Patient Methodology

Overview

Abstract

The engine allows for patient variability via a set of parameters used to define aspects of the simulated human. These parameters are used throughout the system models to manipulate the physiological responses and homeostatic state. The code base contains several defined patients created for various testing and analysis purposes.

Introduction

The engine was architected for the development and integration of multiscale models for an individualized whole-body predictive patient physiology model. The engine incorporates existing and novel models of organs and physiological systems into a whole-body model of a single generic individual within a reference population. Therefore, specific patient definitions are needed to create a virtual representation of the specific virtual human being simulated. The patient definition leverages the Commmon Data Model (CDM) to allow physiological parameters to be disseminated throughout the engine.

System Design

Background and Scope

Requirements

The patient needs to contain all user-definable parameters specific to an individual. Any parameters that are not explicitly set need to be calculated based on standard, healthy values.

Approach

Each patient parameter falls into one of three categories:

  • Required: The only parameter that is required to be set on the patient at runtime is Sex. All other values not explicitly set will be determined using default values and/or calculated outputs.
  • Optional: These parameters can be optionally explicitly set by the user. Many optional values have bounds associated with them to ensure a healthy initial patient.
  • Unallowed: These parameters are calculated or determined through simulation based on other settings. They can not be modified by the user.

Table 1 provides the values and equations used to determine optional values not explicitly set by the user and those unallowed to be externally modified.

Features and Capabilities

Definitions

Table 1. All patient parameters, how they are determined, and upper and lower limits.
Parameter Modification Category Initial Value (If not Explicitly Set) Lower Bound Upper Bound Notes
Sex Required

\[M = Male,F = Female\]

- - This is the only parameter required to be explicitly set.
Age Optional

\[A[yr] = 44\]

18 yr 65 yr No pediatric or geriatric modeling.
Ideal Weight Optional

\[Iw[kg] = \left\{ {\begin{array}{*{20}{c}} {{\rm{50}}{\rm{.0 + 2}}{\rm{.3}}\left( {{\rm{H[in] - 60}}} \right),\;M}\\ {{\rm{45}}{\rm{.5 + 2}}{\rm{.3}}\left( {{\rm{H[in] - 60}}} \right),\;F} \end{array}} \right.\]

- - [140]
Weight Optional

\[W[kg] = 21.75H{[m]^2}\]

- -
Height Optional

\[{\rm{H[cm] = }}\left\{ {\begin{array}{*{20}{c}} {{\rm{177}},\;M}\\ {{\rm{163}},\;F} \end{array}} \right.\]

M = 163 cm, F = 151 cm M = 190 cm, F = 175.5 cm Min = 3rd percentile, Max = 97th percentile, Standard = 50th percentile. [121]
Body Mass Index Optional

\[BMI[{\rm{kg/}}{m^2}] = W[kg]/{\rm{H[m}}{{\rm{]}}^2}\]

16 kg/m2 30 kg/m2 No severly Underweight or Obese. [273]
Body Fat Fraction Optional

\[{\rm{Ff[cm] = }}\left\{ {\begin{array}{*{20}{c}} {{\rm{0}}{\rm{.21}},\;M}\\ {0.28,\;F} \end{array}} \right.\]

M = 0.02, F = 0.10 M = 0.25, F = 0.32 No obese and not less than essential fat. [255]
Blood Volume Baseline Optional

\[Bv[mL] = 65.6W{[kg]^{1.02}}\]

Bv * 0.85 Bv * 1.15 Above Stage 1 Hypovolemia. [127]
Basal Metabolic Rate Optional

\[{\rm{Bmr[kcal/day] = }}\left\{ {\begin{array}{*{20}{c}} {{\rm{88}}{\rm{.632 + 3}}{\rm{.397W[kg] + 4}}{\rm{.799H[cm] - 5}}{\rm{.677A[yr]}},\;M}\\ {{\rm{447}}{\rm{.593 + 9}}{\rm{.247W[kg] + 3}}{\rm{.098H[cm] - 4}}{\rm{.330A[yr]}},\;F} \end{array}} \right.\]

- - [322]
Heart Rate Baseline Optional

\[Hr[bpm] = 72\]

50 bpm 110 bpm Bradycardia < 60 bpm & Tachycardia > 100 bpm.
Systolic Arterial Pressure Baseline Optional

\[Sys[mmHg] = 114\]

90 mmHg 120 mmHg No hypotension or hypertension.
Diastolic Arterial Pressure Baseline Optional

\[Dia[mmHg] = 73.5\]

60 mmHg 80 mmHg No hypotension or hypertension. Includes pressure fraction check: Dia > 0.75 Sys.
Pulse Pressure Pressure Baseline Optional

\[Pp[mmHg] = Sys[mmHg] - Dia[mmHg]\]

0.25 * Sys -
Mean Arterial Pressure Optional

\[Map = \frac{1}{3}Sys + \frac{2}{3}Dia\]

- - [152]
Respiration Rate Baseline Optional

\[Rr[bpm] = 12\]

8 bpm 20 bpm
Alveoli Surface Area Optional

\[Asa[{m^2}] = \frac{{{\rm{Tlc[L]}}}}{{6.17}} \times {\rm{70}}\]

- - Calculated using standard Tlc (6.17 L) [130] and standard Asa (70 m2) [309].
Right Lung Ratio Optional

\[Rlr = 0.525\]

0.5 0.6
Skin Surface Area Optional

\[Ssa[{m^2}] = 0.20247W{[kg]^{0.45}}H{[m]^{0.725}}\]

- - [91]
Heart Rate Maximum Optional

\[H{r_{\max }}[bpm] = 208 - 0.7A[yr]\]

- - [358]
Heart Rate Minimum Optional

\[H{r_{\min }}[bpm] = 0.001\]

- -
Functional Residual Capacity Optional

\[Frc[mL] = 30Iw[kg]\]

- - [130]
Total Lung Capacity Optional

\[Tlc[mL] = 80Iw[kg]\]

- - [130]
Residual Volume Optional

\[Rv[mL] = 16Iw[kg]\]

- - [130]
Lean Body Mass Unallowed

\[Lbm = W(1 - Ff)\]

- -
Body Density Unallowed

\[Bd = {{\left( {\frac{{4.95}}{{Ff + 4.5}} + \frac{{4.57}}{{Ff + 4.142}}} \right)} \mathord{\left/ {\vphantom {{\left( {\frac{{4.95}}{{Ff + 4.5}} + \frac{{4.57}}{{Ff + 4.142}}} \right)} 2}} \right. \kern-\nulldelimiterspace} 2}\]

- - Average of Siri [341] and Brozek [43] equations.
Tidal Volume Baseline Unallowed

\[Tv[mL] = 37Iw[kg] - Frc[mL]\]

- - [130]
Expiratory Reserve Volume Unallowed

\[Erv = Frc - Rv\]

- - [130]
Inspiratory Capacity Unallowed

\[Ic = Tlc - Frc\]

- - [130]
Inspriatory Reserve Volume Unallowed

\[Irv = Ic - Tv\]

- - [130]
Vital Capacity Unallowed

\[Vc - Tlc - Rv\]

- - [130]

Stabilization

There are two complete sets of patient parameters stored in the data model:

  1. Initial Patient: These are the healthy patient parameters before any conditions or action are applied. All patient parameters are set at the beginning of the resting stabilization period (see System Methodology). These values are used to modify the inner workings of systems. The complex interactions require a simulated period to allow everything to balance into a stable, homeostatic, healthy starting point. These parameters should not be changed during a simulation.
  2. Current Patient: After each stabilization period (i.e., resting, conditions, and feedback), several parameters are reset due to their reliance on combined effects. These parameters can further be changed during a simulation.

While every effort has been made to allow any combination of patient parameters within bounds, there is no guarantee that all combinations will be able to reach a stable starting homeostatic point.

Dependencies

Patient parameters are not dependent on any systems, but many systems are dependent on specific patient values. Some parameters are used to modify baseline fluid/thermal circuit values or direct calculation of outputs, and others manipulate how feedback mechanisms work. For details see the following system methodology sections regarding dependencies and patient variability:

Results and Conclusions

Verification and Validation


Table 2. There are several patients that we created for base validation, system-specific patient effects validation, and extreme case will stabilization.
Name Standard Male Standard Female Default Male Default Female Overweight Underweight Tachycardic Bradycardic Extreme Female Extreme Male
Sex Male Female Male Female Male Male Male Male Female Male
Age 44 yr 44 yr - - 44 yr 44 yr 44 yr 44 yr 18 yr 65 yr
Weight 170 lb 130 lb - - 215 lb 115 lb 170 lb 170 lb - -
Height 71 in 64 in - - 71 in 71 in 71 in 71 in 4.5 ft 7 ft
Body Fat Fraction 0.21 0.28 - - 0.25 0.15 0.18 0.18 0.32 0.02
Heart Rate Baseline 72 bpm 72 bpm - - 72 bpm 72 bpm 110 bpm 50 bpm 60 bpm 100 bpm
Systolic Arterial Pressure Baseline 114 mmHg 114 mmHg - - 114 mmHg 114 mmHg 114 mmHg 114 mmHg 90 mmHg 120 mmHg
Diastolic Arterial Pressure Baseline 73.5 mmHg 73.5 mmHg - - 73.5 mmHg 73.5 mmHg 73.5 mmHg 73.5 mmHg 60 mmHg 80 mmHg
Respiration Rate Baseline 12 bpm 12 bpm - - 12 bpm 12 bpm 20 bpm 8 bpm 8 bpm 20 bpm
Right Lung Ratio - - - - - - - - 0.5 0.6

Table 3. There are several patients we created for combined effects validation and showcase scenarios.
Name Cynthia Gus Joel Nathan Rick Hassan Soldier Jeff Carol Jane
Sex Female Male Male Male Male Male Male Male Female Female
Age 30 yr 32 yr 44 yr 44 yr 23 yr 28 yr 22 yr 25 yr 40 yr 18 yr
Weight 130 lb 190 lb 170 lb 170 lb 161 lb 185 lb 170 lb 180 lb 160 lb 120 lb
Height 64 in 70 in 71 in 71 in 68 in 72 in 71 in 72 in 66 in 64 in
Body Fat Fraction 0.18 0.18 0.18 0.18 0.18 0.18 0.18 0.12 0.25 0.18
Heart Rate Baseline 72 bpm 93 bpm 110 bpm 72 bpm 100 bpm 110 bpm 84 bpm 72 bpm 72 bpm 72 bpm
Systolic Arterial Pressure Baseline 114 mmHg 90 mmHg 120 mmHg 114 mmHg 120 mmHg 90 mmHg 114 mmHg 114 mmHg 114 mmHg 114 mmHg
Diastolic Arterial Pressure Baseline 73.5 mmHg 60 mmHg 80 mmHg 73.5 mmHg 80 mmHg 60 mmHg 73.5 mmHg 73.5 mmHg 73.5 mmHg 73.5 mmHg
Respiration Rate Baseline 18 bpm 14 bpm 15 bpm 16 bpm 16 bpm 18 bpm 16 bpm 16 bpm 18 bpm 18 bpm

All of the patients that are included with the code base have been validated to ensure that they reach a homeostatic point that hits all of the defined criteria. The following tables show the state of the patients after all stabilization phases (see System Methodology for details) and compare the resulting patient values to those initially set/computed. Values that are explicitly set are expected to have very tight tolerances, while those that are initially calculated may drift due to the complex interaction of all patient parameters and system settings. The most sensitive of these parameters to external effects is tidal volume.

Values that are colored green are within 10% of the original set or calculated/estimated (expected) value, yellow are within 30%, and red are greater than 30% error. Values that are not within 10% are not necessarily a failure. As previously described, many of these are estimated before the stabilization simulation begins, and are really determined and overwritten after all other factors reach homeostasis. Those values that are explicitly set by the user/patient file should have much tighter tolerances.

Table 4. StandardMale patient values with expected and engine output.


Property Name Expected Value Engine Value Percent Error Notes
TotalMetabolicRate(kcal/day) 1737.3 Mean of 1737.3 0.0%  
BloodVolume(mL) 5517.7 Mean of 5491.3 0.5%  
DiastolicArterialPressure(mmHg) 73.5 Mean of 73.6 0.1%  
HeartRate(1/min) 72 Mean of 72 0.0%  
MeanArterialPressure(mmHg) 87.0 Mean of 95.3 9.6%  
RespirationRate(1/min) 12 Mean of 12 0.3%  
SystolicArterialPressure(mmHg) 114.0 Mean of 114.3 0.2%  
TidalVolume(mL) 527.1 Mean of 535.2 1.5%  
Patient-ExpiratoryReserveVolume(mL) 1054.2 Mean of 1054.2 0.0%  
Patient-FunctionalResidualCapacity(mL) 2259.0 Mean of 2259.0 0.0%  
Patient-InspiratoryCapacity(mL) 3765.0 Mean of 3765.0 0.0%  
Patient-InspiratoryReserveVolume(mL) 3237.9 Mean of 3229.7 0.3%  
Patient-ResidualVolume(mL) 1204.8 Mean of 1204.8 0.0%  
Patient-TotalLungCapacity(mL) 6024.0 Mean of 6024.0 0.0%  
Patient-VitalCapacity(mL) 4819.2 Mean of 4819.2 0.0%  
Table 5. StandardFemale patient values with expected and engine output.


Property Name Expected Value Engine Value Percent Error Notes
TotalMetabolicRate(kcal/day) 1306.0 Mean of 1306.0 0.0%  
BloodVolume(mL) 4196.9 Mean of 4181.6 0.4%  
DiastolicArterialPressure(mmHg) 73.5 Mean of 73.7 0.2%  
HeartRate(1/min) 72 Mean of 72 0.1%  
MeanArterialPressure(mmHg) 87.0 Mean of 95.2 9.4%  
RespirationRate(1/min) 12 Mean of 12 0.4%  
SystolicArterialPressure(mmHg) 114.0 Mean of 114.4 0.4%  
TidalVolume(mL) 382.9 Mean of 420.8 9.9%  
Patient-ExpiratoryReserveVolume(mL) 765.8 Mean of 765.8 0.0%  
Patient-FunctionalResidualCapacity(mL) 1641.0 Mean of 1641.0 0.0%  
Patient-InspiratoryCapacity(mL) 2735.0 Mean of 2735.0 0.0%  
Patient-InspiratoryReserveVolume(mL) 2352.1 Mean of 2314.7 1.6%  
Patient-ResidualVolume(mL) 875.2 Mean of 875.2 0.0%  
Patient-TotalLungCapacity(mL) 4376.0 Mean of 4376.0 0.0%  
Patient-VitalCapacity(mL) 3500.8 Mean of 3500.8 0.0%  
Table 6. DefaultMale patient values with expected and engine output.


Property Name Expected Value Engine Value Percent Error Notes
TotalMetabolicRate(kcal/day) 1601.1 Mean of 1601.1 0.0%  
BloodVolume(mL) 4863.8 Mean of 4840.5 0.5%  
DiastolicArterialPressure(mmHg) 73.5 Mean of 73.5 0.1%  
HeartRate(1/min) 72 Mean of 72 0.0%  
MeanArterialPressure(mmHg) 87.0 Mean of 95.3 9.6%  
RespirationRate(1/min) 12 Mean of 12 0.3%  
SystolicArterialPressure(mmHg) 114.0 Mean of 114.3 0.2%  
TidalVolume(mL) 505.9 Mean of 511.0 1.0%  
Patient-ExpiratoryReserveVolume(mL) 1011.9 Mean of 1011.9 0.0%  
Patient-FunctionalResidualCapacity(mL) 2168.3 Mean of 2168.3 0.0%  
Patient-InspiratoryCapacity(mL) 3613.8 Mean of 3613.8 0.0%  
Patient-InspiratoryReserveVolume(mL) 3107.9 Mean of 3102.9 0.2%  
Patient-ResidualVolume(mL) 1156.4 Mean of 1156.4 0.0%  
Patient-TotalLungCapacity(mL) 5782.0 Mean of 5782.0 0.0%  
Patient-VitalCapacity(mL) 4625.6 Mean of 4625.6 0.0%  
Table 7. DefaultFemale patient values with expected and engine output.


Property Name Expected Value Engine Value Percent Error Notes
TotalMetabolicRate(kcal/day) 1296.4 Mean of 1296.4 0.0%  
BloodVolume(mL) 4111.3 Mean of 4095.8 0.4%  
DiastolicArterialPressure(mmHg) 73.5 Mean of 73.8 0.4%  
HeartRate(1/min) 72 Mean of 72 0.1%  
MeanArterialPressure(mmHg) 87.0 Mean of 95.1 9.4%  
RespirationRate(1/min) 12 Mean of 12 1.0%  
SystolicArterialPressure(mmHg) 114.0 Mean of 114.3 0.2%  
TidalVolume(mL) 385.7 Mean of 412.7 7.0%  
Patient-ExpiratoryReserveVolume(mL) 771.4 Mean of 771.4 0.0%  
Patient-FunctionalResidualCapacity(mL) 1653.0 Mean of 1653.0 0.0%  
Patient-InspiratoryCapacity(mL) 2754.9 Mean of 2754.9 0.0%  
Patient-InspiratoryReserveVolume(mL) 2369.2 Mean of 2345.9 1.0%  
Patient-ResidualVolume(mL) 881.6 Mean of 881.6 0.0%  
Patient-TotalLungCapacity(mL) 4407.9 Mean of 4407.9 0.0%  
Patient-VitalCapacity(mL) 3526.3 Mean of 3526.3 0.0%  
Table 8. Overweight patient values with expected and engine output.


Property Name Expected Value Engine Value Percent Error Notes
TotalMetabolicRate(kcal/day) 2010.8 Mean of 2010.8 0.0%  
BloodVolume(mL) 7011.2 Mean of 6978.3 0.5%  
DiastolicArterialPressure(mmHg) 73.5 Mean of 73.5 0.0%  
HeartRate(1/min) 72 Mean of 72 0.0%  
MeanArterialPressure(mmHg) 87.0 Mean of 95.3 9.5%  
RespirationRate(1/min) 12 Mean of 12 0.1%  
SystolicArterialPressure(mmHg) 114.0 Mean of 114.3 0.2%  
TidalVolume(mL) 527.1 Mean of 576.0 9.3%  
Patient-ExpiratoryReserveVolume(mL) 1054.2 Mean of 1054.2 0.0%  
Patient-FunctionalResidualCapacity(mL) 2259.0 Mean of 2259.0 0.0%  
Patient-InspiratoryCapacity(mL) 3765.0 Mean of 3765.0 0.0%  
Patient-InspiratoryReserveVolume(mL) 3237.9 Mean of 3188.2 1.5%  
Patient-ResidualVolume(mL) 1204.8 Mean of 1204.8 0.0%  
Patient-TotalLungCapacity(mL) 6024.0 Mean of 6024.0 0.0%  
Patient-VitalCapacity(mL) 4819.2 Mean of 4819.2 0.0%  
Table 9. Underweight patient values with expected and engine output.


Property Name Expected Value Engine Value Percent Error Notes
TotalMetabolicRate(kcal/day) 1403.1 Mean of 1403.1 0.0%  
BloodVolume(mL) 3703.5 Mean of 3685.7 0.5%  
DiastolicArterialPressure(mmHg) 73.5 Mean of 73.5 0.0%  
HeartRate(1/min) 72 Mean of 72 0.1%  
MeanArterialPressure(mmHg) 87.0 Mean of 95.2 9.5%  
RespirationRate(1/min) 12 Mean of 12 0.7%  
SystolicArterialPressure(mmHg) 114.0 Mean of 114.3 0.2%  
TidalVolume(mL) 527.1 Mean of 475.7 9.8%  
Patient-ExpiratoryReserveVolume(mL) 1054.2 Mean of 1054.2 0.0%  
Patient-FunctionalResidualCapacity(mL) 2259.0 Mean of 2259.0 0.0%  
Patient-InspiratoryCapacity(mL) 3765.0 Mean of 3765.0 0.0%  
Patient-InspiratoryReserveVolume(mL) 3237.9 Mean of 3292.9 1.7%  
Patient-ResidualVolume(mL) 1204.8 Mean of 1204.8 0.0%  
Patient-TotalLungCapacity(mL) 6024.0 Mean of 6024.0 0.0%  
Patient-VitalCapacity(mL) 4819.2 Mean of 4819.2 0.0%  
Table 10. Tachycardic patient values with expected and engine output.


Property Name Expected Value Engine Value Percent Error Notes
TotalMetabolicRate(kcal/day) 1737.3 Mean of 1737.3 0.0%  
BloodVolume(mL) 5517.7 Mean of 5489.8 0.5%  
DiastolicArterialPressure(mmHg) 73.5 Mean of 73.8 0.4%  
HeartRate(1/min) 110 Mean of 110 0.0%  
MeanArterialPressure(mmHg) 87.0 Mean of 94.5 8.6%  
RespirationRate(1/min) 20 Mean of 20 1.1%  
SystolicArterialPressure(mmHg) 114.0 Mean of 114.0 0.0%  
TidalVolume(mL) 527.1 Mean of 373.7 29.1%  
Patient-ExpiratoryReserveVolume(mL) 1054.2 Mean of 1054.2 0.0%  
Patient-FunctionalResidualCapacity(mL) 2259.0 Mean of 2259.0 0.0%  
Patient-InspiratoryCapacity(mL) 3765.0 Mean of 3765.0 0.0%  
Patient-InspiratoryReserveVolume(mL) 3237.9 Mean of 3393.1 4.8%  
Patient-ResidualVolume(mL) 1204.8 Mean of 1204.8 0.0%  
Patient-TotalLungCapacity(mL) 6024.0 Mean of 6024.0 0.0%  
Patient-VitalCapacity(mL) 4819.2 Mean of 4819.2 0.0%  
Table 11. Bradycardic patient values with expected and engine output.


Property Name Expected Value Engine Value Percent Error Notes
TotalMetabolicRate(kcal/day) 1737.3 Mean of 1737.3 0.0%  
BloodVolume(mL) 5517.7 Mean of 5493.6 0.4%  
DiastolicArterialPressure(mmHg) 73.5 Mean of 73.7 0.3%  
HeartRate(1/min) 50 Mean of 50 0.0%  
MeanArterialPressure(mmHg) 87.0 Mean of 95.7 10.0%  
RespirationRate(1/min) 8 Mean of 8 0.2%  
SystolicArterialPressure(mmHg) 114.0 Mean of 114.4 0.3%  
TidalVolume(mL) 527.1 Mean of 710.6 34.8%  
Patient-ExpiratoryReserveVolume(mL) 1054.2 Mean of 1054.2 0.0%  
Patient-FunctionalResidualCapacity(mL) 2259.0 Mean of 2259.0 0.0%  
Patient-InspiratoryCapacity(mL) 3765.0 Mean of 3765.0 0.0%  
Patient-InspiratoryReserveVolume(mL) 3237.9 Mean of 3055.0 5.6%  
Patient-ResidualVolume(mL) 1204.8 Mean of 1204.8 0.0%  
Patient-TotalLungCapacity(mL) 6024.0 Mean of 6024.0 0.0%  
Patient-VitalCapacity(mL) 4819.2 Mean of 4819.2 0.0%  
Table 12. Cynthia patient values with expected and engine output.


Property Name Expected Value Engine Value Percent Error Notes
TotalMetabolicRate(kcal/day) 1366.6 Mean of 1366.6 0.0%  
BloodVolume(mL) 4196.9 Mean of 4180.6 0.4%  
DiastolicArterialPressure(mmHg) 73.5 Mean of 73.6 0.2%  
HeartRate(1/min) 72 Mean of 72 0.1%  
MeanArterialPressure(mmHg) 87.0 Mean of 95.2 9.4%  
RespirationRate(1/min) 18 Mean of 18 0.1%  
SystolicArterialPressure(mmHg) 114.0 Mean of 114.4 0.3%  
TidalVolume(mL) 382.9 Mean of 314.1 18.0%  
Patient-ExpiratoryReserveVolume(mL) 765.8 Mean of 765.8 0.0%  
Patient-FunctionalResidualCapacity(mL) 1641.0 Mean of 1641.0 0.0%  
Patient-InspiratoryCapacity(mL) 2735.0 Mean of 2735.0 0.0%  
Patient-InspiratoryReserveVolume(mL) 2352.1 Mean of 2420.1 2.9%  
Patient-ResidualVolume(mL) 875.2 Mean of 875.2 0.0%  
Patient-TotalLungCapacity(mL) 4376.0 Mean of 4376.0 0.0%  
Patient-VitalCapacity(mL) 3500.8 Mean of 3500.8 0.0%  
Table 13. Gus patient values with expected and engine output.


Property Name Expected Value Engine Value Percent Error Notes
TotalMetabolicRate(kcal/day) 1914.8 Mean of 1914.8 0.0%  
BloodVolume(mL) 6180.6 Mean of 6159.3 0.3%  
DiastolicArterialPressure(mmHg) 60.0 Mean of 60.6 1.0%  
HeartRate(1/min) 93 Mean of 93 0.0%  
MeanArterialPressure(mmHg) 70.0 Mean of 76.2 8.8%  
RespirationRate(1/min) 14 Mean of 14 0.1%  
SystolicArterialPressure(mmHg) 90.0 Mean of 90.0 0.0%  
TidalVolume(mL) 511.0 Mean of 500.0 2.2%  
Patient-ExpiratoryReserveVolume(mL) 1022.0 Mean of 1022.0 0.0%  
Patient-FunctionalResidualCapacity(mL) 2190.0 Mean of 2190.0 0.0%  
Patient-InspiratoryCapacity(mL) 3650.0 Mean of 3650.0 0.0%  
Patient-InspiratoryReserveVolume(mL) 3139.0 Mean of 3148.6 0.3%  
Patient-ResidualVolume(mL) 1168.0 Mean of 1168.0 0.0%  
Patient-TotalLungCapacity(mL) 5840.0 Mean of 5840.0 0.0%  
Patient-VitalCapacity(mL) 4672.0 Mean of 4672.0 0.0%  
Table 14. Joel patient values with expected and engine output.


Property Name Expected Value Engine Value Percent Error Notes
TotalMetabolicRate(kcal/day) 1737.3 Mean of 1737.3 0.0%  
BloodVolume(mL) 5517.7 Mean of 5487.3 0.6%  
DiastolicArterialPressure(mmHg) 80.0 Mean of 80.0 0.0%  
HeartRate(1/min) 110 Mean of 110 0.1%  
MeanArterialPressure(mmHg) 93.3 Mean of 100.4 7.6%  
RespirationRate(1/min) 15 Mean of 15 0.5%  
SystolicArterialPressure(mmHg) 120.0 Mean of 120.0 0.0%  
TidalVolume(mL) 527.1 Mean of 456.1 13.5%  
Patient-ExpiratoryReserveVolume(mL) 1054.2 Mean of 1054.2 0.0%  
Patient-FunctionalResidualCapacity(mL) 2259.0 Mean of 2259.0 0.0%  
Patient-InspiratoryCapacity(mL) 3765.0 Mean of 3765.0 0.0%  
Patient-InspiratoryReserveVolume(mL) 3237.9 Mean of 3309.8 2.2%  
Patient-ResidualVolume(mL) 1204.8 Mean of 1204.8 0.0%  
Patient-TotalLungCapacity(mL) 6024.0 Mean of 6024.0 0.0%  
Patient-VitalCapacity(mL) 4819.2 Mean of 4819.2 0.0%  
Table 15. Nathan patient values with expected and engine output.


Property Name Expected Value Engine Value Percent Error Notes
TotalMetabolicRate(kcal/day) 1737.3 Mean of 1737.3 0.0%  
BloodVolume(mL) 5517.7 Mean of 5491.4 0.5%  
DiastolicArterialPressure(mmHg) 73.5 Mean of 73.6 0.1%  
HeartRate(1/min) 72 Mean of 72 0.0%  
MeanArterialPressure(mmHg) 87.0 Mean of 95.3 9.6%  
RespirationRate(1/min) 16 Mean of 16 0.5%  
SystolicArterialPressure(mmHg) 114.0 Mean of 114.3 0.2%  
TidalVolume(mL) 527.1 Mean of 433.7 17.7%  
Patient-ExpiratoryReserveVolume(mL) 1054.2 Mean of 1054.2 0.0%  
Patient-FunctionalResidualCapacity(mL) 2259.0 Mean of 2259.0 0.0%  
Patient-InspiratoryCapacity(mL) 3765.0 Mean of 3765.0 0.0%  
Patient-InspiratoryReserveVolume(mL) 3237.9 Mean of 3332.5 2.9%  
Patient-ResidualVolume(mL) 1204.8 Mean of 1204.8 0.0%  
Patient-TotalLungCapacity(mL) 6024.0 Mean of 6024.0 0.0%  
Patient-VitalCapacity(mL) 4819.2 Mean of 4819.2 0.0%  
Table 16. Hassan patient values with expected and engine output.


Property Name Expected Value Engine Value Percent Error Notes
TotalMetabolicRate(kcal/day) 1931.5 Mean of 1931.5 0.0%  
BloodVolume(mL) 6014.8 Mean of 5993.1 0.4%  
DiastolicArterialPressure(mmHg) 60.0 Mean of 60.5 0.9%  
HeartRate(1/min) 110 Mean of 110 0.0%  
MeanArterialPressure(mmHg) 70.0 Mean of 76.2 8.8%  
RespirationRate(1/min) 18 Mean of 18 1.3%  
SystolicArterialPressure(mmHg) 90.0 Mean of 90.2 0.2%  
TidalVolume(mL) 543.2 Mean of 420.2 22.6%  
Patient-ExpiratoryReserveVolume(mL) 1086.4 Mean of 1086.4 0.0%  
Patient-FunctionalResidualCapacity(mL) 2328.0 Mean of 2328.0 0.0%  
Patient-InspiratoryCapacity(mL) 3880.0 Mean of 3880.0 0.0%  
Patient-InspiratoryReserveVolume(mL) 3336.8 Mean of 3463.6 3.8%  
Patient-ResidualVolume(mL) 1241.6 Mean of 1241.6 0.0%  
Patient-TotalLungCapacity(mL) 6208.0 Mean of 6208.0 0.0%  
Patient-VitalCapacity(mL) 4966.4 Mean of 4966.4 0.0%  
Table 17. Soldier patient values with expected and engine output.


Property Name Expected Value Engine Value Percent Error Notes
TotalMetabolicRate(kcal/day) 1862.2 Mean of 1862.2 0.0%  
BloodVolume(mL) 5517.7 Mean of 5490.8 0.5%  
DiastolicArterialPressure(mmHg) 73.5 Mean of 73.5 0.0%  
HeartRate(1/min) 84 Mean of 84 0.0%  
MeanArterialPressure(mmHg) 87.0 Mean of 94.8 9.0%  
RespirationRate(1/min) 16 Mean of 16 0.3%  
SystolicArterialPressure(mmHg) 114.0 Mean of 114.5 0.4%  
TidalVolume(mL) 527.1 Mean of 454.5 13.8%  
Patient-ExpiratoryReserveVolume(mL) 1054.2 Mean of 1054.2 0.0%  
Patient-FunctionalResidualCapacity(mL) 2259.0 Mean of 2259.0 0.0%  
Patient-InspiratoryCapacity(mL) 3765.0 Mean of 3765.0 0.0%  
Patient-InspiratoryReserveVolume(mL) 3237.9 Mean of 3310.3 2.2%  
Patient-ResidualVolume(mL) 1204.8 Mean of 1204.8 0.0%  
Patient-TotalLungCapacity(mL) 6024.0 Mean of 6024.0 0.0%  
Patient-VitalCapacity(mL) 4819.2 Mean of 4819.2 0.0%  
Table 18. Jeff patient values with expected and engine output.


Property Name Expected Value Engine Value Percent Error Notes
TotalMetabolicRate(kcal/day) 1918.2 Mean of 1918.2 0.0%  
BloodVolume(mL) 5849.0 Mean of 5821.1 0.5%  
DiastolicArterialPressure(mmHg) 73.5 Mean of 73.6 0.1%  
HeartRate(1/min) 72 Mean of 72 0.1%  
MeanArterialPressure(mmHg) 87.0 Mean of 95.4 9.6%  
RespirationRate(1/min) 16 Mean of 16 0.6%  
SystolicArterialPressure(mmHg) 114.0 Mean of 114.4 0.3%  
TidalVolume(mL) 543.2 Mean of 459.6 15.4%  
Patient-ExpiratoryReserveVolume(mL) 1086.4 Mean of 1086.4 0.0%  
Patient-FunctionalResidualCapacity(mL) 2328.0 Mean of 2328.0 0.0%  
Patient-InspiratoryCapacity(mL) 3880.0 Mean of 3880.0 0.0%  
Patient-InspiratoryReserveVolume(mL) 3336.8 Mean of 3422.9 2.6%  
Patient-ResidualVolume(mL) 1241.6 Mean of 1241.6 0.0%  
Patient-TotalLungCapacity(mL) 6208.0 Mean of 6208.0 0.0%  
Patient-VitalCapacity(mL) 4966.4 Mean of 4966.4 0.0%  
Table 19. Carol patient values with expected and engine output.


Property Name Expected Value Engine Value Percent Error Notes
TotalMetabolicRate(kcal/day) 1464.8 Mean of 1464.8 0.0%  
BloodVolume(mL) 5186.9 Mean of 5166.5 0.4%  
DiastolicArterialPressure(mmHg) 73.5 Mean of 73.8 0.3%  
HeartRate(1/min) 72 Mean of 72 0.0%  
MeanArterialPressure(mmHg) 87.0 Mean of 95.2 9.4%  
RespirationRate(1/min) 18 Mean of 18 1.1%  
SystolicArterialPressure(mmHg) 114.0 Mean of 114.3 0.3%  
TidalVolume(mL) 415.1 Mean of 329.1 20.7%  
Patient-ExpiratoryReserveVolume(mL) 830.2 Mean of 830.2 0.0%  
Patient-FunctionalResidualCapacity(mL) 1779.0 Mean of 1779.0 0.0%  
Patient-InspiratoryCapacity(mL) 2965.0 Mean of 2965.0 0.0%  
Patient-InspiratoryReserveVolume(mL) 2549.9 Mean of 2637.9 3.5%  
Patient-ResidualVolume(mL) 948.8 Mean of 948.8 0.0%  
Patient-TotalLungCapacity(mL) 4744.0 Mean of 4744.0 0.0%  
Patient-VitalCapacity(mL) 3795.2 Mean of 3795.2 0.0%  
Table 20. Jane patient values with expected and engine output.


Property Name Expected Value Engine Value Percent Error Notes
TotalMetabolicRate(kcal/day) 1376.6 Mean of 1376.6 0.0%  
BloodVolume(mL) 3867.8 Mean of 3853.5 0.4%  
DiastolicArterialPressure(mmHg) 73.5 Mean of 73.8 0.3%  
HeartRate(1/min) 72 Mean of 72 0.1%  
MeanArterialPressure(mmHg) 87.0 Mean of 95.1 9.3%  
RespirationRate(1/min) 18 Mean of 18 1.1%  
SystolicArterialPressure(mmHg) 114.0 Mean of 114.2 0.2%  
TidalVolume(mL) 382.9 Mean of 315.5 17.6%  
Patient-ExpiratoryReserveVolume(mL) 765.8 Mean of 765.8 0.0%  
Patient-FunctionalResidualCapacity(mL) 1641.0 Mean of 1641.0 0.0%  
Patient-InspiratoryCapacity(mL) 2735.0 Mean of 2735.0 0.0%  
Patient-InspiratoryReserveVolume(mL) 2352.1 Mean of 2420.7 2.9%  
Patient-ResidualVolume(mL) 875.2 Mean of 875.2 0.0%  
Patient-TotalLungCapacity(mL) 4376.0 Mean of 4376.0 0.0%  
Patient-VitalCapacity(mL) 3500.8 Mean of 3500.8 0.0%  
Table 21. ExtremeFemale patient values with expected and engine output.


Property Name Expected Value Engine Value Percent Error Notes
TotalMetabolicRate(kcal/day) 1172.9 Mean of 1172.9 0.0%  
BloodVolume(mL) 2891.1 Mean of 2884.5 0.2%  
DiastolicArterialPressure(mmHg) 60.0 Mean of 60.5 0.9%  
HeartRate(1/min) 60 Mean of 60 0.1%  
MeanArterialPressure(mmHg) 70.0 Mean of 76.5 9.3%  
RespirationRate(1/min) 8 Mean of 8 0.3%  
SystolicArterialPressure(mmHg) 90.0 Mean of 90.3 0.3%  
TidalVolume(mL) 221.9 Mean of 463.3 108.8%  
Patient-ExpiratoryReserveVolume(mL) 443.8 Mean of 443.8 0.0%  
Patient-FunctionalResidualCapacity(mL) 951.0 Mean of 951.0 0.0%  
Patient-InspiratoryCapacity(mL) 1585.0 Mean of 1585.0 0.0%  
Patient-InspiratoryReserveVolume(mL) 1363.1 Mean of 1115.5 18.2%  
Patient-ResidualVolume(mL) 507.2 Mean of 507.2 0.0%  
Patient-TotalLungCapacity(mL) 2536.0 Mean of 2536.0 0.0%  
Patient-VitalCapacity(mL) 2028.8 Mean of 2028.8 0.0%  
Table 22. ExtremeMale patient values with expected and engine output.


Property Name Expected Value Engine Value Percent Error Notes
TotalMetabolicRate(kcal/day) 2070.0 Mean of 2070.0 0.0%  
BloodVolume(mL) 7120.4 Mean of 7076.5 0.6%  
DiastolicArterialPressure(mmHg) 80.0 Mean of 80.4 0.5%  
HeartRate(1/min) 100 Mean of 100 0.0%  
MeanArterialPressure(mmHg) 93.3 Mean of 100.9 8.1%  
RespirationRate(1/min) 20 Mean of 20 1.7%  
SystolicArterialPressure(mmHg) 120.0 Mean of 120.4 0.3%  
TidalVolume(mL) 736.4 Mean of 432.2 41.3%  
Patient-ExpiratoryReserveVolume(mL) 1472.8 Mean of 1472.8 0.0%  
Patient-FunctionalResidualCapacity(mL) 3156.0 Mean of 3156.0 0.0%  
Patient-InspiratoryCapacity(mL) 5260.0 Mean of 5260.0 0.0%  
Patient-InspiratoryReserveVolume(mL) 4523.6 Mean of 4832.6 6.8%  
Patient-ResidualVolume(mL) 1683.2 Mean of 1683.2 0.0%  
Patient-TotalLungCapacity(mL) 8416.0 Mean of 8416.0 0.0%  
Patient-VitalCapacity(mL) 6732.8 Mean of 6732.8 0.0%  

Conclusions

The methodology used to define and set patient parameters is successful in allowing for the simulation of unique humans.

Future Work

Coming Soon

There are no planned near-term additions.

Recommended Improvements

The physiology engine is providing consistent and accurate physiology simulation, and its ability to simulate physiology for a generic representative of a population will improve as development continues. It is not within the scope of the current project for the engine to predictively simulate the physiology of a specific (or average) individual within a population, but the development of technologies that make the engine usable and extensible to the community also facilitate multiscale model development and can be leveraged for predictive simulation and thus clinical use.

One way to extend the engine for clinical use is to use data from sources such as electronic health records (EHRs), lab reports, fitness evaluations, or wearable sensors to create a personalized physiological profile. A tool could then translate the personal physiological profile into parameters that can inform the physiology models within the systems' framework.

Appendices

Glossary

CDM - Common Data Model

Data Model Implementation

Patient

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