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Computers in medicine is focus of prof's research

CAMBRIDGE, Mass. -- Even as a young girl in Brazil, Lucila Ohno-Machado knew what she wanted to do when she grew up. "I've always wanted to work with computers in medicine," she said.

Today the professor with joint appointments at MIT and Harvard is working on such things as computer models that will help plan treatment for diseases using the patient's medical history and diagnosis.

Medical informatics is the field in which researchers study the use of biomedical information and data for problem-solving and decision-making in health care. Ohno-Machado has several ongoing research projects in this area. For example, she is using machine-learning algorithms to construct diagnostic and prognostic models of diseases.

"Diagnoses are things that MDs do well since that is taught more in medical school, but people don't do as well with prognoses," said the associate professor with appointments at the Harvard-MIT Division of Health Sciences and Technology and at Harvard Medical School.

"Furthermore, recent developments in functional genomics suggest that it may be possible to do even more precise diagnoses if gene expression is taken into account. Since the new methodology is heavily dependent on computation, we can anticipate a critical need for computers to help clinicians make diagnoses and prognoses."

Ohno-Machado is also working to automate the process of selecting patients for clinical trials of new therapies. Such trials are, for example, an effective way to deal with advanced breast cancer, but there are hundreds of trials ongoing at any one time with very specific requirements. Ohno-Machado's goal is to design a computer program that can sort through the myriad criteria using known patient data, then estimate the patient's probability of fitting other criteria in a given trial so that the most appropriate trials can be properly ranked and considered.

Ohno-Machado stresses the need to be very responsible when dealing with the expectations and anxiety of cancer patients. She is an ardent believer in the need for "bench and bedside" methods to communicate and collaborate. To that end, she teaches medical informatics to both health-care providers and computer scientists to bridge the gap between the two fields. In addition to teaching HST 950: Medical Computing, and HST 951: Medical Decision Support, last year she received a Taplin award from HST to develop and build a biomedical informatics curriculum.

Besides her research and teaching, Ohno-Machado, who is also Associate Director of the Decisions Systems Group at Brigham and Women's Hospital, has a strong desire to give back to her native country. In 1999 she received a grant from the NIH/Fogarty International Center to do medical informatics training in developing countries.

The first part of the training is to send specialists from the US to Brazil to teach short courses. (HST faculty members Robert Greenes and Peter Szolovits have taught courses there.) The second part of the grant brings Brazilian researchers to the US for training. The program is designed to incorporate training into several subdomains in biomedical informatics.

This winter, in response to an NIH request for applications for international collaboration in genetics training, Dr. Ohno-Machado worked with Drs. Richard Maas and George Church, both affiliated faculty of HST, to plan a rigorous post-doctoral training program for young Brazilian researchers.

"Brazilians have actively participated in the Human Genome Project and similar research, such as sequencing the genome of certain plants and infectious diseases of national importance," she said. The Brazilian research community in genomics and bioinformatics, although extremely talented, lacks active support for collaboration with leading international centers of excellence in genomics and bioinformatics. The proposed program tries to fill this gap by bringing together Brazilian and U.S. faculty to address important health problems.

In addition to her research, teaching and advising responsibilities, Ohno-Machado is also mother to three boys aged 6, 4 and 2. She had been able to juggle her work and home life somewhat successfully until recently, but "the third one unbalanced me," she said half-jokingly. She and her husband divide the childcare, with him staying home (at least for now).

This story is adapted from an article by Becky Sun, Harvard-MIT Division of Health Sciences and Technology, that ran in the January 2002 issue of The Connector , an HST newsletter.

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