JP2015097004A - Examination support system and examination support method - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an examination support system and an examination support method capable of increasing accuracy of diagnosis while reducing load imposed to an examiner and a subject.SOLUTION: An examination support system 1A includes: a recording determination unit 2 that detects a sign that a subject experiences a pain or discomfort during a movement; and a recording execution unit 3 that, when the recording determination unit 2 detects the sing of the subject's pain or discomfort, acquires a piece of information on subject's posture when the subject experiences the pain or discomfort, and records the acquired subject posture information.

Description

  Embodiments described herein relate generally to a diagnosis support apparatus and a diagnosis support method.

  The patient (subject) has pain or discomfort in the limbs, shoulders, hips, neck, etc., and the doctor (examiner) feels the pain or incongruity in the examination (inquiry) when visiting an orthopedic or osteopathic clinic. It is necessary to identify the part that remembered (feeled). At this time, based on the patient's report, the doctor assumes the possible symptoms, changes the patient's posture, and further pushes or twists the region of interest, and provides information on the location where the patient felt pain or discomfort. Obtained and examined. Further, in the follow-up after treatment, in order to confirm the recovery of the corresponding part, it is confirmed that the patient's pain and discomfort are eliminated by reproducing the same posture as the previous examination and palpating the corresponding part.

  As mentioned above, doctors perform examinations by changing the posture of the patient and further pushing or twisting the area of interest, but information such as the posture and palpation area that felt pain or discomfort at the time of the examination was instantaneous. Or rely on the experience and memory of a doctor. For this reason, it is difficult to accurately record posture and palpation site information, which is a factor that reduces the accuracy of diagnosis.

  In addition, since the posture and palpation site that felt pain and discomfort at the time of examination are important information for diagnosis, if the information is ambiguous, the posture that felt pain or discomfort should be used to obtain accurate information. The patient will be taken over and over again. For this reason, in addition to the burden on the doctor, the patient is repeatedly burdened with unnecessary pain, and the burden on the patient also increases.

  Furthermore, during follow-up (recovery confirmation), information on postures and palpation sites that felt pain and discomfort during past visits largely depended on doctor's memory and medical record records. Diagnosis may be lost, which is a factor that reduces the accuracy of diagnosis.

JP 2001-43345 A

  The problem to be solved by the present invention is to provide a diagnosis support apparatus and a diagnosis support method capable of improving the accuracy of diagnosis and further reducing the burden on the examiner and the subject.

  The medical examination support device according to the embodiment, when the detection unit detects that the subject feels pain or discomfort during operation, and the detection unit detects that the subject feels pain or discomfort, An acquisition unit that acquires subject posture information related to the posture of the subject when he / she feels pain or discomfort, and a storage unit which stores the subject posture information acquired by the acquisition unit.

  In the diagnosis support method according to the embodiment, the step of detecting that the subject feels pain or discomfort during operation, and the case that the subject feels pain or discomfort is detected, the pain or discomfort is memorized. A step of acquiring subject posture information relating to the posture of the subject at the time, and a step of storing the acquired subject posture information.

It is a block diagram showing a schematic structure of a medical examination support device concerning a 1st embodiment. It is explanatory drawing for demonstrating the medical examination record by the facial expression which concerns on 1st Embodiment. It is explanatory drawing for demonstrating the medical examination record based on 1st Embodiment. It is explanatory drawing for demonstrating the recording information by the medical examination record which concerns on 1st Embodiment. It is explanatory drawing for demonstrating the screen display at the time of attitude | position navigation which concerns on 1st Embodiment. It is a flowchart which shows the flow of the medical examination recording process which concerns on 1st Embodiment. It is a flowchart which shows the flow of the recording browsing process which concerns on 1st Embodiment. It is a flowchart which shows the flow of the attitude | position navigation process which concerns on 1st Embodiment. It is a flowchart which shows the flow of the past record selection process which concerns on 1st Embodiment. It is explanatory drawing for demonstrating the screen display at the time of the record browsing which concerns on 2nd Embodiment. It is a block diagram which shows schematic structure of the consultation assistance apparatus which concerns on 3rd Embodiment. It is explanatory drawing for demonstrating the rehabilitation recording by the facial expression which concerns on 3rd Embodiment. It is explanatory drawing for demonstrating the recording information by the rehabilitation recording which concerns on 3rd Embodiment. It is a flowchart which shows the flow of the rehabilitation recording process which concerns on 3rd Embodiment. It is a flowchart which shows the flow of the rehabilitation record browsing process which concerns on 3rd Embodiment.

(First embodiment)
A first embodiment will be described with reference to FIGS.

  As shown in FIG. 1, the diagnosis support apparatus 1 </ b> A according to the first embodiment includes a record determination unit 2 that determines timing for recording information used for diagnosis support, and a record execution that executes recording according to the determination result. A unit 3 and an information providing unit 4 that provides recorded information (recording information) to a user are provided.

  The recording determination unit 2 includes a facial expression detection unit 2a that detects a facial expression of a patient, a voice detection unit 2b that detects a voice of a user such as a patient or a doctor, a gesture detection unit 2c that detects a user's gesture, A recording instruction detection unit 2d that detects a recording instruction, a recording determination unit 2e that determines whether or not recording is necessary, a facial expression analysis unit 2f that analyzes a facial expression of a patient, a voice analysis unit 2g that analyzes a user's voice, A gesture analysis unit 2h that analyzes a user's gesture and a determination information database (DB) 2i that stores determination information used for recording execution determination are provided.

  The facial expression detection unit 2a, the voice detection unit 2b, and the gesture detection unit 2c are detection units that acquire sensor information. As the facial expression detection unit 2a and the gesture detection unit 2c, for example, a camera that captures the facial expression and motion of the patient can be used. Moreover, as the audio | voice detection part 2b, it is possible to use a microphone etc., for example. Since the camera captures the pattern of the examination, it is provided in the examination room so that the entire patient and doctor can be photographed. The microphone is also provided in the examination room so as to capture the voice of the patient and doctor.

  The recording instruction detection unit 2d is a detection unit that detects an input operation from a user as a recording instruction. As the recording instruction detection unit 2d, for example, an input unit (input device) such as a button or a foot switch can be used. As an example, a button is carried by the patient, and when the button is pressed by the patient or a foot switch is stepped on by a doctor, a recording instruction will be detected.

  The recording determination unit 2e includes sensor information (for example, video information and audio information) detected by each of the detection units 2a to 2c and determination information (for example, facial expression data and audio data) stored in the determination information database 2i. If the condition for recording information is satisfied, the information management unit 3d is requested to record information (execute information recording). Also when the recording instruction is detected by the recording instruction detection unit 2d, the information management unit 3d is requested to record information. During the examination, data obtained from each of the detection units 2a to 2c is continuously acquired and sent to the recording determination unit 2e.

  The facial expression analysis unit 2f analyzes the patient's facial expression detected by the facial expression detection unit 2a using facial expression recognition technology, and recognizes the facial expression. The facial expression of the patient recognized by the facial expression analysis unit 2f and the facial expression data stored in the determination information database 2i are compared by the record determination unit 2e, and it is determined that the facial expression is, for example, a facial expression that feels painful or strange. Then, an information recording request is issued to the information management unit 3d.

  The voice analysis unit 2g analyzes the voice of the patient or doctor detected by the voice detection unit 2b using voice recognition technology and recognizes the voice. The voice of the patient or doctor recognized by the voice analysis unit 2g and the voice data stored in the judgment information database 2i are compared by the recording judgment unit 2e, and the voice of the patient is, for example, a voice that feels painful or uncomfortable. If it is determined (for example, a voice such as “pain” or “discomfort”), an information recording request is issued to the information management unit 3d. Further, when it is determined that the doctor's voice is, for example, a voice instructing information recording (for example, a voice such as “record”), an information recording request is issued to the information management unit 3d.

  The gesture analysis unit 2h analyzes gestures (gestures, hand gestures, etc.) of patients and doctors detected by the gesture detection unit 2c using gesture recognition technology, and recognizes the gestures. The patient / doctor gesture recognized by the gesture analysis unit 2h and the gesture data stored in the determination information database 2i are compared by the recording determination unit 2e, and the patient / doctor gesture instructs, for example, information recording. If it is determined as a gesture (for example, a gesture such as “waving hand” or “raising one finger”), an information recording request is issued to the information management unit 3d.

  The determination information database 2i is a database (storage unit) that stores and manages various types of determination information used by the recording determination unit 2e, for example, information such as facial expression data, audio data, and gesture data. As the determination information database 2i, for example, various storage devices such as a magnetic disk device and a semiconductor disk device can be used.

  Note that the recording determination unit 2 having each of these units is a determination unit that determines whether or not the patient feels pain or discomfort during operation, such as a doctor's examination, that is, the patient feels pain or discomfort during operation. It functions as a detection unit that detects the fact. When it is detected that the patient feels pain or discomfort during operation, an information recording request is issued to the information management unit 3d as described above.

  The recording execution unit 3 includes a posture detection unit 3a that detects the posture of a user such as a patient or a doctor, a photographing unit 3b that captures an image (such as a still image or a moving image), a personal detection unit 3c that identifies an individual user, An information management unit 3d that manages recording information, a posture analysis unit 3e that analyzes the posture of the user, a video analysis unit 3f that analyzes video, and a recording information database (DB) 3g that stores recording information. Yes.

  The posture detection unit 3a is an acquisition unit that detects and acquires posture information related to the posture of a patient or a doctor, and sends the acquired posture information to the information management unit 3d. The posture detection unit 3a detects and acquires posture information of a patient or a doctor by a motion tracking technique using a sensor such as a camera, for example.

  The imaging unit 3b is for imaging a patient or a doctor, and is provided in the examination room so that the entire patient or doctor can be imaged, for example. For example, a camera or the like can be used as the photographing unit 3b. In addition, when using a camera as the imaging | photography part 3b, it is also possible to share the camera with the above-mentioned facial expression detection part 2a and the gesture detection part 2c.

  The individual detection unit 3c is a detection unit that detects information related to an individual to be tracked (for example, feature information for specifying an individual). This is to identify an individual to be tracked first, because a motion tracking technique using a sensor such as a microphone or a camera is used during the examination. By recognizing the individual, not only can the patient and doctor information be judged individually, but also when other people such as nurses enter the video during the examination, they may misidentify them and cause malfunctions. It can be prevented from occurring.

  The information management unit 3d responds to an information recording request from the recording determination unit 2e, and various information obtained at the timing, such as patient and doctor posture data, video data, facial expression data, voice data, personal identification data, etc. Are recorded in the record information database 3g. The facial expression data and audio data are data transmitted from the recording determination unit 2e to the information management unit 3d together with an information recording request, and posture data detected by the posture detection unit 3a and video obtained by the photographing unit 3b. Both the data and personal identification data detected by the individual detection unit 3c are recorded in the recording information database 3g.

  The posture analysis unit 3e analyzes posture information related to the posture detected by the posture detection unit 3a, grasps the posture of the patient or doctor, and transmits the posture data to the information management unit 3d. This posture data is recorded in the recording information database 3g by a certain unit (for example, for each examination or for each part) by the information management unit 3d.

  The video analysis unit 3f analyzes video information regarding the video captured by the imaging unit 3b, grasps video data of a patient or a doctor, and transmits the video data to the information management unit 3d. This video data is associated with the above-described posture data (posture data obtained at the same timing as the above-mentioned video data) by the information management unit 3d, and is recorded in the recording information database 3g in the same constant units as described above.

  The recorded information database 3g is a database (stored) that stores and manages various types of information recorded by the information management unit 3d, such as posture data, video data, facial expression data, audio data, personal identification data, management data, and the like. Part). As the recording information database 3g, for example, various storage devices such as a magnetic disk device and a semiconductor disk device can be used.

  Here, for example, as shown in FIG. 2, when the patient A1 is palpated by a doctor (palpator) A2 and the arm of the patient A1 is moved by the doctor A2 (see the black arrow in FIG. 2), the patient A1 When the patient feels pain and changes their facial expression (when the expression “pain”), the facial expression change is detected by the facial expression detection unit 2a, and the facial expression analysis unit 2f recognizes that the patient A1 feels pain. Based on the analysis result that the patient A1 feels pain, the recording determination unit 2e determines the recording execution, and an information recording request is issued to the information management unit 3d. At the timing of the recording request, the video information B1 and the posture information B2 are acquired from the photographing unit 3b and the posture detection unit 3a, and the information is analyzed by the posture analysis unit 3e and the video analysis unit 3f. Recorded in the database 3g.

  Further, as shown in FIG. 3, when the patient A1 is palpated by the doctor A2 and the arm of the patient A1 is moved by the doctor A2 (see the black arrow in FIG. 3), the doctor sees the reaction of the patient A1. When a voice for instructing recording is output (when a voice of “record” is output), the voice is detected by the voice detector 2b and analyzed by the voice analyzer 2g. Thereafter, based on the analysis result that the voice indicates recording, the recording determination unit 2e determines recording execution, and an information recording request is issued to the information management unit 3d. At the timing of the recording request, the video information B1 and the posture information B2 are acquired from the photographing unit 3b and the posture detection unit 3a, and the information is analyzed by the posture analysis unit 3e and the video analysis unit 3f. Recorded in the database 3g.

  For example, as shown in FIG. 4, the aforementioned video information B1 and posture information B2 are associated with each other on the date and time, that is, arranged in time series and recorded in the recording information database 3g. In this way, when the patient feels pain and discomfort, that is, at the timing of the recording request, video information and posture information when the patient feels pain and discomfort are automatically saved. This makes it possible to more accurately and easily record video information and posture information when the patient feels pain or discomfort during the examination.

  Returning to FIG. 1, the information providing unit 4 assists posture reproduction by a request management unit 4 a that manages requests from users, a display unit 4 b that displays various images related to medical examination and posture reproduction (posture navigation), and the like. And a posture reproduction assisting unit 4c.

  The request management unit 4a transmits the request to the information management unit 3d in response to a request from the user. For example, the request management unit 4a requests the information management unit 3d to display a list of past examinations of the target patient, and causes the display unit 4b to display the examination list. At this time, the information management unit 3d uses the information obtained from the individual detection unit 3c in response to a request from the request management unit 4a, and reads a past examination list corresponding to the patient from the recorded information database 3g. The read past examination list is displayed on the display unit 4b.

  The display unit 4b displays various images such as recording information (for example, video data and posture data) and an inspection list. As the display unit 4b, for example, a liquid crystal display, an organic EL (electroluminescence) display, a CRT (CRT) display, or the like can be used.

  Based on the past posture data and the current posture data, the posture reproduction auxiliary unit 4c compares the data to generate navigation information for making the current posture the same as the past posture. Navigate (guide) how to move the limbs so that their postures are the same. This makes it easy for the patient to take the same posture as in the past, and makes it possible to easily and accurately perform a confirmation operation for confirming discomfort and the elimination (progress) of pain. In particular, since it is possible to perform a comparison in the same posture as during the previous examination during follow-up observation, it is possible to eliminate the ambiguity of the diagnosis due to the difference in posture from the previous diagnosis during follow-up observation.

  For example, as shown in FIG. 5, the previous video and posture (video information B1 and posture information B2) are displayed on the left side of the display unit 4b, and a live image (current video information B1a and posture information B2a) is displayed on the display unit. 4b is displayed on the right side of the screen, and further, explanation information C1 for navigation is displayed below the live image. In FIG. 5, as an example, the posture information B2a is displayed superimposed on the video information B1a. As the navigation explanation information C1, for example, it is possible to use character information that explains how to move the limbs using characters, but this is not a limitation. For example, how to move the limbs using voice Audio information to be explained may be used. Such past and present video information, posture information, and explanation information function as navigation information.

  Next, the diagnosis recording process performed by the above-described diagnosis support apparatus 1A will be described with reference to FIG. 6, the record browsing process will be described with reference to FIG. 7, and the attitude navigation process will be described with reference to FIGS. I will explain.

<Diagnosis record processing>
As shown in FIG. 6, first, a diagnosis record start process, which is preparation for starting a diagnosis record, is executed (step S1). Next, personal identification that identifies a patient or doctor is performed (step S2), and it is determined whether or not the authentication is OK (step S3). If the authentication is NG (NO in step S3), the process returns to step S1.

  Since a motion tracking technique using a sensor such as a microphone or a camera is used during a medical examination, it is necessary to first identify an individual to be tracked. For this reason, when a request for diagnosis start by the doctor is detected by the request management unit 4a, the information management unit 3d identifies the patient and the doctor from the information obtained by the individual detection unit 3c, and then the doctor's approval is obtained. Examination begins.

  If the authentication is OK in step S3 (YES in step S3), sensor information (for example, video information, posture information, audio information, etc.) is acquired (step S4). The acquired sensor information is analyzed (step S5). Thereafter, it is determined whether or not information should be recorded (step S6). If it is determined that information should not be recorded (NO in step S6), the process returns to steps S4 and S7.

  Here, a patient's facial expression and voice, a doctor's recording instruction, and the like are detected by the detection units 2a to 2c, and further analyzed by the analysis units 2f to 2h. Thereafter, based on the analysis result, the recording determination unit 2e determines whether or not the information recording needs to be executed. If the patient's facial expression or voice is determined to be, for example, a facial expression or voice that feels painful or uncomfortable, or if it is determined that a doctor's voice or gesture indicates a recording instruction, information is recorded. It will be judged that it should be.

  In addition, sensor information is continuously acquired by each detection part 2a-2c during a medical examination, and is sequentially sent to the recording judgment part 2e. Voices and gestures sent from patients and doctors are acquired by voice recognition technology and gesture recognition technology, and facial expressions of patients are acquired by facial expression recognition technology, and these information is generalized into information that can be recognized by a computer. It has been converted.

  If the authentication is OK in step S3 described above (YES in step S3), it is determined whether or not a recording instruction has been issued by the patient or doctor in parallel with the processing in steps S4 to S6 described above ( If it is determined in step S7) that a recording instruction has not been issued (NO in step S7), the process returns to steps S4 and S7.

  In the recording instruction, for example, when a patient presses a button or a doctor steps on a foot switch to issue a recording instruction (direct recording instruction), the recording instruction is detected by the recording instruction detection unit 2d, In response to the detection, it is determined that a recording instruction has been issued by the recording determination unit 2e.

  On the other hand, if it is determined in step S6 that information should be recorded (YES in step S6), or if it is determined in step S7 that a recording instruction has been issued (YES in step S7), Information recording is performed at the timing (step S8), and further, the diagnosis status is displayed by the display unit 4b (step S9).

  In the information recording, posture information and video information are acquired from the posture detecting unit 3a and the photographing unit 3b at the timing of the recording request and recording instruction, and the information is analyzed by the posture analyzing unit 3e and the video analyzing unit 3f. The information is recorded in the record information database 3g in association with each other in a certain unit (for example, for each examination or each part). Also, these pieces of information are displayed by the display unit 4b so that a doctor or the like can check the examination status.

  After step S9, it is determined whether or not the diagnosis has been completed (step S10). If it is determined that the diagnosis has not been completed (NO in step S10), the process returns to steps S4 and S7. On the other hand, if it is determined that the examination has ended (YES in step S10), a diagnosis record end process for ending the diagnosis record is executed (step S11).

  At the end of the examination, for example, the doctor gives an instruction to end the examination by using a gesture or inputting an input device such as a mouse. In response to this instruction, the request management unit 4a grasps the request for ending the diagnosis by the doctor, and it is determined that the diagnosis has ended.

  According to such a medical record process, the sensor information obtained from each of the detection units 2a to 2d, for example, a facial expression indicating pain or discomfort of the patient, a speech or gesture for instructing recording, a direct instruction by pressing a button, or the like. In response, video information and posture information when the patient feels pain or discomfort are recorded. In this way, it is possible to record the video information and posture information when the patient feels uncomfortable or pain at the time of the examination (triggered by it), so that the information on the posture and palpation site can be more accurately and easily Can be recorded. As a result, it is possible to reduce the burden on the doctor and the patient, and further, it is possible to eliminate the misconception of the discomfort and pain at the time of the examination and the misidentification of the palpation site and improve the accuracy of the diagnosis.

<Record browsing process>
As shown in FIG. 7, a record browsing start process that is a preparation for starting the record browsing is executed (step S21), and then it is determined whether or not the current device mode is being examined (step S22). When it is determined that the device mode is being examined (YES in step S22), recorded information (for example, video information and posture information) being examined is read from the recorded information database 3g (step S23). The recorded information is displayed on the display unit 4b (step S24). Finally, a record browsing end process for ending the record browsing is executed (step S25).

  On the other hand, if it is determined in step S22 that the current device mode is not being examined (NO in step S22), a list of recorded information is displayed by the display unit 4b (step S26), and browsing data is selected from the list. It is determined whether or not (step S27). Thereafter, when it is determined that the browsing data has been selected (YES in step S27), the recording information that is the selected browsing data is read from the recording information database 3g (step S23), and the read recording information is stored. Displayed by the display unit 4b (step S24). Finally, a record browsing end process for ending the record browsing is executed (step S25).

  In selecting browsing data, for example, a doctor selects browsing data from a list of examinations, which are recorded information displayed in a list, by a gesture or by inputting an input device such as a mouse. In response to this selection, the request management unit 4a grasps the selection request by the doctor, and it is determined that the browsing data has been selected.

  According to such a record browsing process, the record information recorded in the record information database 3g is read out by the information management unit 3d, and the display unit is set in a preset browsing format (for example, time series or each part). 4b. Thereby, the doctor can visually recognize the recorded information recorded during the examination, that is, the posture and the palpation site when he / she feels uncomfortable feeling and pain, and can use it as auxiliary information for diagnosis. For this reason, it is not necessary to make the patient take the posture over and over again for confirmation and identification of an uncomfortable or painful posture, and it is possible to avoid giving unnecessary pain to the patient. , Medical examination can proceed smoothly.

<Attitude navigation processing>
As shown in FIG. 8, posture navigation start processing, which is preparation for starting the posture navigation, is executed (step S31). Next, personal identification that identifies the patient or doctor is performed (step S32), and it is determined whether or not the authentication is OK (step S33). If the authentication is NG (NO in step S33), the process returns to step S31. Note that the authentication means is the same as the above-described examination record processing.

  If the authentication is OK in step S33 (YES in step S33), a past record selection process (details will be described later) is executed (step S34). Next, the selected sensor information is acquired (step S35), and the past and current postures are compared (step S36). The comparison result is used to create navigation information, which is displayed by the display unit 4b (step S37). Thereafter, it is determined whether or not the postures match (step S38). If it is determined that the postures do not match (NO in step S38), the process returns to step S35.

  In step S38, if it is determined that the postures match (YES in step S38), it is determined whether or not the diagnosis has ended (step S39), and if it is determined that the diagnosis has not ended (in step S39). NO), the process is returned to step S34. On the other hand, if it is determined that the examination has ended (YES in step S39), it is determined whether or not to examine another part (step S40), and if it is determined to examine another part (YES in step S40), The process returns to step S34. On the other hand, if it is determined not to examine another part (NO in step S40), a posture navigation end process for ending posture navigation is executed (step S41).

  Note that, at the end of the examination or the examination of another part, for example, the doctor instructs the end of the examination or the examination of another part by using a gesture or inputting an input device such as a mouse. In response to this instruction, when the request management unit 4a grasps the request for ending the examination by the doctor, it is determined that the examination is finished. When the request management unit 4a grasps the request for another part of the examination, To be judged.

  Finally, the past record selection process in step S34 will be described.

  As shown in FIG. 9, a past record selection start process, which is preparation for starting past record selection, is executed (step S51), and then the record information is displayed in a list format on the display unit 4b (step S52). Thereafter, it is determined whether or not browsing data has been selected (step S53). If it is determined that browsing data has not been selected (NO in step S53), the process returns to step S53. The browsing data selection means is the same as the above-described recording browsing process.

  If it is determined in step S53 that browsing data has been selected (YES in step S53), the selected past record information is read from the record information database 3g (step S54), and the read record information is displayed. Displayed by the display unit 4b (step S55). Finally, a past record selection end process for ending the past record selection is executed (step S56).

  According to such posture navigation processing, a test for performing posture navigation is selected from the past test list displayed by the display unit 4b, and posture navigation is started. When the posture navigation is started, the video and posture recorded when feeling uncomfortable or pain in the past are displayed on the display unit 4b, and at the same time, the current real-time video and posture are displayed. Thus, posture navigation is performed with reference to past recorded data when a patient undergoes a revisit after a certain period of time after treatment. Therefore, based on the past posture data and the current posture data, navigating how to move the limbs to take the same posture, and taking the same posture as the past, it makes sense of incongruity and pain relief (progress) Comparison with the same posture as at the time of the previous diagnosis can be made during the follow-up observation to be confirmed, and the ambiguity of the diagnosis due to the difference in posture from the previous diagnosis at the time of follow-up can be eliminated.

  As described above, in the medical examination support apparatus 1A, using the sensor information obtained by the facial expression recognition technology, the voice recognition technology, the motion tracking technology, etc., the patient feels painful or uncomfortable facial expression, or the patient or doctor The patient's posture (palpation site) and doctor's posture at that time are recorded as subject posture information (subject posture information and palpator posture information) obtained from video and motion tracking technology. To do. Thereby, it is possible to browse the information at the time of diagnosis or follow-up and use it as auxiliary information for diagnosis. Therefore, it is possible to prevent misidentification of the posture or palpation site where the patient feels uncomfortable or painful at the time of the examination, and further, it is possible to eliminate the patient from being unnecessarily painful at the time of specifying the affected part.

  In addition, by using the previously recorded video information and posture information at the past examination, it is possible to perform posture navigation for taking the same posture as the previous examination at the time of follow-up observation, and that information is used as a diagnostic aid. (For example, confirmation of recovery status after treatment) can be used. For this reason, it becomes easy to reproduce the same posture (palpation site) at the time of follow-up observation as in the previous examination, and the ambiguity of diagnosis at the time of follow-up observation can be eliminated.

  As described above, according to the first embodiment, when it is detected that the patient (subject) feels pain or discomfort during operation, posture information about the posture of the patient (subject) (Posture information) is acquired, and the acquired posture information is stored. This makes it possible to more accurately and easily record posture information when the patient feels pain or discomfort during the examination. Therefore, posture information when the subject feels pain or discomfort can be used as auxiliary information for diagnosis, and the accuracy of diagnosis can be improved. Furthermore, since it is not necessary for the patient to take a posture repeatedly to confirm or identify a posture that felt uncomfortable or painful, the burden on the patient can be reduced in addition to the burden on the doctor (examiner). .

(Second Embodiment)
A second embodiment will be described with reference to FIG.

  The second embodiment is basically the same as the first embodiment. Therefore, in the second embodiment, differences from the first embodiment will be described, the same parts as those described in the first embodiment will be denoted by the same reference numerals, and the description thereof will also be omitted.

  In the second embodiment, the video information is not the still image recorded at the recording request timing according to the first embodiment but the moving image information (information in which a plurality of still images are arranged in time series) being examined. The moving image information obtained by 3b is recorded in the recording information database 3g. When an information recording request is issued from the recording determination unit 2e during the recording of the moving image information, the information management unit 3d associates and stores posture information with the video at that timing.

  Here, as shown in FIG. 10, moving image information (video information B1) is arranged in the horizontal direction in time series on the screen of the display unit 4b, and the still image at the recording request timing is an example of an emphasis mark. It is surrounded by a frame D1 and highlighted. Further, when one still image is selected from the highlighted still images, posture information B2 and date / time information related to the selected still image are displayed. This makes it possible to use the video information and the posture information as auxiliary information for diagnosis when diagnosis in continuous motion is necessary. In particular, it is possible to look back on postures that feel painful or uncomfortable, and use them as auxiliary information for diagnosis by confirming the posture until the posture that felt painful or uncomfortable, or postures before and after the posture. it can.

  As described above, according to the second embodiment, the same effects as those of the first embodiment can be obtained. Furthermore, by associating posture information with video information, for example, when diagnosis in continuous motion is necessary, the movement until the patient feels painful or uncomfortable, and before and after that posture Therefore, the accuracy of diagnosis can be further improved.

(Third embodiment)
A third embodiment will be described with reference to FIGS.

  The third embodiment is basically the same as the first embodiment. For this reason, in the third embodiment, differences from the first embodiment will be described, the same parts as those described in the first embodiment will be denoted by the same reference numerals, and the description thereof will also be omitted.

  As shown in FIG. 11, the medical examination support apparatus 1B according to the third embodiment includes a patient's automatic rehabilitation (for example, a range of motion of the joint) in addition to each unit (excluding the posture reproduction assistance unit 4c) according to the first embodiment. And an automatic rehabilitation management unit 12 that manages the operation of the automatic rehabilitation.

  The automatic rehabilitation device 11 is a device that is attached to a patient's joint site (for example, knee or elbow) and automatically performs rehabilitation (for example, joint range of motion training) of the patient. Moreover, the automatic rehabilitation management part 12 performs management which drives the automatic rehabilitation apparatus 11 according to the request | requirement from a user. The automatic rehabilitation management unit 12 determines whether or not the patient has felt strong pain or discomfort during rehabilitation by the automatic rehabilitation device 11, that is, whether or not the intensity (degree) of pain or discomfort has become greater than an allowable value. When it is determined that the strength has become larger than the allowable value, the automatic rehabilitation device 11 is urgently stopped.

  Here, the patient performs rehabilitation without overdoing with the automatic rehabilitation apparatus 11, but the degree of recovery varies from person to person, and sometimes the joint is moved to an angle at which the patient feels pain and discomfort. In such a case, the patient can report the recovery status to the doctor by issuing an active recording instruction (for example, a recording instruction using facial expressions, voice, gestures, buttons, etc.) to the system. When a patient issues a recording instruction, for example, the situation (reason for recording) can be recorded by voice through the voice detection unit 2b.

  For example, as shown in FIG. 12, when the automatic rehabilitation device 11 is attached to the leg of the patient A1 and the knee (joint) of the patient A1 is moved, the patient A1 feels pain and changes his facial expression ("painful" ”Is detected by the facial expression detection unit 2a, and the facial expression analysis unit 2f recognizes that the patient A1 feels pain. Based on the analysis result that the patient A1 feels pain, the recording determination unit 2e determines the recording execution, and an information recording request is issued to the information management unit 3d. At the timing of the recording request, the video information B1 and the posture information B2 are acquired from the posture detection unit 3a and the photographing unit 3b, and the information is analyzed by the posture analysis unit 3e and the video analysis unit 3f. Further, intensity information B3 indicating the intensity (degree) of pain or discomfort is generated from the facial expression of the patient A1 by the facial expression analysis unit 2f and sent to the information management unit 3d. These video information B1, posture information B2, and intensity information B3 are associated with each other and recorded in the recording information database 3g.

  As shown in FIG. 13, for example, the aforementioned video information B1, posture information B2, and intensity information B3 are associated with each other on the date and time, that is, arranged in time series and recorded in the recording information database 3g. In FIG. 13, illustrations of facial expressions expressing pain and discomfort are used as the intensity information. However, the present invention is not limited to this. For example, numerical values (for example, 1 is the weakest in 5 steps and 5 is the most). Strong) or wording (for example, no pain, a little pain, pain, very painful) may be used.

  In this way, when the patient feels pain or discomfort during rehabilitation, that is, when the patient feels pain or discomfort at the timing of the recording request, video information, posture information, and intensity information are automatically saved. It will be. This makes it possible to more accurately and easily record video information, posture information, and intensity information when the patient feels pain or discomfort during rehabilitation.

  The posture information (joint movable angle information) is obtained not only from the posture detection unit 3a but also from the automatic rehabilitation management unit 12. However, since the posture information from the automatic rehabilitation apparatus 11 is a control value, in order to perform a more accurate diagnosis, posture information that is an actual measurement value from the posture detection unit 3a that detects the actual posture of the patient is used. Is desirable.

  Next, the rehabilitation recording process performed by the above-described examination support apparatus 1B will be described with reference to FIG. 14, and the rehabilitation record browsing process will be described with reference to FIG.

<Rehabilitation record processing>
As shown in FIG. 14, first, a rehabilitation recording start process, which is preparation for starting rehabilitation recording, is executed (step S61), and then individual identification for specifying a patient is performed (step S62). The personal identification means is the same as the medical examination recording process according to the first embodiment. For this reason, when the request management unit 4a detects a rehabilitation start request by the patient, the information management unit 3d identifies the patient from the information obtained by the individual detection unit 3c.

  After step S62, sensor information (for example, video information, posture information, audio information, etc.) is acquired (step S63), and the acquired sensor information is analyzed (step S64). Is determined (step S65). If it is determined that there is a certain amount of pain (YES in step S65), the automatic rehabilitation apparatus 11 is urgently stopped (step S66).

  On the other hand, if it is determined in step S65 that there is no more than a certain level of pain (NO in step S65), it is determined whether or not information should be recorded (step S67), and it is determined that information should not be recorded. If so (NO in step S67), the process returns to steps S63 and S68.

  Here, a patient's facial expression and voice, or a patient's recording instruction is detected by each of the detection units 2a to 2c, and further analyzed by each of the analysis units 2f to 2h. Thereafter, based on the analysis result, the recording determination unit 2e determines whether or not the information recording needs to be executed. If the patient's facial expression or voice is determined to be, for example, a facial expression or voice that feels painful or uncomfortable, or if it is determined that the patient's voice or gesture indicates a recording instruction, information is recorded. It will be judged that it should be.

  In addition, sensor information is continuously acquired by each detection part 2a-2c during rehabilitation, and is sequentially sent to the recording judgment part 2e. Voices and gestures sent from patients are acquired by voice recognition technology and gesture recognition technology, and facial expressions of patients are acquired by facial expression recognition technology, and these information is generalized and converted into information that can be recognized by a computer. ing.

  Further, after the above-described step S62, in parallel with the above-described processing of steps S63 to S67, it is determined whether or not a recording instruction has been issued by the patient (step S68), and it is determined that no recording instruction has been issued. Then (NO in step S68), the process returns to steps S63 and S68.

  In the recording instruction, for example, when the patient issues a recording instruction by pressing a button (direct recording instruction), the recording instruction is detected by the recording instruction detecting unit 2d, and in response to the detection, the recording determining unit 2e records the recording instruction. It is determined that an instruction has been issued.

  Thereafter, if it is determined in step S67 that information should be recorded (YES in step S67), or if it is determined in step S68 that a recording instruction has been issued (YES in step S68), Information recording is performed at the timing (step S69), and the rehabilitation status is displayed by the display unit 4b (step S70).

  In recording information, at the timing of a recording request or recording instruction, posture information and video information are acquired from the posture detecting unit 3a and the photographing unit 3b and analyzed by the posture analyzing unit 3e and the video analyzing unit 3f. The posture information and video information and the intensity information sent from the recording determination unit 2e are associated with each other, and are recorded in the recording information database 3g in a certain unit (for example, for each examination or for each part). These pieces of information are displayed by the display unit 4b so that a patient, a doctor, or the like can check the rehabilitation status.

  After step S70, it is determined whether or not rehabilitation has ended (step S71). If it is determined that rehabilitation has not ended (NO in step S71), the process returns to steps S63 and S68. On the other hand, if it is determined that the rehabilitation has ended (YES in step S71), a rehabilitation recording end process for ending the rehabilitation recording is executed (step S72).

  At the end of rehabilitation, for example, the patient gives an instruction to end rehabilitation by using a gesture or by performing an input operation on an input device such as a mouse. In response to this instruction, the request management unit 4a grasps the rehabilitation termination request by the patient, and it is determined that the rehabilitation is terminated.

  According to such a rehabilitation recording process, sensor information obtained from each of the detection units 2a to 2d, for example, a facial expression that indicates a patient's pain or discomfort, a statement or gesture that instructs recording, a direct instruction by pressing a button, or the like In response, video information, posture information, and intensity information when the patient feels pain and discomfort are recorded. In this way, when the patient feels discomfort or pain during rehabilitation (triggered by it), the video information, posture information, and intensity information can be recorded, so the posture and palpation site information In addition, information on the intensity of pain or discomfort can be recorded accurately and easily. As a result, it is possible to reduce the burden on the doctor and the patient, and further, it is possible to eliminate the misconception of the posture, the contact part, and the strength that feel uncomfortable or painful at the time of rehabilitation, thereby improving the accuracy of diagnosis.

<Rehabilitation record browsing process>
As shown in FIG. 15, a rehabilitation record browsing start process, which is preparation for starting rehabilitation record browsing, is executed (step S81), and then the recorded information is displayed in a list format by the display unit 4b (step S82). It is determined whether or not it has been selected (step S83). If it is determined that browsing data has not been selected (NO in step S83), the process returns to step S83. The browsing data selection means is the same as the recording browsing process according to the first embodiment.

  On the other hand, if it is determined in step S83 that browsing data has been selected (YES in step S83), recording information (progressive recording information) related to the selected browsing data is read from the recording information database 3g (step S84). The read rehabilitation progress information is displayed by the display unit 4b (step S85). Finally, a rehabilitation record browsing end process for ending the rehabilitation record browsing is executed (step S86).

  According to such a rehabilitation record browsing process, the recorded information recorded in the recorded information database 3g is read by the information management unit 3d and displayed in a preset browsing format (for example, for each time series or each part). Displayed by the unit 4b. Thus, the doctor can use the recorded information recorded during rehabilitation, that is, the posture and the palpation site when the user feels uncomfortable feeling and pain, and further use it as auxiliary information for diagnosis. For this reason, it is not necessary to make the patient take the posture over and over again for confirmation and identification of an uncomfortable or painful posture, and it is possible to avoid giving unnecessary pain to the patient. , Medical examination can proceed smoothly.

  As described above, according to the third embodiment, the same effects as those of the first embodiment described above can be obtained. Furthermore, since it becomes possible to record posture information (for example, angle) and intensity information indicating its strength during rehabilitation (indirect range of motion training) by the automatic rehabilitation device 11, it is possible to record such information. It can be used for follow-up observation (comparison with the previous time). In addition, when it is determined that the patient felt strong pain during the range-of-motion training by the automatic rehabilitation device 11 (the intensity has become larger than the allowable value), the automatic rehabilitation device 11 is stopped urgently. It is possible to prevent the patient from doing so and to reduce the burden on the patient.

  In the third embodiment, intensity information indicating the intensity (degree) of pain or discomfort is recorded in association with video information or posture information, but this intensity information is recorded in the first or second embodiment. In other embodiments, intensity information may be recorded in association with video information and posture information.

  As mentioned above, although some embodiment of this invention was described, these embodiment is shown as an example and is not intending limiting the range of invention. These novel embodiments can be implemented in various other forms, and various omissions, replacements, and changes can be made without departing from the scope of the invention. These embodiments and modifications thereof are included in the scope and gist of the invention, and are included in the invention described in the claims and the equivalents thereof.

DESCRIPTION OF SYMBOLS 1A Medical examination support apparatus 1B Medical examination support apparatus 2 Recording judgment unit 3 Recording execution unit 3a Posture detection part 3g Recording information database 4 Information provision unit 4b Display part 11 Automatic rehabilitation apparatus

Claims (12)

A detection unit for detecting that the subject felt pain or discomfort during operation;
When the detection unit detects that the subject feels pain or discomfort, an acquisition unit that acquires subject posture information regarding the posture of the subject when feeling pain or discomfort,
A storage unit for storing the subject posture information acquired by the acquisition unit;
A medical assistance device characterized by comprising: When the detection unit detects that the subject feels pain or discomfort, the acquisition unit palpates the subject who feels the pain or discomfort in addition to the subject posture information. Get palpator posture information about the palpator's posture,
The examination support apparatus according to claim 1, wherein the storage unit stores the subject posture information and the palpator posture information acquired by the acquisition unit in association with each other. When the detection unit detects that the subject feels pain or discomfort by the detection unit, in addition to the subject posture information, intensity information regarding the intensity of the pain or discomfort sensed by the subject Get
The examination support apparatus according to claim 1, wherein the storage unit stores the subject posture information and the intensity information acquired by the acquisition unit in association with each other.   Automatic rehabilitation for automatically rehabilitating the subject when it is determined whether the strength information acquired by the acquisition unit is greater than an allowable value and the strength is determined to be greater than the allowable value. The diagnosis support apparatus according to claim 3, further comprising a management unit that stops the apparatus. The acquisition unit acquires subject posture information related to the current posture of the subject who has felt the pain or discomfort,
In order to make the current posture the same as the past posture by comparing the subject posture information related to the current posture acquired by the acquisition unit and the past subject posture information stored by the storage unit The medical examination support apparatus according to claim 1, further comprising a management unit that generates the navigation information.   The medical examination support apparatus according to any one of claims 1 to 5, further comprising a display unit that displays information stored by the storage unit. Detecting that the subject felt pain or discomfort during operation;
When detecting that the subject felt pain or discomfort, obtaining subject posture information related to the posture of the subject when feeling pain or discomfort, and
Storing the acquired subject posture information;
A diagnostic support method characterized by comprising: In the obtaining step, when it is detected that the subject feels pain or discomfort, in addition to the subject posture information, the posture of the palpator who is palpating the subject who feels the pain or discomfort Acquire palpator posture information about
8. The examination support method according to claim 7, wherein in the storing step, the acquired subject posture information and the palpator posture information are stored in association with each other. In the obtaining step, when it is detected that the subject feels pain or discomfort, in addition to the subject posture information, obtains intensity information on the pain or discomfort felt by the subject,
The examination support method according to claim 7 or 8, wherein in the storing step, the acquired subject posture information and the intensity information are stored in association with each other.   Determining whether the strength of the acquired intensity information is greater than an allowable value, and stopping the automatic rehabilitation device that automatically performs rehabilitation of the subject when it is determined that the strength is greater than the allowable value The diagnostic support method according to claim 9, further comprising: Obtaining subject posture information relating to the current posture of the subject who felt pain or discomfort, and
Comparing the acquired subject posture information with respect to the current posture and the stored past subject posture information, and generating navigation information for making the current posture the same as the past posture; and
The medical examination support method according to claim 7, further comprising:   The medical examination support method according to any one of claims 7 to 11, further comprising a step of displaying the stored information.

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