JPH02294876A - Hematologic diagnosing apparatus using expert system art - Google Patents

Abstract

PURPOSE: To reduce and minimize problems encountered in the intelligent processing of hemotological data by retrieving one or more messages adapted to the parameter value of a patient from a memory means to interpret the blood state or the patient. CONSTITUTION: A computer 10 like a personal computer is provided and is provided with normal memory devices 22 and 24, a central processing unit 28, and peripheral devices such as a printer 14 and an inspection screen 12. What is called a knowledge base 102 applicable to the hemotological diagnosis and commands based on which the device processes input data are stored in memory devices 22 and 24, and a means 16 which inputs device or input data to devices is provided. Consequently, the device executes commands and prints out applicable hemotological messages and diagnostic messages. Thus, the hemotological diagnosis processing is automatized, and a waste of time and error of diagnosis in the process of trial and error are reduced.

Description

[Detailed description of the invention] [Industrial application fields] The present invention relates to a hematology diagnostic device.

The hematology diagnostic device retrieves diagnostic information and hematology information from a memory storage device based on the instrument-acquired hematology data supplied within the device, and retrieves diagnostic information and hematology information from a memory storage device, and allows a hematology expert (hematologist) or general practitioner to retrieve diagnostic information and hematology information from a memory storage device. It is also effective for recording. As will be discussed below, the apparatus employs computer data processor technology, and more specifically expert system technology, a branch of technology commonly known as artificial intelligence.

The terms ``hematological'' and ``diagnostic'' are used in a broad sense and with some overlap in this regard.
``matological reminder'' or 1 hematological message (hematological
essage)- and “diagnosis reminder” (diagn
ostics re[[linder]” or “diagnostic message”
For example, see Appendix 1, where a typical diagnostic printout is shown. The Appendix is referenced throughout this document.

As discussed below, the position for "Diagnostic Reminder" includes a message that changes downward to indicate a diagnosis in the ultimate sense of that term, and the presence of input data that is actually or possibly invalid. Technical alert} (t
From time to time, messages entitled "Diagnostic Alerts" will appear. Due to their appearance in "Diagnostic Reminders" these messages will be considered "Diagnostic" for purposes below.

Along similar lines, messages appearing under "Hematology Reminders" are considered "Hematology Messages" even if they appear to be of a more or less diagnostic nature.

Throughout this document, reference is made to related publications listed at the end of the detailed description. The item is Bll (read as related book item 1)
, BI2, BI3, etc.

Throughout the description, references are generally indicated simply as BII.

The hematological and medical terms used in this book are BI
It closely follows the terminology given in I and BI9 to BIL3. The terminology of artificial intelligence/expert systems used in this document closely follows the terminology given in BI2, particularly its glossary, but reference may be made to BI3 to BI6.

As mentioned above, "hematology data" is what is supplied to the device, and in this document, "hematology parameters" or simply "parameters", "hematology index" or simply "arguments" are referred to as "hematology data". is used interchangeably with “. In some cases, "hematology diagnostic significance message" is used as a generic term for "hematology" message and "diagnosis" message.

Hereinafter, the "apparatus of the present invention" and the "system of the present invention" will be referred to as "apparatus" and "system", respectively.

[Prior art and problems to be solved by the invention] Prior art As of the mid-1980s, blood diagnostics is still widely practiced using traditional testing methods with well-authored works such as BII. has been done. Otherwise, the hematologist or physician relies on his or her memory. In any case, the method is intelligent. As will be understood from the following description, the number of hematology parameters processed by the device is four, and will be expressed as PHGL throughout this description.

These include platelet counts (Platelet Cou
nt), hematocrit,
Granulocyte Count
) and lymphocyte/monocyte count} (Lymphocyt
e/Monocyte Count). Alternative abbreviations are PLT, HCT#GRANS and #
It becomes LYMPH. Intelligent approaches are applied to the same or similar parameters, or some of the quadruplets or similar parameters, in addition to other types of input data; Based on the type or data source. The intelligent approach will be described assuming that it is based on PHGL data, but this description will be the most general.

The parameter PHGL is indicated as a numerical value for an "intelligent processor" (or device).

The intellectual approach is through what is known in the scientific or mathematical fields as trial and error.

Based on the 4-parameter data at hand, the doctor applies a certain test blood/diagnostic status or conclusion to the 4-parameter set, that is, the patient in question.
In this case, the above-mentioned states or conclusions are generally more than one (rather than a single one). The next step is to check whether this assumption is correct. If it is not correct, try another experimental assumption and repeat the test. When the hypothesis eventually turns out to be true or a "bit", the intelligent processor must continue testing the hypothesis to ensure that all of the possibly multiple "hits" are reached. For doctors who are skilled in this type of work, it can be said that the speed at which the process converges to the correct conclusion on the first try is quite fast. this is,
This is because it is not sufficient to assume test conditions under which four sets of specific parameter values are inconsistent, as an inexperienced doctor might assume. Nevertheless, the trial-and-error process is too time-consuming and can lead to diagnostic errors (e.g. due to fatigue) and omissions (multiple conclusions should be drawn) by the physician. Become something.

To alleviate this situation, efforts have been made to automate the hematology diagnostic process. Before considering this,
Let's take a quick look at the automation system. In particular, we will continue to describe medical diagnostic methods, ie, expert systems that are applied in many medical fields, including hematology, general medicine, and internal medicine.

The number of existing systems applied to automated medical diagnostic methods is staggering, and the majority have been constructed as single units.

In some cases, the second Unisoto was constructed as an improvement or modification of the first Unisotho, or no device has appeared since then. As far as hematology diagnostic systems have been proposed so far, the number is extremely small, with only two such systems being published in the literature. Also here, one unit is configured for each of these two systems without any duplication. The reason for the above-mentioned one-unit configuration for blood diagnostic methods will now be discussed, but it also applies to general medical diagnostic methods.

The specialized literature on general medical diagnostic expert systems is quite extensive. BI2 mentions several systems, and others are listed in related books. An overview and list of these systems are also available.
Some of them have brief summaries specific to each system listed. BI6 to BI8 or BI
See l2.

When it comes to hematology diagnostic systems, their number is quite limited. One of the well-known systems is HEME (B
I9 to BI12).

This system creates a computer program that uses probabilistic techniques to aid in the diagnosis of common blood diseases. HE-IE is presented as a set of papers by Cornell University/International Business Machine (IBM). The time spent developing and operating HEMH spans approximately 15 to 20 years. HEME is intended to function as a continuous self-improvement system. HEM
E is mainly used as a research instrument and as a training device for students majoring in hematology.

As shown on pages 764 and 765 of BILL, its use is quite rare for various reasons mentioned therein.

Another well-known blood diagnostic system is ANEMIA, mentioned in BI13. ANEMIA is a computer program created in Italy to aid in the diagnosis of anemia. Like HEME, ANEMIA
is also being operated at the research center, but no progress has been made beyond this stage.

Handling HEME and ANEMIA is extremely complicated for doctors who are not computer experts. The two systems are interactive (see B I 2), so the user must continuously and repeatedly interrogate the system in order to advance the diagnosis, while the system Answers to the interrogation will be given. Of course, interactive systems have particular advantages in particular applications and may not be well-suited to small medical practices. As will be understood hereinafter, the system of the present invention is non-interactive, and the user of the system essentially deals with the system itself in a "one-shot operation" and does not require much skill in operating the system.

Users of previously proposed medical diagnostic expert systems must be familiar with cryptographic computer code languages and must interact with the equipment. In contrast, in the system of the present invention, mutual communication is carried out in conversational human language, or in the so-called short mode, or in a short slogan-type word structure, and the expressions are also in simple human language. It will be done.

OBJECTS OF THE INVENTION The general purpose of the invention is to provide "intelligent processing" of hematology data.
The aim is to reduce and minimize the problems encountered in

Another object of the present invention is to provide computer-based expert-level assistance to physicians during the interpretation of hematology data.

A further object of the present invention is to provide a blood diagnostic device that uses expert level hematology knowledge.

Yet another object of the invention is to be easily operable,
To provide a blood diagnostic device with a non-interactive configuration that does not require extensive training in computer technology, requires little or no manual data entry, and further provides readouts expressed in human language. It is in.

[Means and effects for solving the problem] Overview of the method of the invention As mentioned above, the system uses four hematology parameters HP
It operates based on GL and each input numerical value. In addition,
HEME (BI9, page 588) and ANEM I
A (B I 13, page 17) also operated with some of the same or similar hematology parameters, but these systems used more additional "findings" or input data. For example, HEME was able to act on as many as 585 findings. The system of the invention is based on operation with a very small number of parameters,
The number of parameters is kept constant. As far as the user is concerned, this simplifies the operation inside the device.

In the apparatus of the present invention, each of the four parameters is subdivided into numerical ranges. These ranges are clinically important intervals, i.e. C I I
(Clinically Important Inter
rvals). HEME (BI 9,
(see page 588), range subdivision (for some of the hematology parameters) is also performed, but this is obviously by the user, who is a physician. In the system,
Subdivision is done internally and automatically. However, as will be seen in the next section, the impact of automatic subdivision is even more dramatic. In the system, H is given 12 CII, P has 8 CII, G has 10 Cll and L has 8 CIJ (see Appendix 2). The expected number of CII matches for these four sets, taking all ranges into account, is L2X 8 X IOX 8 = 78
It will be 80.

However, the total number of messages (hematology messages and diagnostic messages) is only about 70 as of late 1986 and early 1987ff. Due to the unique approach discussed in the next section, instead of scanning or setting 7680 possibilities, or setting an AND state of 7680, the device only scans or sets about 70.

Before proceeding to the next section, HEME (see BI9)
and ANEM I A (see B I 13).The canine part of the general medical diagnostic system is also based on the so-called ``rule-based (r
ule-base)” expert system (
(See BI2 for explanation). “Frame-based
e-base)'' expert systems (see BI3) are also known in the field of artificial intelligence.

Inventive Approach - Brief Description The system of the present invention has some similarities with rule-based systems and frame-based systems, but only as far as the end result is concerned. The intent of the present system is unique in manipulating input parameters to arrive at an output printout. Briefly stated with reference first to Appendix 5, the system contemplates allocating approximately 70 locations to approximately 70 possible hematology and diagnostic messages, or more precisely, 70 one-pit identifiers for each. It is to be. Note that the position 70 is a spatial position as far as the position in the memory is concerned, but it is a temporal position when scanning. One preselected bit string or pit stream of these positions is formed for each of the four parameters HPGL as shown in Appendix 5. H has 12 valid bit strings, a preselected one being expected based on the particular H input value or argument at hand. The same applies to PGL.

The arrangement of all binary digits in one particular position in the four bit strings results in a “success”.
ess)" or "hits." Also, multiple hits are those achieved for hematology messages and/or individually printed diagnostic messages. "Hit" hematology messages or reminders and The diagnostic message or reminder is retrieved from memory and printed out.The description in this paragraph has been somewhat simplified, but will be detailed later.

SUMMARY OF THE INVENTION The apparatus according to the invention comprises a computer, for example a personal computer, having conventional memory storage, a central processing unit and peripheral devices such as a printer and a viewing screen. In the memory device there is a so-called knowledge base (BI) applicable to hematology diagnostics.
2) and instructions on which the device processes the input data. The device also includes means for inputting input data into the device. Accordingly, the device executes the commands and prints out the applicable hematology and diagnostic messages.

A more detailed interpretation of this summary will be provided in the description below.

One interpretation is discussed above under the heading "Procedure of the Invention - Brief Description." The brief description will subsequently be explained in more detail.

Some of the advantages of the invention have been discussed above, and others will be mentioned in the concluding section of this document.

Other objects, advantages and features of the present invention, as well as modifications thereof, will become apparent with reference to the following detailed description of the invention, claims and accompanying drawings. The invention will be explained by way of example. Furthermore, the parameter HPG
The value of L is Becton Dickinson, Franklin Lakes, New Jersey 07417, USA.
This is based on the premise that the results were obtained as measured or displayed using a hematology device manufactured by John Dickinson. The equipment is manufactured more particularly by the Becton Dickinson Company, Clay Adams Division, Franklin Lakes, New Jersey 07417, USA, which company may hereinafter be referred to as Becton Dickinson or simply B-D. Becton Dickinson is the assignee of this invention. The BD device is known as the QBCII centrifugal hematology device. QBC is a registered trademark of Becton Dickinson.
e Buffy Coat). The latter device is simply called the QBCII device, and will be briefly mentioned here. However, the present invention can be applied by processing hematology parameter data obtained from other systems or other instrument devices, whether calculated by the device or artificially. It should be understood that this can also be performed based on the calculated hematology parameter data.

The QBCn system is described in the literature available from the manufacturer, ie reference is made to BIL4 to BIL7. The properties of QBCII are described in professional journal literature, and here we will discuss the properties of B
See Il8 and BIl9.

As briefly described here, the QBCII system involves the preparation of either a patient's blood sample or an analyte in a special blood tube known as a buffy coat tube (see BI14 through BIL7 and BIL9). Ru. Place this blood tube in a centrifuge, BIL4, B IlB, B I
Apply centrifugal action to the blood tube as described in L7. In this case, please also refer to BIL8. Next, as described in BI6 to BI9, the blood tubes are installed in a device called QBCn (this QBCn is appropriate), and the blood tubes attached to the device are placed in 6 locations (for venous blood) or 7 locations (for capillary blood). (for use).

This QBCn instrument not only has a visual numerical display of the four parameters HPGL, but also three additional numerical parameter displays,
In other words, a total of seven parameters are appropriately displayed. These three additional parameters will be described later.

The visual display of the QBCII instrument is provided by light emitting diodes on the instrument panel of the indicator. Additionally and optionally, a computer printer, such as an Epson model LX86, may be plugged into the QBCII instrument to print out the seven parameter values. For the purposes of this discussion, it will be assumed that the HP G L value is given to the user of the device as a minimum value, either by personal reading of the QBCn instrument or by the user at the time the printout is currently being performed. This may be done by reading the printout of the instrument printer, or by reading the printout at a later time, or by communicating to the operator now or later, whether vocally, in writing, or electrically. The system recalculates and prints out the three additional parameter values, whether or not the values were originally known by the operator.

The QBCII instrument displays the numerical values of the seven batch parameters and prints them out through its printer. The system of the present invention includes:
The above four parameters HPLG are received as input, but all seven are to be reprinted. Such prints are shown in Appendix 1. As can be seen from Appendix 1, H is expressed as a percentage, while PLG is expressed as a multiplication of x109 or 109, respectively. The fifth parameter WBC or total WBC (White Blood Cell Count)
) is also represented by 109 le. The sixth and seventh parameters are respectively percent granular leukocytes (Perce
nt Granulocytes) and Percent Lymphs +
Monos). Therefore, the latter two are related to the parameters G and L mentioned above.

Up to now, it has been stated that the present invention may be implemented using a personal computer, but this method will be used for explanation.

1 and 2 Referring to FIG. 1, a computer (CPTR) or data processor 10 is shown, which may be considered a personal computer such as, for example, an IBM PC Model AT. Computer 10 includes conventional peripherals, such as a cathode ray tube (CRT) monitor or screen 12, and, for example, an Epson printer model LX.
It is equipped with 14 printers (PTR) such as 8B. Further, the computer 10 has a conventional keyboard (K B
D) 16 and a container 18 containing a memory storage device such as a magnetic "floppy disk" 20. It is assumed that computer 10 is pre-tuned to the PL/M-86 language, and that language is described in BI 20. Floppy disk 20 stores the knowledge base of the expert system. "Knowledge base" is used in the sense indicated by BI2 and BI4. The knowledge base will be discussed in detail later as it applies to the expert system discussed below. For now, the following description will suffice. The knowledge base includes a wide range of hematological and diagnostic knowledge of the type represented in the Bll, but from which there is a vast amount of knowledge, i.e., obtained from hematology instruments such as the QBCII, or calculated. Specific knowledge applicable to the four parameter values HPGL obtained by is extracted. The disk 20 is further “
BI2
As in the case of , I will touch on the usage of this word in a broad sense.

The inference engine, as applied to the knowledge base, is shown in Appendix 1.
refers to the processing of the device based on the values of four parameters for producing applicable diagnostic printouts of the type shown in .

Disk 20 in place shall be considered part of the memory storage of computer 10.

The keyboard 16 is used by the operator to enter values for the four basic parameters of HPGL. Basically, the operator enters only four numerical values via the keyboard 16. Next, the printer 14 prints descriptive phrases of the type shown in the examples in Appendix 1 in parallel for each of the same numerical values. Following the entry of the four numerical values, the operator presses either the letter key "S" or "L". “S” is “
``Short mode'' further refers to an instruction to the device to execute in this short mode.Similarly, ``L'' refers to the selection of ``long mode'' and further refers to an instruction to the device to execute in this long mode.Appendix 1 contains examples of short mode displays and long mode displays, and further displays of these examples under the heading "Expert Systems" (Figure 3: Appendix 1), as well as "L" of the system below.
Including more information on how to distinguish between "Execute" and "S" Execute.Pressing the "S" key or the "L" key is an "Execute" command, and the system executes the type of document shown in Appendix 1. Proceed to print it out.

Referring to FIG. 2, a computer 10 is shown in block form, including the usual internal equipment associated with this type of personal computer. Its memory storage device is disk (DK) 2
0, a random access memory (RAM) 22 and a read-only memory (ROM) 24 are provided. Each of memories 22 and 24 may necessarily be considered in the form of multiple stages or groups rather than a single unit. For disk 20, a normal disk drive (
DDR) 26 is provided. Computer 10 further includes a conventional central processing unit (CPU) 28.

The CPU 2g performs processing required by the present invention. That is, the "inference engine" that will be discussed now with reference to Figures 3 and 4.
perform the processing required. Such processing also ultimately involves arithmetic operations. Finally, computer 10 includes input/output devices (I/O) or interfaces 30.

EXPERT SYSTEM (FIG. 3; APPENDIX 1) Referring to FIG. 3, the expert system is designated by the reference numeral 100. The expert system 100 has two main sub-blocks: a knowledge base 102 and an inference engine 1.
04.

We will continue to provide comprehensive definitions of knowledge bases and inference engines, and provide detailed explanations below. As shown in FIG. 3, in a typical flow, four parameter values and knowledge base information enter the inference engine 104. A printout of the type shown in Appendix 1 is output from the inference engine 104. It may be helpful at this point to consider the latter printout in order to further explain FIGS. 3 and 4.

In Appendix 1, double identification of pages is used. The page is 1. Consecutive numbers such as L, 1.2, 1.3, etc. are assigned. Second, the page is Hematochrysotho(H)
Value, “short mode” (S) or long mode”
(L). The meaning of these modes will be explained below.

Generally for other pages, Appendix Page 1.1
．． H40/S and H40l are added to the identification of 1.2.

Appendix page l. L (H 40/S) may be applied to patients exhibiting all blood values within normal limits. This page shows three types of so-called reminders that form part of the knowledge base 102. “Description” reminders are juxtaposed against the four basic numbers of the reprinted HPGL. These reminders are also referred to as "qualitative reminders" and sometimes also "descriptors" or "qualitative phrases."

ANEM I A (see page 17 of B I 13) produced similar descriptors with a slightly different meaning. Next, shown on appendix page 1, 1 is a second type of reminder, where it is displayed as a "general hematology clinical reminder" or simply a hematology reminder. The third type of reminder shown next on appendix page 1.1 is referred to as a "diagnostic consideration" or simply a diagnostic reminder.

As a slight digression from Appendix 1, a fourth type of reminder, referred to as a "subcase reminder," is indicated in some circumstances as a subordinate reminder to a hematology or diagnosis reminder. If the reminder covers a very broad range, conversely, a dependent subcase reminder applies to a narrow range within the broad range, which in turn becomes applicable to the patient.

Returning to Appendix 1 again, page 1.2 (H4[)/L
) is a long mode printout, but each of its four HPGL values is the same as that of H40/S and applies to the same patient. Similarly, page 1 of Appendix 1
．． 3 and 1.4 (H53/S and H53/L) apply to one patient and the same patient. From here on, one printout (short mode or long mode) may be provided for each set of four HPGL numbers. Pages 1, 2 (H 40/L) and Pages 1.4
In C H 53/L), reminders appear as "complete messages", each complete message consisting of a "header" and a "body" of the message.

Page 1.1 (H40/S) and Page 1.3 (
H53/S) only the header is shown. In addition, page 1.3 (H53/S) and page 14 (H53/L)
Now, there are multiple hematology reminders, in this example two.

This means a plurality (2) of "hits" or "successes" within the meaning of the overview of this book, as will be described in more detail in the explanation of FIG.

Page 1.5 of the Appendix (H49.9/S) displays another typical printout. The diagnostic reminder therein is either unusual or should be interpreted as a header because (1) a statement more similar to "body" appears in a position where a "header" is expected; In the corresponding long mode version (not shown), exactly the same diagnostic reminder appears. The system declines to give diagnostic reminders (in the ultimate sense) based on HPGL values and suggests more tests. There are also many regarding this specific reminder in "Miscellaneous Matters" (Written Conclusions).

In conjunction with identification by the device, a header is presented only for short mode, but a header and body are presented for long mode. This is achieved in the following way. Hematology reminder messages and diagnostic reminder messages are stored in memory. The header information stored in byte format (one byte is 8 bits) is connected with pseudo bytes, which is then followed by a "body byte" connected with the message termination byte.Like this. The storage operation described above is carried out with this structure.The pseudo byte is the pseudo message end byte.This byte is interpreted as the end of the message in short mode, so the message search ends at the end of the header. In long mode, the system ignores the pseudo bytes and continues its search through the body of the message until the true end of the message.

So-called technical alerts (possibly or limitedly invalid human data) are listed in the appendix and are discussed under the headings ``Technical Alerts'' and ``Corrections.''

Knowledge Base Sequence (FIG. 3) Referring again to FIG. 3 for further discussion of knowledge base 102. Part of the knowledge base is the delimitation or demarcation of the CII (Clinically Important Interval). This is shown in Appendix 2 - CII Summary. This summary is organized in the first example by the four parameters HPGL and then by each CII assigned to it individually. Thus, as previously stated in the introduction to this document, H is a CII or range of 12, P is a CII or range of 8, G is a CII or range of 10, and L is a CII or range of 8.
or assigned to a range respectively. The H table is also typical for other parameters, and for each CII, in addition to the descriptors or descriptive reminders mentioned above,
Applicable hematocrit ranges are indicated.

Following "CII Boundary", knowledge base block 102 lists the types of reminders described above.

Additionally, priority information, Applicable and Null Do
[IIain) Finally, the reminder text etc. discussed with reference to Appendix 1 are listed. The form of reminder text will be discussed further in the next heading.

Knowledge Base...Continued (Appendix 3 and 4) Appendix Table 3 shows the compact form of the knowledge base. As mentioned earlier in the introduction to this document, the number of messages is approximately 70, and this number includes diagnostic messages and hematology messages. More precisely, as of 1986-1987, the number is 6.
It is 9.

The system approach assigns a number sequence from 0 to 68 rather than from 1 to 69.

Appendix 3 is organized as follows. Regarding the above discussion of multiple (rather than single) messages, these multiple messages are one and intended for application within the same hematology or diagnostic item. . Therefore, Appendix Page 1.1 or 1.2 (H4
0/S or H 40/L), a single hematology message and a single diagnostic message are shown. However, within the meaning of Schedules 3 and 4, these two reminders are derived from separate serial numbers from 0 to 68, and more specifically, for the hematology reminder, No. 13,
No. 1 for diagnostic reminders. 5 becomes 3. Correspondingly, these two messages (No. 13
and No. 5 3 ) is stored in another location in memory. The diagnostic reminders on pages 1 and 5 of the appendix (H49.9/S) are not included in the serial numbers from 0 to 68. See “Miscellaneous Items.”

No. originally indicated with reference to Appendix 3. Considering 0,
A list is presented below. Line item type H
indicates that the reminder is a hematology reminder. The type H of the next line item also indicates that the reminder is a hematology reminder. The next line term 11aDOM H is passed through for the time being. The next four line items are No. Define an “applicable domain” for 0.

Therefore, for each of the four parameters HPGL, C
ll individual ranges are given. Note that this range is No.
Applicable to 0.

Looking at Table 1 below, the four parameter values given in the example on page 1.1 of Appendix 1 are again listed. Next, each applicable CII as obtained from Appendix 2 is listed, and furthermore >10.0, No. L3,
No. Each CII listed for 53 is shown.

Table 1 Example 1 Appendix 1 Page CI+ 1.1 (Appendix 2) H406 P254 5 G5.05 L3.04 Cll/No. O Cll/No. 13 (Appendix 3)
(Appendix 3) Cll ha'o. 53 (Appended Table 3) On the surface, No. O (Schedule 3) would be eligible, but in fact it is not, or to put it better, the qualification is Schedule 3
No. It is invalidated by what appears in the five rows of zeros. The -1st row of these five rows is null (
0), and this is NO. The null domain for 0 is the CI given for the four parameters
defined by each range of I. That is, H: 6-8;
P: 5-5 (simply means 5); G: 4-5; L: 4
~4 (simply 4).

Both the applicable domain and the null domain require the existence of a logical AND condition for the CII under consideration. Null domains are more restricted ranges of CII that each fall within the CII of the applicable domain. How "invalidation due to null domain" is achieved will be explained with reference to FIG.

Further examination of Table 1 shows that in Appendix 3, the No. of H type reminders. 13 and D type reminder No.
5 3 satisfies the example given in Table 1 and therefore No. 3 satisfies the example given in Table 1. 13 and no. 5 3 messages are printed out.

In Appendix 3, No. 3 4 to No. Subcases occur for 3 8 and other numbers. No. 3 4
, whose line item S2 is (typically) meaningful; A subcase also occurs for 2.

It continues like this.

In Appendix 3, No. Line item DO appearing for 1
Returning to the consideration regarding MH, this means that ``H is the main''
It means that. This is block 102 in FIG.
This is part of the priority information shown in . The priority contemplated here is in full force and effect when multiple hematology messages or multiple diagnostic messages qualify for printout, i.e. "multiple hits" or "multiple successes." “When there is

While H is dominant to Nα0, No. 4 7
For No., the parameters are not dominant at all, but on the contrary, for No. 4 3, No. 32, No. For L4, two parameters, three parameters and all four parameters appear respectively. Also referring to Appendix 2, the CII table is part of a knowledge base or database. Similarly, a distribution table of the degree of abnormality for each CII is also included. The weight value that is part of the knowledge base (
Weight) is ranked from 0 to 4 and assigned to each CII according to the degree of abnormality. Thus, for H (see page 1 of Appendix 3), CII5 to CII8
each corresponds to a weight value of 0, while the other CIII and CII
l2 matches the weight value 4. Similar considerations apply to the other three parameters.

A "dominance multiplier" is allocated to each of the four parameters. This multiplier is a number very close to 1.

More specifically, H...1.100. P...L
O10. G...1.001, L...1000
becomes. In the case of multiple "hits," during execution of the instruction, for each applicable dominance parameter, multiply its respective weight by its respective dominance multiplier and sum the resulting multiplicative products. do. The sum obtained in this way is called the "priority score number." This number is calculated for each hematology message that is eligible for printout, and printouts are performed in order of highest priority score number. Similar processing occurs for eligible diagnostic reminders. The weight assignment and dominance multiplier charts provide tie-breaking priority assignments for situations where ties exist in several messages. The relative value of the dominance multiplier confirms that the message triggered by the anomaly is printed first, other things being equal among the messages. Despite all these measurements, if a tie occurs, the "tie" messages are retrieved first and printed out in that order.

In Appendix 4, the reminder summary on page 4,1 is as follows:
No. 0 to No. 3, the information that repeats what is given in Appendix 3 and adds it to each message header, and the parameter numerical range applicable to each CII are shown. Appendix page 4.2 is No. From Q to No.
Each complete message text (header and body) is shown in order for up to 3. Referring again to Table 1 and following discussion, the hematology messages applicable to the printouts shown on pages 1 and 2 of Appendix 1 are the N of Appendix 3.
o. It has been pointed out that it applies to 13. Perfect hematology message no. Like O, Perfect Hematology Message No. 13 both apply to normal hematocrit, but there are some differences between these two complete methods. This is NCL 13 and No. This is because 0 occurs under mutually exclusive conditions. Other reminder texts are also shown in other examples in Appendix 1. The reminder text is block 102 of the knowledge base in Figure 3.
This is the last item listed in , and concludes the explanation of FIG.

FIG. 4 Referring now to FIG. 4, a flow chart of the operation of the system is shown. In connection with the explanation of FIGS. 1 and 2, operation can be started by inputting four parameter values via the keyboard 16 and selecting the long mode by inputting the letter L or selecting the short mode by inputting the letter S. It will be done. As a result, the system executes the instructions stored in the memory device by determining the CII of the four-parameter or four-argument HPLG applicable to the four input numbers, as shown in block 202 of FIG. Start. This step is also referred to as preselection of applicable CII. Referring to Appendix 2, select one of the 12 applicable CIIs for H, ie the one applicable to the H value of the input numerical value, along with its descriptor (see Appendix 2).

Similar processing is performed for the remaining three parameters or arguments PGL.

In the next step (block 2o4) the "output" display means "preparation for printout". The four numbers just entered are prepared for printout along with the descriptive phrase (Appendix 2) just retrieved from memory.

The next block 206 requests a search for "Input CII Reminder Set." The number of reminder sets retrieved is 4, i.e. each individual parameter H
This means that there is one for each applicable CII of PGL. A reminder set is a serial number applied to the CII selected in question. 0~No. All numbers are selected from 68 (Appended Table 3).

From Table 1, the applicable CII, namely H: (5; P: 5, G
:5, L:4 and scan Appendix 3 for reminder set numbers applicable to H CII=6. Consequently, the numbers below will satisfy H CII=6.

Table 2 As expected from the previous discussion of Table 1, reminder set numbers 0, 13. Indicates the existence of 53.

In fact, we scanned the reminders to select a reminder number applicable to H CII=6.

The reader does not need to take the trouble to perform a similar scan for the remaining parameters PLG since they are compactly shown in Appendix 5.

Appendix 5 includes 12 possible CII representations for H, 8 possible CII representations for P, and 10 possible CII representations for G.
The display items of CII and the display items of 8 CII for L are also shown. CII number setting starts from (1) for each item. On the other hand, reminder set numbers and their associated column positions start at (0). The CII representation of Appendix 5 and the remaining contents of Appendix 5 are stored in the system's memory device as part of the knowledge base.

In Appendix 5, each CII is configured into a bit string,
This bit string is then organized into 9 bytes. For purposes of explanation, the numbering of these bytes starts with (1).

Bytes are organized in binary form. Since there are 8 bits per byte, a total of 9×8=72 column positions are valid. Numbering starts at (1) for this sentence and the next sentence. These 72 positions provide 69 reminder sets defined in Appendix 3, i.e.
The sequences from to 68 are stored appropriately. This sequence (that is, the vertical column placement) is shown in Appendix page 1.5.
(H49.9/S) does not include the diagnostic reminder message. See “Miscellaneous Matters.” In order to continue the next discussion, it is necessary to set byte numbers from 0 to 9 and CII.
It may be convenient to continue with the number settings from 1 to 12 (for H, and for others generally). The number setting for the effective column position is 0 from left to right.
to 71, and the numbering of bit positions within a byte ranges from 0 to 7 from left to right. Following bit position 7, each byte is terminated with a suffix B representing a binary number (rather than a D-decimal number). but,
Even "binary numbers" should be interpreted with some caution. That is, CII No. for P. In 1, consider the first or leftmost byte.

Although this byte is read as 11111111, this should not be interpreted to mean the number 255 (expressed in LO base). Rather, the suffix B indicates whether each of the bit positions of this byte contains a binary 1 or
It means "set", "up" or "on".

Only those bit positions that are set are likely eligible for retrieval of the associated reminder set, and are the binary O (“reset” or “down” or “
The position where "off") appears essentially disqualifies the search.

Returning to Table 2, scanning the CII for H in Appendix 5 upwards and from left to right, the viewer arrives at the bit position that numerically corresponds to the reminder set number shown in Table 2. Referring again to block 206 of FIG. 4, operationally the system retrieves CII6 from memory for H, and based on the example in Table 1, it retrieves CII5 for P and CII5 for G.
CII4 is searched for I5 and L, respectively. These C
The format of II is shown in Appendix 5.

The next step is shown in block 20g of FIG.

The system calculates the intersection points of the reminder set. This calculation process consists of logic A
This is achieved by executing the ND function. Further eligibility for printout requires that a binary 1 appear in each of the four applicable Cll indications (Appendix 5) in a particular column. Refer to Appendix 5 and Table 1
For reference, No-0, No. 13 and N0. 5
3 remain.

The system (block 210 in Figure 4)
I is a null domain, in this case No. Eliminate or exclude reminders that result in an O (see Appendix 3). As mentioned above, the exclusion of reminders due to null domain prohibition also requires a logical AND condition of all four applicable CIIs. In this case, reminder No. 0 is excluded, but no. 13 and no. 5 3 remains.

As the characteristics are shown in Appendix 3, the current process is to select the remaining reminder number, in this case NO. 13 and no. 5
Continue based on the features applicable to 3. In the next step, block 212 of FIG. 4, the remaining reminders are categorized by type, such as hematology reminders, diagnostic reminders, or subcase reminders. Adding to the previous discussion of subcases, a subcase reminder is one that appears with either a hematology reminder or a diagnostic reminder. Subcase reminders are printed immediately after the specific hematology or diagnostic reminders that are subcases. Returning to the consideration of Appendix 3, No. Message No. 2 as a subcase of Whenever Message No. 34 is eligible for printout, message No. 2 is also essentially eligible.

Therefore, other messages are probably also No. 3 4
Some parameters in the CII range still qualify. However, the processor is actually No.
3 senses the designator S2 of 4 (see Appendix 3) and, independent of considerations regarding pond priority, no. 2 immediately followed by No. 2. 3 Print out 4. This point will be discussed further in "Miscellaneous matters".

The following two steps are shown in blocks 214 and 216 of FIG. The step at block 214 calls for calculating parameter weights. The step at block 216 calls for determining the priority of hematology reminders. These two steps are described in conjunction with the description of FIG. 3 and the knowledge base description.

Adding to the previous discussion, the actual dominant factor data is stored in memory locations specified in a data table organized as a byte array in hexadecimal format l- (BI20, Appendix E). Note that in this hexadecimal byte array, each byte contains dominance factor information for the respective reminder message. The superior factor information is encoded in the four bits of the upper two bits (1 nibble - 1/2 byte) of each byte as shown below. In other words, H: bit 7
;P: bit 6; G: bit 5: L: bit 4,
The number settings go down from 7 to O (total 28).

When a bit is set, that parameter becomes dominant for each reminder message. As previously pointed out, a reminder message may have one or more override parameters. No. We will also focus on reminders that do not have a superiority parameter, such as 4 7 (Appended Table 3). That is, Reminder No. 4 7 is printed last. In the process from steps 214 to 216 and finally 220 (computing diagnostic reminder calculation priority), the system selects between all remaining suitable hematology reminders (with their subcases) on the one hand, and on the other hand. Here are all remaining diagnostic reminders (with their subcases)
Essentially make your own priority choices between.

This is based on the reminder type display as displayed for individual reminders in Appendix 3.

In the next step or block 218 (Figure 4), the remaining hematology reminders and subcases are prepared for printing ("output") in the format shown in Appendix 4 and in the priority order determined in step 216. will be completely searched.

Steps 220 and 222 are similar to steps 216 and 218, but apply to the hematology reminder and subcase. Please refer to “Miscellaneous Items” for processing of hematology reminders on Appendix Page 1.5. As a final step 224, the system selects all "
Print out the output.

In connection with the "output" steps 204, 218, 222 and the printout step 224, the system locates by means of a "look-up table" the memory address corresponding to the reminder text to be printed out. Although there is a numerical correspondence between message numbers (total 69; number settings start from 1) and memory addresses, the memory stores a lot of other information other than messages, so even more processing is required in the process. A program that executes the method is shown in the PL/M-86 compiler language. See BI20 for a description of this compiler language.

Describe the preparation or creation of part systems. We have just mentioned one possible method of creating a system, and alternative approaches are probably also possible.

To begin with, a knowledge base in human language is prepared based on the BII, the knowledge engineering engineer's own knowledge, and references to other functions. This entails creating reminder messages, establishing clinically important intervals (CIIs), assigning messages to CIIs, specifying dominance factors, and more generally as described above. These are items and matters assigned to the knowledge base. When the expert system operates, the items to be printed out, that is, the messages, return to human language (Appendix 1). However, when creating or preparing an expert system, reminder messages, like other items that make up the knowledge base, require code conversion or language conversion. This is the reality of creating programs that are stored in a system's memory device.

In preparation for conversion, various items that make up the knowledge base are
Manipulate into computer files on disk using a text editor. Next, the C compiler language (BI
A separate computer program written in the PL/M-86 language (BI20. It is used for creating knowledge-based displays in Appendix 5). Although not all of the PL/M-86 representations of the knowledge base are obtained by conversion in this manner, some are entered directly into computer files using a text editor. Therefore, we will have two sources of PL/M-86 display. Finally, a PL/M-86 language compiler is used to convert the PL/M-86 source files from the two sources into computer executable code that can be stored, for example, on a floppy disk.

In connection with the diagnostic reminder message of Miscellaneous Appendix Page 1.5 (H 49.9/S), it will be recalled that the message does not carry out any diagnostic indication in the ultimate sense. It is further noted that this message is not included in the sequence 0 to 68 of Appendix 3, nor is it included in column position 72 of Appendix 5. Furthermore, the message was not retrieved in step 206 (FIG. 4) and was not retrieved in step 220 . No preparation is made for printout by 222 either. Instead, step 21
2, the "absence" of other diagnostic messages confirms the applicability of that message. In addition, in step 222, immediately attached table page 1.5 (H49.9/S)
message is retrieved from a special location in memory. Considering that this message appears very frequently, the operations just discussed are simple compared to operations in a similar manner for other messages.

In connection with the discussion of subcases, the subcases (No. 34 to No. 38. No. 4) charted in Appendix 3 (No. 34 to No. 313, Nα40 and Nα41)
0 and no. 41), as of late 1986 and early 1987, each of these subcases is subordinate to a hematology reminder message (numbered sequentially from 0 to 68), but none is subordinate to a diagnostic reminder message. I will further note that. Therefore, referring to diagnostic subcases in blocks 218 and 222 (FIG. 4) is equivalent to stating the following. That is, the system is now equipped to handle things that have been reserved for future use.Another such "pre-reservation" involves the assignment of dominance factors to subcases. That's what I said.

Referring again to Appendix 3, specifier type S10, DOM
Nα35 with P, then specifier type M, DOM
Top No. with M. 10 will be described.

If Nα35 should be applicable, then Nα10
is also essentially applicable. No. 35 messages are
Integrated and immediate No. 1, regardless of other priority considerations
．． This follows the to message. DOM H is applied to integrated Nα10, but No. 3 5 DOMs
P is not considered separately. On the surface, No.
3 5 DOM P has no meaning.

Nevertheless, it has (practically) meaning. The system takes into account the expected future situation of assigning multiple subcases to one and several higher level messages, with the assignment of priorities among the subcases mentioned above. , and based on its dominance factor and weighting,
In addition, consideration is performed in exactly the same manner as in the case of non-subcase messages.

Technical Alerts Technical Alerts are messages indicating a combination of implausibilities of HPGL numbers, some of which are indicated as unconditionally implausible, others only as almost implausible, or conditionally. Shown as implausible. Additionally, ANEMIA (see page 19 of B Il3) monitors human data for impropriety. According to an important feature of the system, technical alerts indicate possible errors by the operator that lead to invalid instrument readings.

An example of a technical alert is shown in the printout in Appendix i. Appendix page 6.1. G. 2. &． 3
An example of one technical alert in a diagnostic message is shown in . Similar to the pages in Appendix 1, page 6.1 is recognized as Hl5/S and page 6.2 is Hl5/S.
It is recognized as 15. However, since the long mode printout extends to the second or continuation page 6.3, that page 6.3 is considered as H 15/L2. The technical alert on the Hl5 printout is conditional, which indicates some error that may occur by the operator, such as blood leakage, etc. However, the HPGL values are consistent with non-regenerative anemia and are accepted as reasonable, suggesting repeat testing, followed by repeat measurements.

Appendix page 6.4 (H63/S) further shows unconditional technical alerts and no alternative validation reminders.

Appendix page 6.5 (H28.2/S) provides an alternative validity diagnosis reminder. Therefore, it should be considered as indicating a conditional technical alert. Appendix Page 6.6 (H28.2/S), which is an alternative short mode version to Page 6.5, will be discussed in the next section.

Modifications The above system allows various modifications, such as:
The number of stored messages (Appendix 3) can be easily increased.

A doctor, who is a potential user, had instructed that diagnostic messages should be printed out preferentially before hematology messages. This is accomplished by exchanging the priorities of D with respect to H in the flow of FIG. This modification is closely related to the proposed modification that selects technical alerts as a separate message group in addition to diagnostic messages and hematology messages, and this message group is given top priority. This can also be easily accomplished according to the techniques described above. Appendix page 6.6 (
H2g. 2/S) is the T first configuration, the D second configuration, and the H third configuration.
Show the configuration.

Conclusion From the above, it can be seen that the present invention provides a hematology diagnostic system that is useful in practice. Its advantages are as follows.

Human language display, human power and output. This is in contrast to previous attempts to utilize cryptographic computerized coding, which is subject to error by physicians who are not trained in computers.

Operability based on consistently the same number, same subnumber, and the same type of input parameters (H P GL), all with numbers derived from a single data source (QBCn). This operability has made it possible to create simple equipment that can be installed and easily used in many clinics. This is in contrast to conventional systems in which only one type of system is considered effective at university research centers, and is of great benefit to the medical community.

A non-interactive expert system is used.

This has decisive advantages. This means that advice is given to physicians in a "one-shot" manner, rather than the repeated cross-examination required by traditional methods. Users of the system do not need to have specialized computer knowledge.

The system will not forget important information, will not fatigue, and will not become confused or erratic.

Therefore, a consistently high quality interpretation of the numerical results is provided.

Related Book Item B I 1. Wintrobe. M. M. ; Clinical Hematology, 8th edition (Clinical Hea + Atol
ogy. 8th Edition).

B I 2. M1shkoff. Henry C.
: Understanding artificial intelligence (Llnderstand)
ing Artificial Intel Iigen
ce): Copyright 1985, Howard W SaIIls, Indianapolis, Indiana, USA.
& Co. : Chapter 3; Expert system (pages 53-77): Glossary (pages 251-254):
See related bibliography (pages 247-249).

B I 3. Winston. Patrick H.
enry ; Artificial intelligence; 2nd printing (Artificial
Intelligence; SecondPrin
t1ng), 1979 (Copyright 1977), Reading, Massachusetts, USA. Addison
-Wesley Publishing Company
; Chapter 7: Display knowledge in frames (page 179)
~204).

BI4. U.S. Patent No. 4.591.983, Benn
ett et al., published on May 27, 1986.

BI5, U.S. Patent No. 4.648.044, Ilar
dy and others. Announced on March 3, 1987.

BI6. U.S. Patent No. 4.858.370, Erma
nOthers, published on April 14, 1987. Medical diagnostic expert systems cited in cited references and other publications.

B I 7. Waterman. Donald A.
．． ; Expert System Guide (A Guide)
e to Expert Systems): Addison-We, Reading, Massachusetts, USA
Sley Publishing Company. Copyright 1986; Pages 273-289: Expert system/Medical products catalog; Related books page 319-
See 329.

B I 8. January 1986 issue, Artificial Intelligence Reporter (
Artificial Intelligence R
eporter): Reference guidebook for medical expert systems, pages 3, 12; Books on Medical A1, pages 9, 10.

BI9 to BI 12. Engle. Ralph
L. and Flehlnger, Betty J. Co-authored.

B I 9. HEME: A Computer Aid to Diagnosis of Blood Diseases
gnosis of Hematologic Dise
ase) ; Booklet (Bulletin) New York Academy of Medicine (New York Academy
f Medicine), Vol. 52. NQ. 1
5. June 1976, pages 584-800. B IIO. HEME: Self-improving computer program for diagnosis-oriented analysis of blood diseases: IBM Journal of Research
h and Development). Vol. 1
9. Pages 557-564. November 1975.

B Ill. HEME2: A long history of computer-assisted hematology diagnosis: IEEE Convention Record 19
1982, pages 763-767.

BIl2. Computer-Assisted Diagnosis; Research Report (R
esearch Report) No. RC6872
(Environmental Science), IBM Research Bureau Publishing, Yorktown Heights, New York, USA, December 1977; Pages 1-12.

B I 13. S. Quaglin1 and others. A
NEMIA. Exheart Consultation System; Computers and Biomedical Research
and Biomedical Research).
Vol. 19. Pages 13-27. 1986; Academic Press I
nc. ) Published.

BIl4. QBCIT Centrifugal Hematology System Operator Manual, Becton Dickinson (B-D)
Published (Revision B, October 1984).

B I 15. Booklet 4200-000-003/
AWBC-572, published by B-D. March 1984
Month.

B I 16. Booklet AWBC-1079, B
- Published by D, May 1986.

BIl7. Published booklet DM-QBC-TS-4Q, BD. 1986.

BILg. Sallitt. Robert L.
．． and its pond, evaluation of leukocyte centrifugation count; blood cells (
periodic), published by Springer-Verlag, 1
November 985 issue, pages 281-294.

B I 19. Vardlaw. Stephen
C. and others, Quantitative Buffy Coat Analysis, Journal of the American Medical Association.
rican Medical Association
ion), Vol. 249, No. 5. 1983
February 4, 2015, pages 617-620.

BI20, DOS System Nodame PL/M-86 User Guide, Ir+tel Corporation, Santa Clara, California 95051, USA. Works 1'll985; Chapters 1-3 (PL-M-86 language);
Appendix E - ASCII (American Standard Code for Information Interchange) Character Codes.

B I2L. Old Cr for MS-DOS operation system
O-soft C:I Invirer, User Guide; 14
icrosof't corporation, copyright 1984. 1985, 1986; Main text - C language; Appendix A - ASCII character codes.

Attached Table Catalog A/J Table Number Page A/1 Table 1 1.1 ~1.52.1~
2.3 3.1-3.2 4.1-4.2 5.1-5.3 Appendix 6 6.1-6.6 Title Typical Diagnostic Print 1 Out el + Summary Knowledge Base Reminder Summary Bit String Creation 1) L/M-86 Compiler Technical Alert Physician's Refusal Minder QBC Centrifugal Hematology System Doctor of Medicine Mouth Part. A. Written by Levine, M.D. Maxwell. M. Wintrobe edited hematocrit (%) -40.0 blood small
Slope (X 109 /L) -254 total W B
C (xl09/L) -8.0 percent Granulocytes - G3 Granulocytes (X 109/L) -5.0 percent Limba + Monosu 37 Limba + Monosu (.X 109 Le) -3.0 Normal values for adult males: 40-54%; Normal values for adult females: 37-47% Within normal ranges Within normal limits General hematology Clinical reminder: Reported hematology values are within normal limits for adults. be.

Specific diagnostic considerations include: flat Always.

Doctor Diagnosis Reminder QBC Centrifugal Hematology System Doctor of Medicine Mouth Part, A. Written by Levine, M.D. Maxwell, M. Wintrobe-edited hematocrinometry (%) -40.0 Blood platelets (
X109 /L) -254 total W B C (
xlQ9/L) -8.0 percent Cervical granulocytes -63 granulocytes (X109/L) -5.0 percent Lymph + Monosu 37 Limba + Monosu (X 109/L) -3.0 Normal for an adult male Value: 40-54% Normal value for an adult female. 37-47% Within normal range Within normal range Within normal range Compare with patient's basal value. Normal Hemakurinote values range from 40% to 54% for adult males and from 37% to 47% for adult females, but these values are determined for individuals at sea level. At higher altitudes, 1200 meters <4
Add 2% for every aaa feet). In infants and children, normal hemakrine values are higher than those in adults during the first two months of life, then decrease, and then gradually increase until puberty.

Wintrobe, M. M. ; [Bed hematology, 8th
ri. L885, 18881893, 336
, page 372, including the following as specific diagnostic considerations:

Reported hematology values are within the normal range for adults.

Hematology clinical reminder Reported hematology values are within normal limits for adults.

Reported hematology parameters are within normal limits. This does not exclude the presence of disease. If detection of eosinophilia is clinically important, peripheral smear
r) should be tested. In order to detect changes from early findings, we use these results, especially hematocrit, as a reminder for physician diagnosis.QBC Centrifugal Hematology System Physician Diagnosis Reminder. A. Written by Levine, M.D. Maxwell. M. Edited by Wintrobe, M.D. Mouthpart, A., Levine, M.D. Maxwell, M. Wintrobe edited hematocrinometry (%) -53.0 blood platelet C
X109 /L) -247 total W B C (
x109/L) -28.5% granulocytes-
15 u jO ff(X109/L)-4
．． 3% Limba + Monosu 85 Li/Ba + Monosu (X 109 /L) -24.2 Normal value for adult males: 40-54% Normal value for adult females 237-47% Extremely increased within the normal range Hematochrysotho(%') -53.0 Blood Small
Plate (X109/L) -247 total W B
C (Xl09/L) -28.5 Percent Granulocytes -15 Granulocytes (X109/L) -4.3% Lymph + Monosu 85 Lymph + Monosu (Xl09/L) -24.2 Normal for an adult male Value: 40-54%, normal value for adult females 37-47% within normal range, extremely elevated within normal range General Hematology Clinical Reminder: Lymphocytosis/Tabletonia.

Matcrit to normal.

Mild or borderline polycythemia (El?YTl{ROCYTOS)
IS)).

Specific diagnostic considerations include: Leukocytoid reaction (lymphocytic type).

General Hematology Clinical Reminder: Lymphocytosis/monocytosis.

Causes of lymphocyte/monocyte increases include (a) infectious monocytosis, (b) confirmed acute infections (e.g., pertussis, infectious hepatitis, giant cell viral infections) and confirmed chronic infectious diseases (e.g. , tuberculosis, brucellosis, secondary congenital syphilis); (C) confirmed protozoal infections; (d) some lymphomas and confirmed acute leukemias (blasts expand the lymph/mononuclear cell layer);
and (e) due to chronic lymphocytic leukemia.

Additional tests include those expected from a peripheral smear test, re-examination of residence history, and physical examination. Wintrobe, M. M. ．． Clinical Hematology 2 8th Edition, l285
~1287 pages.

Mild or borderline polycythemia (irithrocytosis).

Because the high lymphocyte count is mostly composed of swollen lymphocytes, it mimics chronic lymphocytic leukemia (CLL), a condition seen in infants and children with whooping cough. The clinical picture of chronic lymphocytic leukemia is associated with other diseases, such as dermatitis helvetiphomys, enforiative dermatitis, chickenpox, gastric cancer, metastatic melanoma, breast cancer, and miliary tuberculosis. Wintrobe,
M. M. ．． Clinical hematology, 8th edition, 1316
page.

The upper limit of normal hematocrit value is 54 for adult males and 47 for adult females. Hematocrit values may be elevated in patients who smoke or live above sea level. The normal hematocrit value for an adult male is 4.
0 to 54%, and 37 to 47% for adult women, but these values are determined based on patients at sea level.
Higher altitudes, i.e. 1200 meters (400 meters)
0 feet) add 2% for each rise. Normal hematocrit levels in infants and children are higher than those in adults during the first two months of life, then decline and gradually rise until puberty. Wintrobe, M. M. ．． Clinical Hematology, 8th edition, page 1885 Table A-1 Table A-3;1
Page 891, Table 2-15.

Diagnostic considerations and symptoms: Leukemic reaction (lymphoid type).

Physician Diagnosis Reminder QBC Centrifugal Hematology System Doctor of Medicine Mouth Part. A. Written by Levine, M.D. Maxwell. M. Edited by Wintrobe The pattern of hematology results obtained, including the following as special diagnostic considerations, is not sufficiently clear to warrant a specific diagnosis or symptomatology. Further actions to be taken will depend on the patient's medical history, physical examination, and blood smear examination.

Hematocrit (%) -49.9 Blood small
Plate (Xl09/L) -525 total W B
C (X109/L) -31.5% Granulocytes -65 Granulocytes (XRO9/L) -20.5% Lymph + Monosu35 Lymph + Monosu (XLO9/L) -11.0 Adult male Normal value = 40-54% Normal value for an adult female. 37-47% Slowly rising markedly Slowly rising General hematology Clinical reminder: Marked granulocytosis.

Thrombocytosis.

Lymphocytosis/monocytosis.

Matcrit to normal.

QBC Cll summary platelet (Xl09/L, approximate number to decimal places) F rl
Feb 20 15: 39: 45 1
987 hematocrit (% number of shots to 2 decimal places) CI
l# Hematoclint range descriptor (after approximation) 1. 0.0~9.9 Extremely decreased 2
．． 10.0-15.9 Extremely decreased 3. 16.0-25.9 Significant decrease 4. 28.0-33.9 Significant decrease5. 34.0~369 Normal value for adult male = 40~54% Normal value for adult female. 37-37% 6. 37.0~419 Normal value for adult male = 40~54% Normal value for adult female. 37-47% 7. 42.0-50.9 Normal value for adult males: 40-54% Normal value for adult females: 37-37
%8. 51.0-549 Normal value for adult males. 40-54% Normal value for adult women 2 37-47% 9.55.0-59.9 Slowly increasing 10. 60.0-65.9
Slow rise11. 68.0-75.9
Extremely rising 12, 760 ~ maximum
Extremely elevated CI I# Platelet range (after rounding) 0.0-19.0 20.0-390 40.0-7980 800-139.0 140.0-440.0 441.0-700.0 701 .0~9980 9990~Maximum Description Child Extremely decreased Extremely decreased Significantly decreased Gradually decreased Within normal range Gradually increased Significantly increased Extremely increased Granulocytes (Xl09/L Approximate number to 1 decimal place) CI I #Granulocyte range (after rounding) 1. 0.0~0.9 2. 1.0~1.5 3. L. 6-1.74.1.
8-3.0 5. 3.1-7.2 6. 7J~9,0 Description Child Extremely decreased Slowly decreased Slowly decreased Within the normal range Within the normal range Slowly increased CI I# Granulocyte range (after rounding) 91-10.0 10.1-15.0 15 ．． f~35. O 35.1 ~ Maximum descriptor Slowly rising Slowly rising Markedly rising Significantly rising Lymph and monos (X109/L, Cl f# Lymph and monos range (after rounding) 00-0.5 0.6-1 .8 1.1- L.S 1.7-4,9 580-60 6.1-12.0 12.1-200 20.1-approximate number up to 1 decimal place) Description Extremely significant decrease Decreased to Slightly lower than normal range Within normal range Slightly increased Slowly increased Significantly increased Extremely increased #O TYPE H DOM H H 6 -8 P 1 -8 Gl-10 L 1 -8 NULL H 6 -8 P 5-5 L 4-4 #I TYPE H DOM H H 1-5 P 1-8 Gl-10 L 1-8 #2 TYPE H DOM H H 9-12 P 1-8 Gl-10 L 1-8 # 3 TYPE H DOM G Hl-12 P 1 -6 0 1 - I L 1 -8 #4 TYPE H DOM G Hl-12 P Co 8 L 1 -8 #5 TYPE H DOM G Hl-12 P 1 -8 6 6 -8 L 1 -8 #6 TYPE H DOM C I{1-12 P 1 - 8 0 9-1 [I L 1 -8 #7 TYPE H DOM L Hl-12 P 1 -8 G 1-10 L 5 -8 #8 TYPE H DOM GH 1-12 P 1 -8 G 1 -4 L 3 - 5 NULL Hl-12 P 1 -8 G 3- 3 L 4 -4 NULL H 1-12 P 1 - 8 G 4 -4 L 3-4 NULL H l-12 P 1 - 8 6 3 - 3 L 3 -3 #9 TYPE H DOM L H 1-12 P 1 -8 0N-10 L 1 - 3 #10 TYPE H DOki P H 5-12 P 1 -4 G4-10 L 1 -8 #11 TYPE H DOM PH1-12 P 6 -8 Gl-10 L 1 -8 #12 TYPE D DOM HGP H 1 -4 P 1 -4 G 1 - 3 L 2 - 5 #13 TYPE H DOM H 6 -8 P 5 - 5 L 4 -4 #14 TYPE D DOM HPGL H 3 - 5 P 5 -7 G 3 - 9 L 3 - 6 # 15 TYPE D D O M H 2 - 3 P 5 - 5 L 3 -4 #16 TYPE D D O ki H 3 - 3 P 5 - 5 L 3 -4 #[7 TYPE D DOM H 4 -4 P 5 - 5 L 3-4 #18 TYPE D DOM H H 2 -4 P 4 - 5 L 3 -4 #19 TYPE D DOM PLG H 4- 5 P 4-6 G3zu L 3 -5 #20 TYPE D DOM H H 2 -4 P 2 -4 L 3 - 5 #21 TYPE D DOM P H 5 -8 P 1 -3 L 4 - 5 #22 TYPE D DOM L H 2 -4 P 4 -8 G 3 - 9 L 3 - 4 NULL H 3 -4 P 5 -6 L 3 -4 #23 TYPE D DOM PH 5 -8 P 7 -8 0 8 1 9 L 4 - 5 #24 TYPE D DOM GH 5 -8 P 5 -6 G 10-10 L 4 -4 #25 TYPE D DOM L H 6 -8 P 5 - 5 L8-8 #26 TYPE D DOM L H 6 -8 P 4 - 5 G 2 - 5 L 5 -7 NULL H 6 -8 P 4 - 5 G 2 - 2 L 5 - 5 #27 TYPE D DOM L H 6 -8 P 4 - 5 L5zu NULL H 6 -8 P 4 - 5 L 5 - 5 #28 TYPE D DOM H H 3-5 P 1-4 G 1-3 L 3-5 NULL H 5-5 ・P 4-4 L 3-5 #29 TYPE D DOM L H 2-4 P 1-4 G 1-3 L 6- 8 NULL H 4 -4 P 4 -4 0 3 - 3 L 6 -6 #30 TYPE D DOM H H 8-11 P 5 -8 G4-10 L 4 - 4 NULL H8-8 P 5 - 5 L 4 - 4 #31 TYPE D DOML H 4 ~ 7 P 3 - 5 L8-8 #32 TYPE D DOM PGL H 1 - 5 P 1 -3 G 1 - 2 L 1 - 3 NULL H 5 - 5 P 3 - 3 G 2 - 2 L 3 -3 #33 TYPE D Dota vIG H 3 -6 P 4 -8 G 10-10 L 4 -4 #34 TYPE S2 DOM H H to-12 P 1 -8 Gl-10 L 1 -8 #35 TYPE S10 DOM PH 5-12 P 1-1 G4-10 L 1-8 #36 TYPE SIO DOM PH5-12 P 2- 2 G 4-10 L 1-8 #37 TYPE 510 DOM PH5- 12 P 3 - 3 G4-10 L 1 -8 #38 TYPE Sho DOM PH 5-12 P 4 -4 L 1 -8 #39 TYPE D DOM L H5-7 P 5 -6 L 2 -3 #40 TYPE SI DOM H H 1 -3 P 1 -8 Gl-LQ L 1 -8 #41 TYPE SLl DOM P H1-12 P 7 -8 Gl-10 L 1 -8 #42 TYPE D Do! t4 L H6zu P 4 - 5 L 5-7 #43 TYPE D DOM HG H 7 -8 P 5-5 G6zu L 4 -4 #44 TYPE D DOM H H 2- 5 P 4- 5 G 2 -4 L 3 -4 NULL H 5- 5 P 5-5 G 3 -4 L 3 -4 NULL H 4 -4 P 5 - 5 L 3 -4 #45 TYPE D DOM L H 4 - 7 P 4 - 5 G 4 - 5 L8-8 #47 TYPE D DOl+4 H 5 - 5 P 5 - 5 L 3 -4 #50 TYPE H DOM H H 6 - 7 P 6 -8 G 5-1O L 5 -8 #53 TYPE D DOM H 6-7 P 5-5 G 4-5 L 4-4 #5G TYPE D DOM L H 4-7 P 4-6 L 1-1 #59 TYPE D DOM H H 1-5 P 6-8 0 6 1 9 L 2 - 4 #46 TYPE D DOM H 2 -4 P 1 -4 0 1 - 3 L 6 -8 NULL H 4 - 4 P 4 -4 G 3 - 3 L 6 - 6 #48 TYPE H DOM H H 6 - 7 P 6 -8 L 5 -8 #49 TYPE H DOM EI H6zu P 6 -8 G5-10 L 1 - 3 #51 TYPE D DOM H H 1 - 3 P 7 -・8 L 4 - 5 # 52 TYPE D DOM H H942 P 1 - 3 L 3-4 #54 TYPE H DOM L H 5 -8 P 5 - 5 L 5 -6 #55 TYPE D DOM GH 5 -8 P 5 - 6 G 2 - 3 L 4-5 #57 TYPE D DOM PH 2-5 P 3-4 G 2-3 L 3-4 #58 TYPE D DOM PH 2-5 P 3-4 L 3-4 #60 TYPE D DOM LH H 4-5 P 4-5 L3zu #61 TYPE D DOM LH H 4-5 P 4-5 L 5-7 #62 TYPE H DOM H H8-8 P 1 ~ 8 G 1 ~ 10 L U8 #63 TYPE D DOM L H 4 ・ 5 P 5- 5 L 1-3 #64 TYPE H DOM PH 1-4 P 1-4 G4-10 L 1-9 #65 TYPE H Do~IP H 5~12 P 1 -4 L 1-8 #66 TYPE H DOM P H 1-4 P 1 -4 L 1-8 #67 TYPE D DOM GH 3-6 P 5-8 L 5-8 #68 TYPE H Do~f HG H 1-4 P 5-6 L 2-5 QBC Reminder Summary 20 gold l1 # 0 Normal hematocrit type: Hematological dom: H Scope of application. ciis H2 6-8 P: 1-8 G=1-1o L; l-8 Null domain: H: 6-8 P, 5-5 0. 4-5 Lz 4-4 Actual value (after rounding) 370-55.0% 00-Maximum XIQ9/L O. Q~Maximum X109/L 00~Maximum XLO9/L 37.0~55.0% 140.0-440. OX109/LL. 8-
7.2 XI09/L1.7 - 4.9 Xl
09/L #1 Anemia type. Hematology dam: H Applicable range C IS H1-5 P, 1-8 G1-IO L. 1 to 8 Real value (after rounding) 0.0 to 37.0% 0.0 to maximum Xl09/L O, θ to maximum X109/L 00 to maximum X109/L #3 Severe granulocytopenia type/blood Scientific dom2G Scope of application/H. 1-12 21-8 G=1-IL・1-8 Actual value (after rounding) 0.0-maximum% OO-maximum Xl09/L O. 0~Q. 'l x l (19/L0.0~maximum - 1 to 8 Tosis) Actual value (after conversion into i number) 55.0 to maximum % 0.0 to i large X109/L 0.0 to maximum X109/L 0.0 to maximum X109/L Normal hematochrysotho.

Polycythemia (irithrocytosis).

Normal hematocrit values for adult males are 40-54% and for adult females 37-47%, but these values are determined for patients based on sea level. An additional 2% will be added for every 1,200 meters (4,000 feet) of elevation gain. The normal hematocrit value of infants and children is higher than that of adults for the first two months after birth, but it becomes lower after that, and gradually increases until the early spring period. Wintrobe, M. M. ．． Clinical Hematology, 8th edition, Ig page 85, Table A-1, Table A-31891
Pages, Tables A-15.

Anemia.

Hematocrino levels lower than the usual symptoms of anemia. Causes of anemia include (a) acute or chronic blood loss, (b) decreased red blood cell production due to infectious disease or inflammation, hypoplasia, tumor, or malnutrition, and (C) increased red blood cell destruction hemolytic anemia. by. The nature and cause of anemic urine should be determined. Additional tests offered include peripheral smear examination, red blood cell index, as well as reticulocyte count. Additional tests may also include examination of the stool for the presence of occult blood and animal organisms, as well as examination of total and subdivided serum bilirubin and urine traces for hemoglobin destruction. Wintrobe, M. M; Clinical hematology, 8th edition, 529-5
Page 58, Table 20-1. 541 pages.

The cause of a hematocrit value higher than normal (polycythemia) is an increased red blood cell mass due to chronic hypoxemia, an "absolute" erythrocytosis caused by polycythemia or other diseases, or This may be due to a decrease in the original mass (“relative polycythemia”). Additional tests that may be suggested include a peripheral smear and other tests commensurate with the medical history and physical examination results (e.g. *Investigate causes of relative erythrocytosis such as dehydration when exposed to poison Qi J).Wintrobe.
M. M. ．． Clinical hematology. 8th edition, 991-101
0 pages.

Severe granulocytopenia.

When the granulocyte count falls below 0.5×109/L, the risk of infectious diseases increases. The cause must be investigated. Preventive antibiotic treatment is generally required. The depletion of granulocyte counts is induced by drugs (common examples include aminopyrine, phenothiazines, sulfonamides, antithroids, and gold) or by chemotherapy. Aplastic anemia is also a cause. More mild forms such as granulocytopenia are observed in confirmed infectious diseases (typhoid fever, pseudotyphoid fever, measles, infectious hepatitis, infectious monocytosis, malaria, brucellosis and most micrococcal diseases). The cause of defective granulocyte production is megaloblastic anemia, especially pernicious anemia. Possible causes include poor cachexia or weakness, systemic erythrocytosis, noma, and hypersensitivity. Additional tests may include those indicated by specific investigations into the clinical manifestations of these diseases, as well as those indicated by physical examination results. Wintrobe, M. lvl. , Clinical Hematology, 8th edition. 1
Pages 304-1312.

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Physician #Diagnosis Reminder QBC Centrifugal Hematology System Physician Diagnosis Reminder QBC Centrifugal Hematology System M.D. Written by Bart A., Levine M.D. Maxwell M. Edited by Wintrobe, MD Robert A. Levine, MD Maxwell M. Wintrobe-edited Hematochrysotho (%)-15 Blood platelets (X109/L) -Total W
B C (Xl09) 1 percent Granulocytes 1 Granulocytes (XLO9 /L) - Percent Lymph + Monosurimba + Monos (X109 /L) - Extremely decreased Extremely decreased Hematocrino (%) )-15.0 Blood platelets (X109/L)-23 total
W B C (x109/L) - 0.7 percent granulocytes - 57 granulocytes (Xl09 /L) - 0.4 percent Limba + Monos 43 Limba + Monos CXl09 /L) - 0.3 extremely decreased extremely Decrease Extremely Decrease Extremely Decrease General Hematology Clinical Reminder General Hematology Clinical Reminder Anemia.

Severe granulocytopenia.

Lymphopenia.

Specific considerations include: float (rloaL)/inaccurate filling terms/leakage omissions.
Blood disease.

Hematocrit value below the usual signs of anemia. Causes of anemia include (a) acute or chronic blood loss, (b) decreased red blood cell production due to infectious disease or inflammation, hypoplasia, tumor, or malnutrition, and (c) increased red blood cell destruction hemolytic anemia. by. The nature and cause of anemia should be determined. Additional tests suggested include examination of the peripheral smear, determination of red blood cell indices, as well as reticulocyte count. Additional tests may also include examination of the stool for occult blood and testing for the presence of parasites, as well as examination of total and subdivided serum bilirubin and urine traces for hemoglobin destruction. Wintrobe, M. M,; Clinical Hematology, 8th edition, 5
pp. 29-558, Table 20-1, p. 541.

Hematocrit at this level results in significant tissue hypoxia and may also be associated with signs and symptoms of heart disease.

Severe granulocytopenia.

When the granulocyte count falls below 0.5×109/L, the risk of infectious diseases increases. The cause must be investigated. Preventive antibiotic treatment is generally required.

A decrease in the number of granulocytes can be caused by drugs (general examples include aminovirine,
(including funinothiazines, sulfonamides, antithroids, and gold) or by chemotherapy. Aplastic anemia is also a cause. Even milder granulocytopenia is observed in cases of confirmed infections (typhoid fever, pseudotyphoid fever, measles, infectious hepatitis, infectious monocytosis, malaria, brucell disease and most micrococcal diseases). The cause of defective granulocyte production may be due to megaloblastic anemia, especially pernicious anemia. Possible causes include cachectic or debilitated states, systemic lupus erythrocytosis, neoplasia, and hypersensitivity. Additional tests may include those indicated by specific investigations into the clinical manifestations of these diseases, as well as those indicated by physical examination results. Windrobe. M. M; Clinical hematology, 8th edition, 1304-131
2 pages.

Doctor Diagnosis Reminder 10 BC Centrifugal Hematology System Doctor of Medicine Bart A. Written by Levine, M.D. Maksounir M. Windrobe editing
Matocrisoto (%)-15
Blood platelets (Xl09/L) - total WB
C (Xl09/L) - Birthent granulocytes, one granulocyte (Xl09 /L) - Bircent lymph + monos - lymph + monos (Xl09 /L) - Extremely decreased Extremely decreased Extremely decreased Hematology Clinical Reminder: Lymphopenia.

Lymphocyte/monocyte depletion occurs in association with bacterial infections in Hodgkin's disease, as a result of Cushing's syndrome or corticosteroid treatment, and as a result of radiation or chemotherapy. It is also seen in collagen duct diseases and acquired immunodeficiency diseases (AIDS). Additional tests include a peripheral smear and tests appropriate to identify possible causes of lymphopenia. Wintrobe, M. M. ．． Clinical hematology, 8th edition, 13
04 pages.

Specific considerations include: Float/inaccurate filling/omission of leakage.

Physician Diagnosis Reminder - QBC Centrifugal Hematology System Doctor of Medicine Rober 1- A. Written by Levine, M.D. Maxwell ~Eng. In cases of obvious aplastic anemia, operator error such as omission of a float or blood leakage must be ruled out. Always check whether the plasma level is within the "fill line" before reading. Wintrobe, M. M
．． , Wardlow, S. C. Levin. R. A. : Quantitative pial analysis, illustrated review and reference guide, Copyright 198
4.

The above hematology values are also consistent with aplastic anemia.

Due to proportional disease in the lymphocyte/monocyte layer, which is not commonly seen in aplastic anemia, float or incorrect filling or omission of leakage is more likely. However, if repeat analysis reveals similar hematology values, aplastic anemia should be considered in all its implications. Windrobe. H. H. ．． Clinical Hematology, 8th edition, pp. 698-700.

Hematocrit (%) -63 Blood platelets (X109/L) -Total W
B C (Xl09/L) - Percent Granulocytes (Xl09/L) - Percent
Lymph + Monosu Lymph + Monosu (X109 /L) -0 Significantly increased 18 Extremely decreased 17 Slowly decreased 16 General hematology clinical reminder slightly lower than normal range: Granulocytopenia (BICYTOPEN
Thromboembolism associated with IA)).

Polycythemia (irithrocytosis).

Mild granulocytopenia.

Lymphopenia.

Specific diagnostic considerations include: Technical alert.

Agglomerated specimen.

Possible improper mixing.

Physician Diagnosis Reminder 10 BC Centrifugal Hematology System Physician Diagnosis Reminder QBC Centrifugal Hematology System Doctor of Medicine Bart A. Written by Levine, MD Maxwell M., Edited by Wintrobe, MD Bart A. Written by Levin, M.D., Maxwell M. Windrobe editing
Matcrit (%) -2
8.2 Blood platelets (Xl09/L) - 77
Total W B C (X109/L) - 2.0 percent granulocytes - 30 granulocytes (X109/L) - 0.8 percent Lymph + Monos - 70 Lymph + Monos (X109/L) - 1.4 Significantly decreased Significantly decreased Extremely decreased slightly lower than the normal range Hematology Clinical reminder Severe granulocytopenia.

Relative lymphocytosis.

Anemia.

Lymphopenia.

Specific diagnostic considerations include: Aplastic anemia.

Float/inaccurate filling/omission of leakage.

Preleukemia.

Hematocrit (%) -2
8 platelets (X 109/L) - total
W B C (Xl09/L) - Percent granulocytes/granulocytes (X 1G9/L) - Percentage lymph + Monosu lymph + Monos (X109/L) - Significantly decreased Significantly decreased Extremely decreased Slightly lower than normal range Technical Alert Possible omission of float/inaccurate filling/leakage Aplastic anemia including the following as specific diagnostic considerations.

Preleukemia.

General Hematology Clinical Reminders 12 Severe granulocytopenia.

Anemia.

Relative lymphocytosis.

lymphopenia

[Brief explanation of drawings]

FIG. 1 is a block diagram of a computer or data processor device implementing the invention. FIG. 2 is a block diagram showing the internal structure of the computer of FIG. 1. Figure 3 shows the first
FIG. 3 is a block diagram of an expert system of the present invention incorporated into the apparatus of FIGS. FIG. 4 is a flowchart showing the sequence of events performed by the device to obtain blood diagnostic output results. 10: Data processor 12: CRT monitor or screen 14: Printer 16; Keyboard 18: Container 20: Floppy disk 22: Random access memory 24: Read-only memory 26: Disk drive 28
;Central processing unit 30:Interface 100:Expert system F/θ2 (4 other people)

Claims (1)

[Scope of Claims] 1. data processing means; memory means for storing data and data processing instructions executed by said data processing means; and means for inputting data representative of hematological parameter values derived from patient blood; , means for outputting a message of the significance of a hematology diagnosis applicable to the patient, wherein the memory means is suitable for operations on the hematology parameters and their patient-attributable values. a database and execution instructions for an automatically interpreting hematology diagnostic system, said database containing a relatively large number of hematology diagnosis significance values each associated with a range of values for each of said hematology parameters; a message, said stored execution instructions including instructions for causing a processor to retrieve from said memory means one or more messages whose range combinations apply to patient parameter values; The message is provided in a format that allows interpretation of the patient's blood condition. 2. The database defines, for each parameter, a clinically important interval (
CII), wherein there are parametrically corresponding patient-attributed values in the ranges, and wherein the list includes a series of consecutive CII numbers and a list of CII
a range of values associated therewith for a number and a descriptive phrase associated with said range of values; said stored execution instructions include a descriptive phrase associated with an applicable CII corresponding to each of the patient input parameter values; 2. The apparatus of claim 1, further comprising instructions for determining the applicable descriptive phrase and for preparing output of the applicable descriptive phrase. 3. said stored execution instructions further cause said data processing means to prepare an output for printout of each matched applicable descriptive phrase, its associated parameters and patient-attributed values of said associated parameters; 3. The apparatus of claim 2, further comprising the prepared descriptive phrase and instructions for causing a printout of the prepared item to be produced in accordance with the prepared descriptive phrase. 4. The hematology parameters include hematocrit (H),
Device according to claim 1, characterized in that it is a platelet count (P), a granulocyte (G) and a lymphocyte/monocyte count (L). 5. The stored database further includes an individual reminder message number unique to each reminder message, where the reminder message number is a number that follows consistently for both hematology and diagnostic reminder messages. 3. A device according to claim 2, characterized in that: 6. Said stored database further stores information for each parameter, and then for each parameter applicable to that parameter.
for each said reminder message number;
All of the above parameters at the corresponding 1-bit position and their respective CIs, which are considered as binary numbers at the corresponding bit position.
I number array appears, the parameter and the CII number of the parameter are applicable to the corresponding reminder message number and the reminder message;
6. Device according to claim 5, characterized in that, on the other hand, binary zeros appear in other positions. 7. means for storing a knowledge base representing a plurality of different states of a biological fluid; means for receiving sample data originating from the biological fluid and less than said stored knowledge; and storing said sample data in said storage. means for processing said sample data to compare with said knowledge and interpreting said different states to which said sample data are most similar; and means for providing an output signal indicative of said interpreted state of said biological fluid; An automatic evaluation device regarding the condition of biological body fluids. 8. The apparatus of claim 7, wherein said means for providing an output signal includes a visual display device for displaying said interpreted condition. 9. The apparatus of claim 8, wherein the visual display device includes a print output device. 10. The apparatus of claim 8, wherein the means for providing an output signal includes a human language message representative of the interpreted state of the biological fluid. 11. data processing means; memory means for storing data and data processing instructions executed by said data processing means; means for inputting data representing values of hematological parameters derived from patient blood by quantitative buffy coat analysis; and said patient. and means for outputting a message of significance of a hematological diagnosis applicable to the automatic interpretation of quantitative buffy coat results, wherein the memory means is suitable for operations on the hematological parameters and their values based on quantitative buffy coat analysis. a database and execution instructions for a hematology diagnostic system that automatically interprets the hematology parameters; and the stored execution instructions instruct the processor to select one combination of the ranges to apply to the patient parameter values.
Apparatus comprising instructions for retrieving one or more messages from said memory means, said one or more messages being presented in a format enabling interpretation of said patient's blood status. 12. A non-interactive hematology diagnostic device using expert system technology, comprising a computer/data processor, the computer/data processor storing data and data processing instructions executed by said data processor. a memory device; input means for inputting a complete data set of a particular patient into the computer in a single entry pass, including data representing values of hematological parameters derived from blood analytes of said patient; a central processing unit for processing the data originating from said patient upon execution of the input via said input means, as well as stored data; and for printing out a message of the significance of the hematological diagnosis applicable to said patient. a printer connected to said data processor at said memory device, said memory device containing a database and instructions for automatically interpreting a hematology diagnostic system suitable for operation on said hematology parameters and a printer connected to said data processor; the database includes a relatively large number of hematology diagnostic significance messages, each associated with a range of values for each hematology parameter, the messages being adapted for printout; The stored execution instructions provide the processor with a complete set of messages applicable to the particular patient, the combination of one or more message ranges applying to parameter values for the patient. instructions for retrieving a message set from the memory device and preparing the message set for printing in a single printout pass; and instructions for the printer to print the prepared message in a single printout pass. A device characterized in that it includes an instruction to cause the device to turn out. 13. storing a knowledge base representing a plurality of different states of a biological fluid; obtaining an amount of sample data from the biological fluid that is less than the stored amount of knowledge; and converting the sample data into the stored knowledge base; processing the sample data for comparison with knowledge obtained from the biological fluid; automatically interpreting which of the different states the sample data is most similar to; and comparing the interpreted state of the biological fluid to and providing an output signal to be displayed.