Organizations around the world are creating interactive, “virtual twins” of human physiology to support researchers, clinicians and patients. Many of these projects are part of the EU-funded Virtual Physiological Human (VPH) initiative, whose long-term goal is to develop comprehensive, integrative virtual models of the living human body to drive research and support clinical decisions. As a result, the initiative is already delivering promising solutions for patient care.
“The true virtual physiological human goes from atoms and molecules all the way up to the living individual—that’s an incredibly broad scale,” said John Fenner, a senior lecturer in medical physics at the UK’s University of Sheffield. “But the VPH also attempts to deliver real medical physics at the university. “But the VPH also attempts to deliver real answers to solve real problems today. Often, this can mean stepping back from the most complex models and focusing on the useful clinical questions that can be answered with simpler models.”
“The true virtual physiological human goes from atoms and molecules all the way up to the living individual—that’s an incredibly broad scale.”
JOHN FENNER, SENIOR LECTURER IN MEDICAL PHYSICS, UNIVERSITY OF SHEFFIELD
Delivering these models to clinics that treat patients requires collaboration across disciplines. “Regulators, industry and clinicians are all part of this process,” said Andrew Narracott, also a senior lecturer in medical physics at the university. “If any of these bodies isn’t fully engaged in the process of developing these solutions, it inevitably leads to lengthy delays.”
Narracott points to successful VPH applications like FEops HEARTguide, which provides support in the management of patients requiring heart valve replacement and is now available on the European and Canadian market.
A visualization of data using 3D printing and virtual reality to disseminate results of VPH-CaSE research at the European Parliament. The CFD (computational fluid design) model represents a stented coronary artery, showing contours of wall shear stress, produced by PhD student Susanna Migliori and hosted at LaBS, Politecnico di Milano. For further information see vph-case.eu. (Image © University of Sheffield)
However, obstacles to widespread adoption remain. “The big challenges aren’t always in the technical aspects of the modeling; they’re also in basic elements, like being able to share data,” Fenner said. “There are ethical issues around data privacy, for example. The VPH initiative is active in promoting solutions which will enable VPH research to move rapidly forward.”
Collaboration with regulators is essential. “Since software which results in diagnosis or is used to influence treatment is classified as a ‘medical device,’ regulatory bodies play a critical role in getting applications into the clinic,” Narracott said. “Furthermore, some are now publishing guidance documents that directly refer to the use of computational models for drug development and device design; their recognition of the role of simulation in this process is a significant milestone. Over the next few years, focus will move to extended discussions between simulation experts and regulatory bodies to understand what more needs to be done.”
In the clinic, acceptance of VPH solutions is growing. The University of Sheffield’s Insigneo Institute for in silico medicine, for example, is one of a few key organizations fostering close links between research and clinical environments and sowing the seeds of a cultural shift.
“Training is a vital part of gaining clinical acceptance,” Fenner said. “In recent years, we’ve seen several young doctors taking PhDs in computational technologies, and we continue to encourage clinicians to engage with our physics and bioengineering projects.”
Supported by advanced simulation technologies, the VPH initiative is building foundations to support its long-term vision.
“In 30 years’ time, the application of the VPH may be so obvious that we’ll wonder how we managed without it,” Fenner said. “For now, we’re finding our way forward and working out how we should best use these new technologies.”
The VPH initiative is fully described on the VPH Institute website.
