Virtual patient
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Virtual patients are simulations or representations of individuals involved in one or more health care processes, typically (but not necessarily) patients. Virtual patients are used in medical training, and help expedite drug research, and drug development.
Forms of Virtual Patients
Virtual patients may take a number of different forms:
- Artificial patients: computer simulations of biochemical processes such as the effect of drugs in organisms, the physiologic processes of a given organ or entire systems [systems biology] in a given organism. These can be used in different phases phase I|phase II|phase III|phase IV of a compound or drug in development in a given pharmacological research as a preliminary to testing on animals and humans for the drug development processes.
- Real patients: reflected in data e.g. electronic health records (EHRs). In this case the virtual patient is the reflection of the real patient in terms of data held about them. These are sometimes called e-patients.
- Physical simulators: mannequins (sometimes spelled 'manikins'), models or related artefacts.
- Simulated patients: where the patient is recreated by humans or computer-generated characters and Virtual Humans acting as such or engaging in other kinds of role-play.
- Electronic case-studies and scenarios where users work through problems, situations or similar narrative-based activities.
Types of Interaction with Simulated or Electronic Patients
A number of different modes of virtual patient delivery have been defined:
- Predetermined scenario [directed mode]
- The learner may build up the patient or case data from observations and interactions [blank mode]
- The learner may view and appraise or review an existing patient or scenario [critique mode or rehearsal mode]
- The VP may be used as a mechanism to address particular topics [context mode]
- The learner may use a scenario or patient to explore personal/professional dimensions [reflective mode]
- Banks of patients or scenarios may collectively address broad issues of healthcare [pattern mode]
Types of Interaction with Artificial Patients
- To create and run a mathematical quantitative simulation of a healthy person (physiology) and diseased person to test multiple hypothesis against known and unknown processes in a given set or sets of processes to help fill gaps in knowledge of the physiology or system under investigation.
Possible Benefits of Physical Simulators and Simulated Patients
Simulated patients increase the availability of training opportunities for medical students, making them less dependent on actual cases to learn how to handle different situations. Unlike real patients, simulated patients can be accessed on demand and they can be endlessly replayable to allow the user to explore different options and strategies. They can be structured with narratives that represent real situations while challenging the user with a wide range of tasks.
Despite their efficacy simulated patients are still a tangent and a prosthesis to reality. They should be viewed as augmenting existing modes and methods of clinical teaching.
Possible Benefits of Artificial Patients
Artificial patients increase the possibility of exploring millions of hypothesis driven experiments on known areas of biological systems to extrapolate the unknown, which enables efficient exploration, informed research and development predictive simulation, which must also be proven by real patient studies clinical trial. If more tests can be done on Artificial patients to filter out possibly unnecessary tests or experiments, fewer subjects pharmacovigilance maybe needed. The Artificial patients insilico modeling are still in the early to middle developmental stages. It will require continual updates and development with the endless availability of new data.
Virtual Patient Data Standards
The MedBiquitous consortium established a working group in 2005 to create a free and open data standard for expressing and exchanging virtual patients between different authoring and delivery systems. This was in part to address the problem of exchanging and reusing virtual patients and in part to encourage and support easier and wider use of virtual patients in general.
Examples
Electronic Cases
- WebSP from Karolinska Institutet
- Virtual Patients from Harvard Medical School
- Virtual Patient Project from New York University
- Labyrinth from the University of Edinburgh
- TUSK Case Simulator from Tufts University
- Virtual Patient from Keele University School of Pharmacy
Simulators
Virtual physiology