Computational medicine, present and the future: obstetrics and gynecology perspective.

Medicine is, in its essence, decision making under uncertainty; the decisions are made about tests to be performed and treatments to be administered. Traditionally, the uncertainty in decision making was handled using expertise collected by individual providers and, more recently, systematic appraisal of research in the form of evidence-based medicine. The traditional approach has been used successfully in medicine for a very long time. However, it has substantial limitations because of the complexity of the system of the human body and healthcare. The complex systems are a network of highly coupled components intensely interacting with each other. These interactions give those systems redundancy and thus robustness to failure and, at the same time, equifinality, that is, many different causative pathways leading to the same outcome. The equifinality of the complex systems of the human body and healthcare system demand the individualization of medical care, medicine, and medical decision making. Computational models excel in modeling complex systems and, consequently, enabling individualization of medical decision making and medicine. Computational models are theory- or knowledge-based models, data-driven models, or models that combine both approaches. Data are essential, although to a different degree, for computational models to successfully represent complex systems. The individualized decision making, made possible by the computational modeling of complex systems, has the potential to revolutionize the entire spectrum of medicine from individual patient care to policymaking. This approach allows applying tests and treatments to individuals who receive a net benefit from them, for whom benefits outweigh the risk, rather than treating all individuals in a population because, on average, the population benefits. Thus, the computational modeling-enabled individualization of medical decision making has the potential to both improve health outcomes and decrease the costs of healthcare

Modeling good research practices - overview: a report of the ISPOR-SMDM modeling good research practices task force - 1.

Models—mathematical frameworks that facilitate estimation of the consequences of health care decisions—have become essential tools for health technology assessment. Evolution of the methods since the first ISPOR modeling task force reported in 2003 has led to a new task force, jointly convened with the Society for Medical Decision Making, and this series of seven papers presents the updated recommendations for best practices in conceptualizing models; implementing state–transition approaches, discrete event simulations, or dynamic transmission models; dealing with uncertainty; and validating and reporting models transparently. This overview introduces the work of the task force, provides all the recommendations, and discusses some quandaries that require further elucidation. The audience for these papers includes those who build models, stakeholders who utilize their results, and, indeed, anyone concerned with the use of models to support decision making

Research collaboration

AbstractThe complexity and cost of cardiovascular medical care dictate research to deliver high quality and cost-conscious cardiovascular care. This goal is aided by modeling medical decision making. To be useful, the modeling must be based on real data so that the results can serve as a guide to actual practice. It is suggested that a registry of randomized clinical trials and larger data bases in cardiovascular disease and health care delivery be established. The registry would be a resource for those desiring to model decision making. The registry would contain key words allowing retrieval by modelers accessing the registry and would contain contact information for consideration of possible collaborative work. The initiation of such a registry should contain plans for its evaluation to determine whether the registry itself is a cost-effective tool to encourage the needed research

RESULTS AND CHALLENGES OF ARTIFICIAL NEURAL NETWORKS USED FOR DECISION-MAKING AND CONTROL IN MEDICAL APPLICATIONS

The aim of this paper is to present several approaches by which technology can assist medical decision-making. This is an essential, but also a difficult activity, which implies a large number of medical and technical aspects. But, more important, it involves humans: on the one hand, the patient, who has a medical problem and who requires the best solution; on the other hand, the physician, who should be able to provide, in any circumstances, a decision or a prediction regarding the current and the future medical status of the patient. The technology, in general, and particularly the Artificial Intelligence (AI) tools could help both of them, and it is assisted by appropriate theory regarding modeling tools. One of the most powerful mechanisms that can be used in this field is the Artificial Neural Networks (ANNs). This paper presents some of the results obtained by the Process Control group of the Politehnica University Timisoara, Romania, in the field of ANNs applied to modeling, prediction and decision-making related to medical systems. An Iterative Learning Control-based approach to batch training a feedforward ANN architecture is given. The paper includes authors’ concerns in this domain and emphasizes that these intelligent models, even if they are artificial, are able to make decisions, being useful tools for prevention, early detection and personalized healthcare

Systemic Approach to Estimation of Financial Risks

Modern approaches to risk estimation, forecasting and management are based upon intensive application of mathematical modeling, estimation theory, application of Bayesian statistics, simulation, decision making methods and techniques and other approaches [1]. One of the most suitable instrumentations for risk analysis and management create informational decision support systems (DSS) that are widely used for solving different problems from the realms of forecasting, control, medical and engineering diagnostics, planning and management

Projecting the combined healthcare burden of seasonal influenza and COVID-19

The overlapping 2020-2021 influenza season and COVID-19 pandemic may overwhelm hospitals throughout the Northern Hemisphere. Using a mathematical model, we project that COVID-19 burden will dwarf that of influenza. If non-pharmacological mitigation efforts fail, increasing influenza vaccination coverage by 30% points would avert 54 hospitalizations per 100,000 people.This work was supported by grant U01IP001136 from the Centers for Disease Control, Titos Handmade Vodka, and the Society for Medical Decision Making COVID-19 Decision Modeling Initiative (UTA20-000825).Dell Medical SchoolIntegrative Biolog

Model-Based Interpretation of Time-Varying Medical Data

Temporal concepts are critical is medical therapy-planning. If given early enough, specific therapeutic choices may abort or suppress evolving undesired changes in a patient’s clinical status. Effective medical decision making demands recognition and interpretation of complex temporal changes that permeate the medical record. This paper presents a methodology for representing and using medical knowledge about temporal relationships to infer the presence of clinically relevant events, and describes a program, called TOPAZ, that uses this methodology to generate a narrative summary of such events. A unique feature of TOPAZ is the use of numeric and symbolic modeling techniques to perform temporal reasoning tasks that would be difficult to encode and perform using only one modeling methodology

Multilevel modeling and policy development: guidelines and applications to medical travel

Medical travel has expanded rapidly in recent years, resulting in new markets and increased access to medical care. Whereas several studies investigated the motives of individuals seeking healthcare abroad, the conventional analytical approach is limited by substantial caveats. Classical techniques as found in the literature cannot provide sufficient insight due to the nested nature of data generated. The application of adequate analytical techniques, specifically multilevel modeling, is scarce to non-existent in the context of medical travel. This study introduces the guidelines for application of multilevel techniques in public health research by presenting an application of multilevel modeling in analyzing the decision-making patterns of potential medical travelers. Benefits and potential limitations are discussed