JP2007299307A - Program for screening sleep apnea syndrome - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To prevent a traffic accident caused by a sleep apnea syndrome (SAS), by extracting a person with the high risk of the SAS, with high accuracy. <P>SOLUTION: Respective data of inquiry data indicating a reply content based on a questionnaire, health checking data indicating a BMI value and blood pressure, and a driving evaluation point found based on a measured data by digital tachometer attached to a vehicle driven by the objective person, are accumulated respectively in data files 1, 2, 3, using the plurality of persons of drivers as objects. Evaluation points of the inquiry data and the health checking data are found in the every objective person to calculate total points of those and the driving evaluation point. The total points is collated with a prescribed threshold value in the every objective person, and the person with the high risk of the SAS is extracted to prepare a list for the person requested to be examined. <P>COPYRIGHT: (C)2008,JPO&INPIT

Description

  The present invention relates to a program used for extracting (screening) a person having a possibility of sleep apnea syndrome (abbreviated as “SAS”) for an unspecified large number of people.

  Sleep apnea syndrome (hereinafter abbreviated as “SAS”) refers to a symptom in which an apnea is repeatedly caused by airway obstruction during sleep. With this symptom, the heart is unable to take in fresh air during sleep and the blood oxygen level decreases, so the heart works to pump blood with a stronger force. As a result, blood pressure increases, and there is a higher possibility of causing high blood pressure, cardiac hypertrophy, stroke, etc. than ordinary people. It has also been pointed out that blood sugar levels are also poorly controlled and susceptible to diabetes.

  Furthermore, since there is a SAS, sleep during sleep becomes shallow, so that the person may feel strong sleepiness during the day and may interfere with work or study. There is also a report that the incidence of traffic accidents by SAS patients is much higher than that of ordinary people.

  As an apparatus used for determining whether or not it is a SAS, for example, there is one described in Patent Document 1 below. This device measures physiological parameters indispensable for SAS determination, such as heart rate during sleep, breathing and snoring sounds, blood oxygen saturation, and body posture.

JP-A-5-200031

  Examination based on physiological parameters as described in Patent Document 1 is necessary for specifying SAS. If this test reveals that it is a SAS, then appropriate treatment can improve the symptoms and prevent various illnesses and accidents.

  However, since SAS is a symptom that occurs during sleep and the person cannot be aware of it, many people spend their daily lives without recognizing the necessity of undergoing a test even though they are SAS. Such a person cannot improve the poor physical condition caused by the SAS, and there is a risk that serious symptoms such as a stroke and a heart attack leading to death may occur.

  In addition, if there are many people who are driving, such as truck and taxi drivers, train drivers, or people who have a lot of opportunities to drive cars, not only the person himself, There is a risk of a major accident involving people. Therefore, it is necessary to detect the SAS of the driver particularly early.

  In order to prevent traffic accidents caused by SAS, it is considered best to inspect SAS for all drivers. However, this type of test is expensive and it is necessary to restrain the subject to be screened for a long time, so that it is difficult to carry out a wide range like a general medical examination.

  The present invention has been made paying attention to the above-mentioned problems. By extracting a process of extracting a person having a high possibility of SAS from an unspecified number of persons with high accuracy, it is possible to cause a SAS. The purpose is to prevent the occurrence of traffic accidents.

  The program according to the present invention is for causing a computer to perform a SAS screening, and shows the answers of screening subjects to questions about the presence or frequency of the symptoms of a plurality of symptoms observed in a SAS patient. Data, health checkup data including measurement values of obesity level and blood pressure of the screening subject, and data indicating the risk of running state obtained from measurement data obtained by a digital tachometer attached to a vehicle driven by the screening subject , Input means for input; calculation means for obtaining an evaluation point indicating the high possibility of SAS using the three types of data respectively input by the input means for a plurality of screening subjects; Each screening subject corresponds to SAS using the obtained evaluation score Determining means for determining a possibility that, causing the computer to function as each means; output means for outputting a determination result by the determining means.

  In the above, among the data input by the input means, the answer data of the screening target person for the question can be obtained by a questionnaire for each screening target person. As for obesity and blood pressure, data measured in a normal medical examination may be input, but not limited to this, data measured using a simple measuring instrument (body fat measuring instrument, blood pressure monitor, etc.) May be entered.

  Further, the data indicating the danger level of the running state can be obtained by analyzing the measurement data of the digital tachometer. In a preferred embodiment, data based on the amount of change in speed per unit time is used. For example, by counting the number of times the amount of change in speed per unit time exceeds a predetermined threshold, the frequency at which the speed is suddenly changed can be obtained, and that value can be used as the degree of risk.

It is desirable that the evaluation score required for each screening target person is a value that increases as the possibility of SAS increases. In the calculation of the evaluation score, for example, after obtaining an evaluation score by a method corresponding to the data type for each of the three types of data, a total of the evaluation points for each data type is obtained. The determination means determines, for example, a screening target person whose evaluation score exceeds a predetermined threshold value determined in advance as a person who has a high possibility of SAS. In addition, when a sufficient number of screening subjects are gathered and the evaluation points of each subject are distributed in a state close to a normal distribution, screening subjects corresponding to several percent of the entire distribution range are selected. , You may extract as a person with high possibility of SAS.
Further, for each screening target person, based on the evaluation score, the possibility that the target person may be a SAS may be indicated by a specific numerical value (percentage display), or may be determined by classifying into a plurality of classes.

  The output means outputs, for example, a list of screening subjects who are determined to have a high possibility of SAS, classifies data for all screening subjects as a percentage of the possibility of being SAS, or a plurality of levels. Output the divided data. The output may be output to a monitor or a printer, but is not limited thereto, and may be a process of saving data in a storage medium such as a CD-R or a process of transmitting data to an external computer.

In this invention, since the comprehensive determination is performed using the answer data of the screening subject, the medical examination data, and the data indicating the danger level of the driving state of the vehicle driven by the subject, the reliability of the determination is ensured. Can do.
Here, even if the determination is made only with the response of the screening target person, there may be a false answer or a symptom that the medical examiner does not notice. Moreover, even if hypertension or obesity is detected in the medical examination data, those symptoms are not always caused by SAS. Even if the risk of the driving state of the vehicle is high, it cannot be determined that it is due to the SAS because it may simply be due to the driver's temperament.

However, if the screening target person is really a SAS, the evaluation score for two or more data will be high, such as a high evaluation score for the other two data, even if the evaluation score of the response data is low, and the final evaluation The point is also more likely to exceed a predetermined reference value. On the other hand, if the screening subject is not a SAS, even if the evaluation score for a certain data is high, the evaluation score for the other two data is low, and the final evaluation score is likely to be below the reference value. Therefore, according to the present invention, it is possible to make a highly accurate determination as to whether each screening subject has a possibility of SAS.
Each person can also be screened by taking a simple questionnaire or medical checkup and providing output from a digital tachometer attached to the vehicle he or she normally drives. In particular, an excessive burden is not placed on the screening subject.

  According to the present invention, it is possible to easily and accurately extract a person with a high possibility of SAS without imposing an excessive burden on the screening subject. Therefore, by conducting a full-scale examination on the extracted screening subjects, it becomes possible to identify those who have symptoms of SAS and receive appropriate treatment. Occurrence can be greatly reduced.

FIG. 1 shows the configuration of a SAS screening system (hereinafter simply referred to as “screening system”) based on the program according to the present invention.
This screening system is intended for traffic drivers such as trucks, buses, taxis, etc., and individually judges the possibility of each screening subject being a SAS, and picks up a highly likely subject as a subject requiring examination. 3 data files 1, 2, 3, an evaluation score calculation unit 4, a determination processing unit 5, and a result output unit 6 are included. Furthermore, although not shown here, for each of the data files 1, 2, and 3, an input unit that accepts data to be saved, or secondary processing of the input data, and saves it in the corresponding data file The data processing unit and the like are also set in the same system.

The first data file 1 stores the answer data of the subject himself / herself for the questionnaire conducted for the screening subject (hereinafter simply referred to as “subject”). Hereinafter, the data stored here is referred to as “interview data”, and the data file 1 is referred to as “interview data file 1”.
The second data file 2 includes obesity (BMI) and blood pressure measurements extracted from the medical examination data of each subject. Hereinafter, the second data file 2 is referred to as “health checkup data file 2”. Health checkup data can be created from the results of health checkups received by each subject, but is not limited to this, and can be obtained by simple measurements at business sites such as trucks, buses, taxi companies, etc. You can also.

  The third data file 3 stores driving evaluation points of each subject. Although this driving | operation evaluation score is mentioned later for details, it is obtained by analyzing the measurement data of the digital tachometer attached to the vehicle which a subject drives. Hereinafter, this third data file is referred to as “driving evaluation data file”.

The inquiry data file 1 also stores personal information such as the name, sex, and age of each subject person. In any of the data files 1 to 3, each subject person's data includes an identification number unique to that subject person. By this identification number, it becomes possible to take out the data of the same person from the three data files 1 to 3.
In addition, inquiry data and medical examination data may be collected for each subject and stored in one data file.

  The evaluation point calculation unit 4 obtains evaluation points for the inquiry data and the medical examination data for each subject. Furthermore, what added the said driving | operation evaluation score to the total value of these evaluation points is calculated as a "total score." Based on the total score, the determination processing unit 5 classifies each subject into three levels A, B, and C that have different possibilities of being SAS. In this embodiment, the level with the highest possibility of SAS is C, and the level with the lowest possibility is A.

  The result output unit 6 includes list information (hereinafter, referred to as “required subject list”) and all subjects of subjects determined to be C level (including subjects determined to be B level as necessary). The determination result list of the person is created and displayed on a monitor (not shown) or printed using a printer. These lists can be transmitted to an external computer via a communication line (not shown).

Hereinafter, data processing in the above screening system will be described in detail.
2 and 3 show the structure of a questionnaire sheet serving as a data source for the inquiry data. In the questionnaire sheet of this embodiment, the content shown in FIG. 2 is printed on the front side, and the content shown in FIG. 3 is printed on the back side.
On the front side of the sheet, in addition to a column for entering personal information such as name, questions relating to the daily life of the subject (drinking, smoking, exercise habits, sleep) are set. A plurality (18 in this example) of questions are set on the back side. Each question asks whether there are symptoms of sleep or daytime activity that may occur in the case of a SAS. For each question, there are four questions: “No”, “Occasionally”, “Frequently”, “Always”. Stage options are set.

In this embodiment, scores are given in advance to the four choices for each question in FIG. 3 in a predetermined distribution, and the sum of the scores corresponding to the choices selected by the subject is used as an evaluation score for the inquiry data. Yes.
The score for each option gradually increases along the flow of “sometimes”, “well”, and “always”, with 0 being “no”. However, in this embodiment, the distribution of points differs according to the importance of the question. For example, the fourth question with halftone dots, “Family pointed out that breathing has stopped during sleep” represents the symptoms of SAS itself, so there are three options other than “No” A higher score than the question is set.

  In addition, since each question number (2, 3, 10, 12, 13) with a circle is also a symptom that is often observed in patients with SAS, a high score following the fourth question is set. On the other hand, each question with an underlined question number (1, 5, 6, 7, 8, 9, 14, 16) is a symptom that can be recognized not only by patients with SAS but also by general people. A lower score than other questions is set.

  In this example, the above questionnaire sheet is distributed to each target person, and each question item on the front side is specifically written, and for each question on the back side, the appropriate option is marked with a circle. I am trying to get it. The contents of the collected questionnaire sheets are input to the computer while the operator confirms the contents of the collected questionnaire sheets. However, the method of inputting the inquiry data to the computer is not limited to this. For example, the answer to each question in FIG. 3 may be entered on a mark sheet, and the content may be read using a scanner. Moreover, if sufficient security can be ensured, the contents of the answer may be directly input to each target person via the Internet.

  In this embodiment, the questions written on the front side of the questionnaire sheet are handled as reference data, such as referring to them later in the examination of the examiner who needs to be extracted by screening. However, the present invention is not limited to this, and the contents of answers to these questions may be reflected in the evaluation points. For example, if a point is added according to the amount of alcohol consumed or the number of smoking, or if any of the amount of alcohol consumed, the number of smoking, or the sleeping time exceeds a predetermined value, the score corresponding to each question on the back of the seat is increased. Can be considered.

  Next, for the medical examination data, when the BMI value is a value determined to be obese (for example, 25.0 or more) or the blood pressure is a value determined to be hypertension, a predetermined score is given as an evaluation score. Give. If none of the above applies, the evaluation score of the medical examination data is 0.

  Next, the driving evaluation points are calculated by taking the running state data recorded by the digital tachometer into a computer and processing it. The digital tachometer measures the rotational speed of the engine of the vehicle. However, if the rotational speed of the engine increases, the speed naturally increases. Therefore, for convenience, the traveling speed data indicates the traveling speed of the vehicle. May be.

  FIG. 4 shows the travel speed obtained by the digital tachometer in the form of a graph. The graph (1) represents a safe traveling state, and the graph (2) represents a traveling state with a high degree of danger.

In FIG. 4, in the graph of (2), the rate of change in speed at start and stop is significantly larger than that of the graph of (1). In addition, the traveling speed may not be stable and sudden deceleration or rapid acceleration may be observed.
In view of this point, in this embodiment, a portion where a rapid change in the traveling speed is recognized is extracted from the traveling state data obtained by the digital tachometer, the time lengths thereof are summed, and the total traveling time of the total time The driving evaluation score is calculated by converting the ratio to the period to 100%.

FIG. 5 shows the flow of the operation evaluation point calculation process.
In this process, data generated by a digital tachometer attached to a vehicle driven by one subject is sampled every predetermined unit time (for example, 1 second). Note that at the start of processing, the variables T, DC, and K in FIG. 5 are all initialized to 0. On the other hand, DS is an allowable value for the amount of change in travel speed. Specifically, based on data representing a dangerous driving state as shown in FIG. 4 (2) in advance, a predetermined allowable value is obtained for the amount of change in driving speed per unit time, and the value is set in DS. Yes.

  First, in ST101 (ST is an abbreviation of “step”), it is checked whether or not it is sampling of the final data. Since this determination is “NO” at the time of starting the processing, the processing from ST102 onward is performed. move on.

  In ST102, data is sampled. If this sampling value is not zero, the process proceeds to ST104, and the variable T is updated to one larger value. Further, in the next ST105, a change amount ΔS of the current sampling value with respect to the previous sampling value is obtained. When ST104 is executed for the first sampling data, the previous sampling value is set to zero.

  In ST106, the absolute value of the change ΔS is compared with the allowable value DS. Here, if ΔS is larger than the allowable value DS, ST106 becomes “YES”, the process proceeds to ST107, and the variable DC is set to one larger value. Thereafter, the process returns to ST101, and the loop of ST101 to 107 is repeated until the process for the final data is completed.

  When the sampled data is zero, that is, when the vehicle is stopped, ST104 and the subsequent steps are skipped and the process returns to ST102. If the change amount ΔS is equal to or less than the allowable value DS, ST107 is skipped. Thus, the variable T represents the total amount of time while the vehicle is moving. The variable DC represents the total time during which the speed change exceeding the allowable value DS occurs.

  When the processing for all data is completed, ST101 becomes “YES” and the process proceeds to ST108, where the ratio of DC to the total travel time T is obtained, and the ratio multiplied by 100 is stored in variable K. In ST109, the value of K is stored in the driving evaluation data file 3 as a driving evaluation point.

  In this embodiment, the data recorded by the digital tachometer is taken into a computer and the processing of FIG. 5 is performed to obtain the driving evaluation score. However, the present invention is not limited to this. For example, if there is a system that analyzes the driving state data of a digital tachometer in more detail and evaluates safe driving, the evaluation data obtained by the system is input, and the evaluation data is suitable for the system of this embodiment. It may be converted into a driving evaluation score.

FIG. 6 shows the flow of processing by the screening system of this embodiment.
ST1 to 7 are processes executed for each target person. First, in ST1, the interview data of a predetermined subject is read from the interview data file 1. In the next ST2, options selected for each question are extracted from the inquiry data, and the scores corresponding to these are summed to calculate an inquiry evaluation score.

  Next, in ST3, the medical examination data of the same subject is read from the medical examination data file 2. In ST4, based on the BMI and blood pressure values indicated by the medical examination data, 0 points or predetermined scores are set as the medical examination evaluation points.

  Next, in ST5, the driving evaluation points of the same subject are read from the driving evaluation data file 3. In ST6, a total score is calculated by summing up the inquiry evaluation score, the medical examination evaluation score, and the driving evaluation score.

  In ST7, based on the calculated total score, one of the determination levels A, B, and C is set for the subject. In this embodiment, two threshold values P and Q (P <Q) are set in advance for the total score. If the total score is equal to or less than P, it is determined that the level is A, and the total score is P. If it is larger and less than Q, it is judged as B level, and if the total score is larger than Q, it is judged as C level.

When the processing of ST1 to 7 is executed for all the target persons, ST8 becomes “YES” and the processing of ST9 and subsequent steps is executed.
In ST9, subjects whose determination level is B or C are extracted. In ST10, personal information is read from the inquiry data file 1 for the extracted target person, and an examiner list is created. Further, the created list is displayed on a monitor or printed out, or output to an external system via a communication line.

  In the final ST11, a list that associates the scores for each of the three types of data, the overall score, the determination level, and the like is created for all the subjects, and is output in the same manner as ST10. In addition to the processing in ST10 and ST11, it is also possible to print out a sheet for notifying each subject.

In the above embodiment, BMI and blood pressure data are input as the medical examination data. However, the height and weight may be input instead of the BMI, and the BMI may be calculated when setting the evaluation score. . Alternatively, body fat percentage may be input instead of BMI. In addition, when medical examination data is created based on a full-fledged medical examination, data such as blood glucose level and heart rate may be included in the medical examination data.
Further, regarding the question No. 4 in FIG. 3, it is desirable to extract the subject who selects “always” or “well” as an examiner regardless of the overall evaluation score.

It is a functional block diagram of the screening system for SAS set by the program concerning this invention. It is explanatory drawing which shows the structure of the questionnaire used for preparation of inquiry data. It is explanatory drawing which shows the structure of the questionnaire used for preparation of inquiry data. It is a graph which shows a safe driving state and a dangerous driving state in association with each other based on the output of the digital tachometer. It is a flowchart which shows the flow of a calculation process of a driving | operation evaluation point. It is a flowchart which shows the flow of a screening process.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Interview data file 2 Medical examination data file 3 Driving evaluation data file 4 Evaluation point calculation part 5 Judgment processing part 6 Result output part

Claims (2)

For multiple symptoms observed in patients with sleep apnea syndrome, including data showing screening subjects' answers to questions about the presence or frequency of those symptoms, and measurements of obesity and blood pressure of screening subjects Input means for inputting medical checkup data and data indicating the degree of danger of the running state obtained from measurement data obtained by a digital tachometer attached to a vehicle driven by the screening subject,
An arithmetic means for obtaining an evaluation point representing the high possibility of sleep apnea syndrome, using three types of data respectively input by the input means for a plurality of screening subjects,
Determination means for determining the possibility that each screening target person falls under sleep apnea syndrome using the evaluation score obtained by the calculation means,
Output means for outputting a determination result by the determination means;
A program for screening for sleep apnea syndrome that allows a computer to function as each means of.   The program for screening for sleep apnea syndrome according to claim 1, wherein the data indicating the risk level of the running state is data based on a change in speed per unit time.

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