Simulation Talk

If you read a newspaper last week you may have come across the Twin story. If you didn’t hear about it, let me fill you in.

This was a paired cohort trial across Europe, consisting of nearly 10k recruited-at-birth twin kids. Their parents agreed to raise one child healthy and one unhealthy up to 18 years of age. So, at last, science would be able to definitively answer questions about lifestyle.

The day-to-day habits of each twin were very different. For example, one twin took-up all kind of fitness hobbies like tennis, football, rugby, marathon running; the other took-up Playstation and crisps. One twin would do boxing and the other box-sets.

But maintaining this trial wasn’t always easy. Small children can be really stubborn when they want to be. We all know that kids are selfish and even when involved in the noble pursuit of concrete scientific evidence they can still only look-out for Number One. An example exchange over the dinner table went something like

•  (twin) Muuuum, but I don’t want any more fags
•  (mum) Well if you don’t smoke all your fags you won’t have any pudding! Here’s a lighter, now start smoking!!

Some kids were on 50-a-day. That’s fags and Big Macs, not to mention the booze. This was like Supersize Me for 0 to 18 year olds to once-and-for-all prove the effects of bad lifestyle on health.

The results? We had thousands of real-live Danny Devitos and Arnold Schwarzeneggers.

Of course, this isn’t a real trial. No children were forced to chain smoke or maintain a heavy drinking habit, mainly because of annoying things like “ethics” and “morals” getting in the way.

But there is a branch of scientific research that inhabits a world where you can make babies smoke and down flaming shots. No, not in Middlesbrough but the world of computer simulation.

Computer simulations allow us to experiment with “what-if” scenarios. What if I stopped smoking at 30? What if I get off the bus one stop early? What if I eat my 5-a-day? The simulated world is a bit like Sim City or World of Warcraft but without the elfs. We can investigate the effect of different interventions like giving over 60s statins or we can compare the effects of disease prevention against treatment.

Teams of computer scientists, statisticians, public health experts and clinicians develop superfast computer models, harnessing new computing power to produce an answer quicker than ever so we can simulate more and more people in more and more detail giving us better and better answers.

Probabilistic microsimulations can follow someone from day one at birth to inevitable death and can tell individual stories for 10s of millions of people, like the entire UK population.

In this time of austerity these models can help decisions about where to best put the available moneys for maximum impact.

But, like an American info-mertial, this isn’t all. There’s a way that these models can be used more directly to help you and me.

I went to the doctors recently and I swear he was looking up what was wrong with me on Wikipedia. I wouldn’t have minded so much but he said it was a toss-up between the plague and thrush.

But these PCs on GPs desks can also be put to use with the simulation models too. “Informatics” has the aim to provide desktop tools that can help the doctor and patient. Live evidence can be communicated to the patient about the effects of any change (or not) in their lifestyle. Using interactive widgets like sliders, dials and infographics the patient can be involved in the process and take ownership of their health decisions, which will make it more likely to be motivating and effective. They can see what likely outcomes are from what causes of action.

With more data available than ever before, detailed models and powerful, web-based and user-friendly interactive tools to use them then hopefully in the future there’ll be fewer Danny Devitos and more Arnold Schwarzeneggers.