Why does it take so long to initialize the physiology engine?

The engine represents a single, variable patient. Patient variability requires that the engine analyze the provided patient baseline values and stabilize the physiology to those values. This initialization can take several minutes, but once complete, the engine state can be saved to a file as protobuf binary or json. You can then load this state and instantaneously start execution of the simulation without any initialization time. Please consult the example in the SDK for how to take advantage of this feature and eliminate any initialization time in your application.

What is the fidelity of the physiology engine?

One definition of fidelity is "The degree to which a model or simulation represents the state and behavior of a real world object or the perception of a real world object, feature, condition, or chosen standard in a measurable or perceivable manner; a measure of the realism of a model or simulation [180] . " The validation documentation (in the System Methodology reports) describes how well the engine reproduces physiology at the system level. Like the human body, the engine is a self-compensating system of physiological systems with outcomes based on interventions [204] , and therefore can be considered high-fidelity.

Sometimes the word fidelity is used to refer to the spatial (anatomical) level of resolution of a model. The engine is a closed loop total body physiology model that combines physics-based lumped-parameter models and control system feedback mechanisms to model real-time system-level physiologic behaviors. Spatial resolution is limited by the lumped-parameter approach to sections of organs (what may arguably be referred to as the tissue level). However, the engine uses an extensible architecture to promote integration with external models with varying levels of fidelity (resolution or granularity). For more details, please see the recorded Committee on Credible Practice of Modeling & Simulation in Healthcare webinar.

Are there any publications related to the models that you have developed and choose to implement in the engine?

A list of publications and presentations about the engine can be found on the Publications page. Many of the physiology models in the engine are adapted or implemented directly from models described in literature. The implementation methodology is described in detail in the System Methodology and sub-system documentation, and all of the source publications are cited in the methodology reports and listed in the Bibliography. You can also find blog posts about work related to the physiology engine at https://blog.kitware.com.

What kind of uncertainty quantification do you do perform in your physiology model?

We have not performed a systematic forward propagation or inverse quantification of model uncertainty, nor have we conducted a formal sensitivity analysis. We plan to begin this type of analysis in the near future. However, we can quantify the numerical uncertainty introduced in solving the lumped-parameter fluid dynamics of the two foundation sub-models (Cardiovascular and Respiratory). The engine currently uses a bi-conjugate gradient method specific for sparse square systems (using the Eigen third party packages). This is an iterative method and we use the default tolerance for their solver, which is as close to zero as reasonable (around 1e-16).

Who is developing the physiology engine?

The community at large is contributing to the advancement of the Pulse Physiology Engine with oversight provided by Kitware, Inc..

Can I contact the physiology team to work on my current or upcoming project?

Absolutely. We always welcome new and challenging opportunities to work with research partners and sponsors. Please email us at kitwa.nosp@m.re@k.nosp@m.itwar.nosp@m.e.co.nosp@m.m.

What is the long-term plan for the physiology engine?

Our team's goal is to first and foremost develop the most advanced, open source, whole-body engine created to date. We plan to continue advancing physiologic models and incorporating state of the art models into the physiology engine to ensure we remain at the forefront of physiologic modeling research. We also plan to continue working with the user community to ensure the engine becomes the standard in physiology modeling by integrating it into a variety of applications.

Our system architecture was developed in a way that will make the system easy to extend for new models and external interfaces. The Apache 2.0 license allows for both open-source and proprietary applications to promote widespread use across government, military, academic, and commercial markets.

Is the physiology engine a game?

No, it is an series of mathematical models (engine) that can power immersive learning and serious games for medical training. The engine can provide a realistic training experience by producing real-time results to trauma and treatment. A physiology engine can enhance the user experience of applications by providing a comprehensive physiological response to insults and interventions.

Where do I log a bug for the physiology engine?

Logging bugs helps us improve the engine and we appreciate your feedback. You can report issues in gitlab.

What is your relationship with the Virtual Physiological Human (VPH) project.

The Virtual Physiological Human is a European initiative with the eventual goal of producing a complete mechanistic model of the entire human body. With the engine, we have simulated whole-body physiology with reasonable accuracy for a target population. The goal of the VPH project is individualized medical simulation. We are currently exploring expanding the physiology engine into patient-specific modeling. The engine results have been presented to the VPH community during the 2016 conference [174].

What is the advantage of the Common Data Model (CDM)?

For details about the Common Data Model, please see our Common Data Model and Software Framework documentation.

How fast does the physiology engine run? How can I make it faster?

The engine currently runs at about 5 to 10 times real time, depending on your machine's specifications. The included models and systems are included with the goal of creating the most complete engine possible. If your application does not require all of the existing models/systems, then you can strip features by modifying the source code in the same way that you would integrate a new model. Reducing the scope of the models will increase the speed of calculation.

Do you plan to provide support for interpreter-level model input, for example with the Python language?

We do not have any immediate plans to provide support for those languages. We do have support for Java. We are working towards creating a C# interface on top of our C++ interface. But feel free to report this and other feature requests as issues at gitlab.