On effective testing of health care simulation software

Health care professionals rely on software to simulate anatomical and physiological elements of the human body for purposes of training, prototyping, and decision making. Software can also be used to simulate medical processes and protocols to measure cost effectiveness and resource utilization. Whereas much of the software engineering research into simulation software focuses on validation (determining that the simulation accurately models real-world activity), to date there has been little investigation into the testing of simulation software itself, that is, the ability to effectively search for errors in the implementation. This is particularly challenging because often there is no test oracle to indicate whether the results of the simulation are correct. In this paper, we present an approach to systematically testing simulation software in the absence of test oracles, and evaluate the effectiveness of the technique.