GB2377282A

GB2377282A - Computerised medical database

Info

Publication number: GB2377282A
Application number: GB0103816A
Authority: GB
Inventors: Sanjay Kumar Chugh
Original assignee: Individual
Current assignee: Individual
Priority date: 2001-02-16
Filing date: 2001-02-16
Publication date: 2003-01-08
Also published as: GB0103816D0

Abstract

This application is about a technical innovation to i) develop a database of the following, singly or in combination, in static (or still) and /or dynamic form: graphs, images, tracings, sounds and other recordings (referred to by the acronym GITSO in this document) as applicable to clinical medicine and all its subspecialities and then store them in appropriate format (as relevant to the recording of the test on a suitable website on the internet or on a computer/microchip/device). The innovation also includes the technique of developing intelligent equipment by providing a system to allow linkage of the GITSO database on a computer or website to the equipment used for an investigation by a GITSO output, by comparing various GITSO in the database with that obtained from a patient or subject with the help of a computer program.

Description

A technical innovation to develop a bank of graphs, images, tracings, sounds and other recordings, both static and dynamic (acronym GITSO) related to all branches and subspecialities of clinical and non clinical medicine with capability to compare GITSO outputs from relevant equipment to provide help in diagnosis, research and management of diseases and conditions.

ABSTRACT This patent is about a technical innovation to i) develop a bank of the following, singly or in combination, in static (or still) and/or dynamic form: graphs, images, tracings, sounds and other recordings (referred to by the acronym GITSO in this document) as applicable to clinical medicine and all its subspecialities and then store them in appropriate format (as relevant to the recording of the test on a suitable website on the internet or on a computer/microchip/device). The innovation also includes the technique of developing intelligent equipment by providing a system to allow linkage of the GITSO bank on a computer or website to the equipment used for an investigation by a GITSO output, by comparing various GITSO in the bank with that obtained from a patient or subject with the help of a computer program.

General character This is a technical innovation to provide artificial intelligence to currently available equipment for diagnosis and interventional or operative procedures to treat diseases in clinical medicine or for research and is intended to include vall branches of clinical, and non clinical medicine and their subspecialities as mentioned in claims below.. It is also a technical innovation to provide a bank of GITSO on the internet or on computers or microchips, to be available to physicians, technicians and paramedics like an encyclopedia to help them arrive at a diagnosis as well as provide a list of various management approaches, as well as the outcomes, complications and other relevant information.

Nature In the past, data has been put on some machines but these have been in the form of instructive illustrations, and have been a limited number of selected GITSO as relevant to the technique or equipment in question. It has its limitations of not providing the variations in normal GITSO, including provision for artifacts, as well as providing the various manifestations of a single entity, disease or event in myriad forms. A bank would help provide a wide range of these variations, entities and help provide an exhaustive bank of experience to guide operatore, clinicians, and other users of such systems.

Moreover these GITSO in the past have often been still frames and not live, dynamic and 'same as stored GITSO'. An identification password can be designed to restrict use to authorized personnel as may be considered appropriate by organizations, institutions, governments and others.

Previously, literature from medical and related sciences has been put on the internet, some still images have also been put on the internet as have some GITSO but there is no such proposed large bank of GITSO which would be live, moving, dynamic and'same as the stored GITSO'. For example there is registry data for catheter laboratory procedures available on the internet which describes the procedures and the experience of the operators but it does not provide the actual pictures as recorded in digital moving frames. Hence it cannot be directly compared by a computer programme to identify an exact match to guide the operator with the previous experience both for diagnosis as well as management.

IDEA The proposed technique can overcome these difficulties since the GITSO will be stored in a bank and will be available for direct comparison with an individual case as illustrated below with examples.

For example a particular complex lesion in a coronary artery may have been taken up for an angioplasty procedure. This would require a similar sized, artery with similar configuration to be identified, for the computer to pick it up as a match and provide the details of the previous procedure including difficulties that the previous operators had, steps taken by them to overcome these, complications, management and other relevant information. For example it could pick up information on difficulty with the catheters or wire used and how they succeeded by changing the wire; and again if they used a certain stent did they have a dissection at the end of the procedure and what was the cause of itwas it because the size of stent was too large or because the stent was a particular make ; or whether it was a suboptimal result because of other reasons. Such details could forewarn other operators and even provide them with suggestions for bailout. Since it is suggested that this be also made available online, the operators performance would be supported by the equipment thus acting as an intelligent equipment almost instantly. This would place less reliance on need for extensive training for operators before they can start off on their own in centers where they may be sole operators, or where the back up of other experienced operators is not available. Though this patent application fully appreciates the need for adequate training, the intelligent equipment will supplement the experience especially in small volume centers where a large experience is not available. This would also be especially useful for upcoming new technologies, since it is not always possible for clinicians or other paramedic/technical staff/others to update their training especially when they are in senior positions. Further, this would certainly be very beneficial for those parts of the world where technology may be slow to arrive and opportunities for training are limited.

Another example is related to stress echocardiography. This is a technique of stressing the heart and then taking pictures using ultrasound. These pictures are then stored on the computer and the images at rest are compared with that at stress, in the same phases of cardiac cycle to identify evidence of ischemia which would mean blocked coronary arteries supplying the related aras of heart muscle. This requires significant training. However if there was a large bank of such images and if a match was found for a particular patient where exactly similar image was seen before, then the diagnosis would

be easier, since an expert in the field would have reported on the earlier image stored in the bank.

Stethoscopes have been in use for a long time but clinical diagnoses can be difficult in complex congenital heart disease or other heart conditions. The sounds from a stethoscope could be amplified and sent through a computer or a cellular phone or similar technology to the relevant website on the internet where it can be compared with an appropriate bank of auscultatory recordings or with a bank of phonocardiographic recordings of heart sounds, murmurs and other sounds and identification of the sounds by a computer match can provide a diagnosis or several possible diagnoses.. This may help clinicians/other personnel who are not well trained in diagnosing conditions in certain areas of cardiology such as congenital heart disease. Not only heart sounds but all kinds of sounds that the stethoscope is used to interpret can be evaluated using the bank of sounds stored as a GITSO and provide immediate help in diagnosis or management or other situations since the output is intended to be matched online. For example, this may even be to interpret faint peristaltic sounds if an operator is not sure and other trained personnel are not available to provide guidance..

Best way of putting idea into operation These GITSO would be obtained from relevant literature including books, Journals, videotapes, audiocassettes, CD roms, DVD s and from the archives of recognized institutions. Institutions involved in the practice of clinical medicine will also be requested to prospectively provide GITSO for the purpose of this bank. Each GITSO would have the output as well as related information to qualify such as age, presence of relevant associated diagnosis, risk factors, relevant hardware used if it is a procedure, complications, management provided. The GITSO would be linked to this information.

Using appropriate computer programmes, for example WINDOWS MEDIA or other similar programme for moving images), available on a HP notebook or similar other computers, moving pictures, sounds and music can be stored on a website on the internet as well as on computers. The same technology can be used here. Echocardiograms can be replayed on computers using available programmes on modem computers.

Angiograms can be replayed using DXVIEW OR VIEWSTAR and other programmes.

Similarly electrocardiographic and other graphic traces can be stored on the computer and replayed.

If a patient is studied by one of the equipments for the GITSO and the clinician/operator is not sure of the diagnosis or the specific choice of hardware for performing a procedure, or has any related queries, he could access the bank of GITSO from the relevant computer/microchip/or other suitable site/device or website on the internet. Simple programs can be written to ensure that by the activation/touch of an appropriate button/key/device the computer linked to the equipment in some way, (which may even be through a technology same or similar to that of a cellular phone) would automatically or manually connect to the internet and go to an appropriate section in a website which relates to the appropriate GITSO. Based on the experience contained in these GITSO, a

computer program would seek to identify a matching GITSO to provide the answers. The technology for comparison of images is already available, and is similar to that used for searches on the internet with key words to pick out appropriate literature. Key features can be programmed to ensure that when the computer compares a GITSO data from the GITSO bank, essential features relevant to the GITSO in question for the purpose it is needed are incorporated. For example if a lesion in a right coronary artery is compared with that stored on the GITSO bank, with a view to accessing information on the type of intervention done, relating to details of the angioplasty, it would be important for the computer to find a morphologically similar or appropriate right coronary artery with characteristics such as: similar diameter, similar bends related to the lesion, with similar relationship to side branches, similar diameter of the artery before and after the lesion, similar take off of the artery, similar calcification if present and from a patient of similar age.

An electrocardiogram machine could similarly connect, if required, with the appropriate website bank similarly and by comparison from a previous electrocardiogram stored in a bank, provide a diagnosis or possible diagnoses.

This technology would apply to all related branches of medicine and their related subspecialities. This would, for example also apply to radionuclide imaging of the heart or a CAT scan of the head because these are all included in GITSO referred to above. The application would include application to Surgery, Gynaecology and obstetrics, EarNoseThroat surgery and ophthalmology. Subspecialities of surgery would include: neurosurgery, gastrointestinal, hepatic, neurological, cardiothoracic, orthopedic surgery, and urology. Subspecialities of Medicine would include: neurology, gastroenterology, hepatology, neurology, cardiology respiratory medicine, nephrology, endocrinology, rheumatology, immunology, and forensic medicine. This would also include any specialities not covered in the above including non clinical or paraclinical or preclinical subjects. This would, for example, include pathology, and histopathological slides. The probability of human error can be minimized in these situations as well by the matching capabilities of a computer, equipped with a bank of GITSO on a website or other place on a computer.

FIGURE to illustrate the technology

EQUIPMENT-GITSO OUTPUT--] ] Any kind of equipment related to generation ofGITSO output] !] ] MATCHING BY COMPUTER V] LINK to GITSO BANK-------] I Provides one of the following results 1. Complete match

Claims

2. Partial match 3. No match--FEEDBACK TO INCREASE GITSO INPUTS Also displays information related to GITSO CLAIMS The embodiment of this invention in which an exclusive property or privilege is claimed are defined as follows:

1. That a bank of images, moving pictures, sounds, graphics, tracings and others, called GITSO for the purpose of this proposal, can be made for the various branches of medicine, clinical, and non clinical including its subspecialities.

This bank can be stored on a computer/microchip/other device or on a website or on the internet using available technology.

2. This bank will have the capability to allow comparison of a GITSO generated from an equipment with the GITSO in the bank. The comparison between a desired GITSO under evaluation and those in the bank may be done automatically through the activation of a device/key/button/other or manually. The comparison would entail use of any one of the currently available, computer technologies or any of those which become available in the future. Any of these links may be through wireless technology or through links with cords, or other device/link/technology as relevant. The bank would also display related information stored with the GITSO.

3. The device would have the capability to generate a single answer /diagnosis/solution, or provide multiple solutions/possibilities depending on whether a complete/partial match is generated. In case no match is available, a mechanism to record the situation/event/query may be programmed to help develop the system further, in future, by incorporating the deficient GITSO/relevant information.