News Column

Computers could map a cure

June 21, 2014

APATIENT is rushed to hospital after a severe stroke. Immediate |action is needed to |return blood to the affected part of their brain; without it, they may suffer brain damage or die.

Poised to begin surgery, doctors are warned by real-time computer simulations showing how the blood is flowing around the patient's brain that the consequences of their actions could be dire. Equipped with this information, they change course and the patient survives.

Such a scenario, in which computers are relied upon to make calculations that even the best brain surgeon could not, sounds fantastical. But this is exactly the sort of medical advance the authors of a groundbreaking new book argue is within touching distance.

Computational Biomedicine: Modelling the Human Body is the world's first textbook dedicated to the direct use of computer simulation in the diagnosis, treatment or prevention of a disease. It claims such technology will be "integral" to the way clinical decisions are made in operating theatres by the end of this century.

Arguing that medicine is "on the verge of a radical transformation driven by the inexorably increasing power of |information technology", it predicts that drugs will soon be selected on the basis of an individual patient's "digital profile", so treatments can be tailor-made to suit them.

One of the book's authors is Professor Peter Coveney, director of the University College London Centre for Computational Science. He argues that the very fact of its publication proves the discipline has moved beyond theory and should be embraced by doctors.

"It's no longer just a research activity, it's getting to the stage where one can write a textbook and say 'this is the way things work in this field' without being overly detailed and niche."

Recent advances in computer-simulated medicine were discussed last month at a conference at the University of Sheffield, where the Insigneo |Institute was founded a year ago.

It comprises 123 academics and clinicians working towards a grand European Commission-backed project known as the Virtual Physiological Human: a computerised replica of the |human body that will allow the virtual testing of treatments on patients based on their own specific needs.

Coveney describes this as "the equivalent for the human body of Google Earth".

"You could have a personalised body map and you could be in charge of managing that and interrogating it," he said.

The creation of a virtual |human is many years away. But scientists have used images of a patient's heart to build virtual arteries, with which they can accurately predict the effectiveness of an operation, such as the insertion of a stent, used to treat heart disease.

"It's going to be incremental. But you should be able to build it up so that there are useful components of it along the way," Coveney said of the virtual human project.

"As soon as you start digitising, there are applications."

But there's a problem with computerised medicine: to work properly, it needs patient data and lots of it. Public trust in this area has been damaged by the troubled history of health data projects.

Every scandal is a major setback for the field of virtual medicine, says Coveney. But he believes if patients were handed the power to manage their own data, they would soon view it as no more sensitive than internet banking.

"You have patients' groups who lobby against data being made available but they are often much more conservative on behalf of the patients than the patients as individuals are," he said.

"A lot of patients are willing to provide their data if you ask them, if there's even a part of a chance it might help to cure them."

One of Coveney's colleagues is Derek Groen, a post-doctoral researcher whose work models the blood flow in a patient's brain. Tapping away on his keyboard at UCL's central London campus, Groen is able to communicate with Archer, the UK's most powerful supercomputer. Based at the University of Edinburgh, it is capable of more than a million billion calculations a second, allowing it to complete the modelling of a patient's blood flow with ease.

The use of supercomputers is vital in this type of work, but not all of them are in the UK. In the future, says Coveney, this could throw up thorny ethical dilemmas. If a computer in the US makes calculations that result in the death of a patient in the UK, could it be held liable?

Although his PhD was in |astrophysics, Groen prefers his current work - it could, after all, directly benefit people in the short term. - The Independent on Sunday

Saturday Star

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Source: Saturday Star (South Africa)

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