In silico clinical trials through AI and statistical model checking

A Virtual Patient (VP) is a computational model accounting for individualised (patho-) physiology and Pharmaco-Kinetics/Dynamics of relevant drugs. Availability of VPs is among the enabling technology for In Silico Clinical Trials. Here we shortly outline the state of the art as for VP generation and summarise our recent work on Artificial Intelligence (AI) and Statistical Model Checking based generation of VPs

Complete populations of virtual patients for in silico clinical trials

Motivation Model-based approaches to safety and efficacy assessment of pharmacological drugs, treatment strategies or medical devices (In Silico Clinical Trial, ISCT) aim to decrease time and cost for the needed experimentations, reduce animal and human testing, and enable precision medicine. Unfortunately, in presence of non-identifiable models (e.g. reaction networks), parameter estimation is not enough to generate complete populations of Virtual Patients (VPs), i.e. populations guaranteed to show the entire spectrum of model behaviours (phenotypes), thus ensuring representativeness of the trial. Results We present methods and software based on global search driven by statistical model checking that, starting from a (non-identifiable) quantitative model of the human physiology (plus drugs PK/PD) and suitable biological and medical knowledge elicited from experts, compute a population of VPs whose behaviours are representative of the whole spectrum of phenotypes entailed by the model (completeness) and pairwise distinguishable according to user-provided criteria. This enables full granularity control on the size of the population to employ in an ISCT, guaranteeing representativeness while avoiding over-representation of behaviours. We proved the effectiveness of our algorithm on a non-identifiable ODE-based model of the female Hypothalamic-Pituitary-Gonadal axis, by generating a population of 4 830 264 VPs stratified into 7 levels (at different granularity of behaviours), and assessed its representativeness against 86 retrospective health records from Pfizer, Hannover Medical School and University Hospital of Lausanne. The datasets are respectively covered by our VPs within Average Normalized Mean Absolute Error of 15%, 20% and 35% (90% of the latter dataset is covered within 20% error). Availability and implementation. Our open-source software is available at https://bitbucket.org/mclab/vipgenerato

Complete populations of virtual patients for in silico clinical trials

Motivation Model-based approaches to safety and efficacy assessment of pharmacological drugs, treatment strategies or medical devices (In Silico Clinical Trial, ISCT) aim to decrease time and cost for the needed experimentations, reduce animal and human testing, and enable precision medicine. Unfortunately, in presence of non-identifiable models (e.g. reaction networks), parameter estimation is not enough to generate complete populations of Virtual Patients (VPs), i.e. populations guaranteed to show the entire spectrum of model behaviours (phenotypes), thus ensuring representativeness of the trial. Results We present methods and software based on global search driven by statistical model checking that, starting from a (non-identifiable) quantitative model of the human physiology (plus drugs PK/PD) and suitable biological and medical knowledge elicited from experts, compute a population of VPs whose behaviours are representative of the whole spectrum of phenotypes entailed by the model (completeness) and pairwise distinguishable according to user-provided criteria. This enables full granularity control on the size of the population to employ in an ISCT, guaranteeing representativeness while avoiding over-representation of behaviours. We proved the effectiveness of our algorithm on a non-identifiable ODE-based model of the female Hypothalamic-Pituitary-Gonadal axis, by generating a population of 4 830 264 VPs stratified into 7 levels (at different granularity of behaviours), and assessed its representativeness against 86 retrospective health records from Pfizer, Hannover Medical School and University Hospital of Lausanne. The datasets are respectively covered by our VPs within Average Normalized Mean Absolute Error of 15%, 20% and 35% (90% of the latter dataset is covered within 20% error). Availability and implementation. Our open-source software is available at https://bitbucket.org/mclab/vipgenerato

AI-guided synthesis of personalised pharmacological treatments via in silico clinical trials

A key topic in precision medicine is to develop pharmacological treatments optimised for any given individual (personalised treatments). Model-based approaches (aka In Silico Clinical Trials, ISCT) aim at achieving this goal, by enabling the automatic synthesis and verification of personalised treatments via simulation, before they are actually administered to patients. In this short paper, we introduce the area of ISCT, and review our approach to the in silico automatic synthesis of optimal personalised treatments, where numerical simulation of quantitative models of the human physiology and reactions to drugs is driven by Artificial Intelligence global search

An efficient algorithm for network vulnerability analysis under malicious attacks

Given a communication network, we address the problem of computing a lower bound to the transmission rate between two network nodes notwithstanding the presence of an intelligent malicious attacker with limited destructive power. Formally, we are given a link capacitated network N with source node s and destination node t and a budget B for the attacker. We want to compute the Guaranteed Maximum Flow from s to t when an attacker can remove at most B edges. This problem is known to be NP-hard for general networks. For Internet-like networks we present an efficient ILP-based algorithm coupled with instance transformation techniques that allow us to solve the above problem for networks with more than 200 000 nodes and edges within a few minutes. To the best of our knowledge this is the first time that instances of this size for the above problem have been solved for Internet-like networks