KR101412612B1 - Clinical Decision Supporting Method For Chronic Pulmonary Disease - Google Patents

Abstract

The present invention relates to a method for supporting clinical decision support of chronic lung disease, comprising: providing a subject with at least three primary queries of a major symptom; Receiving an example (YES) or no (NO) of the primary query from the subject; Recommending a visit if the number of YES is greater than a first reference; Providing the subject with at least two or more secondary queries for attention signs when the number of cases is less than the first criterion but greater than the second criterion; Receiving an example or a NO of the secondary query from the subject; And collecting biometric data through an additional testing device when an example of the secondary query is more than a third criterion, and if the example of the secondary query is less than the third criterion, To the clinical decision support method of chronic lung disease.
The present invention makes it easy for an elderly person who has a high sense of discomfort to use equipment to diagnose his or her own health condition and to decide whether or not to visit the home. This enables the elderly to utilize the system without the help of the welfare specialist and other professional medical staff, thus making it possible to construct an aged friendly health management system while greatly reducing the social cost.

Description

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a method,

The present invention relates to a method for supporting clinical decision-making of chronic lung diseases, and more particularly, to a method and apparatus for clinical decision support for chronic lung disease, which is capable of easily checking the health condition of a patient with chronic lung disease, Decision support method.

The Clinical Decision Supporting System (CDSS) is a system that provides physicians with the necessary knowledge and ability to make inferences when they make decisions and judgments about diagnosis and treatment policy And the like.

The CDSS has a primary purpose of not fundamentally harming the patient, but should be able to block the so-called misdiagnosis or wrong treatment. There is also a restriction that the CDSS should not be a medical treatment on behalf of a doctor because it is under a legal system that can not conduct medical activities other than an authorized physician.

Meanwhile, smart care services are being promoted to provide telemedicine and health services for people with chronic diseases. This service provides the necessary diagnostic equipment for the chronic disease patients, and the result of the diagnosis of the chronic disease patients is transmitted to the center, analyzed the data, and is followed by telephone counseling, etc. to receive medical treatment.

Although smartcare services are not yet fully established, it is important to provide a user-friendly interface in that chronic illnesses are mostly elderly seniors, economically disadvantaged, and very poor in dealing with such systems.

Also, in order to analyze the data by using the diagnostic devices distributed and to consult regularly, a professional medical staff can not help but do this. Although there are regional disparities, considering that the number of people involved in smartcare services is several hundred thousand, the social cost will continue to increase.

Therefore, in addition to the establishment of smart care services such as an increase in the elderly population, which is the majority of people with chronic illnesses, an increase in the economic poverty of the elderly population, a rejection of complicated device use, There are many problems to be solved.

SUMMARY OF THE INVENTION [0006] Accordingly, the present invention has been made in order to solve the problems of the prior art described above, and it is an object of the present invention to provide a method and apparatus for diagnosing a chronic disease, And to provide a method of supporting clinical decision support applicable to care systems.

The above object can be achieved by a method for supporting clinical decision support of chronic lung disease according to the present invention, comprising: providing a subject with at least three primary queries for a major symptom; Receiving an example (YES) or no (NO) of the primary query from the subject; Recommending a visit if the number of YES is greater than a first reference; Providing the subject with at least two or more secondary queries for attention signs when the number of cases is less than the first criterion but greater than the second criterion; Receiving an example or a NO of the secondary query from the subject; And collecting biometric data through an additional testing device when an example of the secondary query is more than a third criterion, and if the example of the secondary query is less than the third criterion, Which can be achieved by the method of clinical decision support of chronic lung disease.

Measuring an oxygen saturation of the subject if the number of instances of the primary query is less than the second criterion; And recommending the visit if the measured oxygen saturation is greater than a predetermined determination value.

Alternatively, the biometric data may include a step of determining whether the FEV1 is a FEV1 for 1 second and the FEV1 is decreasing for 1 second; And recommending the visit if the 1-second effort expiratory volume shows a decreasing tendency. The step of determining the tendency of decreasing the FEV1 for 1 second is a step of determining the average value of the value obtained by subtracting the value of 80% or less of the maximum value among the FEV1 , And the maximum value of the 1-second effort expiratory volume performed 3 times or more on the same day can be determined by comparing with the reference value. When the reference value is less than 1 liter, it is judged that the maximum value of the forced expiratory volume for one second is lower than 80% of the reference value. If the reference value is not less than 1 liter and not more than 1.5 liters, It is judged that there is a tendency to decrease when the value is less than the value obtained by adding 0.6 liter to 20% of the reference value. If the reference value is 1.5 liters or more, it can be judged that the maximum value of the forced expiratory volume for 1 second is less than 60% have.

Alternatively, the method may further include repeatedly measuring the forced expiratory volume for one second on the day to store the maximum value.

The primary query may be configured to include at least one of whether the current breath feels colder than usual, whether the amount of sputum has increased compared to usual, and whether the color of sputum has become thicker than usual And the secondary query may be configured to include at least one of whether or not a cold symptom has occurred, whether the breathing has become rougher, whether or not the cough has become worse, and whether or not the neck is sore.

Here, it is preferable that the primary query is made to be inquired to the user on a daily or periodic basis, and further, the diagnosis result may be transmitted to the external medical care server.

The present invention makes it easy for an elderly person who has a high sense of discomfort to use equipment to diagnose his or her own health condition and to decide whether or not to visit the home. This saves social costs significantly because the elderly can use the system without the help of a welfare specialist or other specialist.

BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a schematic illustration of an understanding of a healthcare smart system according to an embodiment of the present invention; FIG.
FIG. 2 is a schematic connection configuration diagram of a healthcare smart system according to an embodiment of the present invention; FIG.
3 is a diagram illustrating an example of operation of a healthcare smart system according to an embodiment of the present invention;
4 is a flowchart illustrating a method for supporting clinical decision support of chronic lung disease according to an embodiment of the present invention; And
5 is a flowchart for explaining a method for decreasing FEV1 according to an embodiment of the present invention.

Hereinafter, embodiments of the present invention will be described in detail with reference to the accompanying drawings.

FIG. 1 is a schematic diagram for understanding an understanding of a healthcare smart system according to an embodiment of the present invention.

Referring to FIG. 1, a healthcare smart system according to an embodiment of the present invention is based on a residential space, a public space, and a concentrated management space.

The residential space is a house where the health care subjects are residing. In each residential space, a biometric data collection device corresponding to the type of the patient's disease, that is, diagnosis equipment is installed, distributed, managed each diagnostic equipment, CDSS-based check terminals are also available. It is desirable to construct a check terminal such as the most familiar TV in order to eliminate a sense of resistance against the use of the device by the elderly. For this purpose, it is preferable that the check terminal includes a TV receiving card or an IPTV receiving apparatus so that a TV program can be viewed.

The public space is a common place for residents living in a certain area. For example, the public space is for the elderly, the self-governing center, the cultural center, and the physical education center. In this public space, a bio-data collection device customized to various diseases, that is, diagnostic equipment is installed, and a CDSS-based public terminal is provided for integrally managing each diagnostic equipment and processing the diagnosis result.

The residential space is a private space and expensive diagnostic equipment can not be distributed to every residential space, but the difference can be found in that the public space can be equipped with relatively expensive diagnostic equipment as compared with the residential space. In addition, in the public space, various exercise aids can be installed and operated in addition to diagnostic devices such as a blood glucose meter, an electrocardiogram meter, a blood pressure monitor, and the like, as well as an exercise amount of a subject.

The common terminal installed in the public space further includes a collection device for collecting the individual identification information for data management of the diagnostic equipment or exercise equipment user. An interface device such as an RFID reader, a barcode reader, or a keypad may be attached.

Although the centralized management space may be a medical facility such as a hospital, unlike such facilities, the nurse and the nursing assistant other than the doctor can be managed and prepared to perform precise diagnosis of people who need concentration management. Therefore, expensive equipment that can be precisely diagnosed is provided in the centralized management space, and a centralized management terminal is provided for integrally processing the various diagnosis results.

CDSS-based health care services performed in residential spaces, public spaces, and concentrated management areas exclude active medical practices, advise visits to medical institutions, and perform final actions to medical institutions.

The portal server stores data collected from various terminals and manages it for each user. It manages distributed diagnostic equipment and terminals, statistical analysis management, service management manpower management, user education video management, user exercise / nutrition management, etc. Of the total.

Particularly, the portal server compares and analyzes the biometric data collection information of the collected user and the biometric data collection information of the same person through the common terminal to automatically determine the abnormality of the diagnostic equipment and the terminal, .

2 is a schematic connection configuration diagram of a healthcare smart system according to an embodiment of the present invention.

2, the healthcare smart system is configured through a networking connection between the check terminal 10, the public terminal 20, the centralized management terminal 30, and the portal server 40, The mobile terminal 10, the public terminal 20, and the centralized management terminal 30 are connected to various diagnosis devices connectable via a wire / wireless connection.

The IDs of the elderly living alone are stored and managed in the check terminal 10 and the portal server 40 and the like can automatically recognize the user ID through identification of the check terminal 10. [ Therefore, the biometric data of the user transmitted from the check terminal 10 and the self diagnosis result are transmitted to the portal server 40 and / or the centralized management terminal 30 together with the user ID information, and stored and managed. Likewise, in the public space, individual ID information is recognized by the public terminal 20 or its associated diagnostic equipment, biometric data, self diagnosis results, and momentum information are transmitted to the portal server 40 together with the user ID, Storage management.

Also, the user who is recommended to perform close inspection in the concentrated space through the check terminal 10 or the public terminal 20 can directly visit the concentrated management space and receive the close inspection. The results of the close inspection are transmitted to the portal server 40 together with the user ID information, and are integrally managed.

On the other hand, although welfare agencies are active to visit and consult with elderly people who live alone or with basic livelihood recipients, it is difficult to visit such a large number of people. .

For example, as shown in FIG. 3, employees who work in the concentrated management space communicate with each other through a video call with the elderly living alone, or through a multi-faceted conversation with another check terminal 10, mental disorders such as depression It can be overcome. Even if a social worker does not visit the home, he or she can take care of the elderly living alone efficiently. Particularly, when each check terminal 10 has a predetermined time, it can be configured to be turned on and mutually communicated, so that a group of people who want to communicate with each other can communicate with good friends .

The biometric data measured by the user visiting the senile dementia is transmitted to the portal server 40, and the portal server 40 evaluates the difference from the biometric data measured at the user's home. If the difference is within the permissible range, there is no problem. If the difference is outside the permissible range, the check terminal 10 in the residential space and any of the diagnosis equipment or the common terminal 20 in the public space and the diagnosis equipment It can be determined that there is abnormality.

In particular, when there are a large number of users, it is easy to determine whether there is an abnormality in the public terminal 20 of the public space and its associated diagnostic equipment. Therefore, the check terminal 10, It is possible to judge whether or not the abnormality of the subsidiary diagnostic equipment is abnormal.

FIG. 4 is a flow chart for explaining a method for supporting clinical decision support of chronic lung disease according to an embodiment of the present invention. The CDSS algorithm includes the check terminal 10, the public terminal 20, and the portal server 40, And preferably can be performed in the check terminal 10 in which the user can manage his / her health every day.

Referring to FIG. 4, first, a query related to a main symptom is provided to a user. , Or may be provided as a voice through a screen of the check terminal 10 or a speaker (S1). Related inquiries on the main symptoms may include, for example, whether the current breath feels colder than usual, whether the amount of sputum has increased compared to usual, whether the color of sputum is thicker than usual, and the like.

The user then enters an answer to acknowledge or deny that there is a major symptom (S2). Depending on how many "YES" are entered in the answer to acknowledge the main symptom, the action is different for the user.

First, when there are two or more "YES" answers to acknowledge the main symptom, the user is recommended to visit the patient (S3). Like the query method, it is possible to make recommendations through display or sound.

If the answer is YES, which indicates that there is a main symptom, the user checks whether the oxygen saturation value is 87 or less (S4). If the oxygen saturation is equal to or less than 87, the user is advised to perform on-site treatment (S3). If the oxygen saturation is greater than 87, the diagnostic result of the elapsed observation is issued (S5).

Finally, if there is one "YES" answer that acknowledges the presence of a major symptom, then a secondary query related to the symptom of the care is provided (S6). Here, the secondary query related to the attention symptom may be configured to include whether or not a cold symptom has occurred, whether the breathing has become rougher, whether or not the cough has become worse, whether or not the neck is sore, and the like.

If there is more than one symptom of attention (S7) as a response to the secondary query (S3), it is advised to treat the patient (S3). If there is no sign of attention, it is determined whether the FEV1 decrease or the oxygen saturation is less than 87 ).

As a result of the judgment, if the FEV1 is determined to be decreased or the oxygen saturation is less than 87, the on-site treatment is recommended. Otherwise, the condition is deteriorated (S9).

The decrease determination of FEV1 will be described with reference to the flowchart shown in Fig.

Referring to FIG. 5, first, a reference value for FEV1 is calculated (S11). The reference value is the average value of the value of less than 80% of the maximum value among the maximum FEV1 values for each day for a predetermined period.

Next, the reference is applied differently according to the size of the reference value (S12).

First, when the reference value is 1.5 liters or more, the FEV1 maximum value (M_FEV1) measured on the same day is less than 60% of the reference value (S13).

If the reference value is 1 to 1.5 liters, the FEV1 maximum value (M_FEV1) measured on the same day is smaller than 20% of the reference value plus 0.6 liters (S14).

If the reference value is less than 1 liter, if the FEV1 maximum value (M_FEV1) measured on the same day is less than 80% of the reference value (S15), the FEV1 decrease is determined (S16).

The maximum value of FEV1 is determined to be the largest among the repeated FEV1 values measured on the same day.

While the embodiments of the present invention have been described, it will be understood by those skilled in the art that modifications may be made without departing from the spirit of the invention.

For example, a person skilled in the art can understand that the reference value (the number of YES) to be a branch disclosed in the flowcharts of Figs. 4 to 5 is not limited to the number shown, and may be changed to an appropriate number depending on the operator.

Therefore, it should be understood that the scope of the present invention covers the technical ideas and equivalents of the present invention described in the claims.

Claims (10)

In the clinical decision support method of chronic lung disease,
Providing a check terminal distributed in a residential space or a public terminal provided in a public space shared by a local resident to provide the examinee with at least three primary inquiries on the main symptom;
Receiving the YES (YES) or NO (NO) of the primary query from the examinee by the check terminal or the public terminal;
If the check terminal or the common terminal is YES or more, the diagnosis result recommending the visit is obtained;
Measuring the oxygen saturation of the subject through the diagnostic equipment connected to the check terminal or the public terminal when the number of instances of the primary query is less than the second criterion;
If the number of cases is less than the first criterion but is greater than the second criterion, the check terminal or the public terminal may provide the subject with at least one secondary query for attention signs;
Receiving, by the check terminal or the common terminal, the YES or NO of the secondary query from the subject; And
Wherein the check terminal or the public terminal derives a diagnosis result recommending the visit if the example of the second query is the third reference or more and if the example of the second query is less than the third reference, And collecting the data. The method for supporting clinical decision support for chronic lung disease.
The method according to claim 1,
Wherein the check terminal or the public terminal derives a diagnosis result recommending an inpatient when the measured oxygen saturation is equal to or less than a predetermined discrimination value and derives a diagnosis result of the transitional observation when the oxygen saturation exceeds the predetermined discrimination value Wherein the method further comprises the step of:
The method according to claim 1,
If the number of instances of the secondary query is less than the third criterion, the biometric data collected through the additional testing device is FEV1 for one second,
Determining whether the check terminal or the public terminal is inclined to decrease the FEV1 for one second; And
Further comprising the step of deriving a diagnosis result recommending an admission if the check terminal or the public terminal shows a tendency of decreasing the forced expiratory volume for one second.
The method of claim 3,
The step of determining the trend of decreasing the FEV1 (FEV1)
For the most recent period of time, the maximum value of the one-second strenuous expiratory volume exceeding 80% of the maximum value for the maximum of 1 second for each day is set as the reference value. Wherein the method comprises the steps of:
5. The method of claim 4,
When the reference value is less than 1 liter, it is judged that the maximum value of the forced expiratory volume for one second on the day is a decrease tendency when the maximum value is less than 80%
If the reference value is more than 1 liter and less than 1.5 liters, it is determined that the maximum value of the forced expiratory volume for one second is lower than 20% of the reference value plus 0.6 liters,
When the reference value is 1.5 liters or more, it is judged that the tendency to decrease is the decreasing tendency when the maximum value of the forced expiratory volume is less than 60% of the reference value for one second on the same day.
The method according to claim 1,
If the number of instances of the secondary query is less than the third criterion, the biometric data collected through the additional testing device is FEV1 for one second,
Wherein the check terminal or the public terminal further comprises the step of repeatedly measuring the forced expiratory volume for one second on the day to store the maximum value.
The method according to claim 1,
The primary query includes:
Whether or not the breath is felt to be colder than usual, whether or not the amount of sputum has increased compared to usual, and whether or not the color of sputum is thicker than usual. Decision support method.
The method according to claim 1,
The secondary query includes:
Wherein the method comprises at least one of the following: whether or not a cold symptom has occurred; whether or not the breath has become rough; whether or not the cough has become worse; and whether or not the neck is sore.
The method according to claim 1,
Wherein the primary query is queried daily or periodically by the user.
The method according to claim 1,
And transmitting the diagnosis result derived by the check terminal or the public terminal to an external medical management server.

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