SCI TV - Evidence-based medicine and clinical decision making in neuromodulation therapy

Neuromodulation therapy is a promising approach for several conditions, especially when alternate approaches have limited efficacy or undesirable side effects. Examples include: cortical stimulation or transcranial magnetic stimulation for depression; deep brain stimulation (DBS) for Parkinson's disease and other movement disorders. However, outcomes from neuromodulation therapy are known to be acutely sensitive to the location and type of stimulation. In addition, physicians have few tools at their disposal to understand where and how individual patients are stimulated, or how each patient compares to others in a cohort. We have recently shown that the use of interactive visualization in clinical decision making for DBS can provide comparable benefit to standard care but in much less time. We are now expanding these studies to determine whether this approach can provide improved symtomatic relief and reduced side effects compared to standard care. To achieve this goal we must address address several distinct problems. First, we introduce a new type of evidence that combines clinical observation with computational models. Second, we are collaborating with visualization experts at SCI to integrate this evidence into an interactive system that runs on mobile computing devices. Third, we are integrating this system into a clinical workflow for the treatment of Parkinson's disease patients. In this talk I will present our recent results and future challenges on this project.