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What physicians can learn from engineers

Thomas Hughes. Image courtesy the University of Texas at Austin.

Cardiovascular disease is still the leading cause of death for both men and women in the industrialized world, causing more than 30 percent of all deaths in the United States. It is also the most costly component of total health care spending.

Below is an opinion article on how computational medicine will make medical care more like the practice of engineering, and why more physicians need to embrace this idea.

To improve health and lower spending cost, physicians should turn to engineering principles and methods. In fact, to improve heart disease outcomes, it appears inevitable that, in the future, the practice of medicine will have to resemble the practice of modern engineering more closely.

Historically, physicians have used various tests to diagnose a medical condition and then plan a treatment or intervention based on experience and statistics. However, statistics alone are not reliable predictors of success for individual patients. There is simply too much variability from case to case, especially for diseased patients.

In contrast, in engineering there is an attempt to accurately predict the performance of a product or procedure for its intended use. The entire design process is based on predicted outcomes, and often a number of criteria must be satisfied simultaneously. The field of computational medicine hopes to bring these engineering principles to patients.

Computational medicine will make medical care more like the practice of engineering, and more physicians need to embrace this idea.

Built on vascular research that began about 20 years ago, computational medicine relies on patient-specific computer modeling to diagnose disease, evaluate the efficacy of various possible treatments, and plan optimal interventions.

For example, by using a computer model of a patient's specific problem, the effectiveness of a bypass graft can be assessed before surgery is performed.

Charles Taylor. Image courtesy the University of Texas at Austin.

However, of even greater importance are the intervention's implications after time has elapsed. How does a treatment hold up a month, six months, a year, or a decade down the line? At this moment, researchers are beginning to develop models of these longer time phenomena.

Computational medicine technologies will enable clinicians to craft cardiovascular therapies that are optimized for the cardiovascular system of each individual, and to evaluate interventions for efficacy and possible side effects before they are performed.

They will also provide design methodologies, enabling biomedical engineers and physicians to devise new therapies while decreasing costs and increasing safety associated with their introduction and clinical testing.

Medicine has much to learn from engineering practice, which leverages modern computational technology to provide consumers with high-quality products to satisfy customer demand at attractive prices.

Indeed, the noninvasive nature of computational medicine technologies may be one of the most effective ways to control spiraling health care costs without sacrificing the quality of care. Closer collaboration between physicians and engineers will facilitate development and introduction of these technologies.

Cardiovascular disease is the current focus of research in computational medicine. However, the concept is obviously more general and is already beginning to affect other areas, such as cancer.

The development and clinical implementation of predictive computational medicine may represent a milestone in the history of engineering and medicine, one that may have significant benefits for the health and welfare of humanity.

In view of the promise of computational medicine to benefit patients and improve efficiency of the health care system while reducing costs, this field is one that merits strong support in federal research programs and the private sector.

-- Thomas Hughes, professor of aerospace engineering and computational mechanics, the University of Texas at Austin.

-- Charles Taylor, founder and chief technology officer at Heartflow Inc.

This article is republished with permission from Knowat the University of Texas at Austin. The original version is available here.

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