By Roland Piquepaille
In "'Dr. Data' Digitizes Medical Care," Karen Southwick says that "David Eddy's Archimedes software dares to turn human heartbeats into the ones and zeros of the digital age -- and, just maybe, the nation's healthcare system on its ear."It sounds pretty ambitious, so let's look at some details.
David Eddy has built a complex software program he calls Archimedes, named for the ancient Greek mathematician who boasted he could move the world with a single lever. The software model, for the first time in medical history, uses mathematical algorithms and equations to translate the beat of a heart or the twitch of a muscle into the ones and zeros of the Digital Age, replicating in numbers the behavior of a disease and creating a "virtual reality" in which patients, providers and institutions interact as they would in the real world.
Put simply, Archimedes is to doctors what airline cockpit simulation software is to pilots -- a way to manipulate the variables of human behavior and environment to mimic real-life outcomes. The model can analyze everything from the onset of disease in the cells of the pancreas to the number of parking lots in the medical center complex -- and the need for more lots five years from now. In other words, it's a complete model of systems as well as patients and diseases.
Southwick also wrote a companion story, "How Archimedes Works," which gives more technical explanations about this software developed by the Biomathematics Unit of Kaiser Permanente's Care Management Institute.
Differential equations and algorithms -- written by Leonard Schlessinger, head of the Biomathematics Unit, and his team -- describe the anatomy, physiology and progress of diseases. For example, coronary artery disease is modeled as the gradual blockage of the arteries. Equations calculate the location and extent of the blockage the occurrence of symptoms; and the outcomes of the disease, based on data from epidemiological studies and clinical trials. Algorithms model the actions of patients and caregivers: patient behavior in seeking care; the performance of tests and treatments by physicians.
Archimedes lets researchers try different treatments or change the processes of care for a disease and then explore the effects. For the four diseases it models so far, Archimedes creates thousands of simulated "people" at risk of getting or who already have a condition. These "people," each with different characteristics, grow older, get diseases, interact with the healthcare system, and live with (or die of) their diseases in similar fashion to populations in the real world.
And what do you need to run Archimedes?
Archimedes uses 200 Pentium 3 and Pentium 4 computers running on Windows 2000. The grid computing software is supplied by United Devices Inc. According to Schlessinger, Archimedes running on a single PC takes about 40 hours to simulate a diabetes trial; it takes less than an hour using the grid. Eddy is working on making a version that is accessible over the Web available in the next two years.
Source: Karen Southwick, for CIO Insight, April 17, 2003
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