One of the most important health care problems is that a large number of patients do not respond to drug treatment. According to a report from the FDA, medication is deemed ineffective for 38-75 % of patients with common diseases. This problem reflects the complexity of common diseases. These may involve altered interactions between thousands of genes, which differ between patients with the same diagnosis. There is a wide gap between this complexity and modern health care, in which diagnostics often relies on a limited number of unspecific diagnostic markers.
Digital twins is a concept from engineering, which has been applied complex systems such as airplanes or even cities The key idea is to computationally model those systems, in order to develop and test them more quickly and economically than in real life. STDC aims to apply this concept to personalize medicine, by constructing 1) network models of all molecular, phenotypic and environmental factors relevant to disease mechanisms in individual patients (digital twins); and 2) computationally treat those twins with thousands of drugs in order to identify the best one or ones to 3) treat the patient (Figure 1).
Figure 1. The digital twin concept for personalized medicine (from Björnsson et al. Genome Medicine).
A) An individual patient with a local sign of disease (red).
B) A digital twin of the patient is constructed in unlimited copies, based on high-performance computational integration of thousands of disease-relevant variables.
C) Each twin is computationally treated with one or more of thousands of drugs. This results in digital cure of one patient (green). D) The drug that has the best effect on the twin is selected for treatment of the patient.
The STDC is a multi-disciplinary consortium with partners from health care, medical and technical faculties and industry. The academic partners come from Karolinska Institute, Karolinska Hospital, Linköping University, Linköping University Hospital, Chalmers Institute of Technology and Lund University.
The background to Relapse and Remission are questions reflecting the limits of a scientific article: Is it possible to express the individual experience of having a chronic disease, as well as the underlying molecular complexity and variability of such a disease? Can art interact with science to address these questions? If so, can this result in other forms of understanding that transcends the limits of either of the two? Relapse and Remission aimed to explore these questions: Two artists, Zsuzsanna Larsson Gilice (the drawing) and Magnus Larsson (the animation) collaborated with Johan Ramström (composer) of the Royal College of Music in Stockholm, who in turn interacted with patients, physicians and scientists. Unlike a scientific illustration Relapse and Remission aims to induce an emotional response, as well as raise questions and awareness of chronic disease. We see this as a starting point for further artistic and scientific exploration of these questions.