CN101877035B - Based on the electrocardiograph system of goldstandard database - Google Patents
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Abstract
The invention discloses a kind of electrocardiograph system based on goldstandard database, system at least comprises a database subsystem (1) and an application service subsystem (2), at least comprise a goldstandard cardiogram case database (4) and an index data base (5) in database subsystem (1), application service subsystem (2) receives the follow-up ECG data from ECG data source (12); By wave form analysis, feature calculation and index coupling, calculate the Electrocardiographic feature of follow-up, application service subsystem (2) utilizes the Electrocardiographic feature of follow-up to go search index database (5) and cardiogram case database (4), obtain the goldstandard cardiogram case set matched with the Electrocardiographic feature of follow-up, this system also comprises an index configurations subsystem (3), and index coupling subsystem (3) comprises index editing machine (22) and index evaluating tool (23); This system can also comprise an information management subsystem (25), information management subsystem (25) is by scanning " goldstandard " case database (4), construct a causal diagnostic model of sign " feature code → diagnostic code ", application service subsystem (2) utilizes this diagnostic model that Electrocardiographic for follow-up feature is directly changed into diagnostic result.
Description
Technical field
The invention belongs to medical hygiene field, relate to a kind of cardiogram automatic analysis system, specifically, relate to a kind of electrocardiograph system based on " goldstandard " ECG data storehouse.
Background technology
Current medical electrocardiograph all requires to possess cardiogram automatic analysis function, and specifically, electrocardiograph can utilize the automatic measured waveform parameter of the routine analyzer carried, circadian parameters carry out diagnostic classification.Through the development of three more than ten years, traditional cardiogram automatic analysis technology is tending towards ripe, and many external clinical testings prove: the comprehensive reliability that can be reached " 70 ~ 80% " by the GEMarquette 12SL routine analyzer that FDA (Food and Drug Adminstration) is recommended; Be better than the average diagnostic level of general clinician, an outstanding ecg analysis and diagnostic routine, greatly can help doctor, particularly young doctor, understand cardiogram faster and more accurately.But up to the present, machine intelligence still cannot surmount human intelligence, outstanding cardiologist or expert consultation can reach >95% diagnostic reliability, this is on the one hand because the mankind have more perfect learning ability, is that machine cannot obtain cardiologist and to rely whole state of an illness information of concerned patients of decision-making on the other hand.
Along with the development of infotech, the particularly widespread use of the various clinic information system of hospital internal, hospital information system stores a large amount of cardiogram cases, in these widely available ECG data storehouses, be no lack of diagnosis case that is that made a definite diagnosis or that embody expert's wisdom.But up to the present, ECG data storehouse is still one " the knowledge gold mine " not yet excavated, utilize that those have been made a definite diagnosis or through the case of expert diagnosis to obtain expert's wisdom and study expertise, be realize the important method of " expert's level " cardiogram automatic analysis; Also be help young doctor to accelerate the important channel of growing up simultaneously.
So-called " goldstandard " database, refers to by the electrocardiographic diagnosis case of clinical research confirmation or make a definite diagnosis through expert consultation the case database that case forms.Clinical research confirmation means generally include: case dissection, operation, endoscopy, electrophysiologic study, physiology assay etc.Make a definite diagnosis case and refer to the diagnosis case unanimously determined through expert consultation." goldstandard " database, except there are certain requirements on growing number, also has strict demand to the diagnostic classification that case covers; Such as, whole diagnostic codes during database must comprise " AHA/ACC/HRS dissolves the suggestion and clinical practice guide of reading about electrocardiographic criteria " are classified, and the growing number of each classification is no less than 10.
Summary of the invention
The object of this invention is to provide a kind of " goldstandard " cardiogram case database that utilizes to carry out the system of ecg analysis.
For technical scheme is:
A kind of electrocardiograph system based on goldstandard database, this system at least comprises a database subset and to unify an application service subsystem, at least comprise a goldstandard cardiogram case database and an index data base in database subsystem, application service subsystem receives the follow-up ECG data from ECG data source; By wave form analysis, feature calculation and index coupling, calculate the Electrocardiographic feature of follow-up, application service subsystem utilizes the Electrocardiographic feature of follow-up to go search index database and cardiogram case database, obtains the goldstandard cardiogram case set matched with the Electrocardiographic feature of follow-up.
This system also comprises an index configurations subsystem, index coupling subsystem comprises index editing machine and index evaluating tool, user utilizes the amendment of index editing machine as the Characteristics of electrocardiogram code set of case indexing, index evaluating tool utilizes the cardiogram case set of making a definite diagnosis for testing to go coupling goldstandard cardiogram case database, by with make a definite diagnosis comparing of diagnostic result, assess amended indexed set, for being more optimal indexed set through checking, user can submit to and upgrade the index data base in database subsystem.
Application service subsystem comprises application service interface, wave form analysis program, feature extraction program, index matcher, Case inquire program, Comprehensive Evaluation program,
Application service interface receives from ECG data source and the ECG data of a buffer memory follow-up, wave form analysis program carries out signal condition to ECG data, waveform recognition, calculation matrix calculates, the treatment step of rhythm analysis and morphological analysis, obtain the dominant quantitative information about electrocardiographic wave, for waveform measurement parameter, feature extraction program utilizes ECG data and/or waveform measurement parameter, pass through template matches, parameter transformation method, generate waveform feature parameter, index matcher utilizes waveform measurement parameter and waveform feature parameter, calculating ECG characteristic sum feature code, Case inquire program is according to Characteristics of electrocardiogram and feature code search index database, the cardiogram case set that feature matches is obtained from case database, Comprehensive Evaluation program is made a definite diagnosis case to the cardiogram that retrieval returns and is carried out aftertreatment, comprise the collision detection of diagnostic code, wave-form similarity detects, compliance evaluation, priority decisions and Code synthesis, that determines to mate most makes a definite diagnosis case and generates comprehensive diagnos result, application service interface by mate most make a definite diagnosis casebook close and comprehensive diagnos result turn back to user or data source.
Goldstandard cardiogram case database is by the electrocardiographic diagnosis case of clinical research confirmation or make a definite diagnosis through expert consultation the cardiogram case database that cardiogram case forms, clinical research confirmation means comprise: case dissection, operation, endoscopy, electrophysiologic study, physiology assay, make a definite diagnosis case and refer to the diagnosis case unanimously determined through expert consultation.
Index data base is the catalogue created in order to the memory location of quick position cardiogram case, the index of cardiogram case adopts Electrocardiographic feature code indexed set and diagnostic code indexed set, and feature code indexed set carries out index according to the information that one group describes Characteristics of electrocardiogram to case database; Diagnostic code indexed set carries out index according to the statement that a group describes electrocardiographic diagnosis classification to case database.
ECG data source can be an electrocardiograph, also can be a storage file or URL address.
Electrocardiographic feature can be the information about patient, also can be the description about the cardiogram rhythm and pace of moving things or waveform morphology.
This system also comprises an information management subsystem, information management subsystem is by scanning goldstandard cardiogram case database, construct a causal diagnostic model of sign " feature code → diagnostic code ", application service subsystem utilizes this diagnostic model that Electrocardiographic for follow-up feature is directly changed into diagnostic result.
Usefulness of the present invention is:
(1) utilize the knowledge that contains in " goldstandard " cardiogram case database institute and human intelligence to carry out expanding machinery and understand Electrocardiographic ability, the accuracy rate of raising cardiogram automatic analysis; Doctor is helped to understand cardiogram faster and more accurately;
(2) coupling cardiogram query function provided by the present invention, contributes to doctor and learns expert diagnosis knowledge and carry out clinical research;
(3) knowledge excavation provided by the present invention and deduction function, contribute to the development diagnosing electrocardiology.
Accompanying drawing explanation
Fig. 1 is the electrocardiographic diagnosis system schematic adopting coupling cardiogram scheme;
Fig. 2 is the electrocardiographic diagnosis system schematic adopting knowledge acquisition and the scheme of deduction.
Embodiment
Below in conjunction with drawings and Examples, the present invention is described in detail.
A kind of electrocardiograph system based on goldstandard database, this system at least comprises a database subsystem 1 and an application service subsystem 2, at least comprise a goldstandard cardiogram case database 4 and an index data base 5 in database subsystem 1, application service subsystem 2 receives the follow-up ECG data from ECG data source 12; By wave form analysis, feature calculation and index coupling, calculate the Electrocardiographic feature of follow-up, application service subsystem 2 utilizes the Electrocardiographic feature of follow-up to go search index database 5 and cardiogram case database 4, obtains the goldstandard cardiogram case set matched with the Electrocardiographic feature of follow-up.
This system also comprises an index configurations subsystem 3, index coupling subsystem 3 comprises index editing machine 22 and index evaluating tool 23, user 24 utilizes index editing machine 22 to revise Characteristics of electrocardiogram code set as case indexing, index evaluating tool 23 utilizes the cardiogram case set of making a definite diagnosis for testing to go coupling goldstandard cardiogram case database 4, by with make a definite diagnosis comparing of diagnostic result, assess amended indexed set, for being more optimal indexed set through checking, user 24 can submit to and upgrade the index data base 5 in database subsystem 1.
Application service subsystem 2 comprises application service interface 16, wave form analysis program 17, feature extraction program 18, index matcher 19, Case inquire program 20, Comprehensive Evaluation program 21,
Application service interface 16 receives from ECG data source 12 and the ECG data of a buffer memory follow-up, wave form analysis program 17 pairs of ECG data carry out signal condition, waveform recognition, calculation matrix calculates, the treatment step such as rhythm analysis and morphological analysis, obtain the dominant quantitative information about electrocardiographic wave, for waveform measurement parameter, feature extraction program 18 utilizes ECG data and/or waveform measurement parameter, pass through template matches, parameter transformation method, generate waveform feature parameter, index matcher 19 utilizes waveform measurement parameter and waveform feature parameter and other information, calculating ECG characteristic sum feature code, Case inquire program 20 is according to Characteristics of electrocardiogram and feature code search index database 5, the cardiogram case set that feature matches is obtained from case database 4, Comprehensive Evaluation program 21 is made a definite diagnosis case to the cardiogram that retrieval returns and is carried out aftertreatment, comprise the collision detection of diagnostic code, wave-form similarity detects, compliance evaluation, priority decisions and Code synthesis, that determines to mate most makes a definite diagnosis case and generates comprehensive diagnos result, application service interface 16 by mate most make a definite diagnosis casebook close and comprehensive diagnos result turn back to user 11 or data source 12.
Goldstandard cardiogram case database 4 is by the electrocardiographic diagnosis case of clinical research confirmation or make a definite diagnosis through expert consultation the cardiogram case database that cardiogram case forms, clinical research confirmation means comprise: case dissection, operation, endoscopy, electrophysiologic study, physiology assay, make a definite diagnosis case and refer to the diagnosis case unanimously determined through expert consultation.
Index data base 5 is the catalogues created in order to the memory location of quick position cardiogram case, the index of cardiogram case adopts Electrocardiographic feature code indexed set and diagnostic code indexed set, and feature code indexed set carries out index according to the information that one group describes Characteristics of electrocardiogram to case database; Diagnostic code indexed set carries out index according to the statement that a group describes electrocardiographic diagnosis classification to case database.
ECG data source 12 can be an electrocardiograph, also can be a storage file or URL address.
Electrocardiographic feature can be the information about patient, also can be the description about the cardiogram rhythm and pace of moving things or waveform morphology.
This system also comprises an information management subsystem 25, information management subsystem 25 is by scanning goldstandard cardiogram case database 4, construct a causal diagnostic model of sign " feature code → diagnostic code ", application service subsystem 2 utilizes this diagnostic model that Electrocardiographic for follow-up feature is directly changed into diagnostic result.
Embodiment 1:
See Fig. 1.The electrocardiographic diagnosis system of coupling cardiogram scheme is adopted to comprise three subsystems: database subsystem 1, application service subsystem 2 and index configurations subsystem 3.
Database subsystem 1 manages case database 4, index data base 5, feature code storehouse 6, diagnostic code storehouse 7 and feature templates storehouse 8 etc.;
" goldstandard " cardiogram case is store, comprising raw data such as patient information, testing environment information, ECG signal in case database 4;
Index data base 5 is the catalogues created in order to the memory location of quick position cardiogram case, can dynamically increase and decrease by Design case based entity, also can be rebuild by index configurations subsystem 3 pairs of index data bases, case indexing mainly adopts feature code indexed set and diagnostic code indexed set, and feature code indexed set carries out index according to the information that one group describes Characteristics of electrocardiogram to case database; Diagnostic code indexed set carries out index according to the statement that a group describes electrocardiographic diagnosis classification to case database, except recording feature code indexed set and diagnostic code indexed set, index data base 5 also have recorded the Electrocardiographic analysis data of case, as waveform measurement parameter, waveform feature parameter etc.;
Feature code storehouse 6 is the data dictionaries describing Characteristics of electrocardiogram, a characteristic can be the information about patient, such as " male sex " or " age >60 ", also can be the description about the cardiogram rhythm and pace of moving things or waveform morphology, such as " quick sinus rate ", also stores the data dictionary of waveform measurement parameter and waveform feature parameter in feature code storehouse 6;
Diagnostic code storehouse 7 is data dictionaries of electrocardiographic diagnosis classification; The diagnostic code and description recommended in " AHA/ACC/HRS dissolves the suggestion and clinical practice guide (2009) of reading about electrocardiographic criteria " can be adopted;
Feature templates storehouse 8 record can be used for the script of calculating ECG feature, is mainly used to Dynamic expansion Characteristics of electrocardiogram collection.
Application service subsystem 2, undertaken alternately by application service interface 16 and user 11 and ECG data source 12, user 11 mainly refers to doctor, data exchange channel 9 can be Web, also can be special client application, ECG data source 12 can be electrocardiograph, also can be a storage file or URL address, data exchange channel 10 is the communication pipes adapted with ECG data source 12, can be Shared Folders, FTP or open CNC;
Application service subsystem 2 carries out exchanges data by data exchange channel 13 and database subsystem 1, and a typical process is that application service subsystem 2 is by the data in data manipulation language (DML) accessing database subsystem 1; Typical data exchange channel 13 is open CNC;
Application service subsystem 2, inside has two methods logic: goldstandard cardiogram case data library searching logic and the diagnostic logic based on goldstandard cardiogram case database.
Diagnostic logic based on goldstandard cardiogram case database is: application service interface 16 receives from ECG data source 12 and the ECG data of a buffer memory follow-up; Wave form analysis program 17 pairs of ECG data carry out the treatment steps such as signal condition, waveform recognition, calculation matrix calculating, rhythm analysis and morphological analysis, obtain the dominant quantitative information about electrocardiographic wave, are referred to as waveform measurement parameter; Feature extraction program 18 utilizes ECG data and/or waveform measurement parameter, by template matches, parameter transformation method, generates waveform feature parameter, and different from waveform measurement parameter, what waveform feature parameter described is the waveform character information of hiding in cardiogram; Index matcher 19 utilizes waveform measurement parameter and waveform feature parameter and other information, calls feature templates storehouse 8, the feature code that calculating ECG characteristic sum and feature code storehouse 5 adapt; Case inquire program 20, according to Characteristics of electrocardiogram symbol lookup index data base 5, obtains the cardiogram case set that feature matches from case database 4; Comprehensive Evaluation program 21 is made a definite diagnosis case to the cardiogram that retrieval returns and is carried out aftertreatment, comprise the collision detection of diagnostic code, wave-form similarity detection, compliance evaluation, priority decisions and Code synthesis etc., that determines to mate most makes a definite diagnosis case and generates comprehensive diagnos result, and the casebook of making a definite diagnosis mated most to close and comprehensive diagnos result turns back to user 11 or data source 12 by application service interface 16.
Goldstandard cardiogram case data library searching logic: user 11 utilizes data exchange channel 9 by the request of application service interface 16 submit Query, index matcher 19 is according to submitted to query entries, call feature templates storehouse 8, the feature code that calculating ECG characteristic sum and feature code storehouse 5 adapt, Case inquire program 20 is according to Characteristics of electrocardiogram symbol lookup index data base 5, from case database 4, obtain the cardiogram case set that feature matches, these cardiogram cases are turned back to user 11 by application service interface 16.
Index configurations subsystem 3 provides index management and the optimizational function of goldstandard cardiogram case database, its user mainly clinical research personnel;
Index configurations subsystem 3 carries out exchanges data by data exchange channel 14 and database subsystem 1.Typical process is that index configurations subsystem 2 is by the data in data manipulation language (DML) accessing database subsystem 1; Typical data exchange channel 14 is open CNC;
Index configurations subsystem 3 passes through data exchange channel 15 and user 24 interface, user 24 mainly clinical investigators, and data exchange channel 9 can be Web, also can be special client application;
Index configurations subsystem 3 comprises three main modular: feature templates editing machine 21, index editing machine 22 and index evaluating tool 23.
User 24 can create, deletes or revise a Characteristics of electrocardiogram by feature templates editing machine 21, the content of Characteristics of electrocardiogram template mainly comprises the shell script of feature code, feature interpretation and calculating feature, once create or have modified a Characteristics of electrocardiogram, generation dynamic list is carried out the renewal in tracking characteristics template base 8 and feature code storehouse 6 by database subsystem 1;
User 24 can choose the index of Characteristics of electrocardiogram collection as goldstandard cardiogram case database 4 by index editing machine 22, and for any amendment of index, database subsystem 2 can generate a dynamic index list to follow the tracks of the change of index data base 5.
Index evaluating tool 23 utilizes one to go to mate " goldstandard " case database 4 for the cardiogram case set of making a definite diagnosis tested, by comparing comprehensive diagnos result and making a definite diagnosis diagnostic result, assess new indexed set, for one through checking be more optimal indexed set, user 24 can be submitted to, and database subsystem 1 will utilize dynamic index list to upgrade whole database.
Embodiment 2:
See Fig. 2.Compared with the system of embodiment 1, the electrocardiographic diagnosis system of knowledge acquisition and the scheme of deduction is adopted to be add an information management subsystem 25 in the electrocardiographic diagnosis system adopting coupling cardiogram scheme.
Information management subsystem 25 works offline, and by scanning goldstandard cardiogram case database, constructs the Directed Graph Model of " feature code → diagnostic code "; And in database subsystem 1 model of creation database 26, utilize sheet format to store this Directed Graph Model.
Correspondingly, the Comprehensive Evaluation program 21 of application service subsystem 2 is die on, and the substitute is model mapping program 28.
The built-in diagnostic logic based on goldstandard cardiogram case database of application service subsystem 2 changes to: after index matcher 19 exports Characteristics of electrocardiogram code, calling model deduces program 28, Characteristics of electrocardiogram code directly can obtain diagnostic result by model mapping, and diagnostic result turns back to user 11 or ECG data source 12 by application programming interfaces 16.
Claims (7)
1. the electrocardiograph system based on goldstandard database, it is characterized in that: this system at least comprises a database subsystem (1) and an application service subsystem (2), at least comprise a goldstandard cardiogram case database (4) and an index data base (5) in database subsystem (1), application service subsystem (2) receives the follow-up ECG data from ECG data source (12); By wave form analysis, feature calculation and index coupling, calculate the Electrocardiographic feature of follow-up, application service subsystem (2) utilizes the Electrocardiographic feature of follow-up to go search index database (5) and cardiogram case database (4), obtains the goldstandard cardiogram case set matched with the Electrocardiographic feature of follow-up;
Application service subsystem (2) comprises application service interface (16), wave form analysis program (17), feature extraction program (18), index matcher (19), Case inquire program (20), Comprehensive Evaluation program (21)
Application service interface (16) receives and the ECG data of a buffer memory follow-up from ECG data source (12), wave form analysis program (17) carries out signal condition to ECG data, waveform recognition, calculation matrix calculates, the treatment step of rhythm analysis and morphological analysis, obtain the dominant quantitative information about electrocardiographic wave, for waveform measurement parameter, feature extraction program (18) utilizes ECG data and/or waveform measurement parameter, pass through template matches, parameter transformation method, generate waveform feature parameter, index matcher (19) utilizes waveform measurement parameter and waveform feature parameter, calculating ECG characteristic sum feature code, Case inquire program (20) is according to Characteristics of electrocardiogram and feature code search index database (5), the cardiogram case set that feature matches is obtained from case database (4), Comprehensive Evaluation program (21) is made a definite diagnosis case to the cardiogram that retrieval returns and is carried out aftertreatment, comprise the collision detection of diagnostic code, wave-form similarity detects, compliance evaluation, priority decisions and Code synthesis, that determines to mate most makes a definite diagnosis case and generates comprehensive diagnos result, application service interface (16) by mate most make a definite diagnosis casebook close and comprehensive diagnos result turn back to user (11) or data source (12).
2. the electrocardiograph system based on goldstandard database according to claim 1, it is characterized in that: this system also comprises an index configurations subsystem (3), index coupling subsystem (3) comprises index editing machine (22) and index evaluating tool (23), user (24) utilizes index editing machine (22) amendment as the Characteristics of electrocardiogram code set of case indexing, index evaluating tool (23) utilizes the cardiogram case set of making a definite diagnosis for testing to go coupling goldstandard cardiogram case database (4), by with make a definite diagnosis comparing of diagnostic result, assess amended indexed set, for being more optimal indexed set through checking, user (24) can submit to and upgrade the index data base (5) in database subsystem (1).
3. the electrocardiograph system based on goldstandard database according to claim 1, it is characterized in that: goldstandard cardiogram case database (4) is by the electrocardiographic diagnosis case of clinical research confirmation or make a definite diagnosis through expert consultation the cardiogram case database that cardiogram case forms, clinical research confirmation means comprise: case dissection, operation, endoscopy, electrophysiologic study, physiology assay, make a definite diagnosis case and refer to the diagnosis case unanimously determined through expert consultation.
4. the electrocardiograph system based on goldstandard database according to claim 1, it is characterized in that: index data base (5) is the catalogue created in order to the memory location of quick position cardiogram case, the index of cardiogram case adopts Electrocardiographic feature code indexed set and diagnostic code indexed set, and feature code indexed set carries out index according to the information that one group describes Characteristics of electrocardiogram to case database; Diagnostic code indexed set carries out index according to the statement that a group describes electrocardiographic diagnosis classification to case database.
5. the electrocardiograph system based on goldstandard database according to claim 1, is characterized in that: ECG data source (12) can be electrocardiographs, also can be a storage file or URL address.
6. the electrocardiograph system based on goldstandard database according to claim 1, is characterized in that: Electrocardiographic feature can be the information about patient, also can be the description about the cardiogram rhythm and pace of moving things or waveform morphology.
7. the electrocardiograph system based on goldstandard database according to claim 1, it is characterized in that: this system also comprises an information management subsystem (25), information management subsystem (25) is by scanning goldstandard cardiogram case database (4), construct a causal diagnostic model of sign " feature code → diagnostic code ", application service subsystem (2) utilizes this diagnostic model that Electrocardiographic for follow-up feature is directly changed into diagnostic result.
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CN102908135B (en) * | 2012-10-08 | 2015-06-10 | 中国科学院深圳先进技术研究院 | ECG diagnosis system and operating method of ECG diagnosis system |
KR102023991B1 (en) * | 2012-11-12 | 2019-09-23 | 삼성전자주식회사 | Device of transmitting a bio signal, device of receiving the bio signal, and method thereof |
CN104095648A (en) * | 2013-04-07 | 2014-10-15 | 上海联影医疗科技有限公司 | CT (computed tomography) scanning control equipment and CT scanning system |
CN104783782B (en) * | 2015-04-13 | 2017-09-01 | 深圳市飞马与星月科技研究有限公司 | Electrocardiosignal automatic testing method and device |
CN104866724A (en) * | 2015-05-26 | 2015-08-26 | 北京海思敏医疗技术有限公司 | Image-based ECG analysis method and apparatus |
CN105877739A (en) * | 2016-02-25 | 2016-08-24 | 姜坤 | Clinical examination method of electrocardio intelligent analyzing system |
CN109215773B (en) * | 2018-11-16 | 2022-03-22 | 郑州大学第一附属医院 | Daily detection method based on big data |
CN110353664B (en) * | 2019-07-25 | 2022-09-20 | 山东凯迪泰科智能系统有限公司 | Electrocardiogram PQRST wave segmentation method and system |
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