CAREER: Enabling "White-Box" Autonomy in Medical Cyber-Physical Systems

尽管在危重患者护理自动化方面进行了长期的努力，但由于一些限制，先前的自动化能力尚未成熟到适合实际使用：(1)自动化的决策/行动不容易被临床医生解释，阻碍了临床医生与自动化的有效互动和监督，以确保患者的安全护理；(2)自动化设计用于执行感兴趣的特定任务，而不考虑患者的整体生理状态；(3)多个自动化功能往往不协调，以避免患者治疗中可能发生的冲突；(4)医疗器械自动化容易出现错误；(5)缺乏对安全关键自动化能力进行评估和批准的监管科学。该研究项目旨在通过研究新的方法来解决这些基本挑战，这些方法包括：(1)以一种促进临床医生解释的方式数学地表示患者生理；(2)设计自动化功能，促进临床医生的互动和监督，协调多个治疗目标和功能，以及对设备错误和故障的恢复能力。此外，该研究计划将通过创建广泛的自动化系统，提高危重患者的护理质量，加快具有先进自动化功能的新医疗设备的部署，促进新兴医疗自动化功能的评估和批准，以及培训STEM劳动力，特别是来自代表性不足的少数民族，从而造福社会和科学，技术，工程和数学（STEM）教育。通过推进医疗网络物理系统（M-CPS）的可推广方法，实现医疗保健中可解释的白盒自主性的长期愿景，本职业计划的目标是研究循环复苏中的生理建模，协调和弹性多变量闭环控制以及调节科学方法。为了实现这一目标，提出了一项综合研究、教育和推广计划。在研究方面，将研究适用于大范围循环复苏场景白盒自主的生理建模和闭环控制方法。具体而言，将开发(1)患者生理和药理学建模和(2)协调和弹性多变量闭环控制的可推广方法。这些方法的价值将通过开发可解释的白盒生理闭环控制算法来证明循环复苏。在教育和推广方面，下一代M-CPS工作人员将接受培训，评估重症监护自主能力的监管科学将得到发展。具体而言，(1)研究生，本科生和K-12学生将被吸引到STEM和M-CPS，(2)将与美国食品和药物管理局合作，通过其医疗设备开发工具计划调查生理模型和闭环M-CPS的测试方法和工具，以及(3)新创造的知识将被传播，以进一步推进M-CPS的研究和教育。该奖项反映了美国国家科学基金会的法定使命，并通过使用基金会的知识价值和更广泛的影响审查标准进行评估，被认为值得支持。

Despite a long-standing effort on the automation in the care of critically ill patients, prior automation capabilities have not been suitably mature for real-world use due to a few limitations: (1) the decisions/actions of the automation could not be easily interpreted by clinicians, preventing clinicians' effective interaction with and supervision of the automation for safe patient care; (2) the automation was designed to perform a particular task of interest without accounting for the overall physiological state of the patient; (3) multiple automation functions were not often coordinated to avoid possible conflicts in patient treatment; (4) automation was prone to errors in the medical devices; and (5) regulatory science for evaluation and approval of safety-critical automation capabilities was lacking. This research program seeks to address these fundamental challenges by studying novel methodologies for (1) mathematically representing the patient physiology in a way to facilitate the interpretation of clinicians and (2) designing automation capabilities that can facilitate clinician interaction and supervision, coordination of multiple treatment goals and functions, and resilience to device errors and faults. In addition, this research program will benefit society and Science, Technology, Engineering and Mathematics (STEM) education by creating a wide range of automation systems that can improve the quality of care of critically ill patients, expediting the deployment of new medical devices with advanced automation capabilities, facilitating the evaluation and approval of emerging healthcare automation capabilities, and training STEM workforce especially from underrepresented minorities. With the long-term vision of enabling interpretable white-box autonomy in healthcare by advancing generalizable methodologies for medical cyber-physical systems (M-CPS), the objective of this CAREER program is to investigate physiological modeling, coordinated and resilient multivariable closed-loop control, and regulatory science methodologies in circulatory resuscitation. An integrated research, education, and outreach program is proposed to achieve this objective. On the research front, physiological modeling and closed-loop control methodologies applicable to white-box autonomy in a wide range of circulatory resuscitation scenarios will be investigated. Specifically, generalizable methodologies for (1) patient physiology and pharmacology modeling and (2) coordinated and resilient multivariable closed-loop control will be developed. The value of these methodologies will be demonstrated by developing interpretable white-box physiological closed-loop control algorithms for circulatory resuscitation. On the education and outreach front, members of the next-generation M-CPS workforce will be trained and regulatory science for evaluating critical care autonomy capabilities will be advanced. Specifically, (1) graduate, undergraduate, and K-12 students will be attracted into STEM and M-CPS, (2) collaboration with the US Food and Drug Administration will be performed to investigate testing methodologies and tools for physiological models and closed-loop M-CPS via its Medical Device Development Tools Program, and (3) newly created knowledge will be disseminated to further advance M-CPS research and education.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.