Knowledge of multiscale mechanisms in pathophysiology is the bedrock of clinical practice. If quantitative methods, predicting patient-specific behaviour of these pathophysiology mechanisms, are to be brought to bear on clinical decision-making, the Human Physiome community and Clinical community must share a common computational blueprint for pathophysiology mechanisms. A number of obstacles stand in the way of this sharing-not least the technical and operational challenges that must be overcome to ensure that (i) the explicit biological meanings of the Physiome's quantitative methods to represent mechanisms are open to articulation, verification and study by clinicians, and that (ii) clinicians are given the tools and training to explicitly express disease manifestations in direct contribution to modelling. To this end, the Physiome and Clinical communities must co-develop a common computational toolkit, based on this blueprint, to bridge the representation of knowledge of pathophysiology mechanisms (a) that is implicitly depicted in electronic health records and the literature, with (b) that found in mathematical models explicitly describing mechanisms. In particular, this paper makes use of a step-wise description of a specific disease mechanism as a means to elicit the requirements of representing pathophysiological meaning explicitly. The computational blueprint developed from these requirements addresses the Clinical community goals to (i) organize and manage healthcare resources in terms of relevant disease-related knowledge of mechanisms and (ii) train the next generation of physicians in the application of quantitative methods relevant to their research and practice.
Keywords: clinical community; disease mechanism modelling; knowledge management; pathophysiology; physiome community.
Avoiding and identifying errors in health technology assessment models: qualitative study and methodological review.Health Technol Assess. 2010 May;14(25):iii-iv, ix-xii, 1-107. doi: 10.3310/hta14250. Health Technol Assess. 2010. PMID: 20501062 Review.
A qualitative systematic review of internal and external influences on shared decision-making in all health care settings.JBI Libr Syst Rev. 2012;10(58):4633-4646. doi: 10.11124/jbisrir-2012-432. JBI Libr Syst Rev. 2012. PMID: 27820528
Toward a VPH/Physiome ToolKit.Wiley Interdiscip Rev Syst Biol Med. 2010 Mar-Apr;2(2):134-147. doi: 10.1002/wsbm.63. Wiley Interdiscip Rev Syst Biol Med. 2010. PMID: 20836018 Review.
Implementing the 2009 Institute of Medicine recommendations on resident physician work hours, supervision, and safety.Nat Sci Sleep. 2011 Jun 24;3:47-85. doi: 10.2147/NSS.S19649. Print 2011. Nat Sci Sleep. 2011. PMID: 23616719 Free PMC article.
D-WISE: Diabetes Web-Centric Information and Support Environment: conceptual specification and proposed evaluation.Can J Diabetes. 2014 Jun;38(3):205-11. doi: 10.1016/j.jcjd.2014.03.006. Can J Diabetes. 2014. PMID: 24909091