CMH Scientific · ABP
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AI as a Biological Primitive · LUMIERE glioblastoma

Patient-specific intervention analysis
in longitudinal glioblastoma

Patient-067's observed longitudinal imaging and surgical history, followed by chemoradiation, resection planning and comparative intervention analysis from her measured tumor states. Patients 071 and 072 illustrate matched clinical states with divergent observed courses. Each module records the session and produces a downloadable report.

OBSERVED COURSE→CHEMORADIATION→SURGICAL PLANNING→COMPARATIVE ANALYSIS→MATCHED STATES → RESPONDERS
01 · OBSERVED

Observed tumor dynamics

Patient-067's MRI follow-up over 167 weeks and 20 scans, with segmented tumor compartments, measured 3-D volumes and expert RANO ratings. The reference view is held constant so interval size change is not confounded by changing scan orientation.

Observed record only
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02 · PLANNING

Chemoradiation analysis

Chemoradiation analysis from any observed scan, shown on the patient's own tumor anatomy. Radiation dose and alkylating-agent exposure can be varied across the supported range and followed over 24 weeks.

Measured starting state · supported response calculation
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03 · PRE-OPERATIVE

Surgical planning

Pre-operative analysis on the patient's week-156 anatomy. Extent of resection, depth and cranial access trajectory can be varied; postoperative behavior is referenced to her three earlier observed resections and compared with the fourth postoperative course.

Observed anatomy and surgical history · selectable resection plan
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04 · COMPARATIVE

Comparative intervention analysis

Chemoradiation, surgery and combined treatment are compared from the same measured week-156 tumor state for a selected objective and horizon. ABP reports no leading option when the calculated outcomes are not separable.

Treatment comparison · reports when options are not separable
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05 · OBSERVED

Matched clinical states, divergent courses

Patients 071 and 072 were closely matched at one scan: similar volume, the same RANO rating, and among the closest 1% of scan pairs on imaging features. Their observed courses diverged: overall survival of 17 weeks after the matched state for one and 96 weeks for the other. Each tumor is shown in that patient's own anatomy at every scan.

Observed record · two patients
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06 · OBSERVED

Response trajectories

Patients whose tumors responded on imaging (RANO partial or complete response): when each response began, how the compartments changed, how long it lasted, whether the scans before it gave any sign, and a matched patient who progressed instead.

Observed record · five patients · response described, not explained
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Rationale for individual-referenced models

Evidence from the type 1 diabetes study.

In 12 people with type 1 diabetes (194,010 five-minute observations), a model trained on the pooled population and models built from each person's own history were given the same task: find an intervention that moves high blood glucose toward a target.

POPULATION MODEL VS EACH PERSON'S OWN MODEL
24.5%

of tests gave the identical intervention

The population-trained model and the person's own model chose the same intervention in only 24.5% of evaluations. In the other 75.5%, they disagreed about what would move that person toward target. This measures agreement, not which answer was right.

ABP INVERSION · SEPARATE RESULT
96.0%

of 400 high-glucose cases moved toward target under ABP inversion

Queried in reverse under clinical constraints, ABP found an intervention direction that reduced the target gap in 96.0% of 400 high-glucose evaluations, with an average gap reduction of 87.8%.

A model trained on the population is not the same thing as a model built from the person. Faced with the same task, the two usually reached different conclusions about what intervention fits the individual. The comparison is architectural: it does not claim that every digital twin is built the same way.
Data provenance. Imaging: LUMIERE dataset (Suter et al., Scientific Data 9:768, 2022), de-identified longitudinal imaging and clinical annotations. Observed scans, recorded resections and postoperative courses are identified directly. LUMIERE does not record chemoradiation schedules; chemoradiation response calculations use the stated literature-informed functions.