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Model-guided therapy for hepatocellular carcinoma: a role for information technology in predictive, preventive and personalized medicine.

Berliner L, Lemke HU, vanSonnenberg E, Ashamalla H, Mattes MD, Dosik D, Hazin H, Shah S, Mohanty S, Verma S, Esposito G, Bargellini I, Battaglia V, Caramella D, Bartolozzi C, Morrison P - EPMA J (2014)

Bottom Line: We may, then, be able to develop a statistically valid methodology, on an individual basis, to predict certain diseases or conditions, to predict certain treatment outcomes, to prevent certain diseases or complications and to develop treatment regimens that are personalized for that particular patient.An IT system for predictive, preventive and personalized medicine (ITS-PM) for HCC is presented to provide a comprehensive system to provide unified access to general medical and patient-specific information for medical researchers and health care providers from different disciplines including hepatologists, gastroenterologists, medical and surgical oncologists, liver transplant teams, interventional radiologists and radiation oncologists.The article concludes with a review providing an outlook and recommendations for the application of MGT to enhance the medical management of HCC through PPPM.

View Article: PubMed Central - HTML - PubMed

Affiliation: New York Methodist Hospital, Brooklyn, NY 11215, USA ; Weill Medical College of Cornell University, New York, NY 10021, USA.

ABSTRACT
Predictive, preventive and personalized medicine (PPPM) may have the potential to eventually improve the nature of health care delivery. However, the tools required for a practical and comprehensive form of PPPM that is capable of handling the vast amounts of medical information that is currently available are currently lacking. This article reviews a rationale and method for combining and integrating diagnostic and therapeutic management with information technology (IT), in a manner that supports patients through their continuum of care. It is imperative that any program devised to explore and develop personalized health care delivery must be firmly rooted in clinically confirmed and accepted principles and technologies. Therefore, a use case, relating to hepatocellular carcinoma (HCC), was developed. The approach to the management of medical information we have taken is based on model theory and seeks to implement a form of model-guided therapy (MGT) that can be used as a decision support system in the treatment of patients with HCC. The IT structures to be utilized in MGT include a therapy imaging and model management system (TIMMS) and a digital patient model (DPM). The system that we propose will utilize patient modeling techniques to generate valid DPMs (which factor in age, physiologic condition, disease and co-morbidities, genetics, biomarkers and responses to previous treatments). We may, then, be able to develop a statistically valid methodology, on an individual basis, to predict certain diseases or conditions, to predict certain treatment outcomes, to prevent certain diseases or complications and to develop treatment regimens that are personalized for that particular patient. An IT system for predictive, preventive and personalized medicine (ITS-PM) for HCC is presented to provide a comprehensive system to provide unified access to general medical and patient-specific information for medical researchers and health care providers from different disciplines including hepatologists, gastroenterologists, medical and surgical oncologists, liver transplant teams, interventional radiologists and radiation oncologists. The article concludes with a review providing an outlook and recommendations for the application of MGT to enhance the medical management of HCC through PPPM.

No MeSH data available.


Related in: MedlinePlus

A schematic for organization of an ITS-PM. This diagram reorganizes many of the TIMMS components in a structure that will enable the secure interchange of information between data sources, database management systems, data analysis systems and end-user applications. (PSM patient-specific model; TIMMS therapy and imaging model management system; PACS picture archiving and communications system; MEBN multi-entity Bayesian network; NoSQL not only structured query language; DBs databases.
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Figure 3: A schematic for organization of an ITS-PM. This diagram reorganizes many of the TIMMS components in a structure that will enable the secure interchange of information between data sources, database management systems, data analysis systems and end-user applications. (PSM patient-specific model; TIMMS therapy and imaging model management system; PACS picture archiving and communications system; MEBN multi-entity Bayesian network; NoSQL not only structured query language; DBs databases.

Mentions: One of our goals is to propose a realistic, plausible approach to the development of DPMs, based on a complex of database and knowledge management systems capable of data storage, data mining, data analysis and decision support. It is imperative that comprehensive and cohesive hardware and software architecture is provided for the ITS-PM to allow each section to function independently, while synchronized and in communication with each other section. At this time, there is no system or collection of systems on the market that can accomplish these tasks. However, Reference Model for Open Distributed Processing (RM-ODP) and service-oriented architecture (SOA) (which may be considered a subset of RM-ODP and is perhaps more widely known) are standards, methodologies or approaches to enterprise system development that could help fulfill the necessary requirements[9,10].It is beyond the scope of this article to provide a complete RM-ODP enterprise proposal with detailed SOA schema. However, at this stage of development, a simplified schematic for the organization of an ITS-PM is presented in FigureĀ 3 for illustrative purposes.


Model-guided therapy for hepatocellular carcinoma: a role for information technology in predictive, preventive and personalized medicine.

Berliner L, Lemke HU, vanSonnenberg E, Ashamalla H, Mattes MD, Dosik D, Hazin H, Shah S, Mohanty S, Verma S, Esposito G, Bargellini I, Battaglia V, Caramella D, Bartolozzi C, Morrison P - EPMA J (2014)

A schematic for organization of an ITS-PM. This diagram reorganizes many of the TIMMS components in a structure that will enable the secure interchange of information between data sources, database management systems, data analysis systems and end-user applications. (PSM patient-specific model; TIMMS therapy and imaging model management system; PACS picture archiving and communications system; MEBN multi-entity Bayesian network; NoSQL not only structured query language; DBs databases.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4274760&req=5

Figure 3: A schematic for organization of an ITS-PM. This diagram reorganizes many of the TIMMS components in a structure that will enable the secure interchange of information between data sources, database management systems, data analysis systems and end-user applications. (PSM patient-specific model; TIMMS therapy and imaging model management system; PACS picture archiving and communications system; MEBN multi-entity Bayesian network; NoSQL not only structured query language; DBs databases.
Mentions: One of our goals is to propose a realistic, plausible approach to the development of DPMs, based on a complex of database and knowledge management systems capable of data storage, data mining, data analysis and decision support. It is imperative that comprehensive and cohesive hardware and software architecture is provided for the ITS-PM to allow each section to function independently, while synchronized and in communication with each other section. At this time, there is no system or collection of systems on the market that can accomplish these tasks. However, Reference Model for Open Distributed Processing (RM-ODP) and service-oriented architecture (SOA) (which may be considered a subset of RM-ODP and is perhaps more widely known) are standards, methodologies or approaches to enterprise system development that could help fulfill the necessary requirements[9,10].It is beyond the scope of this article to provide a complete RM-ODP enterprise proposal with detailed SOA schema. However, at this stage of development, a simplified schematic for the organization of an ITS-PM is presented in FigureĀ 3 for illustrative purposes.

Bottom Line: We may, then, be able to develop a statistically valid methodology, on an individual basis, to predict certain diseases or conditions, to predict certain treatment outcomes, to prevent certain diseases or complications and to develop treatment regimens that are personalized for that particular patient.An IT system for predictive, preventive and personalized medicine (ITS-PM) for HCC is presented to provide a comprehensive system to provide unified access to general medical and patient-specific information for medical researchers and health care providers from different disciplines including hepatologists, gastroenterologists, medical and surgical oncologists, liver transplant teams, interventional radiologists and radiation oncologists.The article concludes with a review providing an outlook and recommendations for the application of MGT to enhance the medical management of HCC through PPPM.

View Article: PubMed Central - HTML - PubMed

Affiliation: New York Methodist Hospital, Brooklyn, NY 11215, USA ; Weill Medical College of Cornell University, New York, NY 10021, USA.

ABSTRACT
Predictive, preventive and personalized medicine (PPPM) may have the potential to eventually improve the nature of health care delivery. However, the tools required for a practical and comprehensive form of PPPM that is capable of handling the vast amounts of medical information that is currently available are currently lacking. This article reviews a rationale and method for combining and integrating diagnostic and therapeutic management with information technology (IT), in a manner that supports patients through their continuum of care. It is imperative that any program devised to explore and develop personalized health care delivery must be firmly rooted in clinically confirmed and accepted principles and technologies. Therefore, a use case, relating to hepatocellular carcinoma (HCC), was developed. The approach to the management of medical information we have taken is based on model theory and seeks to implement a form of model-guided therapy (MGT) that can be used as a decision support system in the treatment of patients with HCC. The IT structures to be utilized in MGT include a therapy imaging and model management system (TIMMS) and a digital patient model (DPM). The system that we propose will utilize patient modeling techniques to generate valid DPMs (which factor in age, physiologic condition, disease and co-morbidities, genetics, biomarkers and responses to previous treatments). We may, then, be able to develop a statistically valid methodology, on an individual basis, to predict certain diseases or conditions, to predict certain treatment outcomes, to prevent certain diseases or complications and to develop treatment regimens that are personalized for that particular patient. An IT system for predictive, preventive and personalized medicine (ITS-PM) for HCC is presented to provide a comprehensive system to provide unified access to general medical and patient-specific information for medical researchers and health care providers from different disciplines including hepatologists, gastroenterologists, medical and surgical oncologists, liver transplant teams, interventional radiologists and radiation oncologists. The article concludes with a review providing an outlook and recommendations for the application of MGT to enhance the medical management of HCC through PPPM.

No MeSH data available.


Related in: MedlinePlus