Patient Methodology

Overview

Abstract

BioGears allows for patient variability via a set of parameters used to define aspects of the simulated human. These parameters are used throughout the system models to manipulate the physiological responses and homeostatic state. BioGears is deployed with several defined patients created for various testing and analysis purposes.

Introduction

The BioGears program consists of the development and integration of multiscale models for an individualized whole-body predictive patient physiology model. BioGears incorporates existing and novel models of organs and physiological systems into a whole-body model of a single generic individual within a reference population. Therefore, specific patient definitions are needed to create a virtual representation of that patient. The patient definition leverages the Commmon Data Model (CDM) to allow physiological parameters to be disseminated throughout the engine.

System Design

Background and Scope

Requirements

The BioGears patient needs to contain all user-definable parameters specific to an individual. Any parameters that are not explicitly set need to be calculated based on standard, healthy values.

Approach

Each patient parameter falls into one of three categories:

  • Required: The only parameter that is required to be set on the patient at runtime is Sex. All other values not explicitly set will be determined using default values and/or calculated outputs.
  • Optional: These parameters can be optionally explicitly set by the user. Many optional values have bounds associated with them to ensure a healthy initial patient.
  • Unallowed: These parameters are calculated or determined through simulation based on other settings. They can not be modified by the user.

Table 1 provides the values and equations used to determine optional values not explicitly set by the user and those unallowed to be externally modified.

Features and Capabilities

Definitions

Table 1. All patient parameters, how they are determined, and upper and lower limits.
Parameter Modification Category Initial Value (If not Explicitly Set) Lower Bound Upper Bound Notes
Sex Required

\[M = Male,F = Female\]

- - This is the only parameter required to be explicitly set.
Age Optional

\[A[yr] = 44\]

18 yr 65 yr No pediatric or geriatric modeling.
Weight Optional

\[W[kg] = 21.75H{[m]^2}\]

Bmi = 16 kg/m2 Bmi = 30 kg/m2 Bmi = Body Mass Index = W[kg]/H[m]2. 21.75 kg/m2 is standard. No severly Underweight or Obese. [249]
Height Optional

\[{\rm{H[cm] = }}\left\{ {\begin{array}{*{20}{c}} {{\rm{177}},\;M}\\ {{\rm{163}},\;F} \end{array}} \right.\]

M = 163 cm, F = 151 cm M = 190 cm, F = 175.5 cm Min = 3rd percentile, Max = 97th percentile, Standard = 50th percentile. [108]
Body Fat Fraction Optional

\[{\rm{Ff[cm] = }}\left\{ {\begin{array}{*{20}{c}} {{\rm{0}}{\rm{.21}},\;M}\\ {0.28,\;F} \end{array}} \right.\]

M = 0.25, F = 0.32 M = 0.02, F = 0.10 No obese and not less than essential fat. [231]
Carina To Teeth Distance Optional

\[{\rm{Ctd[cm] = }}\left\{ {\begin{array}{*{20}{c}} {{\rm{11}}{\rm{.413 + (0}}{\rm{.072 H[cm]) - 3}},\;M}\\ {{\rm{13}}{\rm{.555 + (0}}{\rm{.056 H[cm]) - 3}},\;F} \end{array}} \right.\]

- - [121]
Blood Volume Baseline Optional

\[Bv[mL] = 65.6W{[kg]^{1.02}}\]

Bv * 0.85 Bv * 1.15 Above Stage 1 Hypovolemia. [113]
Basal Metabolic Rate Optional

\[{\rm{Bmr[kcal/day] = }}\left\{ {\begin{array}{*{20}{c}} {{\rm{88}}{\rm{.632 + 3}}{\rm{.397W[kg] + 4}}{\rm{.799H[cm] - 5}}{\rm{.677A[yr]}},\;M}\\ {{\rm{447}}{\rm{.593 + 9}}{\rm{.247W[kg] + 3}}{\rm{.098H[cm] - 4}}{\rm{.330A[yr]}},\;F} \end{array}} \right.\]

- - [300]
Heart Rate Baseline Optional

\[Hr[bpm] = 72\]

50 bpm 110 bpm Bradycardia < 60 bpm & Tachycardia > 100 bpm.
Systolic Arterial Pressure Baseline Optional

\[Sys[mmHg] = 114\]

90 mmHg 120 mmHg No hypotension or hypertension.
Diastolic Arterial Pressure Baseline Optional

\[Dia[mmHg] = 73.5\]

60 mmHg 80 mmHg No hypotension or hypertension. Includes pressure fraction check: Dia > 0.75 Sys.
Respiration Rate Baseline Optional

\[Rr[bpm] = 16\]

12 bpm 20 bpm
Alveoli Surface Area Optional

\[Asa[{m^2}] = \frac{{{\rm{Tlc[L]}}}}{{6.17}} \times {\rm{70}}\]

- - Calculated using standard Tlc (6.17 L) [115] and standard Asa (70 m2) [284].
Right Lung Ratio Optional

\[Rlr = 0.525\]

0.5 0.6
Skin Surface Area Optional

\[Ssa[{m^2}] = 0.20247W{[kg]^{0.45}}H{[m]^{0.725}}\]

- - [78]
Heart Rate Maximum Optional

\[H{r_{\max }}[bpm] = 208 - 0.7A[yr]\]

- - [344]
Heart Rate Minimum Optional

\[H{r_{\min }}[bpm] = 0.001\]

- -
Functional Residual Capacity Optional

\[Frc[mL] = 30W[kg]\]

- - [115]
Total Lung Capacity Optional

\[Tlc[mL] = 80W[kg]\]

- - [115]
Residual Volume Optional

\[Rv[mL] = 16W[kg]\]

- - [115]
Lean Body Mass Unallowed

\[Lbm = W(1 - Ff)\]

- -
Body Density Unallowed

\[Bd = {\left( {\frac{{4.95}}{{Ff + 4.5}} + \frac{{4.57}}{{Ff + 4.142}}} \right)}/2\]

- - Average of Siri [326] and Brozek [38] equations.
Mean Arterial Pressure Unallowed

\[Map = \frac{1}{3}Sys + \frac{2}{3}Dia\]

- - [134]
Tidal Volume Baseline Unallowed

\[Tv[mL] = 37W[kg] - Frc[mL]\]

- - [115]
Expiratory Reserve Volume Unallowed

\[Erv = Frc - Rv\]

- - [115]
Inspiratory Capacity Unallowed

\[Ic = Tlc - Frc\]

- - [115]
Inspriatory Reserve Volume Unallowed

\[Irv = Ic - Tv\]

- - [115]
Vital Capacity Unallowed

\[Vc - Tlc - Rv\]

- - [115]

Stabilization

All patient parameters are set at the beginning of the resting stabilization period (see System Methodology). These values are used to modify the inner workings of systems. The complex interactions require a simulated period to allow physiological parameters to achieve homeostatic values. After each stabilization period (i.e., resting, conditions, and feedback), several parameters are reset due to their reliance on combined effects. The patient definition only allows for healthy values - any chronic pathophysiology needs to be handled using the CDM condition definition.

While every effort has been made to allow any combination of patient parameters within bounds, there is no guarantee that all combinations will be able to reach a stable starting homeostatic point.

Dependencies

Patient parameters are not dependent on any systems, but many systems are dependent on specific patient values. Some parameters are used to modify baseline fluid/thermal circuit values or direct calculation of outputs, and others manipulate how feedback mechanisms work. For details see the following system methodology sections regarding dependencies and patient variability:

Override Capabilities

Overview

Certain patient parameters can now have an override action called to change them mid-run. Currently BioGears operates utilizing a patient file to prepare a set of pre-defined patient-specific parameters which allow a user to modify a patient before a scenario run. If the user wants to modify a parameter during a scenario, then an override action must be used.

An override action consists of two required fields in addition to numerous optional parameter calls. The two required field are state and conformance. The state switch simply lets BioGears know whether the override action call is being turned on (to permit overrides) or off (to return to normal BioGears simulation). The conformance call determins whether the override is allowed to affect other BioGears parameters and conditions. Turning conformance off will only create a mask of the desired parameter in the simularion while turning it on will alter the scenario altogether. The conformance (on) feature is only currently compatible with certain parameters, though turning it on with an incompatible parameter will still allow an irreversible state (which is turned off when conformance is turned off). An example of a call would be as follows, with the override being turned on, set for an hour, and then turned off:

'''<Action xsi:type="OverrideData" State="On" Conformant="On"> <HeartRateOverride value="120" unit="1/min"> </Action> <Action xsi:type="AdvanceTimeData"> <Time value="1" unit="hr"> </Action> <Action xsi:type="OverrideData" State="Off" Conformant="On"> </Action>'''

The current list of override parameters (with conformance compatible parameters designated with a "Conf.") is as follows:

  • Arterial Blood Pressure
  • Calcium Concentration
  • Carbon Dioxide Saturation
  • Carbon Monoxide Saturation
  • Glucose Concentration
  • Lactate Concentration
  • Oxygen Saturation
  • Phosphate Concentration
  • Potassium Concentration
  • Sodium Concentration
  • Total Bilirubin
  • Venous Blood pH
  • White Blood Cell Count
  • Blood Volume
  • Cardiac Output
  • Diastolic Arterial Pressure - Conf.
  • Heart Rate - Conf.
  • Heart Stroke Volume
  • Mean Arterial Pressure - Conf.
  • Systolic Arterial Pressure - Conf.
  • Insulin Synthesis Rate
  • Glucagon Synthesis Rate
  • Acheived Exercise Level
  • Chloride Lost to Sweat
  • Core Temperature
  • Creatinine Production Rate
  • Exercise Mean Arterial Pressure Delta
  • Fatigue Level
  • Lactate Production Rate
  • Potassium Lost to Sweat
  • Skin Temperature
  • Sodium Lost to Sweat
  • Sweat Rate
  • Total Metabolic Rate
  • Total Work Rate Level
  • Left Afferent Arteriole Resistance
  • Left Glomerular Filtration Rate
  • Left Reabsorption Rate
  • Renal Blood Flow
  • Renal Plasma Flow
  • Right Afferent Arteriole Resistance
  • Right Glomerular Filtration Rate
  • Right Reabsorption Rate
  • Urination Rate
  • Urine Osmolality
  • Urine Volume
  • Urine Urea Nitrogen Concentration
  • Expiratory Flow
  • Inspiratory Flow
  • Pulmonary Compliance
  • Pulmonary Resistance
  • Respiration Rate - Conf.
  • Target Pulmonary Ventilation
  • Tidal Volume
  • Total Alveolar Ventilation
  • Total Lung Volume
  • Total Pulmonary Ventilation
  • Extravascular Fluid Volume
  • Intracellular Fluid Volume
  • Liver Glycogen
  • Muscle Glycogen
  • Stored Fat
  • Stored Protein

Results and Conclusions

Verification and Validation


Table 2. There are several patients that we created for base validation, system-specific patient effects validation, and extreme case will stabilization.
Name Standard Male Standard Female Default Male Default Female Overweight Underweight Tachycardic Bradycardic Extreme Female Extreme Male
Sex Male Female Male Female Male Male Male Male Female Male
Age 44 yr 44 yr - - 44 yr 44 yr 44 yr 44 yr 18 yr 65 yr
Weight 170 lb 130 lb - - 215 lb 115 lb 170 lb 170 lb - -
Height 71 in 64 in - - 71 in 71 in 71 in 71 in 4.5 ft 7 ft
Body Fat Fraction 0.21 0.28 - - 0.25 0.15 0.18 0.18 0.32 0.02
Heart Rate Baseline 72 bpm 72 bpm - - 72 bpm 72 bpm 110 bpm 50 bpm 60 bpm 100 bpm
Systolic Arterial Pressure Baseline 114 mmHg 114 mmHg - - 114 mmHg 114 mmHg 114 mmHg 114 mmHg 90 mmHg 120 mmHg
Diastolic Arterial Pressure Baseline 73.5 mmHg 73.5 mmHg - - 73.5 mmHg 73.5 mmHg 73.5 mmHg 73.5 mmHg 60 mmHg 80 mmHg
Respiration Rate Baseline 16 bpm 16 bpm - - 16 bpm 16 bpm 20 bpm 12 bpm 12 bpm 20 bpm
Right Lung Ratio - - - - - - - - 0.5 0.6

Table 3. There are several patients we created for combined effects validation and showcase scenarios.
Name Cynthia Gus Joel Nathan Rick Hassan Soldier Jeff Carol Jane
Sex Female Male Male Male Male Male Male Male Female Female
Age 30 yr 32 yr 44 yr 44 yr 23 yr 28 yr 22 yr 25 yr 40 yr 18 yr
Weight 130 lb 190 lb 170 lb 170 lb 161 lb 185 lb 170 lb 180 lb 160 lb 120 lb
Height 64 in 70 in 71 in 71 in 68 in 72 in 71 in 72 in 66 in 64 in
Body Fat Fraction 0.18 0.18 0.18 0.18 0.18 0.18 0.18 0.12 0.25 0.18
Heart Rate Baseline 72 bpm 93 bpm 110 bpm 72 bpm 100 bpm 110 bpm 84 bpm 72 bpm 72 bpm 72 bpm
Systolic Arterial Pressure Baseline 114 mmHg 90 mmHg 120 mmHg 114 mmHg 120 mmHg 90 mmHg 114 mmHg 114 mmHg 114 mmHg 114 mmHg
Diastolic Arterial Pressure Baseline 73.5 mmHg 60 mmHg 80 mmHg 73.5 mmHg 80 mmHg 60 mmHg 73.5 mmHg 73.5 mmHg 73.5 mmHg 73.5 mmHg
Respiration Rate Baseline 18 bpm 14 bpm 15 bpm 16 bpm 16 bpm 18 bpm 16 bpm 16 bpm 18 bpm 18 bpm

All of the patients that are included with the BioGears deployment have been validated to ensure that they reach a homeostatic point that hits all of the defined criteria. The following tables show the state of the patients after all stabilization phases (see System Methodology for details) and compare the resulting patient values to those initially set/computed. Values that are explicitly set are expected to have very tight tolerances, while those that are initially calculated may drift due to the complex interaction of all patient parameters and system settings. The most sensitive of these parameters to external effects is tidal volume.

Values that are colored green are within 10% of the original set or calculated/estimated (expected) value, yellow are within 30%, and red are greater than 30% error. Values that are not within 10% are not necessarily a failure. As previously described, many of these are estimated before the stabilization simulation begins, and are really determined and overwritten after all other factors reach homeostasis. Those values that are explicitly set by the user/patient file should have much tighter tolerances.

Table 4. StandardMale patient values with expected and BioGears Engine output.


StandardMaleExpected ValueEngine ValuePercent ErrorNotes
PatientAge(yr)44.00000043.9963340.000083
PatientWeight(kg)77.61220377.5935350.000241
PatientHeight(in)71.00000070.9940850.000083
PatientBodyDensity(g/cm^3)1.0575371.099908-0.040066
PatientBodyFatFraction0.1800000.209983-0.166572
PatientLeanBodyMass(kg)63642.03305761.2948930.999037
PatientAlveoliSurfaceArea(m^2)69.98702469.994168-0.000102
PatientRightLungRatio0.5250000.529956-0.009440
PatientSkinSurfaceArea(m^2)1.9681181.969836-0.000873
PatientBasalMetabolicRate(kcal/day)1737.3477471736.8552860.000283
PatientBloodVolumeBaseline(mL)5532.5028345533.538949-0.000187
PatientDiastolicArterialPressureBaseline(mmHg)73.39287274.353905-0.013094
PatientHeartRateBaseline(1/min)50.00000071.994001-0.439880
PatientMeanArterialPressureBaseline(mmHg)94.73349495.782619-0.011074
PatientRespirationRateBaseline(1/min)12.50000015.998667-0.279893
PatientSystolicArterialPressureBaseline(mmHg)113.552910114.589452-0.009128
PatientTidalVolumeBaseline(mL)0.625601515.957011-823.738455
PatientHeartRateMaximum(1/min)177.200000176.9852540.001212
PatientHeartRateMinimum(1/min)0.0010000.0010000.000083
PatientExpiratoryReserveVolume(mL)1.0553991054.912105-998.538317
PatientFunctionalResidualCapacity(mL)2.5976132597.783554-999.065495
PatientInspiratoryCapacity(mL)3.5712433570.702491-998.848703
PatientInspiratoryReserveVolume(mL)2.9456423055.745397-1036.378390
PatientResidualVolume(mL)1.5422141541.871532-998.777900
PatientTotalLungCapacity(mL)6.1688566168.486045-998.939991
PatientVitalCapacity(mL)4.6266424626.614513-998.994021
TotalMetabolicRate(kcal/day)44.0000001736.855286-38.473984
BloodVolume(mL)44.0000005532.543230-124.739619
DiastolicArterialPressure(mmHg)44.00000074.425802-0.691496
HeartRate(1/min)44.00000071.994001-0.636227
MeanArterialPressure(mmHg)44.00000095.845883-1.178316
RespirationRate(1/min)44.00000015.9986670.636394
Table 5. StandardFemale patient values with expected and BioGears Engine output.


StandardFemaleExpected ValueEngine ValuePercent ErrorNotes
PatientAge(yr)44.00000043.9963340.000083
PatientWeight(kg)77.61220359.4950430.233432
PatientHeight(in)71.00000063.9946680.098667
PatientBodyDensity(g/cm^3)1.0575370.9999170.054485
PatientBodyFatFraction0.1800000.279977-0.555429
PatientLeanBodyMass(kg)63642.03305742.7964340.999328
PatientAlveoliSurfaceArea(m^2)69.98702453.9955010.228493
PatientRightLungRatio0.5250000.529956-0.009440
PatientSkinSurfaceArea(m^2)1.9681181.6298640.171867
PatientBasalMetabolicRate(kcal/day)1737.3477471305.8911940.248342
PatientBloodVolumeBaseline(mL)5532.5028344221.6482550.236937
PatientDiastolicArterialPressureBaseline(mmHg)73.39287274.290910-0.012236
PatientHeartRateBaseline(1/min)50.00000071.994001-0.439880
PatientMeanArterialPressureBaseline(mmHg)94.73349495.094577-0.003812
PatientRespirationRateBaseline(1/min)12.50000015.998667-0.279893
PatientSystolicArterialPressureBaseline(mmHg)113.552910113.3392570.001882
PatientTidalVolumeBaseline(mL)0.625601422.964759-675.093733
PatientHeartRateMaximum(1/min)177.200000176.9852540.001212
PatientHeartRateMinimum(1/min)0.0010000.0010000.000083
PatientExpiratoryReserveVolume(mL)1.0553991054.912105-998.538317
PatientFunctionalResidualCapacity(mL)2.5976132233.813880-858.948543
PatientInspiratoryCapacity(mL)3.5712432482.793135-694.218239
PatientInspiratoryReserveVolume(mL)2.9456422058.828460-697.940479
PatientResidualVolume(mL)1.5422141178.901775-763.421624
PatientTotalLungCapacity(mL)6.1688564716.607015-763.583715
PatientVitalCapacity(mL)4.6266423537.705240-763.637745
TotalMetabolicRate(kcal/day)44.0000001305.891194-28.679345
BloodVolume(mL)44.0000004221.018948-94.932249
DiastolicArterialPressure(mmHg)44.00000074.180433-0.685919
HeartRate(1/min)44.00000071.994001-0.636227
MeanArterialPressure(mmHg)44.00000095.043554-1.160081
RespirationRate(1/min)44.00000015.9986670.636394
Table 6. DefaultMale patient values with expected and BioGears Engine output.


DefaultMaleExpected ValueEngine ValuePercent ErrorNotes
PatientAge(yr)44.00000043.9963340.000083
PatientWeight(kg)77.61220368.5942850.116192
PatientHeight(in)71.00000069.9941680.014167
PatientBodyDensity(g/cm^3)1.0575371.099908-0.040066
PatientBodyFatFraction0.1800000.209983-0.166572
PatientLeanBodyMass(kg)63642.03305754.1954840.999148
PatientAlveoliSurfaceArea(m^2)69.98702461.9948350.114195
PatientRightLungRatio0.5250000.529956-0.009440
PatientSkinSurfaceArea(m^2)1.9681181.8398470.065175
PatientBasalMetabolicRate(kcal/day)1737.3477471600.8666170.078557
PatientBloodVolumeBaseline(mL)5532.5028344884.5930180.117110
PatientDiastolicArterialPressureBaseline(mmHg)73.39287274.627082-0.016816
PatientHeartRateBaseline(1/min)50.00000071.994001-0.439880
PatientMeanArterialPressureBaseline(mmHg)94.73349495.318658-0.006177
PatientRespirationRateBaseline(1/min)12.50000014.998750-0.199900
PatientSystolicArterialPressureBaseline(mmHg)113.552910113.4312490.001071
PatientTidalVolumeBaseline(mL)0.625601527.956011-842.918419
PatientHeartRateMaximum(1/min)177.200000176.9852540.001212
PatientHeartRateMinimum(1/min)0.0010000.0010000.000083
PatientExpiratoryReserveVolume(mL)1.0553991054.912105-998.538317
PatientFunctionalResidualCapacity(mL)2.5976132417.798550-929.776893
PatientInspiratoryCapacity(mL)3.5712433032.747313-848.213418
PatientInspiratoryReserveVolume(mL)2.9456422505.791219-849.677436
PatientResidualVolume(mL)1.5422141362.886445-882.720673
PatientTotalLungCapacity(mL)6.1688565450.545864-882.558582
PatientVitalCapacity(mL)4.6266424087.659418-882.504551
TotalMetabolicRate(kcal/day)44.0000001600.866617-35.383332
BloodVolume(mL)44.0000004883.716263-109.993551
DiastolicArterialPressure(mmHg)44.00000074.635688-0.696266
HeartRate(1/min)44.00000071.994001-0.636227
MeanArterialPressure(mmHg)44.00000095.401782-1.168222
RespirationRate(1/min)44.00000014.5481960.669359
Table 7. DefaultFemale patient values with expected and BioGears Engine output.


DefaultFemaleExpected ValueEngine ValuePercent ErrorNotes
PatientAge(yr)44.00000043.9963340.000083
PatientWeight(kg)77.61220358.2951430.248892
PatientHeight(in)71.00000063.9946680.098667
PatientBodyDensity(g/cm^3)1.0575370.9999170.054485
PatientBodyFatFraction0.1800000.279977-0.555429
PatientLeanBodyMass(kg)63642.03305741.9965010.999340
PatientAlveoliSurfaceArea(m^2)69.98702451.9956680.257067
PatientRightLungRatio0.5250000.529956-0.009440
PatientSkinSurfaceArea(m^2)1.9681181.6198650.176947
PatientBasalMetabolicRate(kcal/day)1737.3477471295.8920270.254098
PatientBloodVolumeBaseline(mL)5532.5028344136.6553360.252299
PatientDiastolicArterialPressureBaseline(mmHg)73.39287273.398484-0.000076
PatientHeartRateBaseline(1/min)50.00000071.994001-0.439880
PatientMeanArterialPressureBaseline(mmHg)94.73349494.6369150.001019
PatientRespirationRateBaseline(1/min)12.50000013.998834-0.119907
PatientSystolicArterialPressureBaseline(mmHg)113.552910113.2817610.002388
PatientTidalVolumeBaseline(mL)0.625601455.962009-727.838635
PatientHeartRateMaximum(1/min)177.200000176.9852540.001212
PatientHeartRateMinimum(1/min)0.0010000.0010000.000083
PatientExpiratoryReserveVolume(mL)1.0553991054.912105-998.538317
PatientFunctionalResidualCapacity(mL)2.5976132210.815796-850.095000
PatientInspiratoryCapacity(mL)3.5712432411.799050-674.338861
PatientInspiratoryReserveVolume(mL)2.9456421956.836957-663.315939
PatientResidualVolume(mL)1.5422141155.903691-748.509243
PatientTotalLungCapacity(mL)6.1688564622.614846-748.347152
PatientVitalCapacity(mL)4.6266423466.711156-748.293121
TotalMetabolicRate(kcal/day)44.0000001295.892027-28.452092
BloodVolume(mL)44.0000004136.049178-93.001118
DiastolicArterialPressure(mmHg)44.00000073.530272-0.671143
HeartRate(1/min)44.00000072.007998-0.636545
MeanArterialPressure(mmHg)44.00000094.778044-1.154046
RespirationRate(1/min)44.00000014.2586020.675941
Table 8. Overweight patient values with expected and BioGears Engine output.


OverweightExpected ValueEngine ValuePercent ErrorNotes
PatientAge(yr)44.00000043.9963340.000083
PatientWeight(kg)77.61220397.991835-0.262583
PatientHeight(in)71.00000070.9940850.000083
PatientBodyDensity(g/cm^3)1.0575370.9999170.054485
PatientBodyFatFraction0.1800000.249979-0.388776
PatientLeanBodyMass(kg)63642.03305773.4938770.998845
PatientAlveoliSurfaceArea(m^2)69.98702488.992585-0.271558
PatientRightLungRatio0.5250000.529956-0.009440
PatientSkinSurfaceArea(m^2)1.9681182.169819-0.102484
PatientBasalMetabolicRate(kcal/day)1737.3477472010.832459-0.157415
PatientBloodVolumeBaseline(mL)5532.5028347017.415313-0.268398
PatientDiastolicArterialPressureBaseline(mmHg)73.39287274.621083-0.016735
PatientHeartRateBaseline(1/min)50.00000071.994001-0.439880
PatientMeanArterialPressureBaseline(mmHg)94.73349496.108092-0.014510
PatientRespirationRateBaseline(1/min)12.50000015.998667-0.279893
PatientSystolicArterialPressureBaseline(mmHg)113.552910115.048214-0.013168
PatientTidalVolumeBaseline(mL)0.625601606.949429-969.186516
PatientHeartRateMaximum(1/min)177.200000176.9852540.001212
PatientHeartRateMinimum(1/min)0.0010000.0010000.000083
PatientExpiratoryReserveVolume(mL)1.0553991055.912022-999.485746
PatientFunctionalResidualCapacity(mL)2.5976133005.749563-1156.119660
PatientInspiratoryCapacity(mL)3.5712434795.600433-1341.837967
PatientInspiratoryReserveVolume(mL)2.9456424188.651004-1420.982354
PatientResidualVolume(mL)1.5422141949.837541-1263.310574
PatientTotalLungCapacity(mL)6.1688567801.349996-1263.634756
PatientVitalCapacity(mL)4.6266425850.512539-1263.526695
TotalMetabolicRate(kcal/day)44.0000002010.832459-44.700738
BloodVolume(mL)44.0000007015.295991-158.438545
DiastolicArterialPressure(mmHg)44.00000074.696793-0.697654
HeartRate(1/min)44.00000071.994001-0.636227
MeanArterialPressure(mmHg)44.00000096.192721-1.186198
RespirationRate(1/min)44.00000015.2380240.653681
Table 9. Underweight patient values with expected and BioGears Engine output.


UnderweightExpected ValueEngine ValuePercent ErrorNotes
PatientAge(yr)44.00000043.9963340.000083
PatientWeight(kg)77.61220352.6956090.321040
PatientHeight(in)71.00000070.9940850.000083
PatientBodyDensity(g/cm^3)1.0575371.099908-0.040066
PatientBodyFatFraction0.1800000.1499880.166735
PatientLeanBodyMass(kg)63642.03305744.7962680.999296
PatientAlveoliSurfaceArea(m^2)69.98702446.9960840.328503
PatientRightLungRatio0.5250000.529956-0.009440
PatientSkinSurfaceArea(m^2)1.9681181.6698610.151544
PatientBasalMetabolicRate(kcal/day)1737.3477471402.8831130.192515
PatientBloodVolumeBaseline(mL)5532.5028343731.6890780.325497
PatientDiastolicArterialPressureBaseline(mmHg)73.39287273.640064-0.003368
PatientHeartRateBaseline(1/min)50.00000071.994001-0.439880
PatientMeanArterialPressureBaseline(mmHg)94.73349495.045181-0.003290
PatientRespirationRateBaseline(1/min)12.50000015.998667-0.279893
PatientSystolicArterialPressureBaseline(mmHg)113.552910113.885611-0.002930
PatientTidalVolumeBaseline(mL)0.625601463.961343-740.625277
PatientHeartRateMaximum(1/min)177.200000176.9852540.001212
PatientHeartRateMinimum(1/min)0.0010000.0010000.000083
PatientExpiratoryReserveVolume(mL)1.0553991054.912105-998.538317
PatientFunctionalResidualCapacity(mL)2.5976132098.825127-806.982092
PatientInspiratoryCapacity(mL)3.5712432073.827210-579.701823
PatientInspiratoryReserveVolume(mL)2.9456421610.865784-545.864066
PatientResidualVolume(mL)1.5422141042.913105-675.244066
PatientTotalLungCapacity(mL)6.1688564172.652337-675.406157
PatientVitalCapacity(mL)4.6266423129.739232-675.460187
TotalMetabolicRate(kcal/day)44.0000001402.883113-30.883707
BloodVolume(mL)44.0000003734.655629-83.878537
DiastolicArterialPressure(mmHg)44.00000073.365483-0.667397
HeartRate(1/min)44.00000072.106473-0.638783
MeanArterialPressure(mmHg)44.00000094.850428-1.155692
RespirationRate(1/min)44.00000015.9986670.636394
Table 10. Tachycardic patient values with expected and BioGears Engine output.


TachycardicExpected ValueEngine ValuePercent ErrorNotes
PatientAge(yr)44.00000043.9963340.000083
PatientWeight(kg)77.61220377.5935350.000241
PatientHeight(in)71.00000070.9940850.000083
PatientBodyDensity(g/cm^3)1.0575371.099908-0.040066
PatientBodyFatFraction0.1800000.1799850.000081
PatientLeanBodyMass(kg)63642.03305763.5947010.999001
PatientAlveoliSurfaceArea(m^2)69.98702469.994168-0.000102
PatientRightLungRatio0.5250000.529956-0.009440
PatientSkinSurfaceArea(m^2)1.9681181.969836-0.000873
PatientBasalMetabolicRate(kcal/day)1737.3477471736.8552860.000283
PatientBloodVolumeBaseline(mL)5532.5028345533.538949-0.000187
PatientDiastolicArterialPressureBaseline(mmHg)73.39287274.358305-0.013154
PatientHeartRateBaseline(1/min)50.000000108.990919-1.179818
PatientMeanArterialPressureBaseline(mmHg)94.73349495.600335-0.009150
PatientRespirationRateBaseline(1/min)12.50000018.998417-0.519873
PatientSystolicArterialPressureBaseline(mmHg)113.552910114.637848-0.009554
PatientTidalVolumeBaseline(mL)0.625601438.963426-700.667019
PatientHeartRateMaximum(1/min)177.200000176.9852540.001212
PatientHeartRateMinimum(1/min)0.0010000.0010000.000083
PatientExpiratoryReserveVolume(mL)1.0553991055.912022-999.485746
PatientFunctionalResidualCapacity(mL)2.5976132597.783554-999.065495
PatientInspiratoryCapacity(mL)3.5712433570.702491-998.848703
PatientInspiratoryReserveVolume(mL)2.9456423131.739065-1062.177067
PatientResidualVolume(mL)1.5422141541.871532-998.777900
PatientTotalLungCapacity(mL)6.1688566168.486045-998.939991
PatientVitalCapacity(mL)4.6266424626.614513-998.994021
TotalMetabolicRate(kcal/day)44.0000001736.855286-38.473984
BloodVolume(mL)44.0000005533.584726-124.763289
DiastolicArterialPressure(mmHg)44.00000074.393084-0.690752
HeartRate(1/min)44.000000108.990919-1.477066
MeanArterialPressure(mmHg)44.00000095.607313-1.172893
RespirationRate(1/min)44.00000018.9984170.568218
Table 11. Bradycardic patient values with expected and BioGears Engine output.


BradycardicExpected ValueEngine ValuePercent ErrorNotes
PatientAge(yr)44.00000043.9963340.000083
PatientWeight(kg)77.61220377.5935350.000241
PatientHeight(in)71.00000070.9940850.000083
PatientBodyDensity(g/cm^3)1.0575371.099908-0.040066
PatientBodyFatFraction0.1800000.1799850.000081
PatientLeanBodyMass(kg)63642.03305763.5947010.999001
PatientAlveoliSurfaceArea(m^2)69.98702469.994168-0.000102
PatientRightLungRatio0.5250000.529956-0.009440
PatientSkinSurfaceArea(m^2)1.9681181.969836-0.000873
PatientBasalMetabolicRate(kcal/day)1737.3477471736.8552860.000283
PatientBloodVolumeBaseline(mL)5532.5028345532.539032-0.000007
PatientDiastolicArterialPressureBaseline(mmHg)73.39287273.3738870.000259
PatientHeartRateBaseline(1/min)50.00000049.9958340.000083
PatientMeanArterialPressureBaseline(mmHg)94.73349494.7150080.000195
PatientRespirationRateBaseline(1/min)12.50000012.998917-0.039913
PatientSystolicArterialPressureBaseline(mmHg)113.552910113.5343400.000164
PatientTidalVolumeBaseline(mL)0.625601629.947513-1005.948114
PatientHeartRateMaximum(1/min)177.200000176.9852540.001212
PatientHeartRateMinimum(1/min)0.0010000.0010000.000083
PatientExpiratoryReserveVolume(mL)1.0553991054.912105-998.538317
PatientFunctionalResidualCapacity(mL)2.5976132597.783554-999.065495
PatientInspiratoryCapacity(mL)3.5712433570.702491-998.848703
PatientInspiratoryReserveVolume(mL)2.9456422941.754895-997.680374
PatientResidualVolume(mL)1.5422141541.871532-998.777900
PatientTotalLungCapacity(mL)6.1688566168.486045-998.939991
PatientVitalCapacity(mL)4.6266424626.614513-998.994021
TotalMetabolicRate(kcal/day)44.0000001736.855286-38.473984
BloodVolume(mL)44.0000005529.827190-124.677891
DiastolicArterialPressure(mmHg)44.00000073.284670-0.665561
HeartRate(1/min)44.00000049.995834-0.136269
MeanArterialPressure(mmHg)44.00000094.678411-1.151782
RespirationRate(1/min)44.00000012.3337500.719688
Table 12. Cynthia patient values with expected and BioGears Engine output.


CynthiaExpected ValueEngine ValuePercent ErrorNotes
PatientAge(yr)44.00000029.9975010.318239
PatientWeight(kg)77.61220359.4950430.233432
PatientHeight(in)71.00000063.9946680.098667
PatientBodyDensity(g/cm^3)1.0575371.099908-0.040066
PatientBodyFatFraction0.1800000.1799850.000081
PatientLeanBodyMass(kg)63642.03305748.7959340.999233
PatientAlveoliSurfaceArea(m^2)69.98702453.9955010.228493
PatientRightLungRatio0.5250000.529956-0.009440
PatientSkinSurfaceArea(m^2)1.9681181.6298640.171867
PatientBasalMetabolicRate(kcal/day)1737.3477471366.8861120.213234
PatientBloodVolumeBaseline(mL)5532.5028344221.6482550.236937
PatientDiastolicArterialPressureBaseline(mmHg)73.39287274.320708-0.012642
PatientHeartRateBaseline(1/min)50.00000071.994001-0.439880
PatientMeanArterialPressureBaseline(mmHg)94.73349495.129074-0.004176
PatientRespirationRateBaseline(1/min)12.50000017.998500-0.439880
PatientSystolicArterialPressureBaseline(mmHg)113.552910113.3807530.001516
PatientTidalVolumeBaseline(mL)0.625601388.967591-620.750502
PatientHeartRateMaximum(1/min)177.200000186.984421-0.055217
PatientHeartRateMinimum(1/min)0.0010000.0010000.000083
PatientExpiratoryReserveVolume(mL)1.0553991054.912105-998.538317
PatientFunctionalResidualCapacity(mL)2.5976132234.813797-859.333480
PatientInspiratoryCapacity(mL)3.5712432482.793135-694.218239
PatientInspiratoryReserveVolume(mL)2.9456422093.825544-709.821449
PatientResidualVolume(mL)1.5422141178.901775-763.421624
PatientTotalLungCapacity(mL)6.1688564716.607015-763.583715
PatientVitalCapacity(mL)4.6266423537.705240-763.637745
TotalMetabolicRate(kcal/day)44.0000001366.886112-30.065593
BloodVolume(mL)44.0000004221.275368-94.938077
DiastolicArterialPressure(mmHg)44.00000074.398525-0.690876
HeartRate(1/min)44.00000071.994001-0.636227
MeanArterialPressure(mmHg)44.00000095.250491-1.164784
RespirationRate(1/min)44.00000017.9985000.590943
Table 13. Gus patient values with expected and BioGears Engine output.


GusExpected ValueEngine ValuePercent ErrorNotes
PatientAge(yr)44.00000031.9973340.272788
PatientWeight(kg)77.61220386.692777-0.116999
PatientHeight(in)71.00000069.9941680.014167
PatientBodyDensity(g/cm^3)1.0575371.099908-0.040066
PatientBodyFatFraction0.1800000.1799850.000081
PatientLeanBodyMass(kg)63642.03305771.0940760.998883
PatientAlveoliSurfaceArea(m^2)69.98702477.993502-0.114399
PatientRightLungRatio0.5250000.529956-0.009440
PatientSkinSurfaceArea(m^2)1.9681182.039830-0.036437
PatientBasalMetabolicRate(kcal/day)1737.3477471914.840457-0.102163
PatientBloodVolumeBaseline(mL)5532.5028346194.483879-0.119653
PatientDiastolicArterialPressureBaseline(mmHg)73.39287259.7997180.185211
PatientHeartRateBaseline(1/min)50.00000092.992252-0.859845
PatientMeanArterialPressureBaseline(mmHg)94.73349475.8927770.198881
PatientRespirationRateBaseline(1/min)12.50000013.998834-0.119907
PatientSystolicArterialPressureBaseline(mmHg)113.55291090.0155000.207281
PatientTidalVolumeBaseline(mL)0.625601626.947763-1001.153123
PatientHeartRateMaximum(1/min)177.200000185.984504-0.049574
PatientHeartRateMinimum(1/min)0.0010000.0010000.000083
PatientExpiratoryReserveVolume(mL)1.0553991055.912022-999.485746
PatientFunctionalResidualCapacity(mL)2.5976132778.768475-1068.739034
PatientInspiratoryCapacity(mL)3.5712434114.657169-1151.163936
PatientInspiratoryReserveVolume(mL)2.9456423487.709406-1183.023503
PatientResidualVolume(mL)1.5422141723.856369-1116.780220
PatientTotalLungCapacity(mL)6.1688566894.425560-1116.618129
PatientVitalCapacity(mL)4.6266425170.569191-1116.564099
TotalMetabolicRate(kcal/day)44.0000001914.840457-42.519101
BloodVolume(mL)44.0000006197.856957-139.860385
DiastolicArterialPressure(mmHg)44.00000059.763105-0.358252
HeartRate(1/min)44.00000092.992252-1.113460
MeanArterialPressure(mmHg)44.00000075.882561-0.724604
RespirationRate(1/min)44.00000013.9988340.681845
Table 14. Joel patient values with expected and BioGears Engine output.


JoelExpected ValueEngine ValuePercent ErrorNotes
PatientAge(yr)44.00000043.9963340.000083
PatientWeight(kg)77.61220377.5935350.000241
PatientHeight(in)71.00000070.9940850.000083
PatientBodyDensity(g/cm^3)1.0575371.099908-0.040066
PatientBodyFatFraction0.1800000.1799850.000081
PatientLeanBodyMass(kg)63642.03305763.5947010.999001
PatientAlveoliSurfaceArea(m^2)69.98702469.994168-0.000102
PatientRightLungRatio0.5250000.529956-0.009440
PatientSkinSurfaceArea(m^2)1.9681181.969836-0.000873
PatientBasalMetabolicRate(kcal/day)1737.3477471736.8552860.000283
PatientBloodVolumeBaseline(mL)5532.5028345532.539032-0.000007
PatientDiastolicArterialPressureBaseline(mmHg)73.39287280.776170-0.100600
PatientHeartRateBaseline(1/min)50.000000108.990919-1.179818
PatientMeanArterialPressureBaseline(mmHg)94.733494102.165388-0.078451
PatientRespirationRateBaseline(1/min)12.50000014.998750-0.199900
PatientSystolicArterialPressureBaseline(mmHg)113.552910121.107109-0.066526
PatientTidalVolumeBaseline(mL)0.625601537.955178-858.901722
PatientHeartRateMaximum(1/min)177.200000176.9852540.001212
PatientHeartRateMinimum(1/min)0.0010000.0010000.000083
PatientExpiratoryReserveVolume(mL)1.0553991054.912105-998.538317
PatientFunctionalResidualCapacity(mL)2.5976132597.783554-999.065495
PatientInspiratoryCapacity(mL)3.5712433570.702491-998.848703
PatientInspiratoryReserveVolume(mL)2.9456423032.747313-1028.570895
PatientResidualVolume(mL)1.5422141541.871532-998.777900
PatientTotalLungCapacity(mL)6.1688566168.486045-998.939991
PatientVitalCapacity(mL)4.6266424626.614513-998.994021
TotalMetabolicRate(kcal/day)44.0000001736.855286-38.473984
BloodVolume(mL)44.0000005530.170550-124.685694
DiastolicArterialPressure(mmHg)44.00000080.678154-0.833594
HeartRate(1/min)44.000000109.211364-1.482076
MeanArterialPressure(mmHg)44.000000102.147058-1.321524
RespirationRate(1/min)44.00000014.9987500.659119
Table 15. Nathan patient values with expected and BioGears Engine output.


NathanExpected ValueEngine ValuePercent ErrorNotes
PatientAge(yr)44.00000043.9963340.000083
PatientWeight(kg)77.61220377.5935350.000241
PatientHeight(in)71.00000070.9940850.000083
PatientBodyDensity(g/cm^3)1.0575371.099908-0.040066
PatientBodyFatFraction0.1800000.1799850.000081
PatientLeanBodyMass(kg)63642.03305763.5947010.999001
PatientAlveoliSurfaceArea(m^2)69.98702469.994168-0.000102
PatientRightLungRatio0.5250000.529956-0.009440
PatientSkinSurfaceArea(m^2)1.9681181.969836-0.000873
PatientBasalMetabolicRate(kcal/day)1737.3477471736.8552860.000283
PatientBloodVolumeBaseline(mL)5532.5028345533.538949-0.000187
PatientDiastolicArterialPressureBaseline(mmHg)73.39287274.386302-0.013536
PatientHeartRateBaseline(1/min)50.00000071.994001-0.439880
PatientMeanArterialPressureBaseline(mmHg)94.73349495.818016-0.011448
PatientRespirationRateBaseline(1/min)12.50000015.998667-0.279893
PatientSystolicArterialPressureBaseline(mmHg)113.552910114.623250-0.009426
PatientTidalVolumeBaseline(mL)0.625601514.957094-822.140125
PatientHeartRateMaximum(1/min)177.200000176.9852540.001212
PatientHeartRateMinimum(1/min)0.0010000.0010000.000083
PatientExpiratoryReserveVolume(mL)1.0553991054.912105-998.538317
PatientFunctionalResidualCapacity(mL)2.5976132597.783554-999.065495
PatientInspiratoryCapacity(mL)3.5712433570.702491-998.848703
PatientInspiratoryReserveVolume(mL)2.9456423055.745397-1036.378390
PatientResidualVolume(mL)1.5422141541.871532-998.777900
PatientTotalLungCapacity(mL)6.1688566168.486045-998.939991
PatientVitalCapacity(mL)4.6266424626.614513-998.994021
TotalMetabolicRate(kcal/day)44.0000001736.855286-38.473984
BloodVolume(mL)44.0000005532.617002-124.741295
DiastolicArterialPressure(mmHg)44.00000074.470322-0.692507
HeartRate(1/min)44.00000071.994001-0.636227
MeanArterialPressure(mmHg)44.00000095.892947-1.179385
RespirationRate(1/min)44.00000015.9986670.636394
Table 16. Hassan patient values with expected and BioGears Engine output.


HassanExpected ValueEngine ValuePercent ErrorNotes
PatientAge(yr)44.00000027.9976670.363689
PatientWeight(kg)77.61220384.392968-0.087367
PatientHeight(in)71.00000071.994001-0.014000
PatientBodyDensity(g/cm^3)1.0575371.099908-0.040066
PatientBodyFatFraction0.1800000.1799850.000081
PatientLeanBodyMass(kg)63642.03305769.1942350.998913
PatientAlveoliSurfaceArea(m^2)69.98702475.993668-0.085825
PatientRightLungRatio0.5250000.529956-0.009440
PatientSkinSurfaceArea(m^2)1.9681182.059828-0.046598
PatientBasalMetabolicRate(kcal/day)1737.3477471931.839040-0.111947
PatientBloodVolumeBaseline(mL)5532.5028346030.497542-0.090013
PatientDiastolicArterialPressureBaseline(mmHg)73.39287260.0887930.181272
PatientHeartRateBaseline(1/min)50.000000108.990919-1.179818
PatientMeanArterialPressureBaseline(mmHg)94.73349475.7246910.200656
PatientRespirationRateBaseline(1/min)12.50000017.998500-0.439880
PatientSystolicArterialPressureBaseline(mmHg)113.55291090.0822940.206693
PatientTidalVolumeBaseline(mL)0.625601522.956428-834.926767
PatientHeartRateMaximum(1/min)177.200000187.984337-0.060860
PatientHeartRateMinimum(1/min)0.0010000.0010000.000083
PatientExpiratoryReserveVolume(mL)1.0553991055.912022-999.485746
PatientFunctionalResidualCapacity(mL)2.5976132733.772224-1051.416883
PatientInspiratoryCapacity(mL)3.5712433978.668500-1113.085128
PatientInspiratoryReserveVolume(mL)2.9456423455.712072-1172.160902
PatientResidualVolume(mL)1.5422141677.860202-1086.955458
PatientTotalLungCapacity(mL)6.1688566712.440723-1087.117549
PatientVitalCapacity(mL)4.6266425034.580522-1087.171579
TotalMetabolicRate(kcal/day)44.0000001931.839040-42.905433
BloodVolume(mL)44.0000006034.227818-136.141541
DiastolicArterialPressure(mmHg)44.00000060.108785-0.366109
HeartRate(1/min)44.000000108.990919-1.477066
MeanArterialPressure(mmHg)44.00000075.758463-0.721783
RespirationRate(1/min)44.00000017.9985000.590943
Table 17. Soldier patient values with expected and BioGears Engine output.


SoldierExpected ValueEngine ValuePercent ErrorNotes
PatientAge(yr)44.00000021.9981670.500042
PatientWeight(kg)77.61220377.5935350.000241
PatientHeight(in)71.00000070.9940850.000083
PatientBodyDensity(g/cm^3)1.0575371.099908-0.040066
PatientBodyFatFraction0.1800000.1799850.000081
PatientLeanBodyMass(kg)63642.03305763.5947010.999001
PatientAlveoliSurfaceArea(m^2)69.98702469.994168-0.000102
PatientRightLungRatio0.5250000.529956-0.009440
PatientSkinSurfaceArea(m^2)1.9681181.969836-0.000873
PatientBasalMetabolicRate(kcal/day)1737.3477471861.844872-0.071659
PatientBloodVolumeBaseline(mL)5532.5028345532.539032-0.000007
PatientDiastolicArterialPressureBaseline(mmHg)73.39287274.389902-0.013585
PatientHeartRateBaseline(1/min)50.00000083.993002-0.679860
PatientMeanArterialPressureBaseline(mmHg)94.73349495.436448-0.007420
PatientRespirationRateBaseline(1/min)12.50000015.998667-0.279893
PatientSystolicArterialPressureBaseline(mmHg)113.552910114.429966-0.007724
PatientTidalVolumeBaseline(mL)0.625601531.955678-849.311740
PatientHeartRateMaximum(1/min)177.200000192.983921-0.089074
PatientHeartRateMinimum(1/min)0.0010000.0010000.000083
PatientExpiratoryReserveVolume(mL)1.0553991055.912022-999.485746
PatientFunctionalResidualCapacity(mL)2.5976132597.783554-999.065495
PatientInspiratoryCapacity(mL)3.5712433570.702491-998.848703
PatientInspiratoryReserveVolume(mL)2.9456423039.746730-1030.947089
PatientResidualVolume(mL)1.5422141541.871532-998.777900
PatientTotalLungCapacity(mL)6.1688566168.486045-998.939991
PatientVitalCapacity(mL)4.6266424626.614513-998.994021
TotalMetabolicRate(kcal/day)44.0000001861.844872-41.314656
BloodVolume(mL)44.0000005532.539718-124.739539
DiastolicArterialPressure(mmHg)44.00000074.412576-0.691195
HeartRate(1/min)44.00000083.993002-0.908932
MeanArterialPressure(mmHg)44.00000095.517445-1.170851
RespirationRate(1/min)44.00000015.9986670.636394
Table 18. Jeff patient values with expected and BioGears Engine output.


JeffExpected ValueEngine ValuePercent ErrorNotes
PatientAge(yr)44.00000024.9979170.431866
PatientWeight(kg)77.61220382.093160-0.057735
PatientHeight(in)71.00000071.994001-0.014000
PatientBodyDensity(g/cm^3)1.0575371.099908-0.040066
PatientBodyFatFraction0.1800000.1199900.333388
PatientLeanBodyMass(kg)63642.03305772.2939770.998864
PatientAlveoliSurfaceArea(m^2)69.98702473.993835-0.057251
PatientRightLungRatio0.5250000.529956-0.009440
PatientSkinSurfaceArea(m^2)1.9681182.039830-0.036437
PatientBasalMetabolicRate(kcal/day)1737.3477471917.840207-0.103890
PatientBloodVolumeBaseline(mL)5532.5028345862.511539-0.059649
PatientDiastolicArterialPressureBaseline(mmHg)73.39287274.229515-0.011400
PatientHeartRateBaseline(1/min)50.00000071.994001-0.439880
PatientMeanArterialPressureBaseline(mmHg)94.73349495.767721-0.010917
PatientRespirationRateBaseline(1/min)12.50000015.998667-0.279893
PatientSystolicArterialPressureBaseline(mmHg)113.552910114.733240-0.010395
PatientTidalVolumeBaseline(mL)0.625601540.954928-863.696713
PatientHeartRateMaximum(1/min)177.200000190.984087-0.077788
PatientHeartRateMinimum(1/min)0.0010000.0010000.000083
PatientExpiratoryReserveVolume(mL)1.0553991055.912022-999.485746
PatientFunctionalResidualCapacity(mL)2.5976132687.776056-1033.709796
PatientInspiratoryCapacity(mL)3.5712433842.679830-1075.006319
PatientInspiratoryReserveVolume(mL)2.9456423301.724902-1119.884635
PatientResidualVolume(mL)1.5422141632.863951-1057.779060
PatientTotalLungCapacity(mL)6.1688566531.455803-1057.779060
PatientVitalCapacity(mL)4.6266424898.591852-1057.779060
TotalMetabolicRate(kcal/day)44.0000001917.840207-42.587277
BloodVolume(mL)44.0000005861.689782-132.220222
DiastolicArterialPressure(mmHg)44.00000074.284464-0.688283
HeartRate(1/min)44.00000071.994001-0.636227
MeanArterialPressure(mmHg)44.00000095.818407-1.177691
RespirationRate(1/min)44.00000015.9986670.636394
Table 19. Carol patient values with expected and BioGears Engine output.


CarolExpected ValueEngine ValuePercent ErrorNotes
PatientAge(yr)44.00000039.9966670.090985
PatientWeight(kg)77.61220373.0939100.058216
PatientHeight(in)71.00000065.9945010.070500
PatientBodyDensity(g/cm^3)1.0575370.9999170.054485
PatientBodyFatFraction0.1800000.249979-0.388776
PatientLeanBodyMass(kg)63642.03305754.7954340.999139
PatientAlveoliSurfaceArea(m^2)69.98702465.9945010.057047
PatientRightLungRatio0.5250000.529956-0.009440
PatientSkinSurfaceArea(m^2)1.9681181.8198480.075336
PatientBasalMetabolicRate(kcal/day)1737.3477471464.8779470.156831
PatientBloodVolumeBaseline(mL)5532.5028345205.5662750.059094
PatientDiastolicArterialPressureBaseline(mmHg)73.39287273.766054-0.005085
PatientHeartRateBaseline(1/min)50.00000071.994001-0.439880
PatientMeanArterialPressureBaseline(mmHg)94.73349494.887894-0.001630
PatientRespirationRateBaseline(1/min)12.50000017.998500-0.439880
PatientSystolicArterialPressureBaseline(mmHg)113.552910113.4827450.000618
PatientTidalVolumeBaseline(mL)0.625601434.963759-694.273697
PatientHeartRateMaximum(1/min)177.200000179.985004-0.015717
PatientHeartRateMinimum(1/min)0.0010000.0010000.000083
PatientExpiratoryReserveVolume(mL)1.0553991054.912105-998.538317
PatientFunctionalResidualCapacity(mL)2.5976132506.791136-964.036257
PatientInspiratoryCapacity(mL)3.5712433298.725152-922.691087
PatientInspiratoryReserveVolume(mL)2.9456422863.761393-971.202784
PatientResidualVolume(mL)1.5422141450.879114-939.776740
PatientTotalLungCapacity(mL)6.1688565805.516288-940.100922
PatientVitalCapacity(mL)4.6266424353.637257-939.992861
TotalMetabolicRate(kcal/day)44.0000001464.877947-32.292681
BloodVolume(mL)44.0000005204.161419-117.276396
DiastolicArterialPressure(mmHg)44.00000073.828125-0.677912
HeartRate(1/min)44.00000071.994001-0.636227
MeanArterialPressure(mmHg)44.00000094.949391-1.157941
RespirationRate(1/min)44.00000016.9985840.613669
Table 20. Jane patient values with expected and BioGears Engine output.


JaneExpected ValueEngine ValuePercent ErrorNotes
PatientAge(yr)44.00000017.9985000.590943
PatientWeight(kg)77.61220354.8954260.292696
PatientHeight(in)71.00000063.9946680.098667
PatientBodyDensity(g/cm^3)1.0575371.099908-0.040066
PatientBodyFatFraction0.1800000.1799850.000081
PatientLeanBodyMass(kg)63642.03305744.9962510.999293
PatientAlveoliSurfaceArea(m^2)69.98702448.9959180.299929
PatientRightLungRatio0.5250000.529956-0.009440
PatientSkinSurfaceArea(m^2)1.9681181.5698690.202350
PatientBasalMetabolicRate(kcal/day)1737.3477471376.8852790.207479
PatientBloodVolumeBaseline(mL)5532.5028343894.6754980.296037
PatientDiastolicArterialPressureBaseline(mmHg)73.39287273.565871-0.002357
PatientHeartRateBaseline(1/min)50.00000071.994001-0.439880
PatientMeanArterialPressureBaseline(mmHg)94.73349495.032482-0.003156
PatientRespirationRateBaseline(1/min)12.50000018.998417-0.519873
PatientSystolicArterialPressureBaseline(mmHg)113.552910113.914409-0.003184
PatientTidalVolumeBaseline(mL)0.625601402.966425-643.127127
PatientHeartRateMaximum(1/min)177.200000194.983754-0.100360
PatientHeartRateMinimum(1/min)0.0010000.0010000.000083
PatientExpiratoryReserveVolume(mL)1.0553991054.912105-998.538317
PatientFunctionalResidualCapacity(mL)2.5976132143.821378-824.304242
PatientInspiratoryCapacity(mL)3.5712432210.815796-618.060622
PatientInspiratoryReserveVolume(mL)2.9456421806.849454-612.397497
PatientResidualVolume(mL)1.5422141088.909273-705.068828
PatientTotalLungCapacity(mL)6.1688564353.637257-704.744646
PatientVitalCapacity(mL)4.6266423265.727901-704.852707
TotalMetabolicRate(kcal/day)44.0000001376.885279-30.292847
BloodVolume(mL)44.0000003895.121079-87.525479
DiastolicArterialPressure(mmHg)44.00000073.403952-0.668272
HeartRate(1/min)44.00000072.056986-0.637659
MeanArterialPressure(mmHg)44.00000094.950665-1.157970
RespirationRate(1/min)44.00000018.9984170.568218
Table 21. ExtremeFemale patient values with expected and BioGears Engine output.


ExtremeFemaleExpected ValueEngine ValuePercent ErrorNotes
PatientAge(yr)44.00000017.9985000.590943
PatientWeight(kg)77.61220341.3965510.466623
PatientHeight(in)71.00000053.9955010.239500
PatientBodyDensity(g/cm^3)1.0575370.9999170.054485
PatientBodyFatFraction0.1800000.319973-0.777633
PatientLeanBodyMass(kg)63642.03305728.1976510.999557
PatientAlveoliSurfaceArea(m^2)69.98702436.9969170.471375
PatientRightLungRatio0.5250000.529956-0.009440
PatientSkinSurfaceArea(m^2)1.9681181.2298980.375090
PatientBasalMetabolicRate(kcal/day)1737.3477471172.9022740.324889
PatientBloodVolumeBaseline(mL)5532.5028342925.7562280.471170
PatientDiastolicArterialPressureBaseline(mmHg)73.39287257.8175830.212218
PatientHeartRateBaseline(1/min)50.00000059.995001-0.199900
PatientMeanArterialPressureBaseline(mmHg)94.73349474.3323070.215353
PatientRespirationRateBaseline(1/min)12.50000011.9990000.040080
PatientSystolicArterialPressureBaseline(mmHg)113.55291088.8651960.217412
PatientTidalVolumeBaseline(mL)0.625601460.961593-735.830286
PatientHeartRateMaximum(1/min)177.200000194.983754-0.100360
PatientHeartRateMinimum(1/min)0.0010000.0010000.000083
PatientExpiratoryReserveVolume(mL)1.0553991054.912105-998.538317
PatientFunctionalResidualCapacity(mL)2.5976131872.843956-719.986402
PatientInspiratoryCapacity(mL)3.5712431399.883362-390.987730
PatientInspiratoryReserveVolume(mL)2.945642938.921770-317.749446
PatientResidualVolume(mL)1.542214817.931850-529.362077
PatientTotalLungCapacity(mL)6.1688563272.727318-529.524168
PatientVitalCapacity(mL)4.6266422454.795468-529.578198
TotalMetabolicRate(kcal/day)44.0000001172.902274-25.656870
BloodVolume(mL)44.0000002931.295679-65.620356
DiastolicArterialPressure(mmHg)44.00000057.634636-0.309878
HeartRate(1/min)44.00000060.457386-0.374031
MeanArterialPressure(mmHg)44.00000074.267485-0.687897
RespirationRate(1/min)44.00000012.8289590.708433
Table 22. ExtremeMale patient values with expected and BioGears Engine output.


ExtremeMaleExpected ValueEngine ValuePercent ErrorNotes
PatientAge(yr)44.00000064.994585-0.477150
PatientWeight(kg)77.61220399.491710-0.281908
PatientHeight(in)71.00000083.993002-0.183000
PatientBodyDensity(g/cm^3)1.0575371.099908-0.040066
PatientBodyFatFraction0.1800000.0199980.888898
PatientLeanBodyMass(kg)63642.03305797.4918770.998468
PatientAlveoliSurfaceArea(m^2)69.98702489.992502-0.285846
PatientRightLungRatio0.5250000.529956-0.009440
PatientSkinSurfaceArea(m^2)1.9681182.469794-0.254901
PatientBasalMetabolicRate(kcal/day)1737.3477472069.827543-0.191372
PatientBloodVolumeBaseline(mL)5532.5028347124.406398-0.287737
PatientDiastolicArterialPressureBaseline(mmHg)73.39287280.809167-0.101049
PatientHeartRateBaseline(1/min)50.00000099.991669-0.999833
PatientMeanArterialPressureBaseline(mmHg)94.733494101.985603-0.076553
PatientRespirationRateBaseline(1/min)12.50000018.998417-0.519873
PatientSystolicArterialPressureBaseline(mmHg)113.552910120.806834-0.063881
PatientTidalVolumeBaseline(mL)0.625601545.954511-871.688365
PatientHeartRateMaximum(1/min)177.200000162.9864200.080212
PatientHeartRateMinimum(1/min)0.0010000.0010000.000083
PatientExpiratoryReserveVolume(mL)1.0553991055.912022-999.485746
PatientFunctionalResidualCapacity(mL)2.5976133035.747063-1167.667761
PatientInspiratoryCapacity(mL)3.5712434884.593018-1366.757187
PatientInspiratoryReserveVolume(mL)2.9456424338.638507-1471.900796
PatientResidualVolume(mL)1.5422141979.835041-1282.761506
PatientTotalLungCapacity(mL)6.1688567920.340082-1282.923597
PatientVitalCapacity(mL)4.6266425940.505040-1282.977627
TotalMetabolicRate(kcal/day)44.0000002069.827543-46.041535
BloodVolume(mL)44.0000007122.416318-160.873098
DiastolicArterialPressure(mmHg)44.00000080.755202-0.835346
HeartRate(1/min)44.00000099.991669-1.272538
MeanArterialPressure(mmHg)44.000000101.971579-1.317536
RespirationRate(1/min)44.00000018.9984170.568218

Conclusions

The methodology used to define and set patient parameters is successful in allowing for the simulation of unique humans.

Future Work

Coming Soon

There are no planned near-term additions.

Recommended Improvements

The BioGears physiology engine is providing consistent and accurate physiology simulation, and its ability to simulate physiology for a generic representative of a population will improve as development continues. It is not within the scope of the current project for BioGears to predictively simulate the physiology of a specific (or average) individual within a population, but the development of technologies that make BioGears usable and extensible to the community also facilitate multiscale model development and can be leveraged for predictive simulation and thus clinical use.

One way to extend BioGears for clinical use is to use data from sources such as electronic health records (EHRs), lab reports, fitness evaluations, or wearable sensors to create a personalized physiological profile. A tool could then translate the personal physiological profile into parameters that can inform the BioGears physiology models within the systems' framework.

Appendices

Acronyms

CDM - Common Data Model

Data Model Implementation

BioGears