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.
Weight Optional

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

Bmi = 16 kg/m2 Bmi = 30 kg/m2 Bmi = Body Mass Index = W[kg]/H[m]2. 21.75 kg/m2 is standard. No severly Underweight or Obese. [192]
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. [86]
Body Fat Fraction Optional

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

M = 0.25, F = 0.32 M = 0.02, F = 0.10 No obese and not less than essential fat. [180]
Carina To Teeth Distance Optional

\[{\rm{Ctd[cm] = }}\left\{ {\begin{array}{*{20}{c}} {{\rm{11}}{\rm{.413 + (0}}{\rm{.072 H[cm]) - 3}},\;M}\\ {{\rm{13}}{\rm{.555 + (0}}{\rm{.056 H[cm]) - 3}},\;F} \end{array}} \right.\]

- - [98]
Blood Volume Baseline Optional

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

Bv * 0.85 Bv * 1.15 Above Stage 1 Hypovolemia. [92]
Basal Metabolic Rate Optional

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

- - [230]
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.
Respiration Rate Baseline Optional

\[Rr[bpm] = 16\]

12 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) [94] and standard Asa (70 m2) [217].
Right Lung Ratio Optional

\[Rlr = 0.525\]

0.5 0.6
Skin Surface Area Optional

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

- - [60]
Heart Rate Maximum Optional

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

- - [263]
Heart Rate Minimum Optional

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

- -
Functional Residual Capacity Optional

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

- - [94]
Total Lung Capacity Optional

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

- - [94]
Residual Volume Optional

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

- - [94]
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 [247] and Brozek [26] equations.
Mean Arterial Pressure Unallowed

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

- - [109]
Tidal Volume Baseline Unallowed

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

- - [94]
Expiratory Reserve Volume Unallowed

\[Erv = Frc - Rv\]

- - [94]
Inspiratory Capacity Unallowed

\[Ic = Tlc - Frc\]

- - [94]
Inspriatory Reserve Volume Unallowed

\[Irv = Ic - Tv\]

- - [94]
Vital Capacity Unallowed

\[Vc - Tlc - Rv\]

- - [94]

Stabilization

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. After each stabilization period (i.e., resting, conditions, and feedback), several parameters are reset due to their reliance on combined effects. The patient definition only allows for healthy values - any chronic pathophysiology needs to be handled using the CDM condition definition.

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 16 bpm 16 bpm - - 16 bpm 16 bpm 20 bpm 12 bpm 12 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
BasalMetabolicRate(kcal/day) 1737.3 Mean of 1737.0 -0%
BloodVolumeBaseline(mL) 5517.7 Mean of 5588.1 1.3%
DiastolicArterialPressureBaseline(mmHg) 73.5 Mean of 73.0 -0.7%
HeartRateBaseline(1/min) 72 Mean of 73 1.4%
MeanArterialPressureBaseline(mmHg) 87.0 Mean of 94.6 8.8%
RespirationRateBaseline(1/min) 16 Mean of 16 0%
SystolicArterialPressureBaseline(mmHg) 114.0 Mean of 113.7 -0.3%
TidalVolumeBaseline(L) 0.540 Mean of 0.554 2.6%
ExpiratoryReserveVolume(L) 1.080 Mean of 1.139 5.5%
FunctionalResidualCapacity(L) 2.313 Mean of 2.373 2.6%
InspiratoryCapacity(L) 3.856 Mean of 3.796 -1.6%
InspiratoryReserveVolume(L) 3.316 Mean of 3.241 -2.3%
ResidualVolume(L) 1.234 Mean of 1.234 0%
TotalLungCapacity(L) 6.169 Mean of 6.169 0%
VitalCapacity(L) 4.935 Mean of 4.935 0%
Table 5. StandardFemale patient values with expected and engine output.


Property Name Expected Value Engine Value Percent Error Notes
BasalMetabolicRate(kcal/day) 1306.0 Mean of 1306.0 0%
BloodVolumeBaseline(mL) 4196.9 Mean of 4223.6 0.6%
DiastolicArterialPressureBaseline(mmHg) 73.5 Mean of 73.6 0.1%
HeartRateBaseline(1/min) 72 Mean of 73 1.4%
MeanArterialPressureBaseline(mmHg) 87.0 Mean of 94.8 8.9%
RespirationRateBaseline(1/min) 16 Mean of 16 0%
SystolicArterialPressureBaseline(mmHg) 114.0 Mean of 113.4 -0.5%
TidalVolumeBaseline(L) 0.413 Mean of 0.443 7.2%
ExpiratoryReserveVolume(L) 0.826 Mean of 0.839 1.6%
FunctionalResidualCapacity(L) 1.769 Mean of 1.782 0.7%
InspiratoryCapacity(L) 2.948 Mean of 2.935 -0.4%
InspiratoryReserveVolume(L) 2.536 Mean of 2.490 -1.8%
ResidualVolume(L) 0.943 Mean of 0.943 0%
TotalLungCapacity(L) 4.717 Mean of 4.717 0%
VitalCapacity(L) 3.774 Mean of 3.774 0%
Table 6. DefaultMale patient values with expected and engine output.


Property Name Expected Value Engine Value Percent Error Notes
BasalMetabolicRate(kcal/day) 1601.1 Mean of 1601.0 -0%
BloodVolumeBaseline(mL) 4863.8 Mean of 4932.9 1.4%
DiastolicArterialPressureBaseline(mmHg) 73.5 Mean of 73.4 -0.1%
HeartRateBaseline(1/min) 72 Mean of 73 1.4%
MeanArterialPressureBaseline(mmHg) 87.0 Mean of 94.8 8.9%
RespirationRateBaseline(1/min) 16 Mean of 16 0%
SystolicArterialPressureBaseline(mmHg) 114.0 Mean of 113.6 -0.3%
TidalVolumeBaseline(L) 0.477 Mean of 0.523 9.6%
ExpiratoryReserveVolume(L) 0.954 Mean of 1.008 5.7%
FunctionalResidualCapacity(L) 2.044 Mean of 2.098 2.6%
InspiratoryCapacity(L) 3.407 Mean of 3.353 -1.6%
InspiratoryReserveVolume(L) 2.930 Mean of 2.830 -3.4%
ResidualVolume(L) 1.090 Mean of 1.090 0%
TotalLungCapacity(L) 5.451 Mean of 5.451 0%
VitalCapacity(L) 4.361 Mean of 4.361 0%
Table 7. DefaultFemale patient values with expected and engine output.


Property Name Expected Value Engine Value Percent Error Notes
BasalMetabolicRate(kcal/day) 1296.4 Mean of 1296.0 -0%
BloodVolumeBaseline(mL) 4111.3 Mean of 4136.9 0.6%
DiastolicArterialPressureBaseline(mmHg) 73.5 Mean of 73.2 -0.4%
HeartRateBaseline(1/min) 72 Mean of 73 1.4%
MeanArterialPressureBaseline(mmHg) 87.0 Mean of 95.0 9.1%
RespirationRateBaseline(1/min) 16 Mean of 16 0%
SystolicArterialPressureBaseline(mmHg) 114.0 Mean of 114.1 0.1%
TidalVolumeBaseline(L) 0.405 Mean of 0.438 8.4%
ExpiratoryReserveVolume(L) 0.809 Mean of 0.817 1%
FunctionalResidualCapacity(L) 1.734 Mean of 1.742 0.5%
InspiratoryCapacity(L) 2.889 Mean of 2.881 -0.3%
InspiratoryReserveVolume(L) 2.485 Mean of 2.440 -1.8%
ResidualVolume(L) 0.925 Mean of 0.925 0%
TotalLungCapacity(L) 4.623 Mean of 4.623 -0%
VitalCapacity(L) 3.698 Mean of 3.698 0%
Table 8. Overweight patient values with expected and engine output.


Property Name Expected Value Engine Value Percent Error Notes
BasalMetabolicRate(kcal/day) 2010.8 Mean of 2011.0 0%
BloodVolumeBaseline(mL) 7011.2 Mean of 7071.4 0.9%
DiastolicArterialPressureBaseline(mmHg) 73.5 Mean of 73.1 -0.6%
HeartRateBaseline(1/min) 72 Mean of 73 1.4%
MeanArterialPressureBaseline(mmHg) 87.0 Mean of 94.8 9%
RespirationRateBaseline(1/min) 16 Mean of 16 0%
SystolicArterialPressureBaseline(mmHg) 114.0 Mean of 114.0 0%
TidalVolumeBaseline(L) 0.683 Mean of 0.634 -7.1%
ExpiratoryReserveVolume(L) 1.365 Mean of 1.345 -1.5%
FunctionalResidualCapacity(L) 2.926 Mean of 2.905 -0.7%
InspiratoryCapacity(L) 4.876 Mean of 4.897 0.4%
InspiratoryReserveVolume(L) 4.193 Mean of 4.264 1.7%
ResidualVolume(L) 1.560 Mean of 1.560 0%
TotalLungCapacity(L) 7.802 Mean of 7.802 0%
VitalCapacity(L) 6.241 Mean of 6.241 0%
Table 9. Underweight patient values with expected and engine output.


Property Name Expected Value Engine Value Percent Error Notes
BasalMetabolicRate(kcal/day) 1403.1 Mean of 1403.0 -0%
BloodVolumeBaseline(mL) 3703.5 Mean of 3777.5 2%
DiastolicArterialPressureBaseline(mmHg) 73.5 Mean of 73.0 -0.7%
HeartRateBaseline(1/min) 72 Mean of 73 1.4%
MeanArterialPressureBaseline(mmHg) 87.0 Mean of 94.8 9%
RespirationRateBaseline(1/min) 16 Mean of 16 0%
SystolicArterialPressureBaseline(mmHg) 114.0 Mean of 114.0 -0%
TidalVolumeBaseline(L) 0.365 Mean of 0.443 21.4%
ExpiratoryReserveVolume(L) 0.730 Mean of 0.719 -1.5%
FunctionalResidualCapacity(L) 1.565 Mean of 1.554 -0.7%
InspiratoryCapacity(L) 2.608 Mean of 2.619 0.4%
InspiratoryReserveVolume(L) 2.243 Mean of 2.176 -3%
ResidualVolume(L) 0.835 Mean of 0.835 0%
TotalLungCapacity(L) 4.173 Mean of 4.173 -0%
VitalCapacity(L) 3.338 Mean of 3.338 -0%
Table 10. Tachycardic patient values with expected and engine output.


Property Name Expected Value Engine Value Percent Error Notes
BasalMetabolicRate(kcal/day) 1737.3 Mean of 1737.0 -0%
BloodVolumeBaseline(mL) 5517.7 Mean of 5546.9 0.5%
DiastolicArterialPressureBaseline(mmHg) 73.5 Mean of 74.4 1.2%
HeartRateBaseline(1/min) 110 Mean of 112 1.9%
MeanArterialPressureBaseline(mmHg) 87.0 Mean of 95.7 10%
RespirationRateBaseline(1/min) 20 Mean of 20 0%
SystolicArterialPressureBaseline(mmHg) 114.0 Mean of 114.3 0.3%
TidalVolumeBaseline(L) 0.540 Mean of 0.490 -9.1%
ExpiratoryReserveVolume(L) 1.080 Mean of 1.142 5.7%
FunctionalResidualCapacity(L) 2.313 Mean of 2.375 2.7%
InspiratoryCapacity(L) 3.856 Mean of 3.794 -1.6%
InspiratoryReserveVolume(L) 3.316 Mean of 3.303 -0.4%
ResidualVolume(L) 1.234 Mean of 1.234 0%
TotalLungCapacity(L) 6.169 Mean of 6.169 0%
VitalCapacity(L) 4.935 Mean of 4.935 0%
Table 11. Bradycardic patient values with expected and engine output.


Property Name Expected Value Engine Value Percent Error Notes
BasalMetabolicRate(kcal/day) 1737.3 Mean of 1737.0 -0%
BloodVolumeBaseline(mL) 5517.7 Mean of 5597.8 1.5%
DiastolicArterialPressureBaseline(mmHg) 73.5 Mean of 72.8 -1%
HeartRateBaseline(1/min) 50 Mean of 51 2%
MeanArterialPressureBaseline(mmHg) 87.0 Mean of 94.5 8.6%
RespirationRateBaseline(1/min) 12 Mean of 12 0%
SystolicArterialPressureBaseline(mmHg) 114.0 Mean of 113.6 -0.3%
TidalVolumeBaseline(L) 0.540 Mean of 0.645 19.5%
ExpiratoryReserveVolume(L) 1.080 Mean of 1.137 5.3%
FunctionalResidualCapacity(L) 2.313 Mean of 2.371 2.5%
InspiratoryCapacity(L) 3.856 Mean of 3.798 -1.5%
InspiratoryReserveVolume(L) 3.316 Mean of 3.153 -4.9%
ResidualVolume(L) 1.234 Mean of 1.234 0%
TotalLungCapacity(L) 6.169 Mean of 6.169 0%
VitalCapacity(L) 4.935 Mean of 4.935 0%
Table 12. Cynthia patient values with expected and engine output.


Property Name Expected Value Engine Value Percent Error Notes
BasalMetabolicRate(kcal/day) 1366.6 Mean of 1367.0 0%
BloodVolumeBaseline(mL) 4196.9 Mean of 4235.3 0.9%
DiastolicArterialPressureBaseline(mmHg) 73.5 Mean of 72.9 -0.8%
HeartRateBaseline(1/min) 72 Mean of 73 1.4%
MeanArterialPressureBaseline(mmHg) 87.0 Mean of 94.7 8.9%
RespirationRateBaseline(1/min) 18 Mean of 18 0%
SystolicArterialPressureBaseline(mmHg) 114.0 Mean of 114.0 -0%
TidalVolumeBaseline(L) 0.413 Mean of 0.416 0.7%
ExpiratoryReserveVolume(L) 0.826 Mean of 0.840 1.7%
FunctionalResidualCapacity(L) 1.769 Mean of 1.783 0.8%
InspiratoryCapacity(L) 2.948 Mean of 2.934 -0.5%
InspiratoryReserveVolume(L) 2.536 Mean of 2.517 -0.7%
ResidualVolume(L) 0.943 Mean of 0.943 0%
TotalLungCapacity(L) 4.717 Mean of 4.717 0%
VitalCapacity(L) 3.774 Mean of 3.774 0%
Table 13. Gus patient values with expected and engine output.


Property Name Expected Value Engine Value Percent Error Notes
BasalMetabolicRate(kcal/day) 1914.8 Mean of 1915.0 0%
BloodVolumeBaseline(mL) 6180.6 Mean of 7608.3 23.1%
DiastolicArterialPressureBaseline(mmHg) 60.0 Mean of 60.8 1.3%
HeartRateBaseline(1/min) 93 Mean of 94 1.1%
MeanArterialPressureBaseline(mmHg) 70.0 Mean of 76.6 9.4%
RespirationRateBaseline(1/min) 14 Mean of 14 0%
SystolicArterialPressureBaseline(mmHg) 90.0 Mean of 90.5 0.6%
TidalVolumeBaseline(L) 0.603 Mean of 0.750 24.3%
ExpiratoryReserveVolume(L) 1.207 Mean of 1.237 2.5%
FunctionalResidualCapacity(L) 2.585 Mean of 2.616 1.2%
InspiratoryCapacity(L) 4.309 Mean of 4.278 -0.7%
InspiratoryReserveVolume(L) 3.706 Mean of 3.527 -4.8%
ResidualVolume(L) 1.379 Mean of 1.379 -0%
TotalLungCapacity(L) 6.895 Mean of 6.895 -0%
VitalCapacity(L) 5.516 Mean of 5.516 -0%
Table 14. Joel patient values with expected and engine output.


Property Name Expected Value Engine Value Percent Error Notes
BasalMetabolicRate(kcal/day) 1737.3 Mean of 1737.0 -0%
BloodVolumeBaseline(mL) 5517.7 Mean of 5265.5 -4.6%
DiastolicArterialPressureBaseline(mmHg) 80.0 Mean of 79.9 -0.1%
HeartRateBaseline(1/min) 110 Mean of 112 2%
MeanArterialPressureBaseline(mmHg) 93.3 Mean of 100.5 7.7%
RespirationRateBaseline(1/min) 15 Mean of 15 0%
SystolicArterialPressureBaseline(mmHg) 120.0 Mean of 118.9 -0.9%
TidalVolumeBaseline(L) 0.540 Mean of 0.623 15.5%
ExpiratoryReserveVolume(L) 1.080 Mean of 1.140 5.6%
FunctionalResidualCapacity(L) 2.313 Mean of 2.373 2.6%
InspiratoryCapacity(L) 3.856 Mean of 3.796 -1.6%
InspiratoryReserveVolume(L) 3.316 Mean of 3.174 -4.3%
ResidualVolume(L) 1.234 Mean of 1.234 0%
TotalLungCapacity(L) 6.169 Mean of 6.169 0%
VitalCapacity(L) 4.935 Mean of 4.935 0%
Table 15. Nathan patient values with expected and engine output.


Property Name Expected Value Engine Value Percent Error Notes
BasalMetabolicRate(kcal/day) 1737.3 Mean of 1737.0 -0%
BloodVolumeBaseline(mL) 5517.7 Mean of 5588.3 1.3%
DiastolicArterialPressureBaseline(mmHg) 73.5 Mean of 73.1 -0.5%
HeartRateBaseline(1/min) 72 Mean of 73 2%
MeanArterialPressureBaseline(mmHg) 87.0 Mean of 94.7 8.8%
RespirationRateBaseline(1/min) 16 Mean of 16 0%
SystolicArterialPressureBaseline(mmHg) 114.0 Mean of 113.6 -0.4%
TidalVolumeBaseline(L) 0.540 Mean of 0.555 2.8%
ExpiratoryReserveVolume(L) 1.080 Mean of 1.139 5.5%
FunctionalResidualCapacity(L) 2.313 Mean of 2.373 2.6%
InspiratoryCapacity(L) 3.856 Mean of 3.796 -1.6%
InspiratoryReserveVolume(L) 3.316 Mean of 3.240 -2.3%
ResidualVolume(L) 1.234 Mean of 1.234 0%
TotalLungCapacity(L) 6.169 Mean of 6.169 0%
VitalCapacity(L) 4.935 Mean of 4.935 0%
Table 16. Hassan patient values with expected and engine output.


Property Name Expected Value Engine Value Percent Error Notes
BasalMetabolicRate(kcal/day) 1931.5 Mean of 1932.0 0%
BloodVolumeBaseline(mL) 6014.8 Mean of 7406.8 23.1%
DiastolicArterialPressureBaseline(mmHg) 60.0 Mean of 61.0 1.6%
HeartRateBaseline(1/min) 110 Mean of 111 0.9%
MeanArterialPressureBaseline(mmHg) 70.0 Mean of 76.6 9.5%
RespirationRateBaseline(1/min) 18 Mean of 18 0%
SystolicArterialPressureBaseline(mmHg) 90.0 Mean of 90.2 0.2%
TidalVolumeBaseline(L) 0.587 Mean of 0.605 3.1%
ExpiratoryReserveVolume(L) 1.175 Mean of 1.217 3.6%
FunctionalResidualCapacity(L) 2.517 Mean of 2.560 1.7%
InspiratoryCapacity(L) 4.196 Mean of 4.153 -1%
InspiratoryReserveVolume(L) 3.608 Mean of 3.547 -1.7%
ResidualVolume(L) 1.343 Mean of 1.343 -0%
TotalLungCapacity(L) 6.713 Mean of 6.713 0%
VitalCapacity(L) 5.371 Mean of 5.371 -0%
Table 17. Soldier patient values with expected and engine output.


Property Name Expected Value Engine Value Percent Error Notes
BasalMetabolicRate(kcal/day) 1862.2 Mean of 1862.0 -0%
BloodVolumeBaseline(mL) 5517.7 Mean of 5574.9 1%
DiastolicArterialPressureBaseline(mmHg) 73.5 Mean of 73.4 -0.1%
HeartRateBaseline(1/min) 84 Mean of 86 2.4%
MeanArterialPressureBaseline(mmHg) 87.0 Mean of 95.0 9.2%
RespirationRateBaseline(1/min) 16 Mean of 16 0%
SystolicArterialPressureBaseline(mmHg) 114.0 Mean of 114.4 0.4%
TidalVolumeBaseline(L) 0.540 Mean of 0.596 10.4%
ExpiratoryReserveVolume(L) 1.080 Mean of 1.140 5.6%
FunctionalResidualCapacity(L) 2.313 Mean of 2.374 2.6%
InspiratoryCapacity(L) 3.856 Mean of 3.795 -1.6%
InspiratoryReserveVolume(L) 3.316 Mean of 3.200 -3.5%
ResidualVolume(L) 1.234 Mean of 1.234 0%
TotalLungCapacity(L) 6.169 Mean of 6.169 0%
VitalCapacity(L) 4.935 Mean of 4.935 0%
Table 18. Jeff patient values with expected and engine output.


Property Name Expected Value Engine Value Percent Error Notes
BasalMetabolicRate(kcal/day) 1918.2 Mean of 1918.0 -0%
BloodVolumeBaseline(mL) 5849.0 Mean of 5907.7 1%
DiastolicArterialPressureBaseline(mmHg) 73.5 Mean of 73.3 -0.2%
HeartRateBaseline(1/min) 72 Mean of 73 2.1%
MeanArterialPressureBaseline(mmHg) 87.0 Mean of 95.0 9.1%
RespirationRateBaseline(1/min) 16 Mean of 16 0%
SystolicArterialPressureBaseline(mmHg) 114.0 Mean of 114.0 -0%
TidalVolumeBaseline(L) 0.572 Mean of 0.594 4%
ExpiratoryReserveVolume(L) 1.143 Mean of 1.192 4.3%
FunctionalResidualCapacity(L) 2.449 Mean of 2.498 2%
InspiratoryCapacity(L) 4.082 Mean of 4.034 -1.2%
InspiratoryReserveVolume(L) 3.511 Mean of 3.439 -2.1%
ResidualVolume(L) 1.306 Mean of 1.306 -0%
TotalLungCapacity(L) 6.532 Mean of 6.532 -0%
VitalCapacity(L) 5.225 Mean of 5.225 -0%
Table 19. Carol patient values with expected and engine output.


Property Name Expected Value Engine Value Percent Error Notes
BasalMetabolicRate(kcal/day) 1464.8 Mean of 1465.0 0%
BloodVolumeBaseline(mL) 5186.9 Mean of 5197.9 0.2%
DiastolicArterialPressureBaseline(mmHg) 73.5 Mean of 73.5 -0.1%
HeartRateBaseline(1/min) 72 Mean of 73 1.4%
MeanArterialPressureBaseline(mmHg) 87.0 Mean of 95.1 9.3%
RespirationRateBaseline(1/min) 18 Mean of 18 0%
SystolicArterialPressureBaseline(mmHg) 114.0 Mean of 114.1 0.1%
TidalVolumeBaseline(L) 0.508 Mean of 0.438 -13.7%
ExpiratoryReserveVolume(L) 1.016 Mean of 1.078 6.1%
FunctionalResidualCapacity(L) 2.177 Mean of 2.239 2.8%
InspiratoryCapacity(L) 3.629 Mean of 3.567 -1.7%
InspiratoryReserveVolume(L) 3.121 Mean of 3.129 0.3%
ResidualVolume(L) 1.161 Mean of 1.161 0%
TotalLungCapacity(L) 5.806 Mean of 5.806 0%
VitalCapacity(L) 4.645 Mean of 4.645 0%
Table 20. Jane patient values with expected and engine output.


Property Name Expected Value Engine Value Percent Error Notes
BasalMetabolicRate(kcal/day) 1376.6 Mean of 1377.0 0%
BloodVolumeBaseline(mL) 3867.8 Mean of 3911.3 1.1%
DiastolicArterialPressureBaseline(mmHg) 73.5 Mean of 73.1 -0.6%
HeartRateBaseline(1/min) 72 Mean of 73 1.4%
MeanArterialPressureBaseline(mmHg) 87.0 Mean of 94.7 8.9%
RespirationRateBaseline(1/min) 18 Mean of 18 0%
SystolicArterialPressureBaseline(mmHg) 114.0 Mean of 113.8 -0.2%
TidalVolumeBaseline(L) 0.381 Mean of 0.403 5.8%
ExpiratoryReserveVolume(L) 0.762 Mean of 0.757 -0.7%
FunctionalResidualCapacity(L) 1.633 Mean of 1.628 -0.3%
InspiratoryCapacity(L) 2.722 Mean of 2.726 0.1%
InspiratoryReserveVolume(L) 2.341 Mean of 2.323 -0.8%
ResidualVolume(L) 0.871 Mean of 0.871 0%
TotalLungCapacity(L) 4.354 Mean of 4.354 -0%
VitalCapacity(L) 3.484 Mean of 3.484 0%
Table 21. ExtremeFemale patient values with expected and engine output.


Property Name Expected Value Engine Value Percent Error Notes
BasalMetabolicRate(kcal/day) 1172.9 Mean of 1173.0 0%
BloodVolumeBaseline(mL) 2891.1 Mean of 3508.4 21.4%
DiastolicArterialPressureBaseline(mmHg) 60.0 Mean of 61.1 1.8%
HeartRateBaseline(1/min) 60 Mean of 61 1.7%
MeanArterialPressureBaseline(mmHg) 70.0 Mean of 77.3 10.4%
RespirationRateBaseline(1/min) 12 Mean of 12 0%
SystolicArterialPressureBaseline(mmHg) 90.0 Mean of 91.0 1.1%
TidalVolumeBaseline(L) 0.286 Mean of 0.420 46.6%
ExpiratoryReserveVolume(L) 0.573 Mean of 0.601 4.9%
FunctionalResidualCapacity(L) 1.228 Mean of 1.256 2.3%
InspiratoryCapacity(L) 2.046 Mean of 2.017 -1.4%
InspiratoryReserveVolume(L) 1.759 Mean of 1.595 -9.3%
ResidualVolume(L) 0.655 Mean of 0.655 0%
TotalLungCapacity(L) 3.273 Mean of 3.273 -0%
VitalCapacity(L) 2.619 Mean of 2.619 0%
Table 22. ExtremeMale patient values with expected and engine output.


Property Name Expected Value Engine Value Percent Error Notes
BasalMetabolicRate(kcal/day) 2070.0 Mean of 2070.0 0%
BloodVolumeBaseline(mL) 7120.4 Mean of 6809.8 -4.4%
DiastolicArterialPressureBaseline(mmHg) 80.0 Mean of 79.2 -1%
HeartRateBaseline(1/min) 100 Mean of 103 3%
MeanArterialPressureBaseline(mmHg) 93.3 Mean of 100.1 7.2%
RespirationRateBaseline(1/min) 20 Mean of 20 0%
SystolicArterialPressureBaseline(mmHg) 120.0 Mean of 119.0 -0.9%
TidalVolumeBaseline(L) 0.693 Mean of 0.558 -19.4%
ExpiratoryReserveVolume(L) 1.386 Mean of 1.363 -1.7%
FunctionalResidualCapacity(L) 2.970 Mean of 2.947 -0.8%
InspiratoryCapacity(L) 4.951 Mean of 4.974 0.5%
InspiratoryReserveVolume(L) 4.257 Mean of 4.418 3.8%
ResidualVolume(L) 1.584 Mean of 1.584 -0%
TotalLungCapacity(L) 7.921 Mean of 7.921 0%
VitalCapacity(L) 6.337 Mean of 6.337 -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

Acronyms

CDM - Common Data Model

Data Model Implementation

Patient