.


NCCMMS is seeking to provide a vital resource in helping this country use its health care dollars more efficiently and effectively.

Friday, May 25, 2012

NCCMMS Blog is online

As we continue to cultivate the National Center for Collaboration in Medical Modeling and Simulation, or NCCMMS, I will be posting information to this blog as a secondary form of info dissemination.

We have a website that is currently undergoing massive overhaul, along with the rest of the Eastern Virginia Medical School website.  You can find us here:  http://www.evms.edu/nccmms

I have also posted concept maps to a public server.  These maps help to break down NCCMMS conceptually.  You can find the maps here:  http://bit.ly/JPIBy6.

Stay tuned for more updates.

Bob