TherapyEdge, Inc. announced in July 2002 that it will collaborate with the International Association of Physicians in care (IAPAC) to provide members worldwide with access to the TherapyEdge-HIVTM system. TherapyEdge-HIV is a Web-based software program that employs artificial intelligence to assess a patient's clinical status, alert for potential medical issues, and present viable, individualized therapy options based on their likelihood of success, in real time.
As part of the newly announced collaboration, TherapyEdge is offering IAPAC members two weeks of complementary access to TherapyEdge-HIV. For details regarding TherapyEdge-HIV complementary access, and special subscription pricing, please contact IAPAC Director of Membership Joey Atwell at firstname.lastname@example.org, or register directly with TherapyEdge at www.therapyedge.com.
"TherapyEdge-HIV," stated John W. Mellors, Chief of Infectious Diseases and Director of the HIV/AIDS Program at the University of Pittsburgh, "does in milliseconds what would take me 20 or 30 minutes sitting down in a quiet room, leafing through a patient's charts, checking the past medical history, virus resistance profiles, drug doses and interactions, pulling together all my knowledge."
"TherapyEdge HIV gathers and integrates patient data, the latest clinical research, and therapy options in a way that would otherwise take an enormous amount of time for me to do diligently," said Gary Blick, Medical Director of CICLE Medical in Norwalk, Connecticut, a TherapyEdge clinical evaluation site. "Since TherapyEdge focuses this knowledge on an individual-patient basis, it simplifies the onerous research and administrative tasks that would otherwise take me away from delivering quality personalized patient care."
That there are now thousands of combinations, including "boosted" protease inhibitor hybrids, does not make the selection process easy. "The virus changes into an almost endless variety of forms," explained Mellors, an authority on HIV drug resistance. "Individuals react differently to different medicines. The medications interact in so many different ways that you can't keep them in your head with any accuracy. To keep these things sorted out and optimized is a real challenge." Indeed, the body of knowledge required to make a good choice -- keeping the pill burden light, avoiding bad drug interactions and exploiting good ones, sidestepping drug toxicities -- is constantly evolving.
With TherapyEdge-HIV, the clinician inputs the patient's characteristics "and with a series of keystrokes asks the artificial intelligence system what regimens it would recommend and rank them," said Donna Mildvan, Chief of the Infectious Diseases Division at Beth Israel Medical Center in New York. Working by "the rules of the best practices according to a panel of experts," she said its answers are "very comparable" to what experts recommend.
TherapyEdge-HIV has undergone extensive evaluation and testing in clinical centers with large numbers of HIV-infected patients, and is the result of five years of development and collaboration with leading clinicians and researchers in the field of HIV/AIDS, pharmacologists, and leading software experts.
Four knowledge base subsystems -- pharmacology, resistance, clinical data, and therapy assessment -- are used to continuously assess a patient's status. These subsystems, integrated with the system's artificial intelligence technology, generate the patient-specific alerts/warnings, based on analyses of laboratory as well as resistance test results, current/prior medical conditions, allergies and current or previous medications.
When a change in HIV therapy is necessary, the system looks at all the possible ways of treating a patient, eliminates those that are contraindicated, and sorts the remainder from the most to the least fit by using thousands of filtration rules. For example, if a drug causes a patient an allergic reaction, filtration drops it from further consideration. In addition, tournament rules rank the drug combinations that pass through the sieve of filtration rules. Tournaments weigh combinations in terms of criteria doctors judge important for effective therapy and patient compliance, including potency, regimen simplicity, and preserving other treatment options if resistance develops. Tournament rules, like filtration rules, get updated continuously as HIV medicine progresses. Together with HIV resistance interpretation, the filtration and tournament rules bring to bear the disparate details and emerging research an HIV specialist may know, but that might slip a busy mind pressed for time.
TherapyEdge-HIV can therefore rapidly generate patient-tailored treatment options in milliseconds. Or, "the alternative [task] for the user," comments Mildvan, "is to say 'Here is what I, the clinician, am considering using. Do you see any problems with that? Do you see any preferences for other regimens?' In other words, how does artificial intelligence see my choice? It's really a cross check of your judgment as a clinician."
Back to the August 2002 issue of IAPAC Monthly.