Many challenges must still be overcome before computational medicine becomes a routine part of patient care
Computational medicine, a fast-growing method of using computer models and sophisticated software to figure out how disease develops–and how to thwart it–has begun to leap off the drawing board and land in the hands of doctors who treat patients for heart ailments, cancer and other illnesses. Using digital tools, researchers have begun to use experimental and clinical data to build models that can unravel complex medical mysteries.
These are some of the conclusions of a new review of the field published in the Oct. 31 issue of the journal Science Translational Medicine. The article, “Computational Medicine: Translating Models to Clinical Care,” was written by four Johns Hopkins professors affiliated with the university’s Institute for Computational Medicine.
The institute was launched in 2005 as collaboration between the university’s Whiting School of Engineering and its School of Medicine. The goal was to use powerful computers to analyze and mathematically model disease mechanisms. The results were to be used to help predict who is at risk of developing a disease and to determine how to treat it more effectively.
In recent years, “The field has exploded. There is a whole new community of people being trained in mathematics, computer science and engineering, and they are being cross-trained in biology,” said institute director Raimond Winslow. “This allows them to bring a whole new perspective to medical diagnosis and treatment. Engineers traditionally construct models of the systems they are designing. In our case, we’re building computational models of what we trying to study, which is disease.”
Looking at disease through the lens of traditional biology is like trying to assemble a very complex jigsaw puzzle with a huge number of pieces, he said. The result can be a very incomplete picture. “Computational medicine can help you see how the pieces of the puzzle fit together to give a more holistic picture,” Winslow said. “We may never have all of the missing pieces, but we’ll wind up with a much clearer view of what causes disease and how to treat it.”
Biology in both health and disease is very complex, Winslow added. It involves the feed-forward flow of information from the level of the gene to protein, networks, cells, organs and organ systems. This is already complex, he said, and to make matters even more difficult, it also involves feed-back pathways by which, for example, proteins, mechanical forces at the level of tissues and organs, and environmental factors regulate function at lower levels such as the gene.
Computational models, Winslow said, help us to understand these complex interactions, the nature of which is often highly complex and non-intuitive. Models like these allow researchers to understand disease mechanisms, aid in diagnosis, and test the effectiveness of different therapies. By using computer models, he said, potential therapies can be tested “In Silico” at high speed. The results can then be used to guide further experiments to gather new data to refine the models until they are highly predictive.
“Our intent in writing this journal article was to open the eyes of physicians and medical researchers who are unfamiliar with the field of computational medicine,” said Winslow, who is first author of the Science Translational Medicine overview. He also wanted to describe examples of computational medicine that are making their way out of research labs and into clinics where patients are being treated. “This transition,” he said, “is already under way.”
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