des-ist: A Simulation Framework to Streamline Event-Based In Silico Trials

To popularise in silico trials for development of new medical devices, drugs, or treatment procedures, we present the modelling framework des-ist (Discrete Event Simulation framework for In Silico Trials). This framework supports discrete event-based simulations. Here, events are collected in an acyclic, directed graph, where each node corresponds to a component of the overall in silico trial. A simple API and data layout are proposed to easily couple numerous simulations by means of containerised environments, i.e. Docker and Singularity. An example in silico trial is highlighted studying treatment of acute ischemic stroke, as considered in the INSIST project.

The proposed framework enables straightforward coupling of the discrete models, reproducible outcomes by containerisation, and easy parallel execution by GNU Parallel. Furthermore, des-ist supports the user in creating, running, and analysing large numbers of virtual cohorts, automating repetitive user interactions. In future work, we aim to provide a tight integration with validation, verication and uncertainty quantication analyses, to enable sensitivity analysis of individual components of in silico trials and improve trust in the computational outcome to successfully augment classical medical trials and thereby enable faster development of treatment procedures.