CN106326649B - Real-world individual medical auxiliary information interactive conversion platform system based on evidence-based medicine and application - Google Patents
Real-world individual medical auxiliary information interactive conversion platform system based on evidence-based medicine and application Download PDFInfo
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Abstract
The invention relates to a real-world individual medical auxiliary information interactive conversion platform system based on evidence-based medicine, in particular to a medical intermediate information processing category. The invention automatically reads in or imports or inputs data through a Bluetooth or network or performs data input through an instrument and the like, and initializes a detection value based on the obtained first comparison value or second comparison value; the method comprises the steps of obtaining group correction values or individual correction values according to a data conversion method and a data conversion step; finally, the detection report is completed by the computer program for the detection value and the group correction value or the individual correction value thereof. The interaction platform system solves the problem that the group or evidence-based medicine cannot be matched with the real-world individual medicine, achieves the real-world individual medicine based on the evidence-based medicine theory, and is preferably used for physical examination, chronic disease screening or intelligent blood pressure device and the like.
Description
Technical Field
The invention mainly establishes a real-world individual medical auxiliary information interactive conversion platform system based on evidence-based medicine, and belongs to the medical intermediate information processing category.
Background
With the development of medicine, evidence-based medical theory has become the dominant place in modern medicine. Evidence-based medicine is evidence-based medicine, belongs to the category of group medicine, and its theory is more suitable for group medicine. The object of real world individuals facing clinicians is not entirely suitable, and the distribution of test information derived from an individual is not exactly the same as that obtained by a population, and some are even quite different. If population medicine based theory is mechanically applied to different individuals in the real world, significant deviations in diagnosis and treatment may result. The consensus that "follow the guideline" is achieved for clinical medicine is therefore well documented.
Further, it is first agreed that the state according to the standard and guideline is based on a group, which is different from the real state of the clinical medicine facing the individual, and the comparison of the information of the group and the real-world individual is different from the state of the analysis interval, and the two information are not in the same interval, specifically can be divided into:
Firstly, the distribution state of the auxiliary information of the group medicine based on the evidence-based medical theory or conclusion is consistent with the distribution state of the individuals in the real world. For example, the systolic blood pressure of human blood pressure is taken as an example, and the distribution interval of the systolic blood pressure of group blood pressure and the systolic blood pressure of real-world individuals is 90-140mmHg. This ideal situation is only a small percentage of the clinical situation.
Secondly, the distribution state of the auxiliary information of the group medical science according to the theory and conclusion of evidence-based medicine is not consistent with the distribution state of the individuals in the real world, which accounts for the vast majority of the clinical situations. It is divided into two cases:
1. The profile of the real world individual is outside the profile according to which the evidence-based medicine is based. The intervals can be consistent or inconsistent, but the normal curve moves left or right in parallel: the real world individual distribution profile moves to the right towards the evidence-based distribution profile, which is manifested in that the upper limit of the individual's distribution is generally higher than the upper limit of the evidence-based distribution profile. For example, the systolic blood pressure of the population is distributed in the range of 90-140mmHg, while the systolic blood pressure of a real-world individual is distributed in the range of 110-150mmHg. The lower limit of the interval representing the individual's distribution state is generally lower than the lower limit of the distribution state according to evidence-based medicine, as the distribution state curve of the real world individual is shifted to the left according to evidence-based medicine. For example, the systolic blood pressure distribution range of the group blood pressure is still 90-140mmHg, while the systolic blood pressure distribution range of a certain real-world individual is 80-110mmHg.
2. The distribution profile of the real world individual is within the distribution profile according to which the evidence-based medicine is based. The distribution interval of the real world individuals varies greatly, but is necessarily within the distribution state curve according to the evidence-based medicine.
Still further, it is secondarily questioned that the basic medical comparison value (i.e., the medical reference range value) of the auxiliary information on which the standard and guideline are based is poorly associated with the real-world individual detection value, and the basic medical comparison value and the real-world individual detection value are not associated with each other. In the clinic, such medical alignment values are divided into a first alignment value (i.e. a conventional population reference value) and a second alignment value (i.e. a conventional individual reference value).
The first comparison value can be classified into three types according to the degree of closeness between the first comparison value and the detection value: firstly, the comparison value and the detection value are directly derived from the same group, and are closely related, so that the comparison value and the detection value are very few in all cases. And secondly, the comparison value and the detection value are only obtained from the same laboratory, or the comparison value is obtained through conversion, verification and the like, and is not directly obtained from the group where the detection value is located, and the comparison value and the detection value are generally related, so that most of the comparison value and the detection value are obtained in all cases. Third, the alignment values are obtained directly from other laboratory or some author reports or machine self-contained alignment values, which may not be related to the detection values, and these are only a few of all cases.
The first comparison value is widely used in clinic, and is mainly used for evaluating the position of individuals in the population state. The method has the advantages that the population platform is good, but the method has the defects that the method cannot be completely matched with real individuals, even in the first ideal situation in the first comparison value, only the abnormal part of the population outside the population range is concerned, the abnormal part of the individuals in the normal range of the population is not considered, the position of the individuals changing under the real state of the individuals cannot be estimated, and the method cannot be directly used for real-world individuation medical practice.
The second comparison value is less clinically used than the first comparison value, and is mainly used for evaluating the position of the individual itself changing in a real historical state. In terms of real individuals, the second comparison value is used for comparison with the detection value, so that the comparability is stronger, the actual situation of the individuals is more met, and the difficulty is brought to the mutual comparison among the individuals.
The second comparison value has the advantage of being completely matched with the real individual, and the problem of comparing the real individual with the real individual is solved well. But the disadvantage is the lack of a uniform common platform that is comparable to each other in existing populations, so that individuals are difficult to compare to each other. And only pays attention to abnormal parts outside the range of the individuals, and cannot distinguish whether the abnormal parts are in the normal range of the group. Nor does it consider the abnormal parts of the population that are within the normal range of the individual, the location of the individual in the population state cannot be assessed, nor can it be used directly in real-world evidence-based medical practice.
Furthermore, the final questioning is that the basis of the standard and the guideline is based on the steady state of the normal state of the healthy human body, and the results are obtained from the processing of the detection information of the healthy crowd through a statistical method, and obey the normal distribution theory. However, special attention is paid to the fact that the acquired information is mostly based on the normal steady state or old normal state of a certain time in the past. These do not fully meet the new clinical reality and the clinical state is more due to the abnormal homeostasis of the patient. For example, a hypertension patient who has been treated and adapted for many years is stabilized at about 150/100mmHg, and a series of hypotensive symptoms such as dizziness appear if the value is lower than the above value. The blood pressure at this time is not in a normal steady state but in a relatively stable abnormal steady state of blood pressure. In clinical medicine, the comparison current situation and the comparison basic should be normal and abnormal stable states, or are collectively called as the current stable state, and the comparison of the abnormal stable states is more important and valuable.
It can be seen that this consensus is not beneficial to clinical medicine, it may lead to excessive dereferencing of the common outcome of the population in clinical practice, ignoring consideration of individual differences; referencing the current state of the individual too much, ignoring consideration of its historical state; reference is made to static steady state too much, ignoring consideration of dynamic steady state.
However, whether the steady state is based on a normal state or an abnormal state, whether the steady state is based on a first comparison value or a second comparison value, the requirements of being able to compare both truly transversely to each other between individuals and longitudinally to the individuals themselves cannot be met. To solve this real-world personalized medicine problem. Medical workers have been trying to find a viable solution for many years in the following areas.
First, in examining medicine, it is desirable to try to meet the needs of more people through this platform by improving the effectiveness of the alignment, thereby solving the real-world personalized medical problem. The reference variation value (RCV) and the individual index evaluation proposed in the recent literature are exemplified, but in practice, this is only the quality control and the current state evaluation of the group reference values, and no more reference is made to the comparison of the individual reference values, nor is the comparison of the individuals on a unified platform. And thus the real world personalized medical problem is not addressed. Studies have shown that such individual indices have little alignment value if <0.6, only > 1.6. In practice, the fraction between >0.6 and <1.6 and below <0.6 is in a large proportion. Moreover, some of the test substances are not objectively identical in their own right, and there are inter-individual and intra-individual differences.
Secondly, in the aspect of evidence-based medicine, the theory of evidence-based medicine is widely accepted by people and is attributed to group medicine. It also attempts to solve personalized medical problems by solving a platform for mutual comparisons among individuals: the guidelines for cerebrovascular diseases say that the blood pressure of patients suffering from diabetes mellitus at the same time should be 130/80mmHg, it is apparent that such so-called individualization is actually only a certain kind of phenomenon or "individualization" of a certain population, considering population treatment when another state exists on the basis of a certain state. Therefore, only the problem of small groups is solved, a platform for comparing individuals with each other is not really established, and the problem of real-world individuation medical treatment is not solved.
Thirdly, in the aspect of the newly proposed precise medical concept, as the precise medical is mainly based on genomics research, the individual difference is tried to be reduced, and a unified platform for mutual comparison among individuals is established, so that the real-world individuation medical treatment is realized. However, the phenotype of either genome is different. As long as there is a discrepancy, the precise medicine is still ascribed to the community medicine, but only the refined community medicine. Such precision medicine likewise cannot establish a platform for mutual comparison between individuals, nor does it solve the real-world personalized medical problem.
It can be seen that in either state, the existing clinical medicine model is based on the community medicine as a platform, and does not take real-world individuals into account. The theory of evidence-based medicine on the one hand is well-established, and on the other hand the fact that individuals differ is well-established. The theory of evidence-based medicine and the individual differences are mutually incompatible and cannot be ignored in both aspects. If only population or evidence-based medicine is mainly considered, neglecting to consider inter-individual differences and intra-individual differences, which does not conform to the real world ground truth; on the contrary, if only the differences among individuals and the differences among individuals are mainly considered, the consideration of the population or evidence-based medicine is neglected, and the basic reality of the theory application of the evidence-based medicine is not satisfied. In addition, if only normal steady state is considered, only abnormal steady state is ignored, only normal part of the population value is considered as normal part of the individual, and consideration of abnormal part of the individual in the normal part of the population value is ignored, so that the basic state of the real clinic is not satisfied.
Thus, this existing clinical model is not built on a fair, unified-based platform for lateral comparison between individuals nor for longitudinal comparison of individuals themselves, with the main problem that one lacks a platform for interaction between the population and individuals, and another lacks consideration of different historical states of different individuals. And thus cannot solve the real-world personalized medical problem in the present state.
The invention is established for solving the problem of a unified platform based on meeting both the individual self-evaluation requirement of the real world and the group interaction comparison requirement among individuals under the current steady state.
Disclosure of Invention
The invention aims to solve the technical problem of providing a real-world individual medical auxiliary information interactive conversion platform system based on evidence-based medicine. The method aims at laying a common basis for realizing group and individual interaction comparison through normalized initialization, mapping and inverse normalized interactive conversion processing of data of detection values and comparison values, establishing a technical scheme capable of meeting the self evaluation requirement of real world individuals and the group interaction comparison requirement among individuals, and enabling a program executed by the method in a computer of a device to be used and to be released through an electronic device or a network platform.
The invention aims to overcome the problem that the group or evidence-based medicine is not matched with the real-world individual medicine and solve the mutual basic problem of mutual comparison, and establishes an interactive platform which can assist in realizing the real-world individual medical requirements and can participate in comparison after the selected individual data are converted. Thereby conveniently realizing real-world individuation medical treatment based on evidence-based medical theory.
In order to solve the technical problems, the invention adopts the following technical scheme: the utility model provides a real world individual medical auxiliary information interactive conversion platform system based on evidence-based medicine which characterized in that: the method comprises the following steps:
Data reading, data processing and data display of the detection result data.
The further technical scheme is that the data reading step comprises the steps of reading detection result data obtained by detection through an external storage medium introduction mode, a network introduction mode or a keyboard manual input mode and establishing an individual detection result database.
The further technical scheme is that the data reading step further comprises a first comparison value and a second comparison value obtained through a direct or indirect method, and a comparison information database based on the first comparison value and the second comparison value is built.
The further technical scheme is that the data processing step comprises data initialization processing and data conversion processing.
The further technical scheme is that the data processing step comprises data initialization processing of individual detection result data based on a comparison information database;
The first comparison value and the second comparison value perform data initialization processing on the individual detection result data according to the following initialization formula (A) or (B):
Svp＝(A-Mp)/Sp (A)
Svi＝(A-Mi)/Si (B)
wherein: s vp is a first initialization value;
a is individual detection result data;
M p is the average value of the upper limit and the lower limit of the first comparison value interval, namely the first comparison average value;
S p is the difference between the upper limit and the first comparison mean value of the first comparison value interval or the difference between the first comparison mean value and the lower limit, namely the first comparison difference;
S vi is a second initialization value;
m i is the average value of the upper limit and the lower limit of the second comparison value interval, namely the second comparison average value;
S i is the difference between the upper limit of the second comparison value interval and the second comparison mean or the difference between the second comparison mean and the lower limit, namely the second comparison difference.
The further technical scheme is that the data processing step comprises the following conversion formula (C) for the individual detection result data based on the first initialization value and the second initialization value, or the following conversion formula (D) for the group requirement value or the standard value set by the guideline and the like based on the second initialization value and the first initialization value:
Psv＝[(A-Mi)×Sp/Si]+Mp (C)
Isv＝[(Ap-Mp)×Si/Sp]+Mi (D)
wherein: p sv is the population correction value;
a is individual detection result data;
M p is the average value of the upper limit and the lower limit of the first comparison value interval, namely the first comparison average value;
S p is the difference between the upper limit and the first comparison mean value of the first comparison value interval or the difference between the first comparison mean value and the lower limit, namely the first comparison difference;
i sv is an individual correction value;
A p is a group requirement value or a standard value which accords with the guidelines and other settings;
m i is the average value of the upper limit and the lower limit of the second comparison value interval, namely the second comparison average value;
S i is the difference between the upper limit of the second comparison value interval and the second comparison mean or the difference between the second comparison mean and the lower limit, namely the second comparison difference.
The further technical scheme is that the data display step comprises the step of displaying the detection value, the correction value result and the detection report thereof in a screen output or network output or printing report mode.
The first comparison value refers to a reference value obtained from a normal stable population or a reference value obtained from a sick abnormal stable population, namely a population reference value in the current state.
The further technical scheme is that the second comparison value refers to a reference value obtained by an individual in normal state or a reference value obtained by an individual in abnormal state, i.e. an individual reference value in the current state.
The further technical scheme is that the application of the real-world individual medical auxiliary information interactive conversion platform system based on evidence-based medicine is characterized in that: the intelligent blood pressure meter, the intelligent blood glucose meter and the electronic thermometer are applied to medical detection instruments, are preferably used for traditional instruments and modern wearable products in experience systems in clinical medicine, and can also comprise performance evaluation of medical management systems, performance evaluation of education systems and the like.
The invention has the following four properties and beneficial effects:
The first point is that the detected value, the group correction value or the individual correction value, the initialization value and the like are displayed in the report simultaneously or selectively; the various values described in the report are all intermediate information that is only used by medical personnel for further comparison and processing of conventional medical reports or by criteria of conventional communities, or for further comparison and processing by evidence-based medical guidelines or compliance requirements. To accommodate and facilitate clinical satisfaction of medical personnel to achieve real-world personalized medicine.
The second point is information obtained through the processes of data processing, conversion and the like, and a platform for transverse comparison among individuals or a platform for longitudinal comparison of the individuals are laid. By means of the interactive conversion platform, medical staff can simply and further bridge between evidence-based medicine and individual medicine, and therefore real-world individuation medical treatment is achieved.
The third point is that the group correction value obtained in the new platform is combined with the traditional first comparison value to realize comparison, medical treatment is carried out on the group correction value and the correction value according to the same traditional or clinical standard requirement, and the aim of realizing real-world clinical individuation medical treatment based on clinical standard can be achieved by combining the correlation between the traditional value and the correction value; or the individual correction value obtained by processing the standard-reaching value is combined with the traditional second comparison value to realize the comparison, the medical treatment is carried out according to the same guideline or the individual world correction value and the detection value required by standard-reaching, and the aim of realizing the real-world standard-reaching individuation medical treatment based on evidence-based medicine can be achieved by combining the correlation between the traditional value and the correction value.
The fourth point is that the present invention converts data according to normal distribution principle and rule, especially using multi-element or binary normal distribution theory, so that the converted value does not change the original data attribute.
The inventor utilizes the normal distribution principles to combine clinical application and combines the basic principles of linear conversion, normalization and cross mapping inverse normalization, and proposes and designs the technical scheme for solving the conversion of individual and group data.
Drawings
The invention will be described in further detail with reference to the drawings and the detailed description.
FIG. 1 is a schematic diagram of an apparatus for data processing and conversion thereof based on a first comparison value and a second comparison value in accordance with the present invention;
FIG. 2 is a flow chart of the data processing and conversion thereof based on the first comparison value and the second comparison value of the present invention;
FIG. 3 is a flow chart of the generation of the first initialization value and the second initialization value according to the present invention;
FIG. 4 is a flow chart of individual correction values and population correction values in the present invention;
FIG. 5 is steps involved in the formation of personalized physical examination reports in the present invention;
FIG. 6 is a flow chart of the personalized medical assistance information interaction platform system of the present invention.
Procedure of the illustrations and invention
The following description of the embodiments of the present invention will be made more complete and clear by reference to the figures of the embodiments of the present invention, it being apparent that the embodiments described are only some, but not all, of the embodiments of the present invention. All other embodiments, which can be made by those skilled in the art without making any inventive effort, are intended to be within the scope of the present patent.
In the following description, numerous specific details are set forth in order to provide a thorough understanding of the present invention, but the present invention may be practiced in other ways than those described herein, and persons skilled in the art will readily appreciate that the present invention is not limited to the specific embodiments disclosed below.
The method comprises the following steps:
Data reading, data processing and data display of the detection result data.
Preferably, the step of reading the data includes reading the detection result data obtained by detection through an external storage medium (such as bluetooth, or an instrument, a data transmission line), a network (such as a medical LIS system, a mobile terminal or a cloud server) or a keyboard manual input mode, and establishing an individual detection result database.
Preferably, the data reading step further includes obtaining a first comparison value and a second comparison value by a direct or indirect method and creating a comparison information database.
Preferably, the data processing step includes a data initialization process and a data conversion process.
Preferably, the data processing step includes data initialization processing of individual detection result data based on the comparison information database;
The first comparison value and the second comparison value perform data initialization processing on the individual detection result data according to the following initialization formula (A) or (B):
Svp＝(A-Mp)/Sp (A)
Svi＝(A-Mi)/Si (B)
wherein: s vp is a first initialization value;
a is individual detection result data;
M p is the average value of the upper limit and the lower limit of the first comparison value interval, namely the first comparison average value;
S p is the difference between the upper limit and the first comparison mean value of the first comparison value interval or the difference between the first comparison mean value and the lower limit, namely the first comparison difference;
S vi is a second initialization value;
m i is the average value of the upper limit and the lower limit of the second comparison value interval, namely the second comparison average value;
S i is the difference between the upper limit of the second comparison value interval and the second comparison mean or the difference between the second comparison mean and the lower limit, namely the second comparison difference.
Preferably, the data processing step includes performing data conversion processing on the individual detection result data according to the following conversion formula (C) based on the first initialization value and the second initialization value mapping, or performing data conversion processing on the group demand value or the standard value set for guidelines and the like according to the following conversion formula (D) based on the second initialization value and the first initialization value mapping:
Psv＝[(A-Mi)×Sp/Si]+Mp (C)
Isv＝[(Ap-Mp)×Si/Sp]+Mi (D)
wherein: p sv is the population correction value;
a is individual detection result data;
M p is the average value of the upper limit and the lower limit of the first comparison value interval, namely the first comparison average value;
S p is the difference between the upper limit and the first comparison mean value of the first comparison value interval or the difference between the first comparison mean value and the lower limit, namely the first comparison difference;
i sv is an individual correction value;
A p is a group requirement value or a standard value which accords with the guidelines and other settings;
m i is the average value of the upper limit and the lower limit of the second comparison value interval, namely the second comparison average value;
S i is the difference between the upper limit of the second comparison value interval and the second comparison mean or the difference between the second comparison mean and the lower limit, namely the second comparison difference.
Preferably, the data display step includes displaying the detection report of the detection value and the correction value result thereof by means of screen output or network output or printing report, or transmitting the detection report to a cloud server for storage through a network or transmitting the detection report to a mobile terminal through a network APP information communication platform.
Preferably, the first comparison value refers to a reference value obtained from a population in normal steady state or a reference value obtained from a population in abnormal steady state in a sick state, i.e. a population reference value in the current state.
Preferably, the second comparison value refers to a reference value obtained from a normally steady-state individual or a reference value obtained from a sick, non-normally steady-state individual, i.e. an individual reference value in the current state.
In the following, individual detection result data is also referred to as a detection value.
FIG. 1 is a schematic diagram of an apparatus for implementing the technical scheme of the present invention for data processing and conversion of a detection value based on a first comparison value and a second comparison value, mainly comprising a data input portion, a data processing portion, a CPU device portion, and four portions for result output printing.
The data input part mainly comprises external medium input (such as Bluetooth, or instrument, data transmission line), network input (such as medical LIS system, mobile terminal or APP information communication platform or cloud server) or keyboard manual input.
The data processing part consists of five modules, namely a comparison information database module for generating and establishing a first comparison value and a second comparison value, a data input module for reading data of detection values, a data initialization processing module for processing the read detection values based on the first comparison value or/and data initialization processing based on the second comparison value, a data conversion processing module for acquiring individual correction values and group correction values after data processing, and a display module for displaying the two correction values and related data.
The data result output part mainly comprises an external printer output part, a network outgoing part or a computer screen display output part and the like;
The CPU device portion controls the above-described respective portions so that the system can operate better.
Fig. 2 is a schematic flow chart for implementing the technical scheme of the present invention, wherein the flow chart comprises three parts, and the first part is used for reading detection data, including reading detection current data of a person, reading or obtaining a first comparison value of a current state through statistical processing of detection data of a certain number of groups, and reading or obtaining a second comparison value of the current state through statistical processing of a certain number of historical detection data of the individual. The second part is data judgment processing including that someone detection data acquires a first initialization value based on the initialization of the first comparison value and that someone detection data acquires a second initialization value based on the initialization of the second comparison value, and the third part is data conversion including that someone detection data acquires a group correction value and a group requirement value or a standard value set in compliance with guidelines or the like based on the first initialization value conversion processing and acquires an individual correction value based on the second initialization value conversion processing. The whole flow of the process of obtaining the comparison value, reading the detection value, initializing the data, converting the data and the like can be seen in the figure.
The lower part of fig. 3 is a first comparison value generation and initialization flow, which establishes or extracts a first comparison value and performs initialization in a data processing initialization module: first, a first comparison value database unit is established in the first comparison value database module, and the storage units can acquire data from other laboratories except the first comparison value database unit or from the laboratory of the inspector through verification and analysis of the data, so that the first comparison value is established. However, in clinical practice, data obtained directly from other laboratories is statistically processed to establish a first comparison value or directly references the established first comparison value, but is validated during and before use.
For comparison, the measured value is initialized based on the first comparison value in the data initialization processing module, and the initialization uses the normalization principle, and the expression is written as follows:
S vp＝(A-Mp)/Sp............... (expression 1)
Wherein: s vp is a first initialization value;
a is individual detection result data;
M p is the average value of the upper limit and the lower limit of the first comparison value interval, namely the first comparison average value;
S p is the difference between the upper limit and the first comparison mean value of the first comparison value interval or the difference between the first comparison mean value and the lower limit, namely the first comparison difference;
The second comparison value generation and initialization flow is shown in the upper part of fig. 3, and the second comparison value is established in the comparison value database module. The second comparison value is obtained after statistical processing by using the previous physical examination result by a method similar to the first comparison value generation method, wherein the requirements of the obtaining mode, the laboratory, the examination interval time and the like of the second comparison value generation are specifically described. To ensure stability of the second alignment value generation. After the second comparison value is obtained, the detection value is initialized by using a normalization principle, and the expression is written as follows:
S vi＝(A-Mi)/Si … … … … (expression 2)
Wherein: s vi is a second initialization value;
a is individual detection result data;
m i is the average value of the upper limit and the lower limit of the second comparison value interval, namely the second comparison average value;
S i is the difference between the upper limit of the second comparison value interval and the second comparison mean or the difference between the second comparison mean and the lower limit, namely the second comparison difference.
The left side of fig. 4 is a flow of generating the group correction value, when the detection value needs to be converted into the group correction value, the process is performed on the basis of the first comparison value initialization and the second comparison value initialization, if the first initialization value and the second initialization value are equal, the second initialization value can be substituted into the expression of the first initialization value and expressed for simplification, and the value calculated by the expression is the required group correction value. The conversion utilizes the principles of mapping and inverse normalization, namely, the individuals are mapped to the group, the second initialization value of the individual data is mapped to the first initialization value of the group data, then the values of the corresponding intervals of the group are inversely normalized, and the expression is written as follows:
P sv＝[(A-Mi)×Sp/Si]+Mp … … … … … … … … (expression 3)
Wherein: p sv is the population correction value;
a is individual detection result data;
M p is the average value of the upper limit and the lower limit of the first comparison value interval, namely the first comparison average value;
S p is the difference between the upper limit and the first comparison mean value of the first comparison value interval or the difference between the first comparison mean value and the lower limit, namely the first comparison difference;
m i is the average value of the upper limit and the lower limit of the second comparison value interval, namely the second comparison average value;
S i is the difference between the upper limit of the second comparison value interval and the second comparison mean or the difference between the second comparison mean and the lower limit, namely the second comparison difference.
The right side of fig. 4 is a flow of generating individual correction values, when a group demand value or a standard reaching value set by a guideline or the like needs to be converted into an individual correction value, the first initialization value and the second initialization value are set to be equal on the basis of the first comparison value initialization and the second comparison value initialization, and when the first initialization value and the second initialization value are equal, the first initialization value is substituted into an expression of the second initialization value and the expression is simplified, and a value calculated by the expression is the required individual correction value. The conversion uses the principle of mapping and inverse normalization, wherein a group is mapped to an individual, a first initialization value of group data of a group requirement value or a target value set by a guideline and the like is mapped to a second initialization value of individual data, and then the value of the corresponding interval of the individual is inversely normalized, and the expression is written as follows:
I sv＝[(Ap-Mp)×Si/Sp]+Mi … … … … … (expression 4)
Wherein: i sv is an individual correction value;
A p is a group requirement value or a standard value which accords with the guidelines and other settings;
M p is the average value of the upper limit and the lower limit of the first comparison value interval, namely the first comparison average value;
S p is the difference between the upper limit and the first comparison mean value of the first comparison value interval or the difference between the first comparison mean value and the lower limit, namely the first comparison difference;
m i is the average value of the upper limit and the lower limit of the second comparison value interval, namely the second comparison average value;
S i is the difference between the upper limit of the second comparison value interval and the second comparison mean or the difference between the second comparison mean and the lower limit, namely the second comparison difference.
The diagrammatic representations of fig. 2 to 4 are, firstly, the data storage and the input and reading of data established by means of computer program processing and instructions. The technical scheme according to the invention firstly carries out initialization processing, and then carries out group correction value processing or individual correction value processing according to the requirement. The group correction value is based on the second initialization value conversion processing on the group initialization basis, and the individual correction value is based on the first initialization value conversion processing on the individual initialization basis. Finally, the processed result is directly displayed or printed by the instruction of a computer.
Fig. 5 is a diagram showing steps related to personalized physical examination report, mainly comprising the steps of adding a second comparison value of individuals established by historical detection data of a physical examination system based on a known physical examination system, reading a unified first comparison value, or acquiring the first comparison value by a physical examination person simultaneously, then initializing, and further performing correction value processing. Based on the original report system, the group correction value is increased. Through the platform, the aim of realizing personalized assessment in real-world personalized medical treatment by using unified diagnosis standards is fulfilled.
In clinical use, a doctor can combine other real-world clinical situations and make corresponding judgment and processing by referring to the detection value and the correction value result at the same time:
Firstly, both are not in the comparison interval, if both exceed the upper limit or both are lower than the lower limit, the processing and the judgment are not in any dispute.
And one of the two is not in the comparison interval, wherein if one of the two exceeds the upper limit, or one of the two is lower than the lower limit. One of the two is beyond the upper limit and the detection value is beyond the upper limit, the correction value is in the comparison interval, or the correction value is beyond the upper limit, and the detection value is in the comparison interval. One of the two values is lower than the lower limit and the detection value is lower than the lower limit, the correction value is in the comparison interval, or the correction value is lower than the lower limit, and the detection value is in the comparison interval.
The correction value is in the comparison interval, and the detection value is outside the comparison interval, can be observed in principle first, and the treatment is favored to be temporarily not treated under the condition of careful precautions; the correction value is outside the comparison interval, and the detection value is inside the comparison interval, and the treatment is also favored under the careful assumption while observing in principle.
FIG. 6 is a flow chart of the personalized medical auxiliary information interactive platform system in the patent of the invention, firstly, through data reading, then searching historical data, after judging, two paths of initialization processing are carried out, then, individual correction values or group correction values are obtained through data conversion, and finally, a doctor carries out man-machine judgment on the interactive platform according to standards or requirements. And obtaining the result of comparison on the unified interaction platform to be achieved.
All the processing methods are realized through an instruction program of a CPU (Central processing Unit) system of the computer, and finally, the processing methods are connected with a printer or a network and the like through a communication interface according to computer instructions and selections, and the results are printed and/or issued through the network and the like. The present invention of the above technical solution can be fully implemented by those skilled in the art.
Examples
The following examples describe embodiments of the present invention in detail with reference to the accompanying drawings, wherein two examination results of two patients related to a physical examination system in a personalized medical assistance information interactive conversion platform system based on evidence-based medicine are adopted.
Specific data are shown in table 1, and table 1 is a display format of certain data in the personalized physical examination report.
Example one, one example of a process relating to blood pressure observation: the blood pressure values detected by the first and second people on a certain day are 120/80mmHg, except that the first people have obvious symptoms of hypertension such as headache at the moment, and the second people have obvious symptoms of hypotension such as dizziness at the moment. Blood pressure of both persons is a normative state that is not yet standardized from a general clinical medical concept or from a traditional medical point of view.
TABLE 1
According to the scheme of the invention, referring to the flow of fig. 5 and 6, first, the individual blood pressure comparison value data of the first person and the second person are obtained and established through the existing historical physical examination data or other historical data, the individual blood pressure comparison value data of the first person and the second person are read, and the first comparison value and the second comparison value are obtained through statistical processing from the read historical data of the individual detection result, wherein the second comparison mean value of the first person is 90mmHg, the second comparison difference of the first person is 15mmHg, the second comparison mean value of the second person is 140mmHg, and the second comparison difference of the second person is 15mmHg. Then, the first comparison mean value of the systolic pressure is 115mmHg and the first comparison difference is 25mmHg from the obtained group blood pressure comparison value data and is read, then the first initialization value and the second initialization value are obtained through initializing the detection result data and the first comparison value or the second comparison value, and finally, the group correction value or the individual correction value is obtained through carrying out data conversion processing on the detection value or the group requirement value or the standard reaching value which is in accordance with guidelines and the like and the first initial value or the second initial value, wherein the specific expression is as follows:
One is an embodiment that obtains and applies population correction values: the acquired population correction values are first provided to medical personnel who then compare and process the individual condition with the population medical criteria. When the contraction pressures of the first and second are 120mmHg, the relevant numerical values are read by a computer program and processed by a program read in through a comparison value database module, a data input module, a data initialization module, a data conversion module, a data display module and the like, and the group correction values of the first and second are respectively displayed as follows: the systolic blood pressure state of both a and b can be assessed and treated as a combination of them clinically, assuming a systolic blood pressure standard of >140mmHg for the systolic blood pressure of 165mmHg for the systolic blood pressure of a first, 82mmHg for the systolic blood pressure of a second, or <90mmHg for the systolic blood pressure of a lower blood pressure population. It is particularly emphasized here that the criteria for diagnosis may be ambiguous and variable over time, and that based on such population correction values provided, medical personnel can only randomly perform judgment and decision processing in combination with clinical and varied criteria.
One is to acquire individual correction values and apply practical examples: this is to provide medical personnel with individual correction values obtained to guide the application of guidelines or certain set population target values. These are obtained by establishing guidelines or some set group target value data storage unit, read by a computer program, comprising:
The latest Chinese cerebral apoplexy prevention and treatment guidelines in 2010 are obtained through reading established guidelines or certain set group target value data storage units, and indicate that the acute phase needs to be depressurized when thrombolysis is carried out on patients with the acute phase being more than 180/100 mmHg. Through the above scheme and process, referring to fig. 5 and 6, when both the systolic blood pressure reaches 180mmHg, the corresponding individual correction values of both the systolic blood pressure are respectively: the A had a weight of 129mmHg and the B had a weight of 179mmHg. In clinical thrombolysis, the actual condition and guideline requirements of the individual can be combined, for example, after careful comparison, the first can be made to select depressurization before thrombolysis when the systolic pressure is about 130mmHg or the second is about 179mmHg. The pressure should not be reduced uniformly by 180mmHg, otherwise clinical problems may occur, in this case, the first part is more obvious. It is also noted that guidelines for target values may be indeterminate and variable over time, and that such individual correction values provided can only be randomly determined and processed by medical personnel in conjunction with clinical and guideline changes.
Similarly, when the blood pressure of the ischemic cerebrovascular disease of the diabetes mellitus is more than 130/80mmHg and the contraction pressure of the ischemic cerebrovascular disease of the diabetes mellitus is 130mmHg, the individual correction values of the contraction pressure of the ischemic cerebrovascular disease of the diabetes mellitus and the ischemic cerebrovascular disease are respectively 99mmHg and 149mmHg by comparing an information value database module, a data input module, a data initialization module, a data conversion module, a data display module and the like through processing of a computer program, referring to the figure 5 and the figure 6. In clinical practice, the method can be considered in combination with the actual situation of an individual and the standard reaching requirement of guidelines, for example, the method can reach the standard when the systolic pressure is about 99mmHg or the systolic pressure is about 149mmHg after careful comparison. Rather than uniformly reaching the standard when the systolic pressure is reduced to 130mmHg, clinical problems may occur, as noted above, the guideline for the target value may likewise be uncertain over time, and such individual correction values provided may only be randomly determined by medical personnel in conjunction with the clinical and guideline changes.
Example two, one practical example related to the detection of total white blood cells: through the scheme and the process of the invention, referring to fig. 5 and 6, firstly, individual leukocyte total number comparison value data of first and second people are established through historical physical examination data or historical data, and are read and processed to obtain a leukocyte total number comparison value, wherein the second comparison mean value of first is 4.0G/L, the second comparison difference of first is 1.5G/L, the second comparison mean value of second leukocyte total number of second is 7.0G/L, the second comparison difference of second is 1.6G/L, and then the population leukocyte total number comparison value data which has been established previously is read to obtain the first comparison mean value of 7G/L, and the first comparison difference is 3G/L. From the traditional medical point of view, the total number of white blood cells measured by the first and second people is 8.0G/L, which is in a normal range, and has no special point, but the combined clinical manifestations are completely different in practice.
The clinical manifestations of A are fever, cough for two days, and blood routine examination: the total number of the white blood cells is 8.0G/L, and the population correction value of the number of the alpha white blood cells is 15G/L finally obtained through processing in a comparison value database module, a data input module, a data initialization module, a data conversion module, a data display module and the like and computer program processing, see fig. 5 and 6.
No discomfort exists in clinical manifestation of B, this time, the routine examination of body and blood: the total number of the white blood cells is 8.0G/L, the white blood cells are obtained through processing in a comparison value database module, a data input module, a data initialization module, a data conversion module, a data display module and the like and computer program processing, and the population correction value of the number of the B white blood cells is 9.8G/L finally, see fig. 5 and 6.
The total number of blood cells of both A and B are the same, but the clinical manifestations and the population correction values are different. After careful consideration of comparison, medical staff performs corresponding clinical treatment in combination with individual clinical conditions. This phenomenon cannot be well explained by the conventional first comparison value, which affects and interferes with the understanding and processing of the clinically real state by people, and by means of this numerical processed correction value of the computer program, the diagnosis cannot be accomplished and realized by people, but the problem that the information is not in one platform is solved, so that the diagnosis processing is closer to the real-world individual state. Of course, the comparison value or certain standards can also be changed according to the change of research results of evidence-based medicine and the like, and medical staff can only judge and process correspondingly according to the change and combining with the actual condition of the individual. It can be seen that this correction value serves only as an indication of intermediate information by which the individual's health or disease diagnosis cannot be obtained directly.
The above illustration is that the results after measurement are initialized in two ways by processing in a comparison value database module, a data input module, a data initialization module, a data conversion module, a data display module and the like, and then individual correction values or group correction values are obtained by mapping, inverse normalization and processing according to requirements. It should be noted that these correction values do not allow a direct determination of the diagnosis, but rather can provide a platform by which the comparison can be made under uniform conditions, creating conditions for clinical diagnostic rationality, making diagnosis and treatment easier and more consistent with real-world individual changes. It can be seen that the technical scheme does not relate to determining diagnosis, but is a necessary condition for providing a unified comparison of basis for diagnosis, and is an effective platform for facilitating diagnosis and realizing personalized medical treatment.
The above-mentioned conditions concerning blood pressure and leucocytes are only one of the common examples in medicine, and many aspects are involved in clinical medicine, such as processing of information including body temperature, pulse, heart rate and various biochemical and various detection indexes of vital signs, psychological detection information, and the like are suitable for the scope of the present invention. The related algorithm of the technical scheme can be applied to occasions and states related to existence of reference intervals in other fields, such as performance evaluation of an education system, performance evaluation of a medical management system and various fields with group and individual differences. Preferred experience systems include applications involving traditional instrumentation and modern wearable products. The technical scheme establishes a unified public comparison interaction platform by adding a group correction value or an individual correction value, and uses the technical scheme or the platform for solving the actual problems of real-world individuation medical treatment which are difficult to avoid clinically through a device.
Claims (1)
1. The utility model provides a real world individual medical auxiliary information interactive conversion platform system based on evidence-based medicine which characterized in that: the method comprises the following steps:
Data reading, data processing and data display of the detection result data;
The data reading step comprises a first comparison value and a second comparison value obtained through a direct or indirect method, and a comparison information database based on the first comparison value and the second comparison value is established;
the data processing step comprises data initialization processing and data conversion processing;
the data initialization process is based on the comparison information database to perform data initialization process on the individual detection result data;
The first comparison value and the second comparison value perform data initialization processing on the individual detection result data according to the following initialization formulas (A) and (B):
Svp＝(A-Mp)/Sp (A)
Svi＝(A-Mi)/Si (B)
wherein: svp is a first initialization value;
a is individual detection result data;
Mp is the average value of the upper limit and the lower limit of the first comparison value interval, namely the first comparison average value;
Sp is the difference between the upper limit of the first comparison value interval and the first comparison mean value or the difference between the first comparison mean value and the lower limit, namely the first comparison difference;
Svi is a second initialization value;
Mi is the average value of the upper limit and the lower limit of the second comparison value interval, namely the second comparison average value;
si is the difference between the upper limit of the second comparison value interval and the second comparison mean value or the difference between the second comparison mean value and the lower limit, namely the second comparison difference;
The data conversion processing is that the individual detection result data is subjected to the following conversion formula (C) based on the first initialization value and the second initialization value, and the group requirement value or the standard reaching value set by the evidence-based medical guideline is subjected to the data conversion processing based on the second initialization value and the first initialization value according to the following conversion formula (D):
Psv＝[(A-Mi)×Sp/Si]+Mp (C)
Isv＝[(Ap-Mp)×Si/Sp]+Mi (D)
wherein: psv is a population correction value;
Isv is individual correction value;
ap is a group requirement value or a standard value which accords with the evidence-based medical guideline setting;
Mi is the average value of the upper limit and the lower limit of the second comparison value interval, namely the second comparison average value;
The first comparison value refers to a reference value obtained from a normal steady-state population or a reference value obtained from a pathological abnormal steady-state population, namely a population reference value in the current state;
the second comparison value refers to a reference value obtained by an individual in normal steady state or a reference value obtained by an individual in abnormal steady state in a pathological state, i.e. an individual reference value in the current state.
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