4 Faces of Medical Modeling

I enjoyed the biomedical modeling plenary at #ISDC2019 more than most. I was struck by the continuum of behavior involved in the system:

  • True biomedical modeling is a bit funny, because it’s not typical System Dynamics, in the sense that it’s nonlinear dynamic simulation, but it’s not behavioral, so it’s missing one of the cornerstones of SD. Nevertheless, I think the way we think about complex systems is a useful complement to other approaches coming more from biology and mathematics (nonlinear dynamics).
  • Behavior enters one level “up”, in problems like Jim Rogers & Ed Gallaher’s work on dose titration in anemia. This is a classic case of smart people having trouble managing a system with fairly simple dynamics – essentially a single pipeline delay in the case of anemia. There may be many similar cases, where large performance improvements are available from simple models (but complicated people management).
  • Next, there are problems that combine behavioral dynamics and misperceptions of feedback with an underlying system that is also quite complex. Gizem Aktas’ work on stress and hormonal regulation is an example, as are diabetes and mental health models.
  • At the far end of the scale, there are health system models, like ReThink Health, which abstract away from the biomedical details of any particular disease. In its place, there’s an extremely complex network of human resources, incentives and decisions.

I think the opportunities are large in all of these areas. Once challenge for the field is that each requires a different interface to other researchers, health practitioners and managers. That’s a lot for relatively few modelers to manage. How can we team up to be more effective?

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