JP2010250780A - Clinical diagnosis support system - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a clinical diagnosis support system suitable for providing medical information for settled diagnosis. <P>SOLUTION: An inherent variation table stores an name of an inspection item for fixed inherent variation type inspection that is an inspection item for confirming development of a disease, and a fixed inherent variation therefor, in association with each other, and stores, in addition thereto, an name of an inspection item for accompanied fixed inherent variation type inspection that is an inspection item for confirming a development condition of the disease, and a fixed inherent variation thereof, in association with the disease. An inspection array table displays all the names of the inspection items for the fixed inherent variation type inspection, and all the names of the inspection items for the accompanied fixed inherent variation type inspection, in association with the disease, as to each disease, sequentially in association with the disease, and displays the fixed inherent variation in association with each name of the inspection item for the fixed inherent variation type inspection, and displays the accompanied fixed inherent variation in association with each name of the inspection item for the accompanied fixed inherent variation type inspection. <P>COPYRIGHT: (C)2011,JPO&INPIT

Description

  The present invention provides clinical diagnosis support for definitive diagnosis that systematically provides disease information, symptom information, and clinical laboratory information as medical information and medical book information as necessary and sufficient information amount for definitive diagnosis. About the system.

1) Medical service The medical service in the medical field consists of clinical diagnosis and treatment. In clinical diagnosis work, a doctor makes a final diagnosis of a final disease by using an interview / medical interview, physical examination, clinical examination, etc. to identify the disease. In the treatment work, the doctor sets an optimal treatment policy corresponding to the disease specified by the definitive diagnosis, and starts a treatment action according to the set treatment policy. Therefore, accurate diagnosis in clinical diagnosis is essential for selecting the optimal treatment policy.

2) Clinical diagnosis work In order to make an accurate diagnosis with a definitive diagnosis, generally, enumerate the disease names (candidate disease names) expected from the patient's symptoms (main complaints, findings), and perform biochemical tests and It is necessary to assemble and execute a plurality of clinical examinations such as image examinations, decode the examination results, and specify diseases from the candidate disease group. That is, a general clinical diagnosis includes three procedures: (1) enumeration of disease names, (2) test assembly, and (3) decoding of test results. In particular, in the interpretation of test results, the results of test result fluctuations (hereinafter simply referred to as “test changes”) were compared with the specific test changes that each candidate disease presents at the time of onset, resulting in a negative test. Diseases are excluded, and specific diseases are selected from those that have a positive test. Therefore, in clinical diagnosis, for all of the candidate diseases listed in the disease name list, it is possible to grasp the tests necessary for definitive diagnosis without compromising the tests and assemble the tests, and the test variation of each test performed is unique to each candidate disease. Matching without fluctuation and omission leads to an accurate diagnosis, which in turn leads to the selection of the optimal treatment method.
Here, clinicians perform the above three procedures based on their own medical knowledge and experience in clinical diagnosis, but it is difficult for one doctor to have all the knowledge in various medical fields. If necessary, refer to the relevant items in the medical book, and refer to other medical information sources such as medical specialized books using the description of the medical book as a clue for matters that cannot be found only in the medical book. I need it. However, it is practically difficult for doctors to accurately acquire information that spreads from medical books to medical specialized books in a short time during clinical diagnosis work. On the other hand, various automatic diagnosis systems that automatically perform such diagnosis work have been proposed, but none of them has yet reached a practical level.

3) Conventional clinical diagnosis support system As a system for supporting the above-described diagnosis work, for example, the following has been proposed.
JP 2001-331581 A JP 2000-123096 A

  Patent Document 1 discloses an automatic diagnosis system that can realize advanced diagnosis and treatment even in a non-specialty field. This automatic diagnosis system uses a computer (client-server system) to diagnose a patient's disease. A plurality of symptoms appearing in the patient and a plurality of diseases that are considered to be possible based on the symptoms. A data storage unit storing a symptom-disease database stored in association with each other and a clinical test database in which clinical test items related to the disease are stored in association with the diseases in the symptom-disease database. The provided symptom is read from the symptom-disease database, based on the disease associated with the read symptom, the clinical test item related to the disease is read, and the diagnosis result by the diagnostic means is displayed.

  Patent Document 2 provides a medical diagnosis system that provides “assistant support to ensure that screening, examination, diagnosis, and treatment that constitute a series of medical actions are performed without errors according to a process that incorporates the results of the latest medical technology, and The task is to provide a “screening support system, diagnosis support system, and medical support system based on keyword analysis that is simple and easy to operate such as data entry and can be used in real time in the medical field” (paragraph 0013 of the same document). , “First storage means for storing data related to disease name and symptom, second storage means for storing information such as disease site, sex, age, medical history, etc., and examination regarding disease name corresponding to the disease name Third storage means for storing related data such as items to be confirmed, findings to be confirmed, and the like, and fourth storage means for storing related data between a disease name and a treatment method for the disease name, Alternatively, input means for inputting two or more symptoms and various data relating to the symptoms as keywords, and access to the first storage means and the second storage means based on the input data input by the input means A search means for searching for one or more applicable disease names and accessing the third storage means to search for a treatment method for the disease, and a disease name searched by the search means is highly likely Listed in order, and if necessary, display means for displaying related information such as items to be examined and findings to be confirmed for each searched disease, and displaying the treatment method for the disease. '' A system is described (Id. 0014).

  Further, in cited document 2, as an embodiment of the invention, “when one or more symptom data is input by an input means, a plurality of those symptom-corresponding disease names are obtained by performing a common set operation of a relational database. “Search and output disease names that reveal symptoms” (in the same paragraph, 0027), “Individual input information such as disease location, findings, sex, age, medical history as well as related data between disease names and symptoms In addition, related data such as items to be examined regarding the disease name and findings to be confirmed corresponding to the disease name are previously built in the system as a relational database, and the disease names searched based on a plurality of symptoms are stored in the individual Based on input information, etc., comprehensively judge and display the names of possible diseases based on the symptoms of individual patients in the order of the most likely ”(see paragraph 0031),“ Related data such as the minimum necessary test items that should be performed in order to finally diagnose a specific disease from among possible names of doctors, laboratory test results to be confirmed, and other findings It is configured to be listed for each listed disease name, thereby preventing diagnosis errors and realizing side-by-side support for screening and diagnostic actions that reflect the results of the latest medical technology etc. '' The point and (paragraph 0032) are described.

4) Problems with conventional clinical diagnosis support systems (non-consideration of onset conditions and associated inherent fluctuations)
However, as will be described later, it is currently impossible to make a definitive diagnosis in about 10% of all diseases using any test method (any test variation). Therefore, even if the conventional clinical diagnosis support system including the above-mentioned Patent Documents 1 and 2 is configured to cover all existing examination items, it is still difficult to apply to a definitive diagnosis. A definitive diagnosis cannot be made by the diagnostic system. In addition, laboratory fluctuations can be classified into fixed and associated eigenvariants, and they can be used for clinical diagnosis from different viewpoints (fixed eigenvariations are used for disease selection and identification, and associated eigenvariations are used for disease selection. The point that can be used for identifying the onset condition in addition to the identification) is based on the knowledge of the present inventor, and conventionally, the examination was performed without particular recognition. In particular, clinical tests are performed using test items that are equivalent to fixed eigenvariable tests to identify the disease. For concomitant eigenvariable tests, an inherent complication occurs for the disease, etc. Confirmation of specific onset conditions has been carried out as a separate test. Therefore, in particular, the accompanying inherent variation is not currently used for clinical diagnosis in the current medical field, and about 80% of the inherent variation corresponding to the accompanying inherent variation is effectively utilized in the clinical diagnosis. Will not be. Of course, the conventional clinical diagnosis support system including the above-mentioned Patent Documents 1 and 2 also considers the disease itself to be diagnosed, but does not consider its onset condition and associated inherent variation at all. That is, about 80% of the inherent variation corresponding to the accompanying inherent variation is not used among all the inherent variations.

  This point will be described in detail. In the conventional clinical diagnosis support system including the above-mentioned Patent Documents 1 and 2, one or more test items are associated with each disease, and the test result of the test item (corresponding to the inherent variation of the present invention). ), The inherent variation of the test item associated with each disease does not take into account the onset conditions for each disease as described above. That is, in any of the past documents known to the inventor, including Patent Documents 1 and 2, the clinical test is divided into a specific test, a non-specific test, and an intermediate test, and the test of the clinical test is performed. There is no disclosure or suggestion that the fluctuation can be divided into a fixed eigenvariation and an adjoint eigenvariation to enable deciphering work. Even when the test variation of the test items used by the conventional clinical diagnosis systems including Patent Documents 1 and 2 is interpreted corresponding to the inherent variation of the present invention, the present inventors have found that the conventional clinical diagnosis support system has During the inherent variation, there is a high possibility that only the test result corresponding to the fixed intrinsic variation is associated with the disease for automatic diagnosis or the like. For example, in the technique of Patent Document 2, a disease name associated with each of a plurality of symptoms is extracted, and the disease name is comprehensively based on individual input information (disease site, findings, sex, age, medical history, etc.). Judgment is made in the order of the most likely judgment, and if necessary, the minimum necessary test items that must be performed to finally diagnose a specific disease from the displayed disease names and finally Although we have disclosed a system that lists relevant data such as laboratory test results and other findings that should be confirmed for each disease name displayed, examination of the examination items associated with each disease is possible even if the disclosure details are examined in detail. The result is merely a test result corresponding to the above-mentioned fixed intrinsic variation, and there is no suggestion about an examination result (corresponding to the above-mentioned accompanying intrinsic variation) that also considers the onset conditions for the disease. Therefore, the technique of Patent Document 2 can be applied to a clinical diagnosis in which it is necessary to finally identify one causative disease in a definitive diagnosis, regardless of whether it is applied to a simple diagnosis such as a screening (health check). That is, the configuration for efficiently and systematically providing sufficient and detailed medical information necessary for clinical diagnosis is disclosed or disclosed to the extent that a person skilled in the art (technical engineers in the medical industry and IT industry) can specify the invention. It is not suggested and is not applicable to actual clinical diagnosis.

  Therefore, the present invention covers medical information on all symptoms, all diseases, and all test items necessary for definitive diagnosis of clinical diagnosis, especially for prevention of oversight of rapidly advanced diseases and serious diseases, etc. While it is possible to comprehensively provide information on candidate diseases according to symptoms in diagnosis, it is possible to comprehensively provide information on test items necessary to make a definitive diagnosis by narrowing down from candidate diseases to causative diseases Therefore, by providing systematically the unique variation information of test items in a manner that allows multiple item comparison studies in association with candidate diseases, even doctors other than specialists can be required in a short time required for actual clinical diagnosis. It is an object of the present invention to provide a practical clinical diagnosis support system for definitive diagnosis that enables the inspection assembly and the decoding of the inspection results.

The clinical diagnosis support system according to claim 1 includes a fixed variation table and a test arrangement display means. The fixed fluctuation table is a test item that can be used for confirming the onset of the disease itself by using the same test result whenever the disease occurs. Stores the test item name of the type test and the fixed eigenvariation, which is an expression indicating the variation content of the test result of the fixed eigenvariable type test when the disease occurs, in association with the disease, and the disease is activated Can be used to confirm the onset condition specific to the disease by using the fact that the same test result is always obtained when the onset condition peculiar to the disease develops. This is an expression that shows the test item name of the associated inherent variation type test, which is a specific test item, and the details of the test result of the associated inherent variation type test when the onset condition specific to the disease occurs A specific variation stored in association with the disease. In addition, the eigenvariation table stores, as the fixed eigenvariation and the adjoint eigenvariation, both subdivided representations of the variation contents of the inspection result of the corresponding inspection item to be the smallest unit, and the fixed A disease name of a disease corresponding to the inherent variation is stored in association with the fixed intrinsic variation, and a combined disease name obtained by combining the disease name of the disease corresponding to the accompanying inherent variation and the onset condition name of the corresponding onset condition Stored in association with the associated inherent variation. On the other hand, the test sequence display means, for each disease, from the inherent variation table, the test item name and its fixed inherent variation of all the fixed intrinsic variation type tests associated with the disease, and all associated with the disease The test item name of the associated inherent variation type test and its associated inherent variation are extracted, and for each disease, the test item name of all fixed intrinsic variation type tests associated with the disease and the test of all associated inherent variation type tests Item names are sequentially listed and displayed on the test sequence display unit in association with the disease, and the test item names of each fixed eigenvariation type test are displayed on the test sequence display unit in association with the fixed eigenvariation, In addition, the inspection item name of each associated eigenvariable type inspection is associated with the associated inherent variation and displayed on the inspection array display unit, and the fixed intrinsic variation is associated with the fixed intrinsic variation. The associated inherent variation is associated with the associated inherent variation (the onset condition specific to the disease for which the associated inherent variation corresponds to the disease name of the disease). Display the associated disease names in association with each other. The test sequence display means further extracts at least two or more of the fixed intrinsic variations for one disease from the inherent variation table and displays them on the test sequence display unit, whereby the two or more of the fixed diseases are listed for the one disease. Enables multi-item comparative study to diagnose fixed natural fluctuations by comparing and examining each other.

  In addition, this clinical diagnosis support system comprehensively stores all disease names, corresponding test items, and their inherent variations in order to prevent omissions about disease names (disease names), corresponding test items, and their inherent variations (ie, , Stores all corresponding test items and all corresponding inherent variations for all diseases), stores only the name of the disease limited to a specific field and the corresponding test item and its inherent variation, and is used for a specific field. Is possible. In addition, the item names of all test items that may be used at the time of diagnosis for each disease name are stored in association with the disease name. For each test item, each disease name is used to eliminate omissions in relation to the disease name. Even if it is not frequently used or special, it is stored without being excluded.

  In addition, in the embodiment, the test sequence display unit is graphically displayed on a user interface (GUI) on the monitor screen, and as a test format table in a tabular format that displays corresponding item names and trends for one disease. Although it is embodied, it is also possible to embody as a format other than the tabular format.

  In addition, the inspection items of the fixed eigenvariation type inspection and the corresponding fixed eigenvariation display in the inspection arrangement display unit are preferably configured so that they are displayed in the order in which a plurality of items are easily compared. That is, for example, each fixed intrinsic variation type test associated with each disease is associated with a rank ID representing a display rank that is the order of high relevance in the multi-item comparison study work (the order in which multiple items are easily compared), With reference to the rank ID, it is possible to display the fixed intrinsic variation type test in the order from the highest display order for one disease in the test sequence table.

  According to a second aspect of the present invention, the clinical diagnosis support system according to the first aspect further includes a symptom storage means for storing a symptom, and a symptom of the onset when the symptom develops for each symptom stored in the symptom storage means. A disease group storage means for storing a candidate disease associated with the symptom, a symptom designation means for designating a specific symptom among the symptoms stored in the disease group storage means, and a symptom designation means When a symptom is designated, candidate disease extraction means for extracting the candidate disease associated with the designated symptom from the disease group storage means, and when a specific symptom is designated by the symptom designation means, The examination item name of the fixed variation type examination item associated with each of the candidate diseases extracted by the candidate disease extraction means and the fixed intrinsic variation thereof, and the accompanying associated with each of the candidate diseases Test item name of the chromatic variation typing and its associated intrinsic variations, respectively, and a specific variation extracting means for extracting from the inherent variation table. The test sequence display means includes the inherent variation extracting means, and when a specific symptom is specified by the symptom specifying means, the inherent variation extracting means is configured to extract the candidate disease extracted by the candidate disease extracting means. For each, extract at least two or more test item names and fixed inherent variations of the fixed variation type test item associated with each of the candidate diseases, and examine the associated variable type test item associated with each of the candidate diseases The item name and its inherent variation are extracted, and the test sequence display means extracts all of the data extracted by the characteristic variation extraction unit on the left side of the test sequence table as the test sequence display unit (test item column in the embodiment). The inspection item names are listed in order from top to bottom, and on the right side of the inspection arrangement table (inspection trend column in the embodiment), the inspection arrangement table The fixed inherent variation and the accompanying inherent variation are listed from the top to the bottom in correspondence with each of the inspection item names listed, and the inspection array display means further lists and displays the inspection array in the inspection array table. Only the disease name of the disease to which the fixed intrinsic variation corresponds is displayed in association with the fixed intrinsic variation, and the associated inherent variation corresponds to the associated intrinsic variation listed and displayed in the test sequence table (the relevant The combined disease name is displayed in association with the disease name of the disease.

  The clinical diagnosis support system according to claim 3 is the configuration according to claim 1, wherein each disease stored in the inherent variation table is a disease that has a differential relationship with the disease and is stored in the inherent variation table. A differential disease storage means for storing a differential disease that is also a related disease in association with the disease, a disease specification means for specifying a specific disease among the diseases stored in the inherent variation table, and a specific disease specified by the disease specification means When a disease is specified, the differential disease extraction means for extracting the differential disease associated with the specified disease from the differential disease storage means, and when the specific disease is specified by the disease specification means, The test item name of the fixed variation type test item associated with the specified disease and its fixed intrinsic variation, and the test item name of the associated inherent variation type test associated with the designated disease In addition to extracting the associated inherent variation from the inherent variation table, the fixed variation type test item name associated with each of the differential diseases extracted by the differential disease extracting means and the fixed specific variation thereof And an inherent variation extracting means for extracting the test item name of the associated inherent variation type test associated with each of the differential diseases and the associated inherent variation from the inherent variation table. The test sequence display means includes the inherent variation extracting means, and when the specific disease is designated by the disease specifying means, the intrinsic variation extracting means associates the designated disease with the disease. At least two or more test item names of fixed variation type test items and their fixed inherent variations are extracted, and test item names of the associated variable type test items associated with the specified disease and their associated inherent variations are extracted. In addition, for each of the differential diseases extracted by the differential disease extraction means, (1 or more) extract the test item name of the fixed variable type test item and its fixed intrinsic variation associated with each of the differential diseases ( At this time, preferably, the test item name of the associated variable type test item associated with each of the differential diseases and its associated inherent variation are not extracted), The inspection sequence display means collects all the inspection item names extracted by the inherent variation extraction means on the left side (inspection item column of the embodiment) as the inspection arrangement display section as the inspection arrangement display section The form is listed in order from top to bottom), and on the right side of the test sequence table (inspection trend column of the embodiment), the test item names listed in the test sequence table are associated with each of the test item names. The fixed intrinsic fluctuations and the accompanying intrinsic fluctuations are aggregated and displayed in an enumerated manner (from top to bottom in the embodiment), while the fixed intrinsic fluctuations extracted for the specified disease (usually, representative ones thereof) That is, the associated eigenvariates that are collected (preferably in the top row) of the fixed eigenvariations relating to the routine examination or the initial examination are listed (preferably at the top) and extracted for the specified disease. (Preferably, representative ones as above) are aggregated and displayed (preferably in the next stage of the fixed intrinsic variation), and the fixed intrinsic variation extracted for the differential disease (for negating the embodiment) (Examination) (preferably in the next stage of the associated inherent variation displayed for the specified disease) and displayed. The test sequence display means further displays only the disease name of the disease to which the fixed intrinsic variation corresponds to the fixed intrinsic variation listed and displayed in the test sequence table, and enumerates in the test sequence table. The associated disease name corresponding to the displayed associated property variation (represented by combining the disease name of the disease with the onset condition of the associated property variation) is displayed in association with it.

  The clinical diagnosis support system according to claim 4, in the configuration of claim 1, further, for each disease stored in the inherent variation table, the test item name of the fixed inherent variation type test and its fixed inherent variation, and the A clinical data storage means for associating and storing the test item name of the associated inherent variation type test and its associated inherent variation, a disease designation means for designating a specific disease among the diseases stored in the clinical data storage means, When a specific disease is designated by the disease designating means, the test item name of the fixed variation type test item associated with the designated disease and its fixed intrinsic variation, and the associated unique associated with the designated disease It includes eigenvariation extraction means for extracting the examination item name of the variable examination and its associated eigenvariation from the clinical data storage means. The clinical data storage means uses the test item name of the fixed eigenvariation type test associated with each disease in the eigenvariation table as the test item name of an affirmative test for confirming the onset of the disease itself. In addition to storing the disease in association with the disease, the inspection item name of the fixed inherent variation type test associated with the disease that becomes the differential disease of the disease in the intrinsic variation table is also confirmed by confirming the onset of the differential disease. As a negative test for denying the onset of the disease itself, it is stored in association with the disease. The clinical data storage means further includes a fixed intrinsic variation of the fixed intrinsic variation type test associated with each disease in the inherent variation table and the fixed intrinsic variation of the examination to be the affirmative test is a disease of the disease A fixed inherent variation of the fixed inherent variation test associated with a disease that is a differential disease of the disease in the inherent variation table, in addition to storing each associated with a name and a test item name of the positive test The fixed inherent variation of the test for the negative test is also stored in association with the disease name of the disease, the test item name of the negative test, and the disease name of the differential disease. When a specific disease is specified by the disease specifying means, the inherent variation extracting means, for the disease specified in the previous period, the test item name of at least two or more affirmative test items associated with the disease and its fixed uniqueness In addition to extracting the variation, in addition to extracting the test item name of the associated variable type test item associated with the designated disease and its associated inherent variation, the negative test item associated with the disease (usually these In addition to the test item name of the whole body test item) and its fixed intrinsic variation, the test sequence display means is located on the left side (test item column of the embodiment) of the test sequence table as the test sequence display unit. In addition, the inspection item names extracted by the eigenvariation extraction means are listed in order from top to bottom, and on the right side of the inspection sequence table (inspection trend column of the embodiment), The affirmative test extracted for the specified disease while listing and displaying the fixed natural variation and the accompanying natural variation from the top to the bottom corresponding to each of the test item names listed in the test sequence table A set of fixed eigenvariations (usually representative of them, i.e., particularly positive tests of fixed eigenvariations for routine or initial tests), preferably (in the top row), and The contingent eigenvariations (preferably as described above, representative) extracted for the specified disease are aggregated and displayed (preferably in the next stage of the fixed eigenvariation at the top level), and the designated The negative tests extracted for the disease are aggregated and displayed (preferably at the next stage of the associated eigenvariation displayed for the specified disease). The inspection sequence table display means further includes a positive test type symbol indicating the positive test in the test item name of the positive test in the test sequence table, and the negative for the negative test. A negative inspection type symbol indicating inspection is attached and displayed.

  Preferably, the clinical data storage means stores, as a test to be stored, an affirmative test consisting of a fixed intrinsic variable test for confirming the onset of the specified disease itself associated with the specified disease, and the related to the differential disease of the specified disease In addition to a negative test consisting of a fixed intrinsic variation test for the differential disease itself, test items other than the positive test and the negative test item are stored as whole-body test items. That is, the test item name of the whole body test is stored in association with the corresponding disease, and the inherent variation is stored in association with the test item and the disease. In addition, the clinical data storage means may further include the fixed inherent variation of the fixed inherent variation test associated with each disease in the inherent variation table and associated with the fixed inherent variation of the test that becomes the positive test. In addition to storing the disease name of the disease in association with the disease name of the disease and the test item name of the positive test, the fixed characteristic associated with the disease that becomes the differential disease of the disease in the inherent variation table The fixed intrinsic fluctuation of the variable examination and the fixed intrinsic fluctuation of the examination that becomes the negative examination are also stored in association with the disease name of the disease and the examination item name of the negative examination. Then, the test sequence display means extracts the test items and inherent variations associated with the designated disease from the clinical data storage means, and displays them in the test sequence table as they are.

  The clinical diagnosis support system according to claim 5 is characterized in that, in the configuration of claim 4, when the specified disease is diagnosed by an exclusion diagnosis method, the inherent variation extracting means determines each of the differential diseases of the disease. The associated inspection item for negative and its fixed inherent variation (usually, the whole body inspection item and its inherent variation) are extracted, and the inspection sequence table display means is extracted by the inherent variation extracting means. The inspection items for negative are listed and displayed in the inspection sequence table. That is, in this case, preferably, when the specified disease is diagnosed by the exclusion diagnosis method, the inherent variation extracting means is the negative test item associated with each of the differential diseases of the disease and the whole body Only inspection items and their respective fixed inherent variations are extracted, and the inspection sequence table display means lists and displays only the inspection items extracted by the inherent variation extraction unit in the inspection sequence table. That is, when there is no test item for affirmation regarding a disease, the disease is diagnosed by the exclusion diagnosis method. use. It is preferable to use biochemical tests as negative test items to cover as many denials of all diseases as possible as test items at this time. It is difficult to do so, so the shortage should be compensated with a systemic examination. Here, the user can diagnose a disease (candidate disease) when all negative test items and / or whole body test items are negative and the negative test items and / or whole body test items are positive. By denying all of the differential diseases, the existence of the only remaining disease is estimated (exclusion diagnosis method).

  In the clinical diagnosis support system according to claim 6, in the configuration of claim 4 or 5, a symptom storage means for storing a symptom, and for each symptom stored in the symptom storage means, an onset occurs when the symptom develops A disease group storage means for storing a candidate disease that is a suspected disease in association with the symptom, a symptom specification means for specifying a specific symptom among the symptoms stored in the disease group storage means, and the symptom specification means Candidate disease extraction means for extracting the candidate disease associated with the designated symptom from the disease group storage means when a specific symptom is designated. The clinical data storage means further stores, as the examination item, the item names of all existing examination items and the item IDs for uniquely identifying the examination items, and among the examination items, A general-purpose test item consisting of a biochemical test (with a specific biochemical test as the main component test) is stored in association with the specific item ID, while a specific item ID of the general-purpose test item is detected by the general-purpose test item Store in association with the disease name of a possible specific disease. Further, by specifying a specific symptom by the symptom specifying means, after extracting all the diseases associated with the specified symptom, among the extracted diseases, associate with a specific item ID of the general-purpose test item There is provided an overlooked disease extraction and display means for extracting only diseases other than the specified disease and listing the diseases in the test sequence table. That is, the clinical data storage means further stores the item names of all existing examination items in association with the item IDs that uniquely identify the examination items, and the specific data that constitutes a part of the examination items. General-purpose test items centered on biochemical tests are stored in association with specific item IDs, while specific item IDs of the general-purpose test items are stored in association with specific diseases detectable by the general-purpose test items. Further, the missed disease extraction / display means extracts all the diseases associated with the symptom by designating the specific symptom, and is associated with the specific item ID of the general-purpose test item among the extracted diseases. Diseases other than the selected diseases are extracted and listed. In addition, general-purpose test items are tests other than specific tests that become positive only by specific diseases (become abnormal values), and are mainly tests for grasping the general condition, which are made of inexpensive and frequently used biochemical tests. I mean. Then, the clinical diagnosis support system extracts all candidate diseases (all diseases estimated to be present when the symptom occurs) associated with the symptom by the missed disease extraction means by specifying the symptom. At the same time, diseases other than the diseases associated with the general-purpose test item are extracted from the extracted diseases and listed.

  Here, in the test sequence table as the test sequence display unit, the test trend expressing the test variation for each disease and each onset condition is used for each disease using the combined disease name expressing the onset condition together with the disease. Displayed in association with the inspection item. At this time, preferably, in order to provide detailed information on the onset condition and complement the understanding of the user, the disease summary display means displays the inherent co-occurrence of the disease displayed in the test sequence table or the affected organ specific to the disease. Specific description of the onset condition such as the type of disease and the process from the time of onset to the end stage (description to the extent described in medical books and specialized books), the symptoms specified for the display of the test sequence (symptom test) and Each disease (general examination) is extracted from a disease table (not shown) with reference to its symptom ID or disease ID (a table storing the disease summary description in association with each disease and each symptom) Displayed as a disease summary in the vicinity (upper position, etc.).

  The present invention includes a master file such as a disease name master file, a clinical master file, and a disease group master file as each of the storage means described above, which includes a disease name master table, a clinical database (in a relational database), and a clinical Although it corresponds to a master table, a disease group master table, etc., it can of course be embodied in other types of databases such as a hierarchical database and a network database without being limited to a relational database.

  The clinical diagnosis support system according to claim 1 has not been conventionally used for confirmation of the disease itself (used for confirmation of complications related to the disease, affected organs, etc.) It can be extracted and displayed in association with the disease together with the accompanying inherent variation which is the variation in the examination. As a result, in addition to being able to make a definitive diagnosis of the disease name based on the fixed eigenvariation of the fixed eigenvariable test and the associated eigenvariable test, the onset condition of the disease is confirmed by confirming the associated eigenvariation of the associated eigenvariable test And an effective treatment method for the disease can be selected based on the confirmed onset condition. In particular, with the configuration of 1-3) above, the three-dimensional structure data consisting of the three elements of the test item, disease name, and onset condition is converted into the two-dimensional structure ( (Table format) data can be stored in the inherent variation table and displayed in the test sequence table. In addition, for each test item, not only the fixed inherent variation of each disease but also the associated inherent variation are stored in association, and the fixed inherent variation and the accompanying inherent variation are candidates for all the diseases of the candidate disease group belonging to the specified symptom. Detailed medical information on all symptoms, all diseases, and all test items necessary for definitive diagnosis of clinical diagnosis, in order to list and display in association with diseases, especially to prevent oversight of rapidly advanced diseases and serious diseases It is possible to comprehensively provide information on candidate diseases according to symptoms in clinical diagnosis in detailed units. In addition, it is possible to comprehensively provide information on test items necessary to make a definitive diagnosis by narrowing down from candidate diseases to causative diseases, while comparing specific items of test items with candidate diseases to compare multiple items. It can be systematically provided in a manner that can be considered, enabling a non-specialist to be able to perform inspection assembly and interpretation of test results in a short time required for actual clinical diagnosis, and is practical. This is a clinical diagnosis support system for definitive diagnosis. In other words, in the clinical diagnosis procedure that requires a rigorous and precise thought judgment process, in order to prevent the oversight when there is a possibility of suddenly advanced disease or serious disease related to the life of the patient, even a general physician, All possible candidate diseases for each symptom can be envisaged without leaking, including those with low possibility, and test items that can be used to determine the validity of each of these candidate diseases Efficiently understand symptom information, disease information, and test item information, which are medical information for a doctor's definitive diagnosis in clinical diagnosis, so that everything including low-use items can be assumed without leakage And systematically.

  Here, in order to supplement the understanding of the use of the accompanying natural variation, which is one of the central features of the present invention, the onset condition will be additionally described.

  First of all, regarding the onset condition, the main organs that are damaged are different for each patient, but the test results change depending on the time of the disease, and the main symptoms that develop depending on the age of the patient also vary. The required test items vary greatly depending on the onset condition, and the test results also have different trends. In many cases, there are multiple onset conditions even for one test item of one disease. As a result, the system becomes complicated if there are an extremely large number of onset conditions, and it is difficult to construct a system for acquiring necessary information only by using the disease name and the test name as IDs. It is. However, each test variation is created and expressed as a basic unit (maximum subdivided expression unit) with the combined disease name combining the onset condition and disease name of the minimum unit for each disease, and stored in the eigenvariation table. Examination fluctuations for each disease, which includes an enormous variation, can be easily extracted from the intrinsic variation table to perform computer operations such as processing and display.

  As for the onset condition, the onset organ name (inherent complication) representing an organ in which the disease is likely to occur is the majority. As for the onset organ names, organ names that are likely to coexist for each disease are specified in medical books, and based on this, the relationship between the disease and the onset organ name can be investigated and covered without leaking. In addition, the examination items required for each organ are also established in the clinic. Therefore, the relationship between the onset organ name (inherent comorbidity) for each of these diseases and the test item (incident eigenvariation type examination) for examining the onset of the onset organ name is also investigated in medical books and specialized books. Can be covered without leaking. Similarly, other onset conditions can be covered without being leaked by investigating the onset conditions themselves in medical books or specialized books. However, the fact that these test items can be used as test items for the disease is not the conventional knowledge but the inventor's unique knowledge, and a combined disease name is created from the onset condition and the disease name, and the combined disease It is not a conventional finding that the associated inherent variation which is the variation content of the test result of the disease when the onset condition develops by name is used to identify the onset condition of the disease in association with the disease. Unique knowledge. In other words, the conventional medical community has no idea or knowledge of associating test variation (associated inherent variation) for each combined disease name, and therefore, the inherent variation that can be stored in the inherent variation table and displayed on the test sequence table. The numbers are orders of magnitude that are not found in traditional medical information sources such as traditional medical books and specialist books, with the addition of contingent eigenvariations that will account for a major proportion of them.

  In addition, as for the onset conditions, for example, in the case of rheumatoid arthritis, joint (joint pain), muscle (stiffness), lung (dyspnea), heart (chest pain), kidney (chronic nephritis), cervical vertebra (neck pain), skin (Ulcers), subcutaneous (mass), spine (rectal bladder paralysis), and other various organs. In addition, since each of them does not appear all but develops alone, even in the same disease, examination trends vary depending on cases. Furthermore, the examination trend for each disease easily fluctuates under various onset conditions, for example, the examination trend easily changes even in the case of an inherent complication that tends to occur at the same time. In this way, even in the same disease, it is a common clinical image of clinical medicine that develops as various medical conditions depending on the case. Therefore, as in the past, necessary tests based on the disease name (based only on the disease name) By selecting an item and confirming the test results, the diagnosis name can be specified, but the onset condition of the disease cannot be specified at all, and a treatment policy for each onset condition required for treatment is determined. Can not do. Conventionally, when an onset condition such as an inherent complication occurs, for example, when an intrinsic complication occurs in an inherent organ, the onset condition is confirmed based on the inherent complication (name of the disease) for the first time. Inspection items are selected. On the other hand, the present invention confirms the onset conditions of each disease (inherent complications etc.) in addition to being associated with fixed inherent variation for confirming the onset of each disease (identifying the diagnosis name) for each disease. Associated with each other, and is displayed in the same test sequence, so it is possible to assemble a test that can confirm the diagnosis name and onset condition from the test sequence table at one time. The examination can determine the name of the diagnosis and the onset condition and determine an effective treatment policy.

  In addition, regarding the onset condition, even in the same disease, it varies depending on the stage (eg, the test value increases at the beginning, decreases in the advanced stage, etc.), and varies with the occurrence of specific inherent complications (eg, carditis, hepatitis, Nephritis / hemolysis, etc., develops in multiple organs, varies from organ to organ (eg, pulmonary tuberculosis / tuberculosis pleurisy / renal tuberculosis / intestinal tuberculosis), varies by etiology (eg, various pneumonia depending on the type of bacteria) Depends on the type (subtype) (eg, various congenital enzyme deficiencies depending on the type of defective enzyme), and varies depending on the type of the underlying disease (eg: hyperviscosity syndrome, etc.) Even in a single disease, such as a disease that develops by developing a disease, the inherent variation easily varies depending on the onset condition. Moreover, it is not sufficient to simply identify an organ or the like, and in many cases, further subdivision is required. For example, even if the inflammation of the heart is the same, the examination method and treatment method are completely different depending on the inflammation site, such as the outer surface of the heart, the inner surface of the membrane, the muscles, multiple of them, etc. One disease, such as myocarditis and carditis, is identified by subdividing it to the smallest unit with the name of the combined disease created for each onset condition, and stored in the eigenvariation table.

  In addition, for the combined disease name formed by combining the onset condition with the disease name, the present invention expresses the examination trend while always associating the three types of data items of the onset condition, the disease name, and the examination item. The combined system name is combined with the name to simplify the overall system configuration. Then, as the expression of “test trend” stored in the inherent variation table and displayed on the examination sequence table, the expression ““ bond disease name ”is“ ** inherent variation ”” is used. That is, a sentence expression such as ““ bond disease name ”is“ ** inherent variation ”” ”is used as one data (one field), and the disease name corresponding to the“ test trend ”column (data item) of the inherent variation table. And the inspection item are stored in association with each other. In this case, disease name + test item name + test trend is one record. Then, the inspection trend is displayed as it is in the inspection trend column of the inspection arrangement table. However, it may be data obtained by dividing the “bond disease name” and “** inherent variation” of the test trend. In other words, the “binding disease name” portion is set as one data (one field), and the “** inherent variation” (examination variation or inherent variation) portion is defined as one data (one field). Can be stored in association with the corresponding disease name and test item, respectively.

  In addition, for a connected disease name, for example, if the disease name is “**”, the expression of the connected disease name is simply “**” when there is no onset condition (unconditional), and an inherent complication occurs ( In the case of a disease (with onset conditions), ** carditis, ** renal failure, ** cholangitis, etc., the disease name “**” is followed by a specific complication and the disease such as tuberculosis that develops in multiple organs. In the case of a disease such as pneumonia, the organ name is added before and after the disease name “**”, such as “pulmonary tuberculosis”, “tuberculous pleurisy”, “renal tuberculosis”, etc. Congenital enzyme deficiency, which is expressed by concatenating the pathogenic bacteria name and disease name “**” with the word “sex”, such as “pneumonia” and “S. aureus pneumonia” In the case of diseases such as symptom, “Glycogenosis (all types)”, “Glycogenosis (muscle type)”, “Glycogenosis (liver, systemic type)” After the name “**”, the disease type is linked and expressed by type. In cases where the underlying disease is a multistage disease such as hyperviscosity syndrome, “cryoglobulinemia (hepatitis virus / contagious Mononucleosis hepatitis, hepatitis viral rapid progressive nephritis, pulmonary renal infarction concomitant endocarditis), etc. "via the parenthesis" (...) "after the disease name" ** " The disease name of the disease is connected and expressed. If this transit primary disease is a disease with multiple stages, the name of the disease after “(...)” may be two stages, in this case, it indicates that the disease has developed through three stages of the disease. .

  Since the clinical diagnosis support system according to claim 2 displays each disease in association with two or more test items in addition to the effect of claim 1, two or more test items corresponding to the inherent variation associated with each disease As a result, each disease and its inherent variation are displayed in association with two or more test items. Therefore, the inherent variation of each disease can be confirmed for two or more displayed test items, and a multiple item comparison study can be easily performed for each disease. Specifically, according to the configuration of claim 2, at least two or more fixed variation type test item names and fixed inherent variations associated with the disease are extracted for each of the candidate diseases, and the two or more fixed variations are extracted. The inspection item name of the type inspection item and its fixed inherent variation are displayed in the inspection arrangement table. At this time, the disease name of the candidate disease is displayed in association with each fixed intrinsic variation. Accordingly, the disease names of the same candidate diseases are displayed in association with the fixed intrinsic variation at least at two or more locations in the fixed intrinsic variation display portion of the test sequence table. In addition, for each candidate disease, the name of the associated variable type test item associated with the disease and its fixed intrinsic variation are also extracted, and the test item name of the associated intrinsic variation type test item and its associated intrinsic variation are also extracted. It will be displayed in the test sequence table. At this time, a combined disease name obtained by combining the disease name of the candidate disease and the onset condition of the associated inherent variation is displayed in association with each associated inherent variation. Therefore, the disease name of the same candidate disease is displayed in association with the associated inherent variation in the display portion of the associated inherent variation in the test sequence table. Therefore, in two or more places in the test sequence table, for the same disease, it is possible to confirm the disease name displayed in association with the fixed intrinsic variation of the disease, in addition to being able to reliably conduct a multiple item comparison study, For the same disease, it is possible to confirm the disease name portion in the combined disease name displayed in association with the accompanying inherent variation, which is generally larger than the fixed intrinsic variation, and reliably prevent the disease from being overlooked.

  In addition to the effect of claim 1 or 2, the clinical diagnosis support system according to claim 3 further narrows down candidate diseases for the designated symptoms with reference to the inherent variation displayed by the test sequence table display means, By specifying a specific disease that has been determined to have a high possibility of onset, a differential disease between them is extracted and displayed. The accompanying inherent variation is displayed in a display mode for comparing the designated disease with the differential disease. Therefore, it becomes easy to compare the inherent variation of the designated disease with the inherent variation of the differential disease, and it becomes easy to finally diagnose the original disease from a plurality of diseases narrowed down from the symptoms. Specifically, according to the configuration of claim 3, at least two or more of the fixed variation type test item name and the fixed inherent variation associated with the disease are extracted for the specified disease, and the two or more fixed variation type tests are extracted. The inspection item name of the item and its fixed inherent variation will be displayed in the inspection arrangement table. At this time, the disease name of the disease is displayed in association with each fixed intrinsic variation. Therefore, the disease name of the designated disease is displayed in association with the fixed intrinsic variation in at least two or more places in the display portion of the fixed intrinsic variation of the test sequence table. In addition, for the specified disease, the inspection item name of the associated variable test item and its fixed inherent variation associated with the disease are also extracted, and the test item name of the associated inherent variation test item and its associated inherent variation are also determined. It will be displayed in the column table. At this time, a combined disease name obtained by combining the disease name of the disease and the onset condition of the associated inherent variation is displayed in association with each associated inherent variation. Therefore, the disease name of the same designated disease is displayed in association with the associated inherent variation also in the display portion of the associated inherent variation in the test sequence table. Therefore, in two or more places in the test sequence table, for the same disease, it is possible to confirm the disease name displayed in association with the fixed intrinsic variation of the disease, in addition to being able to reliably conduct a multiple item comparison study, For the same disease, it is possible to confirm the disease name portion in the combined disease name displayed in association with the accompanying inherent variation, which is generally larger than the fixed intrinsic variation, and reliably prevent the disease from being overlooked. Furthermore, since the fixed inherent variation for the differential disease of the designated disease is displayed in the test sequence table, if the test result for the fixed intrinsic variation of the designated disease is negative, the designated disease should be the diagnostic name. Even if it is not possible, by confirming the test results for the fixed intrinsic variation of each differential disease, it is possible to immediately correct the diagnosis with the differential disease having a positive test result as the diagnosis name.

  The fixed eigenvariation extracted for the specified disease (usually representative of them, that is, a positive test among fixed eigenvariations for routine or initial tests) is displayed at the top. And the associated inherent variation (similar to the above) extracted for the specified disease is displayed in the next stage of the uppermost fixed intrinsic variation, and the fixed intrinsic variation extracted for the differential disease. It is preferable from the standpoint of facilitating visual and systematic understanding to display (negative test) in the next stage of the accompanying inherent variation displayed for the specified disease.

  In the clinical diagnosis support system according to claim 4, in addition to the effect of claim 3, when there is an affirmative test item for the disease to be confirmed, the presence of the disease is confirmed by confirming the inherent variation of the affirmative test item. Can be easily confirmed. Further, when there is a negative test item for the disease to be confirmed, the presence of the disease can be denied by affirming the presence of another disease due to the inherent variation of the negative test item. Furthermore, in addition to these confirmations, it is possible to make a diagnosis with higher accuracy by confirming the inherent variation of the sexual activity test item.

  In addition to the effect of claim 4, the clinical diagnosis support system according to claim 5 systematically lists and displays the inherent variation information for each examination item to be displayed as clinical diagnosis information suitable for diagnosis by the exclusion diagnosis method. it can.

  In addition to the effects of the fourth or fifth aspect, the clinical diagnosis support system according to the sixth aspect can make a diagnosis with high accuracy by listing and displaying diseases that may be overlooked by an inexpensive general-purpose test.

  Hereinafter, the best mode for carrying out the present invention (hereinafter referred to as an embodiment) will be described. Throughout each embodiment, the same members, elements, or parts are denoted by the same reference numerals, and the description thereof is omitted.

1. Inventor's Unique Knowledge Regarding Clinical Diagnosis As a result of intensive studies on clinical diagnosis, the inventor has obtained the following knowledge, and based on this knowledge, completed the clinical diagnosis support system of the present invention.
1) Grasping, subdividing, and utilization of laboratory fluctuations The inventor is able to smoothly and accurately advance the three procedures in the above diagnostic work (listing of disease name, examination assembly, and interpretation of examination results) in a short time in clinical diagnosis. In order to develop a computer system (ie, a clinical diagnosis support system) that can provide medical information described in medical books comprehensively and systematically to physicians in clinical settings, the relationship between diseases and symptoms, and diseases and test items We have conducted extensive research on the relationship. In particular, as described above, in the clinical diagnosis, matching the test variation of each test with the specific test variation of each candidate disease leads to an accurate diagnosis. , For all test items for each disease currently known in clinical medicine, each test method for the test item is subject to comprehensive and individual changes in the test results for each disease By investigating and verifying, and by identifying the trend of test variation for each disease and test item (hereinafter, this test variation trend may be simply referred to as “test trend”), It was possible to improve diagnosis and disease identification.

  In this verification process, in order to be able to compute the contents of the clinical test described in the medical book, the present inventor described the current medical book that consists mostly of abstract expressions for the purpose of sharing writing. It is necessary to specify the test variation for each test item in the smallest unit that is not duplicated or leaked in terms of expression (for example, renal disorder, heart failure, liver function abnormality, etc.) and re-express it as the test trend for each disease I came up with it. Further, in the verification process, the present inventor has discovered that there are two types of inspection variations as inspection variations. In other words, the test variation of a test item that can be used for a certain disease may be a test variation (hereinafter simply referred to as “fixed intrinsic variation”) that always has the same and specific variation contents when the disease occurs. However, when the disease occurs, it does not always have the same and specific fluctuation contents, and conditions associated with the onset of the disease such as the onset and stage of the inherent complication of the disease (hereinafter referred to as the following) (It may be simply referred to as “onset condition”), and attention is paid to the fact that there is an examination variation (hereinafter, also simply referred to as “accompanying inherent variation”) that is the same and unique variation content depending on the condition. Then, based on these findings, the inventor classifies the test variation of all existing diseases (disease names) into fixed inherent variation and accompanying inherent variation, and further minimizes the associated inherent variation for each disease onset condition. Subdivided and specified to be a unit. As a result, the present inventor has found that there are about 17,000 or more kinds of test variations at the time of disease onset. What stores these minimum unit inspection variations is an inherent variation table to be described later.

  Therefore, it is important to utilize laboratory variations in actual clinical diagnosis, but according to the inventor's knowledge, even if all of these enormous numbers of laboratory variations are used, there is no disease that can be diagnosed at all. However, in view of the current situation, it is practically impossible to perform a definitive diagnosis by automatic diagnosis as in the conventional automatic diagnosis system.

  Therefore, the present inventor does not attempt automatic diagnosis from the beginning, but effectively utilizes the enormous number of test variations by computer processing, and information on test variations for each of the candidate diseases enumerated by doctors in the clinical field. We have developed a clinical diagnosis support system that can be systematically and visually presented to a doctor so that there is no leakage and no duplication. In this way, the final decision can be made by the physician based on various laboratory changes presented systematically and visually, so that the clinical diagnosis support system can greatly improve the diagnosis rate. There is a possibility that the support system can be applied to simplify clinical diagnosis work.

2) Number and types of inherent variation 2-1) Number of inherent variations (inspection variation in the smallest unit)
At present, it has been confirmed that there are about 1000 clinical test items that can be used for all diseases. In addition, the variation content (test variation) of the test result of each test item is a specific variation that exhibits a unique variation for each disease, but the test result of one test item exhibits various variations in a plurality of diseases ( The present inventor has confirmed that the total number of inherent variations of all examination items for all diseases is about 17,000 in total as described above, because the same variation content or different variation content is exhibited). . That is, the present inventor has conceived that the test variation of test items used in clinical diagnosis can be divided into about 17,000 minimum units as a whole.

2-2) Types of inherent variation Furthermore, the inventor has conceived that the inherent variation of the inspection item can be divided into “fixed inherent variation” and “adjoint inherent variation” as described above. Among these, the fixed intrinsic variation is an inherent variation that is always unique (identical) variation regardless of the onset condition of a specific disease for a certain test item, depending on the disease itself. The contents of fluctuation can be interpreted. On the other hand, concomitant eigenvariation does not become specific (identical) fluctuation contents even if a specific disease occurs for a test item, but only when a specific onset condition occurs for that disease (its onset) Inherent variation that is inherent (identical) variation content (according to the condition). Therefore, since the fixed intrinsic variation always has the same variation content when the corresponding disease occurs, it can be used immediately for identification of the disease by confirming that the test result has changed. On the other hand, concomitant eigenvariation does not always have the same fluctuation content when the corresponding disease develops (it will be the same fluctuation content only after the onset condition is manifested), but it will change to change After all, it can be used to identify the corresponding disease by confirming that the test result has changed.

  It should be noted that the onset conditions of a disease include stage, inherent comorbidity, onset organ, site of onset, etiology, disease type, pathogenetic disease, fasting, discontinuation of medication, low immunity, etc. for a certain disease. For example, with respect to a certain disease, an accompanying inherent variation is expressed for a test item only when the stage is in the early stage or advanced stage, or an accompanying inherent variation is expressed for a test item only when an inherent complication occurs, Accompanied inherent variation occurs only for test items when the onset organ is a specific organ, adjoint inherent variation occurs only for test items when the onset site is a specific site, disease-causing bacteria Applicable inherent variation with different contents depending on (Etiology) appears, only when an associated inherent variation occurs for a test item only in the case of a subtype of the disease type, or only via a specific primary disease Inherent inherent variation occurs for certain test items, or inherent inherent variation occurs for certain test items only when the patient is fasting, or the patient has stopped taking medicine For inspection items or associated natural variation is expressed in only if the patient has it been confirmed or to express the associated unique variation inspection item in only in the case of low immunity.

2-3) Ratio of fixed inherent variation and accompanying inherent variation Further, when the present inventor confirmed whether the above-mentioned fixed inherent variation or incidental inherent variation corresponds to all inherent variations of all inspection items, It has been confirmed that the accompanying inherent variation accounts for about 3/4 to 4/5 (about 77% of the total intrinsic variation) during the total intrinsic variation.

3) Utilization of all inherent variations in clinical diagnosis 3-1) Consideration of onset conditions As a feature of clinical diagnosis, selecting an effective treatment method only by narrowing the diagnosis name to one disease name (formal disease name) by definitive diagnosis There are many cases that cannot be done. That is, even in the same one disease, the treatment method varies depending on the onset condition. For example, it is common for some causative diseases to develop as a main symptom of various organ disorders that are unique to the causative disease such as nephritis, hepatitis, heart failure, pneumonia, meningitis, anemia, etc. It becomes a typical disease course. Of these, which organ disease develops as a main symptom varies depending on the onset condition of each case. In addition, there are many cases in which a plurality of damaged organs are combined, and even if it is a single organ, for example, in blood, the damaged organ is further subdivided into parts such as red blood cells, white blood cells, platelets, protein components, etc. . As described above, the above-mentioned onset conditions such as organ damage and comorbidity inherent to these diseases vary depending on the disease, but the treatment method varies greatly depending on the organ or site affected by the disease. Onset conditions such as name and proper complications are often more important for treatment selection. Therefore, in practice, a sufficient clinical diagnosis cannot be made unless both the diagnosis name and various onset conditions are determined simultaneously. In addition, there are usually multiple differential diseases for one causative disease, and it is a definitive diagnosis to exclude diseases other than the causative disease from these differential disease groups and finally narrow down to one causative disease However, these differential diseases generally also present onset conditions such as a plurality of organ disorders and inherent complications similar to the causative diseases for each disease. Therefore, in clinical diagnosis, consideration of the differential disease itself is unavoidable, and consideration of the onset conditions of the differential disease is also unavoidable.

3-2) Utilization of concomitant eigenvariation As described above, since it is indispensable to consider various onset conditions for each disease in clinical diagnosis, examinations that include not only fixed eigenvariation but also associated eigenvariation are required in test assembly. Assembling is essential. That is, in the test assembly, it is necessary to select a test item that can confirm not only the fixed inherent variation but also the accompanying inherent variation for each of the candidate diseases whose disease names are listed. Also in the interpretation of inspection results, it is necessary to provide information systematically and visually in a form that clearly distinguishes between fixed and associated eigenvariations of selected inspection items. A systematic and visual information provision based on the fixed and associated eigenvariations stored in the eigenvariation table is a test arrangement table to be described later.

4) Multiple item comparison study In clinical diagnosis, it is rare that a target disease can be confirmed by simply confirming the contents of changes in a single test result, and multiple test items are required to confirm the onset of a single disease. It is useful to compare and examine test variations (hereinafter referred to simply as “multiple item comparison study”). It can be determined that the disease has started. Even in the current medical field, such a multiple item comparison study is used vaguely, but it is not used intentionally, and the term “multiple item comparison study” is not used. That is, in the current medical field, there is no system that can systematically compare and review multiple items, and a mechanism that can be satisfied in terms of certainty is not provided. Therefore, the present inventor intentionally introduced a multi-item comparison study into the clinical diagnosis support system, computerized the fixed inherent variation of the inherent variation table, and displayed it in a manner capable of comparing and examining multiple items on the test sequence table. The configuration is as follows (details will be described later).

5) Types of clinical tests As will be described in detail later, the proper variation table stores the official disease name (disease name), test items, and test trends in association with each other. Of these, test items (clinical tests) are: Decide both expensive and specific tests that are positive with a certain number of tests, inexpensive nonspecific tests that are positive with many tests (mostly biochemical tests), and both specific and nonspecific tests Three types can be classified into three types of gauging intermediate type inspections.

5-1) Specific test A specific test is a useful test that can make a definitive diagnosis if a certain number of test variability matches the clinical findings. That is, the specific test is a useful test that enables the diagnosis name to be specified (definite diagnosis) with a certain number of test items. On the other hand, the specific test is expensive, and when the predicted disease is wrong, a high cost is often wasted. Therefore, it is necessary to carefully select and use the test when assembling. Further, according to the knowledge of the present inventor, the ratio of diseases with specific tests is about 20% of the total, and in particular, the test items useful for adults are halved (about 10% of the total diseases). Therefore, in most cases, test assembly using only specific test is difficult. In the specific test, a specific test of a fixed intrinsic variation type that always exhibits a specific (identical) test variation (that is, a fixed intrinsic variation) for the corresponding disease, and a specific onset condition for the corresponding disease was expressed. It can be bisected into an adjoint eigenvariant specific test that only presents an inherent (identical) test variation.

5-2) Non-specific test Most non-specific tests are inexpensive biochemical tests whose results can be found in a short time, so that a large number can be used in the first test assembly. On the other hand, since non-specific tests (especially biochemical tests) often test positive for many diseases, non-specific tests are useful for picking up the relevant diseases without leaking them. In addition, in the case of non-specific tests, there are many tests that become positive for many diseases, so many diseases picked up by comparing and examining the test variation of multiple test items (multiple item comparison study of fixed intrinsic variation) It is essential to narrow down from a few to a few candidate diseases. In other words, since non-specific tests do not exhibit specific test fluctuations for a specific disease, there is a limit to the identification of diseases unless multiple item comparison studies are used. Furthermore, the test variation exhibited by the non-specific test, like the specific test, is a fixed specific variation type specific test that always exhibits a specific (identical) test variation (that is, fixed intrinsic variation) for the corresponding disease, It can be divided into a specific test of an accompanying inherent variation type that exhibits an inherent (identical) test variation only when a specific onset condition is developed for the corresponding disease, but the fixed inherent variation type non-specific The number of the non-specific tests of the accompanying inherent variation type is much larger than that of the test. Among these, the accompanying non-specific test of the inherent variation type is not suitable for the multi-item comparison examination because the onset conditions of the corresponding diseases are various. Therefore, it is almost impossible to carry out practical inspection assembly only by non-specific inspection without using specific inspection.

  Here, both the specific test and the non-specific test, the accompanying specific variation type non-specific test is used to identify the onset conditions such as inherent comorbidity and diseased organs. Like non-specific tests, it is also used to identify and select the corresponding disease name. In particular, patients often do not visit at a relatively early stage when the fixed eigenvariation changes, but often for the first time in the advanced stage when the associated eigenvariation changes. Names are often identified. As described above, the accompanying specific variation type non-specific test is not suitable for identifying a disease name by a multi-item comparative study because the onset conditions of the corresponding disease are various.

5-3) Intermediate examination The intermediate examination is useful for obtaining findings on the general condition of a patient and the condition of a specific organ. Some diseases, such as pneumonia, urinary tract infections, diabetes, nephritis, etc., can be confirmed with intermediate tests alone. These intermediate tests can be referred to as specific tests for the corresponding disease. In addition, the intermediate test, like the specific test and the non-specific test, is a fixed eigenvariant type intermediate test that always exhibits a specific (identical) test variation (that is, fixed eigenvariation) for the corresponding disease, It can be bisected into a contingent eigenvariant type of intermediate test that exhibits inherent (identical) test variability only when specific onset conditions for the corresponding disease are manifested. Examples of intermediate tests include diagnostic imaging (X-rays, CT, etc.), red sediment (also called blood sedimentation, simply the rate at which red blood cells sink. It is increased in chronic severe inflammatory diseases, but there is no disease specificity. Urinalysis (urine tape examination and microscopic examination), electrocardiogram, etc. are typical.
For the identification of a disease without a specific test, a diagnosis based on a multi-item comparative study of a non-specific test of fixed intrinsic variation type or a multi-item comparative study of an intermediate test is necessary.

5-4) Proportional eigenvariation ratio Both the eigenvariation and the intermediate test of the specific test can be divided into a fixed eigenvariation type test and an adjoint eigenvariation type test. Inspection is the majority.

5-5) Concomitant inherent variation ratio At present, the number of diseases that can be examined by the specific test is about 20% of all diseases, and a definite diagnosis is made by a single specific test for many diseases. I can't.

6) Laboratory assembly of clinical tests As described above, a specific test is positive only for a certain number of diseases, so that a definite diagnosis of a specific disease can be performed by using a small number of specific tests. Therefore, if there are specific tests for all diseases, it is possible to identify the diagnosis name by decoding the test result from each test variation of a small number of specific tests. However, at present, the disease covered by the specific test is about 20% of all the diseases, and the test assembly cannot be performed only by the specific test for all the diseases. That is, at present, clinical diagnosis cannot be performed unless non-specific tests are used. On the other hand, many non-specific tests are positive in many diseases. Therefore, to identify the disease, examination variations of a certain number of fixed specific variable type non-specific tests are compared with each other. (Multiple item comparison study) is necessary. For example, if the test items are A, B, and C, and the diagnosis names are A, B, and 「,“ A ”if A decreases, B is normal, and C increases,“ B ”if A is positive, B increases, and C decreases, It is necessary to examine and compare the test variations of a plurality of test items, such as “A decrease, B increase, and C normal” to identify the disease by decoding the test results. In this case, in order to obtain useful test results, it is necessary to use a sufficient number (usually 20 or more) of non-specific tests depending on the disease. At the same time, in order to obtain useful test results, it is also necessary to use as many intermediate tests as necessary depending on the disease. That is, in current clinical diagnoses where the number of specific tests is not sufficient, in order to obtain useful test results, use as few specific tests as possible, a sufficient number of non-specific tests and intermediate tests. Need to assemble inspection.

7) Clinical diagnostic methods As clinical diagnostic methods, after identifying the name of the diagnosis from clinical findings, a test to confirm the disease and a similar disease (differential disease) of the disease is performed. Diagnosis method based on “symptomatic examination” that performs a diagnosis method by “differential inspection” to be excluded and a test that covers a group of diseases that show certain symptoms (symptoms / signs) in a lump and finds the corresponding disease from the test results There is. Differential testing is often used for rapidly developing diseases such as myocardial infarction and pneumonia, and symptom testing is often used for general diseases that develop slowly, but both are often used together. That is, both the diagnostic method based on the differential test and the diagnostic method based on the symptom test are indispensable clinical diagnostic methods for improving the accuracy of the clinical diagnosis and preventing oversight of the disease.

8) Test assembly in clinical diagnostic method 8-1) Biochemical test As described above, the specific test is a useful test in which the diagnosis name can be specified only by one or several test items. The biochemical test as a non-specific test may become positive in a large number of diseases, and the disease is identified by a small number of test items in the same way as the specific test except for a part of the differential diagnosis. It is difficult. However, the biochemical test is a useful test that enables differentiation and narrowing down of diseases by comparing and examining multiple variations of a large number of test items (in the case of a fixed intrinsic variation type). In addition, since biochemical tests are inexpensive and less invasive to patients (the level of pain to patients), inexpensive biochemical tests are more than 70% of daily tests for both differential and symptomatic tests. It is frequently used as it occupies. Therefore, the biochemical test is useful for selection (identification) of possible disease names as a non-specific test, and is also a test suitable for narrowing down diseases by a multiple item comparison study.

8-2) Narrowing / differentiating diseases by biochemical tests On the other hand, when deciphering test results by comparing multiple items using biochemical tests, multiple fixed items in biochemical test results are compared and examined by comparing multiple items. It will be differentiated and narrowed down. That is, in this case, when a fixed intrinsic variation peculiar to a disease having a plurality of biochemical test results is exhibited (for example, in the case of the above-described examination variation “A decrease / normal B / increase C”), the fixed intrinsic variation It is possible to estimate the presence of a disease that exhibits fluctuations (disease “A” described above). In this way, it is possible to identify and narrow down diseases by comparing and examining a plurality of items of biochemical test results for confirming fixed intrinsic fluctuations. In order to confirm the onset of the onset conditions of each disease that has been narrowed down, it is possible to identify the inherent comorbidities and organ disorders of each disease by deciphering the test results for the associated inherent variation confirmation test items (mainly biochemical tests). Can be confirmed. Here, as described above, it has been confirmed that the inherent variation of the biochemical test is about 70%, and the ratio of the fixed intrinsic variation is small. However, the number of biochemical tests themselves is very large, and each biochemical test is a test that tests positive for several tens of diseases. There are a sufficient number of fixed intrinsic fluctuations that can be used to identify and narrow down diseases. On the other hand, it is possible for some non-specific tests to narrow down or differentiate diseases by comparing multiple items using the inherent variation of non-specific tests including biochemical tests. However, as described above, in the case of most non-specific tests, the decoding work is complicated. Therefore, the multi-item comparative study of non-specific tests is mainly for confirming the onset of the disease itself (by the fixed eigen-variable type test of non-specific tests) by its fixed intrinsic variation (name of disease Confirmation of disease onset conditions by confirming the specific variations of specific tests, non-specific tests, and intermediate tests individually (ie Need to be done (by specific tests, non-specific tests and necessary intermediate tests).

8-3) Inspection assembly From this, in both inspection inspection and symptom inspection inspection, as many as possible by combining several specific tests, a certain number of non-specific tests and necessary intermediate tests. It is useful to distinguish each disease by selecting a plurality of target diseases and comparing a plurality of fixed intrinsic variations of the fixed intrinsic variation type test among them.

  Specifically, in the case of symptom tests (clinical diagnosis based on symptoms), using specific tests and non-specific tests, the disease name enumeration generally includes about 10 to 30 diseases per symptom. List as candidate diseases. Next, in the test assembly, for each of all the listed candidate diseases, a test item capable of determining the presence or absence is selected. Next, in deciphering the test results, the test result variation (test variation) for each test item is deciphered by comparing and examining multiple items, and the candidate diseases are narrowed down to several diseases. Usually, by this initial test assembly and test result decoding, candidate diseases can be narrowed down to several diseases, and diagnosis can be confirmed only by differences in clinical findings.

  On the other hand, in the case of differential testing (clinical diagnosis based on differential), in the disease name enumeration, about 5 diseases are listed as candidate diseases (the disease name (diagnostic name) of the predicted disease and the disease name (differential disease name) of the differential disease. ). Next, in the test assembly, for each of all the listed candidate diseases, a test item capable of determining the presence or absence is selected. Next, in the interpretation of the test results, the test variation of each test item is deciphered by comparing and examining multiple items, and if the predicted diagnosis name is correct, the diagnosis is confirmed with the diagnosis name, and the predicted diagnosis name is incorrect ( Even if the predicted variation in the predicted disease is negative), the variation in the test for any of the differential diseases is always positive, so that the disease can be corrected on the spot as the target disease. That is, in the differential inspection, a definitive diagnosis or correction of the diagnosis name can be performed by one inspection assembly and inspection result decoding.

  In the system of the present invention, in the symptom test, depending on the number of diseases for each symptom, the test is often assembled to include five or more specific tests. Thereby, the disease can be narrowed down to at least several diseases by one symptom test. On the other hand, in the differential test, although it depends on the number of diseases for each disease, in many cases, the test is assembled to include several specific tests. As a result, as described above, a definite diagnosis of the disease name (diagnosis name) predicted by one differential examination or correction of the diagnosis name can be performed.

2. Features of the Invention Based on the above findings, the present inventors have invented a clinical diagnosis support system having the following configurations A to D.
A: Eigen fluctuation storage means (Eigen fluctuation table)
Aa: Fixed inherent variation, accompanying inherent variation, combined disease name Aa-1) Classification storage of inherent variation The inherent variation storage means (inherent variation table) is a disease name consisting of a formal disease name, a test item of a clinical test, and a test item Are stored in association with each other. In addition, for each of all examination items, the intrinsic variation storage means classifies one or more examination variations exhibited by the examination item when one or more corresponding diseases occur into a fixed intrinsic variation and an accompanying intrinsic variation. Store in association with the inspection item.

Aa-2) Fixed inherent variation The fixed inherent variation of the test item is an inherent variation that always has the same variation content regardless of the onset condition of the disease when the specific disease occurs for the test item.
Therefore, the test item is used as a test for confirming the onset of the corresponding disease itself, that is, a test exhibiting a fixed intrinsic variation (fixed intrinsic variation type test).

Aa-3) Accompanied inherent variation The associated inherent variation of a test item does not become a specific variation content even if a specific disease occurs for the test item, and one or more specific onset conditions occur for the disease Inherent variation that becomes unique variation content for the first time, that is, variation variation that does not become constant until one or more unique onset conditions occur for the disease.
The onset conditions of the disease for which the test item exhibits concomitant inherent variation include disease stage, disease complication (inherent complication), disease onset organ (affected organ), disease onset site, disease etiology, disease There are disease types, disease-causing primary diseases, fasting, internal medicine interruption, hypoimmunity.
Therefore, the test item is used as a test for confirming the onset condition of the corresponding disease, that is, a test exhibiting the associated inherent variation (associated inherent variation type test).

Aa-4) Realization of clinical diagnosis in consideration of onset conditions due to concomitant inherent variation Since the concomitant inherent variation type test is not a test item for confirming the onset of the disease itself, conventionally, as a test for the disease in clinical diagnosis It is not used and is a test associated with the disease based on the above findings of the inventor.

  Therefore, in the present invention, in addition to a test exhibiting fixed intrinsic variation that is a test item for the disease (fixed intrinsic variation type test) for one disease, it is a separate test item for the disease, but the onset of the disease A test (adjoint eigenvariation type test) exhibiting an associated inherent variation, which is an inspection item to be used in accordance with the conditions, is associated and stored in the inherent variation table, and displayed in the later-described inspection arrangement table when necessary. .

  As a result, even in a short time at the time of clinical diagnosis, the clinician can determine the onset of the relevant disease by a fixed eigenvariable type test, as well as the onset conditions of the disease caused by the associated eigenvariable type test Therefore, it is possible to select an effective treatment method on the spot.

Aa-5) Two-dimensionalization of three-dimensional data structure based on combined disease name In the eigenvariation table, the test item name of the fixed eigenvariation type test and its fixed eigenvariation are stored in association with each other for one disease. In addition, the inspection item name of the associated inherent variation type inspection and the associated inherent variation are stored in association with each other.

  This associated inherent variation associated a combined disease name, which is a coined word of the corresponding disease name and one or more onset conditions thereof, with the content of the inherent test variation exhibited by the test item when the onset condition was manifested. (That is, in the form of an explanatory sentence consisting of the name of the combined disease + the content of the test variation). The combined disease name is obtained by integrating two elements (data items) of a disease name and an onset condition as one element (data item).

  Here, the accompanying inherent variation of the accompanying inherent variation type examination is data of a three-dimensional structure including three types of elements (data items) of an examination item (examination item name), a disease name, and an onset condition. By using the combined disease name for the two-dimensional structure data consisting of two kinds of elements (data items) of disease name (disease name) and onset condition (ie, the disease name and onset condition) The associated inherent variation of the above three-dimensional data structure is stored in the inherent variation table as two-dimensional structure (table format) and tabulated in the test sequence table. Can be displayed.

  Furthermore, considering the onset condition from another viewpoint, there is a correlation between the disease stage, presence / absence of meal (meal history), induced disease, age, presence / absence of exercise (exercise history), affected organ name, name of the pathogenic fungus, etc. The onset condition is changed from low to low conditions. Moreover, it is often expressed as one onset condition by combining multiple onset conditions with and expression or or expression. Unlike disease names and test item names, onset conditions are difficult to systematically classify and have specific identifiers. Thus, it is almost impossible to make a database systematically by using the database. In other words, since the onset condition also changes over time (variation in the time axis such as stage) and other various conditions, the three items of disease name, test item name, and onset condition are calculated as a simple three-dimensional structure. It cannot be processed, and various conditional expressions need to be added and introduced for computer processing. However, because of the variety of onset conditions, it is difficult to select all necessary conditions in advance and set the conditional expression in advance, and even if the conditional expression is set, it is easy to cause omission of extraction of onset conditions . On the other hand, by combining the onset condition with the disease name in advance using the combined disease name as in the present invention, the three items of the disease name, test item name, and onset condition are uniformly two-dimensionally processed. It is possible to prevent omission of the onset condition as in the case of setting a conditional expression. In addition, in the test sequence table, in addition to being able to arbitrarily extract the test variation of the corresponding disease from a specific test item, the combined disease name includes the disease name (official disease name), so the relevant disease name is also included from the disease name. It is possible to arbitrarily extract the test variation of the disease. That is, in the test sequence table, the target item (arbitrary test variation used for clinical diagnosis) can be extracted from any disease name or test item name required for clinical diagnosis.

  In other words, the feature of the eigenvariation table of this case is that two-dimensional processing can be performed while maintaining the contents of the three-dimensional structure using the combined disease name obtained by combining the disease name and the onset condition. Thereby, (A) disease name ID (a1 · a2 ·) · disease name + onset condition ID (b1 · b2 ·) · onset condition + test item ID (c1 · c2 ·) · test, which is a three-dimensional data structure The item name could be changed to (B) a two-dimensional data structure, disease name ID (a1, a2,.), Combined disease name + test item ID (b1, b2,.), Test item name. Only the two IDs of a and b are required from the data structure (three-dimensional data structure) of (A), which required three IDs of a, b, and c just by changing the disease name to a combined disease name. It is possible to perform the same three-dimensional operation as the data structure (B) (two-dimensional data structure). If the three-dimensional data format is used as it is, it is necessary to further add an extraction operation for each necessary onset condition. However, since it is difficult to create a database of onset conditions, an extraction operation with few leaks is difficult. This makes it possible to simplify each stage. In this case, a unique disease name ID (disease name ID) is associated as an identifier to a combined disease name (only a disease name that has no onset condition), but the onset condition is combined (if there is an onset condition). Since it is included in the disease name, the inherent variation (test variation) of the disease, which is the disease onset condition for each test item, can be uniquely identified by the composite ID of the disease name ID and the item ID of the corresponding test item.

Aa-6) Fixed eigenvariation of the two-dimensional data structure For the fixed eigenvariation type test, the fixed eigenvariation includes only the name of the corresponding disease (the name of the disease with no onset condition) and the test item when the disease occurs. It is associated with the contents of inherent examination variation that is always presented (that is, an expression (explanatory text format) consisting of disease name + examination variation content).

Ab: Concomitant inherent variation and combined disease name Ab-1) Difficulty in acquiring disease onset condition information in clinical diagnosis As described above, in clinical diagnosis, in addition to the need to determine the disease name, Without confirmation, there is a unique situation in which an effective treatment cannot be selected. That is, there are few illnesses that go through the entire course with only a specific disease state specific to one disease, and although the same disease, the main organs that develop differ from case to case, and various unique complications that frequently occur in the disease ( Inherent complications often vary from case to case. Therefore, since there are various disease images depending on the situation for each case even though it is one disease, the necessary examinations and examination trends greatly fluctuate. This point is as described regarding the onset condition and the associated inherent variation.

  On the other hand, medical books are generally used to provide knowledge as a basis for clinical diagnosis. In this medical book, specific disease states and test results specific to the disease are described in detail. That is, the medical book describes only the test for confirming the onset of the disease itself and the test variation (test variation corresponding to the fixed intrinsic variation). However, organ names and comorbidities that differ from case to case are described using the organ names and proper comorbidities as they are, and examination trends are also expressed in abstract terms such as "renal disorder" and "liver dysfunction". Often. That is, in order to know specifically the test items and test trends required for clinical diagnosis regarding the onset conditions such as the names of affected organs and inherent comorbidities of a certain disease, look for specialized books that describe them, It was necessary to perform a subtracting operation to return to the specialized description field and re-examine, and it was very difficult to systematically obtain this information. In particular, since clinical diagnosis requires various tasks to be performed in a very short time, even if a clinician identifies the disease, it is a fact that clinically necessary information regarding the onset condition can be acquired in a short time. It was impossible.

Ab-2) Inherent variation table / test sequence table using combined disease names Here, the inherent comorbidity and organ type for each disease are the default pathology of the disease, and the test items and test trends involved It is already medically determined as a default item for those that require grandchild operation.

  Therefore, the present invention is a test item for confirming the original disease state of the disease among the disease states for each disease (that is, a test that always exhibits the same test variation when the disease occurs regardless of the onset condition) Item), and the test variation of the test item when the disease occurs, is stored in the eigenvariation table in association with the disease as a fixed inherent variation of the disease in association with the disease. In other words, for each disease name, the test item names of all the inherent variation type tests and the fixed inherent variations are stored in association with each other.

  In addition, the present invention identifies the onset conditions such as the inherent complications of the disease and organ names by subdividing them to the minimum unit, and the inherent (always identical) test variation when each onset condition is expressed for the disease While all the inspection items exhibiting the above are specified, the inspection variation is associated with the inspection item name as the accompanying inherent variation. At this time, the accompanying inherent variation is created as an explanatory text in which the combined disease name created by combining the onset condition with the disease name is associated with the test variation presented by the test item. Then, for each disease, all the accompanying inherent variations are associated with the test item names and stored in the inherent variation table. That is, for one disease, the same number of test item names as the number of associated disease names and associated inherent variation are stored in association with each other.

  In this way, the present invention describes the same inherent variation as the pathological description or pathological description of each disease as two types of inherent variation consisting of fixed inherent variation for confirming the disease itself and voluntary inherent variation for confirming the onset condition. Stored in a table.

Ab-3) Storage of inspection variation in the minimum unit The inspection item name stored in the fixed variation table can be used in common throughout the entire family, and does not need to be further subdivided without duplication. It is made up of. Care is taken to avoid technical special terms that are often found in medical books and to be unified with terms that can be applied to the whole family using basic medical terms, etc. ing.

  In addition, the test item name associated with each disease is medically determined and does not change (always the same test item name), but the test variation is for each disease and disease onset condition (for each combined disease name). It consists of different contents. That is, the test variation of each test item is a fixed inherent variation in a certain disease, an associated inherent variation corresponding to a certain onset condition of the disease (a certain connected disease name) in another disease, and further, an onset condition for the relevant disease. If they are different, it becomes an associated inherent variation corresponding to the onset condition (another connected disease name).

  Further, in the concomitant eigenvariation of the accompanying eigenvariation type test, the onset conditions of each disease are subdivided into minimum units, and one or more onset conditions of such minimum units are combined with the disease name to obtain a combined disease name. It is composed. In other words, since not only one disease onset condition but also several may be expressed together, a combined disease name is a combination of one onset condition (disease name + onset condition) and two onset conditions are combined. (Disease name + onset condition + onset condition) is a combination of three onset conditions (disease name + onset condition + onset condition + onset condition). At this time, the combined disease name is not simply a combination of the disease name and the onset condition in order, but is created so as to have an optimal form according to the onset condition.

  That is, in the inherent variation table, in addition to storing the same examination item as a fixed intrinsic variation type examination of a plurality of diseases, it is stored as a number of associated intrinsic variation type examinations corresponding to the names of combined diseases. That is, even if the test item name is the same, the test variation is divided into a fixed eigenvariation and an accompanying eigenvariation and stored separately, and corresponds to the minimum disease onset condition (binding disease name). And is stored after being segmented. As a result, a plurality of inspection variations are displayed corresponding to one inspection item in the inspection arrangement table, and a plurality of inspection variations are stored corresponding to one inspection item in the inherent variation table. become. In the test sequence table, one test item is displayed corresponding to one disease regardless of the presence or absence of the onset condition and the number thereof. For example, regarding the expression of the name of the combined disease during the test variation, the expression “Coxsacky carditis, increased by hepatitis” (expression that indicates that the test value increases when cardiomyopathy or hepatitis coexists with Coxsackie infection) “Heart disease, hepatitis”, “heat stroke, MOF up” (expressed to indicate that test values rise only with heat stroke), “heat stroke, MOF”, “heat stroke rises with MOF” (heat stroke alone Although the test value does not increase, the expression value increases in the case of heat stroke MOF and TSH-deficient Simmons (in the expression that the test value increases when MOF is combined) (the test value increases in Simmons disease due to TSH hormone deficiency) In "TSF deficiency simmons" and "increase in heart failure (cardiac inflammation / myocardial infarction)" (expression expressing heart failure due to cardiac inflammation or myocardial infarction) in "heart failure (carditis / myocardial infarction)" )"etc, Coupled disease name is created in the form of people, coupling disease name is written in all the developing conditions. In addition, in multiple stages of onset conditions, “increased in PHTrP-producing ectopic hormone-producing neoplastic Ca-related pancreatitis” (increased when hypercalcemic pancreatitis develops in ectopic hormone-producing tumor producing PHTrP In some cases, the onset condition is expressed as "PHTrP-producing ectopic hormone-producing neoplastic Caemia pancreatitis".

  Specific examples of combined disease names include Coxsackie carditis and hepatitis (upward arrow mark) (meaning that coxsackie infection is associated with carditis and hepatitis), heat stroke and MOF (upward arrow) Mark) (means that it rises only with heat stroke, but it rises further when combined with MOF), rises with heat stroke MOF (marked with an upward arrow) (not only with heat stroke, but rises when combined with MOF, Meaning), (the contents are completely different depending on the presence or absence of “,”), elevated in TSH-deficient Simmons (upward arrow mark) (improved in Simmons disease due to TSH hormone deficiency), heart failure (carditis)・ In various forms using various onset conditions like a 360-degree variable joint, such as myocardial infarction) rising (marked with an upward arrow) (meaning rising due to heart failure or heart failure due to myocardial infarction) In the brief consolidated. There are many cases where multiple stages of onset conditions occur, and it is elevated in PTHrP-producing ectopic hormone-producing neoplastic hypercalcemic pancreatitis (marked by an upward arrow) (ectopic hormone-producing tumor producing PTHrP, hypercalcemia There is also an increase in the incidence of pancreatitis due to).

Ab-4) Name of disease in fixed eigenvariation In the eigenvariation table, for a fixed eigenvariation type test for each disease, the test item name of the fixed eigenvariation type test and its fixed intrinsic variation are listed for one disease. These fixed intrinsic variations are associated with each other, but this fixed intrinsic variation associates only the corresponding disease name (the name of the disease with no onset condition) with the content of the inherent laboratory variation that the test item always presents when the disease occurs. (That is, in the form of an explanatory text consisting of disease name + examination variation content). That is, even in the case of a fixed intrinsic variation test, the disease name used for the test variation can be considered as a combined disease name with an onset condition of zero.

Ab-5) Storage of all inherent fluctuations As described above, in the inherent fluctuation table, for the explanation of the pathophysiology / pathological condition of one optional disease, the accompanying natural fluctuations such as inherent comorbidities are also the same as fixed intrinsic fluctuations. Is stored as In other words, the inherent variation table stores all possible minimum unit test items, and each specific test trend (test variation) also corresponds to the disease name (with no onset condition) and the combined disease name. Storing. As a result, all inherent variations found in medical books are included in the inherent variation table, up to very rare matters.

  There are less than 20% of all diseases with a special test that makes positive specifically for one disease (if positive, it can be diagnosed as that disease), and there are around 10% of diseases that do not have a diagnostic method even if all test items are used In the current situation (which can be diagnosed with a special exclusion diagnosis method in this case), a mechanism that can take advantage of any associated inherent variation is essential for clinical diagnosis. In this case, any trivial voluntary fluctuations can be utilized as equivalent fluctuations.

  The eigenvariation table includes all test items that can be involved in each disease, but in addition to being expressed in terms of test item names and terms common to all departments, complicated onset conditions are introduced by introducing the names of combined diseases. Various operations such as extraction and aggregation can be performed without considering the above. That is, even for a plurality of diseases, it is possible to compare and examine the names of all test items and trends in a single operation. The fact that there is not even a medical book that specifically expresses all the test trends that can be involved in one disease, and the fact that it is possible to easily perform computer operations such as extraction and aggregation of multiple diseases is an extremely breakthrough achievement. Yes (for example, differential tests using differential disease master files and symptom tests using syndrome master files). In addition, since the examination trend has a three-dimensional structure, it is impossible to compare and examine voluntary inherent fluctuations by a two-dimensional operation without introducing a mechanism corresponding to a connected disease name. As described above, it is difficult to perform additional extraction by three-dimensional operation using onset conditions.

Ab-6) Centralized data processing The inventor has confirmed that the accompanying inherent fluctuations account for 77% of the total intrinsic fluctuations in the inherent fluctuation table. That is, the accompanying eigenvariation type inspection accounts for 77% of the inspections in the eigenvariation table. Therefore, as described above, an effective clinical diagnosis cannot be performed unless the accompanying inherent variation is utilized.

  On the other hand, the accompanying inherent variation has a three-dimensional data structure that varies depending on three factors of examination item, disease name, and onset condition (if any factor is different, it becomes a separate variation). Therefore, if the associated inherent variation is to be displayed in a computer form with the three-dimensional data structure, a display form of the three-dimensional structure is required.

In addition, the fixed eigenvariation has a two-dimensional data structure that fluctuates depending on the two factors of the test item and disease name (if any factor is different, it becomes a separate variation). In order to store the inherent variation in the inherent variation table in a unified manner and to display it on the test sequence table, it is necessary to handle the fixed inherent variation with the same three-dimensional structure without any onset condition as described above. In other words, as with the 3D data structure of “specific test item / specific disease name / specific onset condition” of the accompanying specific variation, the fixed eigenvariation is also 3D “test item / specific disease name / no onset condition”. Must be processed as a data structure.

  Therefore, in the inherent variation table, two-dimensional data processing can be performed while maintaining the contents of the three-dimensional data structure by introducing a combined disease name in which the disease name and the onset condition are combined with the examination variation stored in the examination trend. I am doing so.

  As a result, with regard to the accompanying inherent variation, only by changing the disease name to the combined disease name (by combining the onset conditions), the test item ID, the disease name ID (corresponding only to the disease name), and the onset condition ID The data structure is changed from a three-dimensional data structure that requires two IDs to a two-dimensional data structure that requires two IDs: a test item ID and a disease name ID (corresponding to a combined disease name that is a disease name with onset condition) Thus, the same data processing as in the case of the three-dimensional data structure can be performed.

  In addition, regarding fixed intrinsic fluctuations, it is possible to perform unified data processing as a two-dimensional data structure that requires two IDs, an examination item ID and a disease name ID (corresponding to a disease name with no onset condition). Become.

Ab-7) Difficulties in data extraction processing based on onset conditions Here, the onset conditions vary greatly depending on the classification method, but the number of types exceeds at least several hundreds and is far greater than the number of diseases and test items. In addition, unlike test items, such as stage, induced disease name, affected organ name, and meal intake time, etc., it consists of countless irrelevant dissimilar elements and often overlaps with each other, so a database for computerization is created. It is a very difficult factor to do. In other words, even if the onset condition is stored uniformly, an effective search cannot be performed, and even if an identifier (ID) or the like for performing an effective search is assigned, several hundred or more identifiers are not obtained. It becomes necessary and a realistic database cannot be constructed.

  In addition, as described above, the accompanying inherent variation has a three-dimensional data structure that fluctuates according to three factors of examination item, disease name, and onset condition. To display data by associating disease names, test item names, and test fluctuations in the test sequence table, it is necessary to add data extraction processing for each required onset condition and display the extracted onset conditions in association with the disease name. is there.

  However, since it is difficult to create a database of onset conditions as described above, an extraction operation with little leakage is difficult.

  In addition, it is impossible to create a combined disease name that can be applied to all diseases and all test items unless a doctor who is familiar with organ names and detailed examination changes for each complication occurs. It is very difficult to create.

  In the present invention, for the onset condition having such characteristics, a doctor grasps the onset condition for each disease in advance and creates a combined disease name, and stores the combined disease name in the inherent variation table.

Ab-8) Omission of Onset Condition Extraction Processing by Name of Combined Disease As opposed to this, the present invention converts data originally having a three-dimensional structure into a two-dimensional data structure by introducing the name of a connected disease as described above. Since it is stored in the eigenvariation table in advance, there is no need to perform extraction processing according to the onset conditions as in the case of a three-dimensional data structure, and the inspection items and test variations for each necessary disease can be extracted once. It can be extracted from the inherent variation table and displayed on the test sequence table, and it is possible to extract all target test items for each disease without leaking.

  As a result, the system configuration can be simplified at each stage compared to the case of extracting necessary test items and test variations for each disease while maintaining the three-dimensional data structure consisting of test items, disease names, and onset conditions. In addition, as will be described later, various extremely useful effects that have not existed in the past can be exhibited.

Ac: Inspection type for differential inspection (examination for inspection, inspection for negative, inspection for whole body)
In the inherent variation table, for each test item for each disease, an identifier (for example, “affirmation” or “1”) indicating that the test is an affirmative test that can affirm the disease, and the test An identifier (for example, “Negative” or “3”) indicating that the disease can be denied by affirming the differential disease of the disease, and the test is neither a positive test nor a negative test An identifier (for example, “whole body” or “2”, etc.) indicating that it is an examination (mainly an examination for confirming the inherent variation associated with the onset condition of the disease) is stored in association with each other.

  Here, the affirmative test is a test in which a fixed intrinsic variation of a disease (for example, disease A) corresponding to the examination trend is stored, and the existence of the disease A can be affirmed by confirming the fixed intrinsic variation. .

  On the other hand, in the negative test, a fixed inherent variation of a disease corresponding to the inspection trend (for example, a differential disease B of disease A) is stored. It is a test that can deny the presence of disease A by affirming its existence.

  In addition, the whole body test is a test that cannot be classified as a positive test or a negative test, and most of the associated eigenvariation of the disease is stored in the examination trend. This is a test that can contribute to the selection of a treatment method by specifying the disease onset condition. In addition, although fixed intrinsic fluctuations may also be stored in the examination trend of the whole body examination, the whole body examination mainly consists of an accompanying intrinsic fluctuation type examination. In addition, genetic tests with many problems to be performed, highly invasive tests, tests that can be confirmed with other tests without performing such tests, etc. are stored as whole-body tests for the purpose of avoiding normal tests. Yes. Therefore, the whole body test is a test that is used only when a definitive diagnosis cannot be made by another test.

  That is, in the inherent variation table of the present invention, for each disease, the positive test, the whole body test, and the negative test are stored in association with each other.

  The examination types composed of these affirmative examinations, whole body examinations, and negative examinations are extracted in association with examination items in the differential examination process described later and displayed in the examination arrangement table.

  On the other hand, in the symptom test processing described later, the test type is not extracted because it is not necessary.

Ad: Representative example of inherent variation table (inherent variation master file) FIG. 1 shows a typical example of the inherent variation table described above. In the fixed variation table, all the diseases (formal disease names) are stored in the “disease” item column (data string), and all the test items corresponding to each disease are the “test item” item column (data string). The test trends corresponding to the disease and test item pairs in each row are stored in association with the item column (data string) of “test trend”. In the following fixed fluctuation table, for convenience of explanation, only a part of them (the part corresponding to the disease A and the disease B) is displayed. For convenience of explanation, the disease B, which is a differential disease of the disease A, is displayed after the disease A. However, since the inherent variation table can be realized as a relational database table, a table (table) in a normal relational database. As with, the order of disease is arbitrary. Further, in the item column (data string) of “type”, test items to be displayed corresponding to the disease (assumed diagnosis name) specified in the test sequence table in the differential test are the positive test, the negative test, and Data for distinguishing and aligning with any of the whole body examinations, and with symbols indicating each of the positive examination, the negative examination, and the whole body examination (hereinafter, referred to as “examination type data”). .) Is stored corresponding to each pair of disease and test item. In addition, in the item column (data string) of “test trend”, the contents of the test variation corresponding to each pair of the disease and the test item are stored in an explanatory text format. In the example of the following inherent variation table, for convenience of explanation, parenthesized parts (notes such as “this disease”, “(description of fixed inherent variation of disease A)”, etc.) are described. These notes are not included in the fluctuation table, and notes such as “(Disease A differential disease)” in the test trend of disease B are included to explain that disease B is a differential disease of disease A. These notes are not included in the actual inherent variation table. With regard to the differential disease for each disease, such a note is unnecessary because a series of differential disease groups can be extracted and arranged using the differential disease master file described later.

  The same test item (Examination 1, Examination 7 in the following characteristic variation table) is used as an examination for a plurality of diseases (Disease A, Disease B). When conducting a test, the test results of the positive tests of tests 1 to 3 are compared and examined, and if they are positive, the original diagnosis name (disease A) will be affirmed, and those test results are negative Then, the original diagnosis name (disease A) will be denied. In this case, if the test 7 is positive, the disease B is the target disease, if the test 8 is positive, the disease C is the target disease, and if the test 9 is positive, the diagnosis name is corrected as the disease D is the target disease. Can do. (Move after correction from c)

  In addition, in the inspection trend of the negative test for each disease, in addition to storing the explanatory text of the fixed inherent variation of the differential disease, such as “No specific variation in this disease and other differential diseases” Stores explanatory text explaining that there is no specific variation in the disease and other differential diseases. Thereby, while confirming the test trend of the negative test, the corresponding differential disease can be affirmed, and the presence of the present disease and other differential diseases can be clearly denied. (Move from c)

  Furthermore, in the inherent variation table, data indicating that it is an initial test for test items that are preferably performed from the first time among all test items for each disease (hereinafter, sometimes referred to as “initial test”). May be stored in association with each other, and the inspection items may be displayed on the inspection arrangement table with a symbol indicating that the inspection is an initial motion test (for example, an item column (data string) of “initial motion test” may be displayed). In addition, data such as “1 (initial motion inspection)” and “0 (other than initial motion inspection)” can be stored.

Ae: routine examination In the symptom examination, using the syndrome master file to be described later, collect all diseases (disease group) exhibiting the symptom for each symptom, and the test items corresponding to each collected disease from the inherent variation table Collect and use these inspection items as routine inspections. In the symptom test, unlike the differential test, the test items are not divided into affirmative tests and extracted. In addition, the examination trend for the examination items for each disease collected from the inherent variation table is a considerable number for one symptom as it is, and if it is displayed as it is on the examination sequence table, conversely, confirmation becomes complicated. In Fig. 1, the data are re-expressed in a collective manner for each examination item, and then stored in association with the corresponding disease.

  Furthermore, in the symptom test, for the disease group collected for each symptom (a disease group exhibiting a certain symptom), the small number of specific tests described above, a sufficient number of non-specific tests, and intermediate tests are specified in advance. Are selected as inspections (initial inspections) that are desirable to be performed, and are displayed in the inspection arrangement table with a symbol indicating initial inspection. The initial test mainly consists of inexpensive and less invasive test items centered on biochemical tests. Therefore, in the test sequence table at the time of symptom test, out of all test items for diagnosing diseases belonging to the specified symptom, symbols corresponding to the test items to be the initial test are attached and displayed. If it is done, it is possible to narrow down to one to several diseases at a low cost in the first examination. In addition, all the test items other than the initial test are also displayed in the test sequence table. These tests are used in the second and subsequent tests as necessary, such as when reconfirming or narrowing down to one disease. It corresponds to the item, and mainly consists of expensive inspection items and highly invasive inspection items.

  In differential tests, as well as symptom tests, for each differential disease group (diagnosis name and its differential disease), a small number of specific tests, a sufficient number of non-specific tests, and intermediate tests are specified in advance. The test is selected as a test (initial test) that is desirable to be performed from the first time, and is displayed with a symbol indicating the initial test in the test sequence table. Therefore, even in the test sequence table at the time of the differential test, symbols corresponding to the test items to be the initial test among all test items for diagnosing diseases belonging to the specified symptoms are displayed. .

B: Syndrome correspondence disease group storage means (equivalent to syndrome master file)
B-1) Storage of disease group for each symptom The symptom-corresponding disease group storage means stores all diseases that are assumed to be ill when a symptom develops in association with the symptom as a disease group corresponding to the symptom.

  The syndrome master file stores all the diseases presenting the symptom for each symptom in association with each other, and for each symptom, further description as a “disease overview” focusing on the onset condition for each disease belonging to the symptom (conventional) The same explanatory text as that described for the symptom and the disease group in the medical book is associated and stored. In addition, when displaying the test items and test variations for all the diseases specified in the symptom test on the test sequence table, a disease summary display column for displaying the disease summary of the symptom is also displayed near the test sequence table. Is done. At the same time, since the test variation for each test item is displayed in the column of the test trend of the test sequence table using the name of the connected disease, the doctor who is the user can explain the test variation of the test sequence table. And the explanation of the disease summary in the disease summary display column are checked together to help understanding at the time of diagnosis.

  That is, in the present invention, the disease summary of the symptom is stored in association with each symptom of the syndrome master file. (For example, an item column (data string) of “disease overview” is provided in the syndrome master file.)

B-2) Example of Symptom Corresponding Disease Group Storage Unit A typical example of a syndrome master file as a symptom corresponding disease group storage unit is shown in FIG. As described above, in the present invention, since one disease usually belongs to a plurality of symptoms, for example, as shown in the following syndrome master file, for example, disease A and disease B are stored in association with symptoms i and symptoms b. Will be.

C: Differential disease storage means (equivalent to differential disease master file)
C-1) Storage of differential disease for each disease The differential disease storage means stores the differential disease for each disease in association with the disease as a differential disease group corresponding to the disease.

C-2) Example of differential disease storage means A representative example of a differential disease master file as differential disease storage means is shown in FIG.

D: Clinical master file D-1) Organizing and integrating test variations In the present invention, as described above, in both symptomatic tests and differential tests, the test trend data of the inherent variation table is extracted as it is and displayed in the test sequence table. Instead, the examination trend data of the inherent variation table is consolidated and stored in the clinical master file. That is, in the symptom test, even if the same test item is used for each symptom test, different test variations (descriptions in the “Test Trend” column) are stored in association with each disease. As described above, a considerable number of test variations are displayed in the test sequence table for one symptom and are complicated, so that all test variations belonging to one test item are associated with the test item. The item column (data string) of “test trend” in the clinical master table is stored as one data in association with the symptom. Also in differential tests, complex diseases such as pneumonia (diseases in which multiple primary diseases develop) are stored as they are associated with different test variations for each primary disease even if they are the same test item. Extracting test variations associated with symptoms from inherent variations, as described above, a considerable number of test variations for one symptom are displayed in the test sequence table, and conversely complicated. The fluctuation is associated with the examination item and stored as one data in the item column (data string) of “examination trend” in the clinical master table in association with the disease (complex disease). Then, the data (test item name, test trend, etc.) related to the disease group of the symptom specified in the symptom test or the differential disease group of the disease specified in the differential test is extracted from the clinical master file and listed in the test sequence table. Like to do.

  As a result, a plurality of test variations are displayed in series in the test trend column of one test item displayed in the test sequence table, and it is easy to compare and examine these test variations (multiple item comparison study). Become.

D-2) Representative example of clinical master file A representative example of a clinical master file is shown in FIG. In the following clinical master file, all diseases (formal disease names) or symptoms (symptom names) are stored in the “disease (symptoms)” item column (data string), and all tests corresponding to each disease are stored. All test items belonging to the item or each symptom are stored in association with the item column (data string) of “test item”, and the test trend corresponding to the disease (symptom) and test item pair in each row is “test trend”. It is stored in association with the item column (data string). In the following fixed fluctuation table, only a part (a part corresponding to disease A, disease (complex disease) X, and symptom a) is displayed for convenience of explanation. For convenience of explanation, disease (complex disease) X and symptom i are displayed after disease A, but as described above, the order of the disease and symptom is arbitrary. In addition, in the inspection item for differential inspection, in the item column (data string) of “type”, any of inspection type data of the affirmative inspection, negative inspection, and whole body inspection includes the disease and the inspection item. Stored in correspondence with each pair. In addition, in the item column (data string) of “symptom test”, the contents of the test variation corresponding to each pair of the disease or symptom and the test item are stored in an explanatory text format. As described above, the contents of the fluctuation are in the form of explanatory text in which a plurality of examination fluctuations belonging to one examination item are consolidated for symptoms, and the explanation in which a plurality of examination fluctuations belonging to one examination item are also consolidated for complex diseases. Format. In the example of the eigenvariation table below, for the convenience of explanation, the bracketed parts (notes such as “(original disease)”, “(description of fixed eigenvariation of disease A)”, etc.) are described. There are no such notes in the eigenvariation table.

E: Inherent variation extraction and display means for each inspection item (equivalent to inspection arrangement table)
Ea: Explanation of pathological condition in tabular form The medical book expresses the pathological condition of the disease, which is the most important part of the medical book, in a general explanatory form, whereas the present invention uses an inherent variation table. It is expressed as a list of inspection fluctuations (inspection trends) according to the following inspection arrangement table.

  The test sequence table has a “item name” display field for displaying the test item name and a “test trend” display field for displaying test variations of the extracted disease test items.

  As described above, there are several times (about three times or more) the accompanying inherent fluctuations as the fixed intrinsic fluctuations, and they are actually displayed at the ratio in the test arrangement table. Therefore, concomitant eigenvariation plays a very important role in this system. In particular, in the clinical work of hospitalization and severe illness, detailed differential inspection and confirmation inspection are the main purpose, so actually use concomitant eigenvariation. There are many cases. However, the differential tests and symptom tests in the following explanation are merely for the purpose of diagnosis, and are often in time for comparative examination of fixed intrinsic fluctuations. Therefore, in routine inspection, it is mainly explained only by fixed intrinsic fluctuations.

Eb: Symptomatic examination and differential examination Eb1) In case of symptomatic examination Eb1-1) Extraction of examination fluctuation (fixed intrinsic fluctuation and accompanying intrinsic fluctuation) When any of the symptoms is designated, the symptom-related disease group (all disease names) associated with the designated symptom is extracted from the symptom-corresponding disease group storage means. Further, based on each disease name of the extracted disease group, test items (all test item names) associated with each disease of the disease group are extracted from the inherent variation storage means, and each of the extracted test items A fixed inherent variation and an accompanying inherent variation (explanatory text of each inherent variation) are extracted as inspection variations associated with.

Eb1-2) Batch display of inspection variation (fixed inherent variation / accompanied inherent variation) associated with the inspection item The inspection item specific variation extraction display means lists and displays the extracted inspection items In association with the inspection item, all the fixed inherent variation and the accompanying inherent variation extracted for each inspection item are collectively displayed.

  At this time, each of the one or more fixed intrinsic fluctuations extracted for each test item is a disease name (disease name in the disease group) that is estimated to occur when the test item develops each fixed intrinsic fluctuation. Are displayed in the “test trend” column together with the disease name.

  In addition, each associated inherent variation extracted for each test item is one or more onset conditions (namely, in the disease group) of one disease name that is estimated to occur when the test item develops each associated inherent variation. The disease name and the onset condition are displayed in the “test trend” column in association with the disease onset condition).

  As a result, by confirming the fixed intrinsic variation of each listed examination item, it is possible to identify the disease name that is assumed to be ill from the disease group related to the specified symptom, and in addition, for each listed examination item By confirming the accompanying inherent variation, it is possible to simultaneously specify the onset condition for the disease name on which the onset is assumed, and it is possible to select a treatment method according to the onset condition.

Eb1-3) Display with multiple examination items of the same disease name Furthermore, when one symptom is specified in the symptom test, all the diseases associated with the symptom are extracted, and for each extracted disease, The fixed eigenvariable inspections as two or more fixed tests that are associated with each other are extracted, and the fixed eigenvariable tests as the two or more fixed tests are listed in the inspection arrangement table. That is, for each disease belonging to the specified symptom, the test item name and the test variation associated with the disease are listed and displayed in the test sequence table (the test item name is in the “Item Name” column, the test variation is “ "Trends" column).

  At this time, since two or more test items are extracted for each disease, in the test sequence table, the same disease name has its test variation (fixed inherent variation) during the test variation of two or more test items. Will be displayed.

  As a result, even if only a routine test is performed in the symptom test, for each of the diseases belonging to the specified symptom, the test variation (fixed intrinsic variation) of the plurality of fixed intrinsic variation tests is confirmed and the disease concerned It is possible to determine the onset of the disease, and to effectively prevent oversight of the disease to be discovered due to the test variation. In addition, it is possible to compare and examine the test variation of a plurality of test items (fixed intrinsic variation type test) for the same disease, and depending on the disease, it is possible to make a definitive diagnosis whether the disease is on the spot.

Eb1-4) Display of different test variations of multiple diseases (differentiated diseases) in the same test item In addition, when one symptom is specified in the symptom test, all the diseases associated with the symptom are extracted, , All the diseases that can be distinguished by the same test item (differentiated disease group) and the test variation are displayed in association with the test item (the test item name is in the “Item name” column, the test variation is “test trend” In the "" column). That is, in the “test trend” column of one test item in the test sequence table, test variations of a plurality of diseases that can be distinguished from each other by the test are displayed.

  In other words, in one test item, the disease names of one or more diseases exhibiting a specific test variation are displayed in the “Test Trend” column in association with the test variation, but different from the specific test variation The disease names of other diseases exhibiting fluctuations are displayed in the “test trend” column in association with the different test fluctuations.

  Thereby, the disease displayed in association with the specific test variation and the disease displayed in association with the different test variation are to compare the test result of the test item with the test variation in the “test trend” column. Can be identified.

  For example, in the same test item, one or more diseases (first disease or first disease group) exhibit a first test variation (e.g., increased test value) while one or more other diseases (second disease) Alternatively, when the second disease group) exhibits a second test variation (such as a decrease in test value) that is different from the first test variation, these two types of test variations are displayed as test variations of the same test item. For example, the indication of “disease A is *** test fluctuation (test value increase, etc.), and disease B and C is *** test fluctuation (test value decrease, etc.)” is displayed in the test trend column. In this case, it is determined whether the corresponding disease belongs to the first disease (first disease group) by checking whether the test result of the test item is the first test variation or the second test variation. Whether it belongs to two diseases (second disease group) can be identified.

  Therefore, by confirming the test variation of the same test item, it is possible to distinguish and narrow down a plurality of similar and easily mistaken diseases by each test variation. In addition, combined with the fact that the same disease name is displayed during the test variation of multiple test items, it is possible to perform differentiation between multiple test items that are similar and easily mistaken, and the accuracy of the discrimination is improved. Can be increased.

  At this time, when a plurality of diseases exhibit the same examination variation, the plurality of diseases are displayed in association with the same examination variation. For example, “Disease A, B, and C is *** examination fluctuation (test value rise etc.)” is displayed in the examination trend column.

  Furthermore, at this time, in the same test item, one or more diseases (first disease or first disease group) exhibit the first test variation (e.g., increased test value), while one or more other diseases (first disease) When the second disease or the second disease group) does not exhibit a specific test variation (that is, when there is no specific test variation), in addition to the first test variation, another disease is a specific test. Points that do not exhibit fluctuations are also displayed. For example, “disease A, B, and C are ** laboratory fluctuations (e.g., increased test values), and diseases D, E, and F are not specific fluctuations.” Or “diseases A, B, and C are **. The indication of “* changes in test (elevated test values, etc.) and other diseases (all diseases other than diseases A, B, C)” is displayed in the column of test trends.

  In this way, the first disease or the first disease group is displayed as exhibiting a specific first test variation, while the second disease or the second disease group (or all the other diseases are displayed). By displaying that there is no specific variation for the disease of (1), it is possible to immediately specify that the first disease or the first disease group is a disease related to onset.

Eb1-5) Display arrangement according to the type of test variation (inherent variation) In the symptom test, the test item corresponding to the symptom displayed on the test sequence table is from the top of the test sequence table according to the type of test variation. In the downward direction, the fixed eigenvariable inspection and the accompanying eigenvariable inspection are displayed in order.

Eb1-5-1) Fixed eigenvariable test First, a series of fixed eigenvariable tests are performed from the top to the bottom of the test sequence table to confirm the fixed intrinsic variation of the extracted disease and determine its onset. Is displayed. This series of fixed eigenvariation tests that are displayed first is displayed so that a plurality of fixed eigenvariations for each extracted disease can be compared. That is, a series of test item names and their fixed intrinsic fluctuations for one of the extracted diseases (for example, disease A) are continuously listed from the top to the bottom of the test sequence table.

  Therefore, the disease A can be diagnosed by comparing and examining a plurality of examination fluctuations (fixed intrinsic fluctuations) of a series of examination items that are aggregated and listed.

  At this time, as described above, when a plurality of diseases exhibit the same test variation for one test item, the test trend column assumes that the plurality of diseases exhibit the same test variation for the test item. (For example, “Disease A, B, and C indicate increased test values” is displayed.)

  Furthermore, at this time, when a plurality of diseases exhibit different test variations for the same test item, the test items are displayed in the test trend column as the plurality of diseases exhibit different test variations (for example, ("Disease A, B, and C indicate a test value increase, and disease D, E, and F indicate a test value decrease").

  Furthermore, at this time, when the first disease exhibits a specific test variation for the same test item, but other diseases do not exhibit a specific test variation, the other diseases exhibit a specific variation. (For example, “Disease A, B, C is a test value increase, and other diseases do not have a specific change” is displayed).

  Therefore, it is possible to determine each disease by comparing and examining a plurality of test fluctuations of a series of test items that are listed and displayed in a group.

Eb1-5-2) Concomitant eigenvariable examinations In addition, following a series of fixed eigenvariable examinations, a series of associated eigenvariable examinations for confirming the associated intrinsic fluctuations of the extracted diseases and determining their onset conditions are performed. Displayed from top to bottom. For this associated inherent variation type test, a series of test item names and associated inherent variations for the extracted disease are continuously listed from the top to the bottom of the test sequence table.

  Therefore, it is possible to check the test variation (accompanied inherent variation of the extracted disease) of a series of test items that are aggregated and listed and determine the onset condition (affected organ, inherent comorbidity, etc.) of the extracted disease. .

Eb1-6) Example of test sequence table A typical example of the test sequence table displayed in the symptom test described above is shown in FIG.
In addition, an identifier (“fixed”, “accompanied” or “1”, “2”, etc.) indicating whether the disease is a fixed eigenvariable test or an associated eigenvariable test is provided, and the “type” column However, in an actual system, such an identifier is not provided (they are not displayed on the test sequence table). This is because contingent eigenvariation is displayed as the name of a combined disease with an onset condition, so it can be easily distinguished from fixed eigenvariation, and there is no need to store fixed eigenvariation and accompanying eigenvariation separately. It is. However, if there is a need to identify fixed eigenvariation and accompanying eigenvariation and extract data, it is possible to distinguish them and store them.

Eb2) In the case of differential examination Eb2-1) Extraction of examination fluctuation (fixed intrinsic fluctuation and adjoining intrinsic fluctuation) On the other hand, any of the diseases stored in the intrinsic fluctuation storage means is designated as the examination item specific fluctuation extraction means When extracting the disease-related differential disease group associated with the disease according to the designation from the differential disease storage means, and extracting the test item associated with the disease according to the designation from the inherent variation storage means, And while extracting the fixed intrinsic variation and the accompanying inherent variation as the examination variation associated with each of the extracted examination items, the examination item associated with each disease of the differential disease group is extracted, and the extracted examination item A fixed eigenvariation and an adjoining eigenvariation are extracted as inspection variations associated with each of the above.

Eb2-2) Collective display of inspection variations associated with inspection items The inspection item specific variation extraction means enumerates and displays the extracted inspection items, and associates each inspection item with the listed inspection items. All the fixed eigenvariations and the accompanying eigenvariations extracted for the item are collectively displayed.

  At this time, among the extracted examination items, the fixed intrinsic variation of each examination item associated with the disease name according to the designation is estimated when the examination item exhibits the fixed intrinsic variation. Is displayed together with the disease name in association with the disease name according to the designation. In addition, the associated inherent variation of each test item associated with the disease name according to the designation is presumed that the occurrence of the onset condition corresponding to the disease according to the designation is estimated when the test item manifests each associated inherent variation. The disease name and the onset condition are displayed in association with the onset condition of the disease name related to the designation.

  Thereby, it is possible to identify whether or not the designated disease has occurred by confirming the fixed intrinsic variation of the specified disease among the fixed intrinsic variations of each examination item listed and displayed. By confirming the associated inherent variation of the specified disease among the associated inherent variations of each displayed test item, it is possible to identify the onset condition for the disease name related to the specified onset of the disease, and the onset condition The treatment method can be selected according to the condition.

  Further, among the extracted test items, each fixed intrinsic variation of the test item associated with each disease of the differential disease group (differential disease of the designated disease) is the disease when the relevant test item expresses the fixed intrinsic variation. It is displayed together with the differential disease name in association with the differential disease name. On the other hand, each associated inherent variation of the test item associated with each disease of the differential disease group (differential disease of the designated disease) is the occurrence of the onset condition corresponding to the disease when the relevant test item expresses each associated inherent variation. Is displayed together with the differential disease name and the onset condition in association with the onset condition of the differential disease name.

  Then, in the test variation displayed in association with each listed examination item, the test variation of the disease name related to the designation and the test variation of the differential disease are displayed in parallel. As a result, by confirming the test variation of the same test item, the specified disease and its differential disease are differentiated by the respective test variation, and the onset of the specified disease is finally determined by excluding differential diagnosis It is possible to proceed to a definitive diagnosis after confirmation.

  On the other hand, when the specified disease is excluded due to the confirmation of the test variation, by confirming the test variation of each differential disease in the differential disease group, the onset of the specific differential disease is finally confirmed and The correct diagnosis name can be corrected on the spot.

Eb2-3) Display by multiple examination items of the same disease name Furthermore, when one disease is specified in the differential examination, the disease is extracted and all the differential diseases associated with the disease are extracted. For each disease (designated disease and its differential disease), a fixed eigenvariable type test as two or more routine tests associated with the disease is extracted, and a fixed eigenvariable type test as these two or more routine tests is performed. It is displayed in the test sequence table in a collective manner (on the average, several specific tests and more non-specific tests are displayed as this fixed intrinsic variation test). That is, for each of the specified disease and its differential disease, the test item name and test variation associated with the disease are listed and displayed in the test sequence table (the test item name is displayed in the “Item Name” column and the test variation is “ It is displayed in the “Examination Trend” column).

  At this time, since two or more test items are extracted for each disease, in the test sequence table, the same disease name (designated disease and its differential disease) is present during the test variation of two or more test items. It is displayed together with the inspection variation (fixed intrinsic variation).

  As a result, in the differential examination, it is possible to determine the onset of the disease by confirming the examination fluctuation (fixed intrinsic fluctuation) of a plurality of fixed eigenvariation type examinations by comparison of multiple items for the specified disease. It is possible to effectively prevent oversight of diseases to be discovered. In other words, it is possible to compare and examine the test variation of multiple test items (fixed intrinsic variation type test) for the specified disease (diagnosis name), to make a definitive diagnosis on the spot whether the specified disease is correct, and to specify If the disease is wrong, the correct diagnosis name can be corrected on the spot as described above.

Eb2-4) Display of differential disease name and test variation in the same test item In addition, when one disease is specified in the differential test, the disease is extracted and all differential diseases associated with the disease are extracted. In the extracted designated disease and its differential disease, all diseases (differential disease group) that can be differentiated by the same test item and the test variation are displayed in association with the test item during the test variation (test item name) Is displayed in the “Item Name” field, and the inspection variation is displayed in the “Inspection Trend” field). That is, in the “test trend” column of one test item in the test sequence table, the test variation of the differential disease that can be discriminated by the test is displayed together with the designated disease.

  In other words, in one test item, the disease names of one or more differential diseases exhibiting the same test variation as the designated disease are displayed in the “test trend” column in association with the test variation together with the disease name of the designated disease. On the other hand, the disease names of other differential diseases exhibiting a test variation different from the test variation are displayed in the “test trend” column in association with the different test variation.

  Thereby, the designated disease and the differential disease can be differentiated by comparing the test result of the test item with the test variation in the “test trend” column.

  For example, in the same test item, the specified disease exhibits a first test variation (e.g., test value increase), while the other one or more diseases are different from the first test variation (second test variation (e.g., test value decrease)). , The two types of inspection variations are displayed as inspection variations of the same inspection item. For example, the display of “test change of *** for this disease A (increase in test value, etc.) and test change of *** for disease B and C (for example, decrease in test value)” is displayed in the column of test trends. In this case, it is possible to determine whether the corresponding disease is a designated disease or a differential disease by checking whether the test result of the test item is the first test variation or the second test variation. it can.

  Therefore, by confirming the test variation of the same test item, it is possible to discriminate a differential disease that is likely to be mistaken like the designated disease by each test variation. In addition, the disease name of the specified disease and its differential disease is displayed in the test variation of multiple test items, respectively. The discrimination work can be performed, and the accuracy of the discrimination can be improved.

  At this time, when the designated disease and the differential disease exhibit the same test variation, the same test variation is displayed in association with each other for these diseases. For example, the display of “inspection fluctuation of *** (this disease A and diseases B and C are *** examination changes (examination of examination values))” is displayed in the examination trend column.

  Furthermore, at this time, in the same test item, one or more diseases including the designated disease (first disease or first disease group) exhibit the first test variation (e.g., increased test value), while one or more other When the disease (second disease or second disease group) does not exhibit a specific test variation (that is, when there is no specific test variation), in addition to the first test variation, other diseases Points that do not exhibit specific test variations are also displayed. For example, “this disease A and diseases B and C are *** test fluctuations (e.g., increased test values), and diseases D, E, and F are not specific fluctuations” or “this disease A and disease B, “C is *** test variation (elevated test value, etc.), other diseases (all diseases other than diseases A, B, C) are not specifically varied.” Is displayed in the test trend column. .

  As described above, the first disease or the first disease group including the designated disease is displayed as exhibiting a specific first test variation, while the second disease or the second disease not including the designated disease is displayed. By displaying that there is no specific variation for the disease group (or all other diseases), the first disease including the designated disease or the first disease group is a disease related to the onset Can be identified instantly.

  Conversely, in the same test item, one or more diseases (first disease or first disease group) that do not include this designated disease exhibit the first test variation (e.g., increased test value), while including this disease In the case where one or more other diseases (second disease or second disease group) do not exhibit a specific test variation (ie, when there is no specific test variation), in addition to the first test variation, The points where other diseases do not exhibit specific laboratory variations are also displayed. For example, “disease D, E, F is *** test variation (elevated test value, etc.), this disease A and disease BC have no specific variation.” Or “disease D, E, F is *** Laboratory fluctuations (e.g. increased test values), this disease A and other diseases (all differential diseases other than diseases E, D, and R) have no specific variation. To be made.

  As described above, the first disease or the first disease group not including the designated disease is displayed as exhibiting a specific first test variation, while the second disease or the second disease including the designated disease is displayed. By indicating that there is no specific variation in the disease group (or all other diseases), it is estimated that the designated disease is not the relevant disease (diagnosis is wrong and the other disease is the relevant disease) can do.

Eb2-5) Display arrangement according to the type of inspection variation (inherent variation) In the differential inspection, the inspection items displayed on the inspection arrangement table are changed from the top to the bottom of the inspection arrangement table according to the type of inspection variation. , A positive test, a whole body test, and a negative test are displayed in order.

Eb2-5-1) Affirmative test (fixed intrinsic variation test for specified disease)
First, from the top to the bottom of the test sequence table, a series of positive tests for confirming the fixed intrinsic variation of the designated disease and determining its onset are displayed. The first series of positive tests displayed is a fixed eigenvariation type test, and is displayed so that a plurality of items can be compared for the fixed eigenvariation of the extracted designated disease. That is, a series of test item names and their fixed intrinsic fluctuations for a specified disease are listed and displayed continuously from the top to the bottom of the test sequence table.

  Therefore, it is possible to make a definitive diagnosis for a designated disease by comparing and examining a plurality of examination fluctuations (fixed inherent fluctuations of a designated disease) of a series of examination items that are listed and listed.

  At this time, if the differential disease of the designated disease exhibits the same test variation (fixed intrinsic variation) for one test item, the test trend column assumes that the differential disease exhibits the same test variation for the test item. (For example, “this disease A and diseases B and C are increased in the test value” is displayed).

  In addition, at this time, if the specified test item and the differential disease have different test variations (fixed intrinsic variations) for the same test item, the specified test item and the differential disease have different test variations for the test item. It is displayed in the examination trend column (for example, “this disease A is an increase in the test value, and diseases B, C, D, and E are the test value is lowered”).

  Furthermore, at this time, if the specified disease exhibits specific test variation (fixed intrinsic variation) for the same test item, but the differential disease does not exhibit specific test variation (fixed intrinsic variation), the differential disease is It is displayed that no specific variation is exhibited (for example, “this disease A is an increase in the test value, and there is no specific variation in other diseases”).

  Therefore, it is possible to differentiate between the present disease and the differential disease by comparing and examining a plurality of test fluctuations of a series of test items that are listed and listed.

Eb2-5-2) Examination for whole body (Inherent variation test of designated disease)
In addition, following a series of positive tests, a series of whole body tests for confirming the associated inherent variation of the designated disease and determining its onset condition are displayed from top to bottom. This whole body test consists of an associated inherent variation type examination, and a series of examination item names and associated inherent variations for a specified disease are listed and displayed continuously from the top to the bottom of the examination sequence table. As described above, the whole body examination includes a partly fixed eigenvariation examination.

  Therefore, it is possible to check the test variation (accompanied inherent variation of the designated disease) of a series of examination items that are aggregated and displayed, and determine the onset condition (affected organ, inherent comorbidity, etc.) of the designated disease. .

  However, as described above, the whole-body test is mainly performed by a genetic test, a highly invasive test, and the like, and is used only when necessary.

Eb2-5-3) Negative test (fixed intrinsic variation test for differential disease)
Further, following a series of whole body tests, a series of negative tests for judging non-occurrence of the designated disease is displayed by confirming the fixed inherent variation of the differential disease and determining its onset. This series of negative tests consists of fixed eigenvariable tests. That is, the test item names and their fixed inherent fluctuations for each differential disease are listed and displayed continuously from the top to the bottom of the test sequence table.

  Therefore, it is possible to immediately determine whether or not each differential disease has been diagnosed by examining the test variation (fixed inherent variation of the differential disease) of the series of test items listed. Correct the diagnosis name).

  At this time, when multiple differential diseases exhibit the same test variation (fixed inherent variation) for one test item, the test trend column assumes that the multiple differential diseases exhibit the same test variation for the test item. (For example, “Disease B and C are increased in test value”).

  Also, at this time, if multiple differential diseases exhibit different test variations (fixed intrinsic variations) for the same test item, the test trend column indicates that the multiple differential diseases exhibit different test variations. (For example, “Disease B indicates an increase in test value, and Diseases C, D, and E indicate a decrease in test value” is displayed.)

  Furthermore, at this time, specific differential diseases for the same test item exhibit specific test fluctuations (fixed intrinsic fluctuations), while specified diseases and other differential diseases exhibit specific test fluctuations (fixed intrinsic fluctuations). If not, it is displayed that the specified disease and other differential diseases do not exhibit specific fluctuations (for example, “Disease B has an increased test value, and there is no specific fluctuation in this disease A and other diseases”). Is displayed).

Eb2-6) Example of test sequence table A typical example of the test sequence table displayed in the differential test described above is shown in FIG.

  In addition, when the above-mentioned inherent variation table is described by comparing “test item”, “disease name”, and “onset condition”, as shown in FIG. 7, for each test item, for each corresponding disease name and onset of each disease Each condition becomes a table of a three-dimensional structure in which unique inherent variations exist as data. The onset conditions do not exist innumerably for each disease, but there are types of onset conditions (specific to each disease) according to the disease, and the more specific the disease is, the easier it is to develop (inherent The more specific the disease is, the more likely the symptoms of the onset condition appear). In this way, in this inherent variation storage means, in order to always operate each examination trend in consideration of the onset condition for each disease, “inherent variation” is classified into “fixed inherent variation” and “adjoint inherent variation” ( It is expressed in association with each disease corresponding to each examination trend and stored. That is, the “fixed intrinsic variation” refers to an intrinsic variation that varies specifically (always varies) depending on the original disease (one disease name). “Accompanied inherent variation” refers to an inherent variation that varies according to the onset condition of the primary disease, that is, only after the onset condition occurs. In this way, this system can display all examination trends (cubic data structure) that can be related as various symptom examinations / differential examinations by applying the eigenvariation table, and refer to conventional medical books etc. The subtracting operation is not necessary, and it is also possible to display a plurality of items for comparison and examination (display at the top of the inspection sequence table by checking the fixed eigenvariation involved). Furthermore, it is possible to perform computer processing such as assembling routine tests and seven types of search using a control table (search for fixed specific fluctuations for all diseases and all test items).

3. Summary of the Invention 1) Features and Specific Effects of the Invention As described above, the clinical diagnosis support system according to the present invention is mainly associated with diagnosis for each disease in the conventional clinical diagnosis support system. Used in past clinical diagnosis support systems such as inherent variation, onset condition, combined disease name, inherent variation table, test sequence table, multiple item comparison study, symptom test, differential test, routine test, syndrome master file, clinical master file, etc. A number of new configurations that have never been used. In short, the clinical diagnosis support system according to the present invention includes the following features A to D as its gist, and thereby exhibits a specific effect E.

A: Inherent variation table Inherent variation table is a test item name of a fixed eigenvariable type test that is an examination item for confirming the onset of the disease itself and the variation of the test (variation contents of the test result) This is a test item for confirming the onset condition of the disease in addition to associating and storing the fixed eigenvariation, which is an associated eigenvariation type test (which has not been used for identification of the disease itself). The test item name and the associated inherent variation which is the test variation are also stored in association with the disease. Note that each of the fixed inherent variation and the accompanying inherent variation is expressed by subdividing the variation content of the inspection result of the corresponding inspection item into a minimum unit.

B: Test sequence table The test sequence table sequentially displays test item names of all fixed eigenvariable tests and all associated eigenvariable test tests associated with the disease for each disease in association with the disease. In addition, the fixed inherent variation is displayed in association with the inspection item name of each fixed eigenvariable type inspection, and the associated eigenvariation is displayed in association with the inspection item name of each associated eigenvariable type inspection. Note that the test sequence table does not extract and display the inherent variation of the inherent variation table associated with the disease as it is, but a series of inherent variations that represent the inherent variation of the inherent variation table associated with the disease. The aggregated intrinsic variation of the disease is extracted from the clinical master storing (aggregated intrinsic variation) and displayed.

C: Two-dimensionalization of the three-dimensional data structure of examination / disease / onset condition by combined disease name At this time, the test sequence table associates the associated disease name with the associated disease name and the onset condition to the associated inherent variation Only the corresponding disease name (the name of the combined disease with no onset condition) is displayed in association with the fixed intrinsic variation.

D: Multiple item comparison study At this time, the test sequence table extracts and displays at least two or more fixed intrinsic fluctuations for one disease, thereby comparing and examining two or more fixed intrinsic fluctuations for one disease. Diagnosis (comparison study of multiple items).

E: Specific effect Due to the above-described configurations A to D, a concomitant eigenvariation type test that is not conventionally used for confirmation of the disease itself (used for confirmation of complications related to the disease or affected organs) Can be extracted and displayed in association with the disease together with the associated inherent variation which is the test variation. As a result, in addition to being able to make a definitive diagnosis of the disease name based on the fixed eigenvariation of the fixed eigenvariable test and the associated eigenvariable test, the onset condition of the disease can be confirmed by confirming the associated eigenvariation of the associated eigenvariable test. And an effective treatment for the disease can be selected based on the confirmed onset condition.
In particular, with the configuration of C above, the data of the three-dimensional structure consisting of the three elements of the test item, disease name, and onset condition is converted into a two-dimensional structure (table format) by making the two elements of the disease name and onset condition into one dimension. Can be stored in the inherent variation table and displayed on the inspection sequence table.

2) Summary of features While most of the conventional clinical laboratory systems have been aimed at automatic diagnosis from the beginning, in the present invention, various variable factors can be subdivided and unitized into units that cannot be further classified. Is restructured to fit clinical practice, and basic computerized applications are introduced to medical services (not including insurance services). The subdivided variation factors (ID items) are the main unit of disease name (uniquely identified by disease name ID), examination items (uniquely identified by item ID), examination trends or inherent fluctuations (for each disease) 3 types of different fluctuation contents (identified by a compound ID of disease name ID and item ID). Since pathological changes and examination changes are different for each onset condition, the condition is redifferentiated in units of the onset condition, and is based on the cube data structure based on the inherent variation table. In addition, a symptom ID and an upper and lower ID (abnormal value ID) are added to a symptom master file that has various unavoidable diagnostic methods such as a symptom test and a differential test in clinical medicine, and for searching a summary table described later. As the expression of these onset conditions and inherent variations, the description of the current medical world is used as it is, so that the present invention can be applied immediately clinically, and most clinical medicines that are desired to be computerized can be realized by the present invention. It became. No one has experienced the large amount of data calculated by computer machines and the subdivision / accuracy of onset conditions, and all of the operations (general tests, symptom tests, missed searches, etc.) exceeding 10 in the present invention. It is no exaggeration to say that it is new. By determining the disease name, the desired test assembly can be determined from before the examination, so it is possible to set up a standard test in advance for differential tests and symptom tests consisting of multiple diseases. I was able to. As a result, it is possible to immediately apply this case in a very wide field of clinical work, and many new high-value work that could not have been anticipated can be completed in a few seconds. Applies to technology.

  In the present invention, the “general inspection button” in the summary table to be described later handles differential tests, and the “symptom test button” handles symptomatic tests, but both symptomatic tests and differential tests are included in the present invention. The use of specific routine tests is recommended. Here, the routine inspection corresponds to an inspection item in which a “check” mark is displayed in each inspection arrangement table. If only the routine examination is performed, the diagnosis is almost confirmed by the initial examination of the differential examination, or the diagnosis name is corrected and confirmed. In addition, if we perform routine tests for symptom testing, we have narrowed down to a few of the dozens of dozens of possible diseases, and if we refer to clinical findings, there are many cases that are close to diagnosis.

  In addition, the test sequence table expresses all test items, applicable diseases, onset conditions, and test trends for any disease or symptom while maintaining the three-dimensional content using the combined disease name. Is responsible for a lot of work. Since the test sequence table directly expresses the contents of the cubic (three-dimensional) data structure of FIG. 7, the fan-shaped and infinite, which has been subjected to additional research and study on clinical medicine so far All items subject to subtraction operations close to are included in this. Accordingly, the subtraction operation becomes unnecessary, and instead, it is possible to solve the subtraction operation immediately by simply performing a computer search with various terms in one inspection sequence table. This leads to a tremendous time savings. Furthermore, if you perform a standardized test with a check mark displayed at the beginning of each item by default, the test will be performed with an accuracy close to that of a specialist regardless of whether it is a general physician or a specialist. Just look at the abnormal value test trends of the test results that come together around 5 days, and the diagnosis name and the onset condition such as affected organs and complications will be displayed in the test trend column. That is, it exhibits a function close to or more than automatic diagnosis. Also, in the test sequence table, the classification of positive test, negative test, whole body test is specified, and "positive" test is displayed side by side, so multiple items comparison examination generally performed using "positive" test Can be easily achieved, and is expected to improve prominent diagnostic accuracy and diagnostic speed. The current situation in the medical community is not to list “positive” tests for test variation. And the multi-item comparative study is the source of making it possible to diagnose all diseases by utilizing exclusion diagnosis, regardless of the current very small number of specific tests. If only the diagnosis name is determined, it is possible only by the above-mentioned positive test. Various necessary onset conditions can be determined at the same time. As described above, the test arrangement table is composed of a set of useful tasks that have never been seen in the past.

  Furthermore, the present invention also includes features such as a three-item search using a management table, a symptom search (missing search), and a symptom search (combined search). That is, in the three-item search, the corresponding disease is extracted using only IDs (upper and lower IDs) only in the examination items that are frequently used among the fixed intrinsic variations. Since only fixed intrinsic fluctuations are handled, it does not include diseases that appear in the onset condition, and there is no diagnosis name detection as ambiguous detection. It is a search that is craved in the clinic, and is a mechanism that is only possible using fixed eigenvariation, so it is a rigorous and unprecedented mechanism. In addition, single disease, related disease, and limited disease are targeted for diseases satisfying conditions 1, 2, and 3 among the three conditions. In addition, in the syndrome search by the summary table (missing search, only the upper column of the summary table is used), the symptoms used in the present invention cannot be detected only by the biochemical test, and as a result, it is easy to overlook by the simple test alone. Detect disease (test that should be started with sufficient content considering various conditions from the beginning). Further, in the syndrome search (general search, use of the upper and lower columns of the management table) by the control table, among the symptoms used in the present invention, a disease in which the upper and lower IDs used in the three-item search have an abnormal value is detected ( A search that makes it possible to predict the diagnostic name from the main abnormal test values of the main symptoms is craving in the clinic). As described above, the display of the summary table is an extremely useful work that has newly occurred in this case. This is an operation that can utilize the advantages of computerization in this case, and will be described in detail in the description of the embodiments below.

4). Specific Configuration Next, a specific configuration of the system having the above features will be described.
[overall structure]
In this clinical diagnosis support system, as described above, a clinical master file is created based on the eigenvariation table storing all eigenvariations, and this clinical master file is used as a main file, and further, an examination item master file and a symptom master file. , Using the disease name master file, disease group master file, and differential disease master file, and finally displaying the characteristic variation information as medical information necessary and sufficient for clinical diagnosis by a computer processing procedure to be described later Process the inspection sequence table and display it on the screen. A schematic overall configuration of such a clinical diagnosis support system will be described with reference to FIGS. FIG. 4 shows the overall configuration of each function realization means for symptom examination processing by this clinical diagnosis support system, and FIG. 5 shows the overall configuration of each function realization means for general examination processing by this clinical diagnosis support system. Each means (function realization means) described below realizes its functions using hardware (CPU, ROM, RAM, HDD, etc.) of a computer device such as a personal computer (PC), and performs various processes (procedures). Let the computer run.

  As shown in FIGS. 8 and 9, the clinical diagnosis support system includes medical information management means 10. The medical information management means 10 includes an inherent variation master file 11 corresponding to the inherent variation table, a clinical master file 12 corresponding to the clinical master file, an examination item master file 13 corresponding to the examination item master file, and the symptom master file. A disease name master file 14 corresponding to the disease name master file, a disease group master file 16 corresponding to the disease group master file, and a differential disease master file 17 corresponding to the differential disease master file. Yes. The inherent variation master file 11 and / or clinical master file 12 constitutes the inherent variation storage means of the present invention, the examination item master file 13 constitutes the examination item storage means of the present invention, and the symptom master file 14 represents the symptoms of the present invention. The disease name master file 15 constitutes the disease name storage means of the present invention, the disease group master file 16 constitutes the disease group storage means of the Hong invention, and the differential disease master file 17 stores the differential disease of the present invention. Configure the means. The clinical diagnosis support system further includes an inherent variation registration / editing means 21 that realizes a function for registering, editing, and deleting the inherent variation for each disease and its onset condition for each examination item in the inherent variation master file 11. ing. When there is a fixed inherent variation or accompanying inherent variation to be added / deleted / corrected for a specific inspection item with respect to the inherent variation master file 11, the inherent variation data of the corresponding inspection item is obtained by the inherent variation registration / editing means 21. Additional registration / deletion / modification is possible. The clinical diagnosis support system further includes medical information registration / editing means 22. Data (test items, symptoms, disease names, etc.) to be added / deleted / corrected for each of the examination item master file 13, symptom master file 14, disease name master file 15, disease group master file 16 and differential disease master file 17 In some cases, the medical information registration / editing means 22 can additionally register / delete / correct the corresponding data. Here, each data of the clinical master file 12 is extracted / stored with reference to the corresponding data of the eigenvariation master file 11, but at this time, if there is addition / deletion / correction in the examination item or disease name, A program for automatically adding / deleting / modifying the corresponding examination item or disease name may be added with reference to the examination item master file 13 or disease name master file 15. In this way, it is possible to maintain data consistency between the master files.

  The clinical diagnosis support system further includes a symptom-corresponding candidate disease extracting unit 31 for symptom testing, a symptom summary explanation extracting unit 32 for symptom testing, and a test trend extracting unit 33 for symptom testing and general testing. The symptom correspondence candidate disease extraction means 31 refers to the disease group master file 16 when a certain symptom is designated by a symptom designation means (not shown) displayed on the operation screen, and all candidate diseases associated with the designated symptom. Are extracted and acquired from the disease group master file 16 (or disease name master file 15) and stored in the candidate disease file 31a. At this time, the symptom summary description extracting means 32 refers to the symptom master file 14 (or disease group master file 16), and displays the symptom summary description associated with the specified symptom in the symptom master file 14 (or disease group master file 16). And extracted and stored in the disease summary explanation file 32a. At this time, the examination trend extracting means 33 refers to the clinical master file 12, and the examination trends (fixed intrinsic fluctuation and associated intrinsic fluctuation) of all examination items associated with each candidate disease are obtained from the clinical master file 12. Extracted and acquired, and stored in the inspection trend file 33a. At this time, the examination trend extracting means 33 refers to the inherent variation master file 11 and the examination trends (fixed intrinsic variation and associated inherent variation) of all examination items associated with each candidate disease are inherent variation master file. It is also possible to extract the data from 11 and store it in the inspection trend file 33a. At this time, based on the symptom ID of the designated symptom and the disease name ID of the candidate disease, a verification process can be performed between the extracted candidate disease, the symptom summary description, and the examination trend, thereby performing an error check.

  The clinical diagnosis support system also includes a test storage table 41 as a test storage unit and a disease name storage table 42 as a disease name storage unit. The inspection trend extraction means 33 is specified when one or more inspection items are specified as storage targets among the inspection items stored in the inspection trend file 33a by a storage inspection specification means (not shown) displayed on the operation screen. The inspection items are output to the inspection storage table 41 and stored. Further, when one or more disease names are designated as storage targets among candidate diseases stored in the candidate disease file 31a by a storage disease name designation unit (not shown) displayed on the operation screen, the symptom correspondence candidate disease extraction unit 31 The designated disease name is output and stored in the disease name storage table 42.

  The clinical diagnosis support system includes a medical information screen processing / displaying means 50. The medical information screen processing / display unit 50 includes a candidate disease list processing / display unit 51, a symptom summary explanation processing / display unit 52, and a test sequence table processing / display unit 53 for symptom testing. The candidate disease list processing / display unit 51 acquires all candidate diseases stored in the candidate disease file 31a when a certain symptom is designated, processes the candidate diseases into a list display format, and displays the candidate disease list on the monitor screen 60. Are displayed as a candidate disease list 61 in a predetermined area. The symptom summary explanation processing display means 52 acquires a disease summary explanation stored in the disease summary explanation file 32a when a certain symptom is designated, and displays it as a disease summary explanation 62 in a predetermined area of the monitor screen 60. To do. When a certain symptom is designated, the test sequence table processing and display means 53 acquires the test item stored in the test trend file 33a and the corresponding disease and the inherent variation for each onset condition, and displays a predetermined value on the monitor screen 60. The region is displayed as a test arrangement table 63 for symptom testing.

  Further, the clinical diagnosis support system includes, in addition to the examination trend extraction means 33, a disease correspondence differential disease extraction means 34 for general examination and a disease summary explanation extraction means 35 for general examination. The disease-corresponding differential disease extraction means 34 refers to the differential disease master file 17 when a certain disease is designated by a disease designation means (not shown) displayed on the operation screen, and all the differential diseases associated with the designated disease Are extracted and acquired from the differential disease master file 17 and stored in the differential disease file 34a. At this time, the disease summary description extracting means 32 refers to the disease name master file 15, extracts and acquires the disease summary description associated with the designated disease from the disease name master file 15, and stores it in the disease summary description file 35a. At this time, the examination trend extraction means 33 refers to the clinical master file 12, and the examination trend of all examination items associated with each of the designated disease and each of the extracted differential diseases (each disease in the differential disease group) ( The fixed inherent variation and the accompanying inherent variation) are extracted and acquired from the clinical master file 12, and stored in the examination trend file 33a. As in the case of the above-described symptom test, data can be acquired with reference to the inherent variation master file 11 and stored in the test trend file 33a. At this time, based on the disease name ID of the specified disease and the disease name ID of the differential disease, a verification process may be performed between the specified disease and the extracted differential disease, the disease summary description, and the test trend, and an error check may be performed. it can. At this time, as in the case of the above-described symptom test, the designated examination item can be output and stored in the examination storage table 41, or the designated disease name can be outputted and stored in the disease name storage table 42.

  The medical information screen processing / display means 50 includes a differential disease list processing / display means 54 and a disease summary explanation processing / display means 55 in addition to the test sequence table processing / display means 53 for general examination. The differential disease list processing and display means 54 acquires all the differential diseases stored in the differential disease file 34a when a certain disease is specified, processes it into a list display format in a format for comparison with the specified disease, The differential disease list is displayed as a differential disease list 64 in a predetermined area of the monitor screen 60. The disease summary explanation processing display means 55 acquires the disease summary explanation stored in the disease summary explanation file 32a when a certain disease is designated, and displays it as a disease summary explanation 65 in a predetermined area of the monitor screen 60. To do. When a certain disease is designated, the examination sequence table processing and display means 53 acquires the examination item stored in the examination trend file 33a, the corresponding disease (designated disease and differential disease), and the inherent variation for each onset condition. Then, it is displayed in a predetermined area of the monitor screen 60 as an inspection arrangement table 63 for general inspection.

[Symptom test]
In the case of a symptom test, as described above, for each candidate disease associated with the specified symptom from the inherent variation master file 11 or the clinical master file 12, the fixed inherent variation and the associated inherent variation of each associated inspection item are obtained. All are extracted, but at this time, the inherent variation table for the group of candidate diseases is created (with the cubic data structure as shown in FIG. 7 as described above) and stored in the examination trend file 33a. Become. Then, the test sequence table 63 created based on the test trend file 33a is as shown in FIG. 5 when the test trend extracting means 33 acquires the inherent variation data from the clinical master file 12.

[General inspection]
In the case of a general test, as described above, for each specified disease and all the differential diseases associated with the disease from the inherent variation master file 11 or the clinical master file 12, the fixed inherent variation and associated parameters of each associated test item All the inherent variations are extracted. At this time, an inherent variation table for the group of differential diseases is created and stored in the examination trend file 33a. Then, the test sequence table 63 created based on the test trend file 33a is as shown in FIG. 6 when the test trend extracting means 33 acquires the inherent variation data from the clinical master file 12. Here, the data item “type” (“positive”, “negative”, “whole body”) displayed in the test sequence table 63 is an additional data item in the inherent variation master file 11 and the clinical master file 12. By storing in association with each inspection item, it is possible to display the inspection arrangement table 63 in association with each inspection. “For affirmation” means that the existence of a disease or onset condition corresponding to the inherent variation can be affirmed if the inherent variation of the inspection item can be confirmed, and “For negative” refers to the inherent variation of the inspection item. If it can be confirmed, it means that the existence of a disease corresponding to the inherent variation can be denied. Further, “for the whole body” is an inspection item other than the affirmative inspection item and the negative inspection item, and is an inspection item for observing (checking) the general state of the patient. In addition, in principle, all the items such as “No specific items for this disease” and “No specific items for other differential diseases” have been included in all items since the beginning of displaying trends of all applicable diseases. Yes. “No specific matter” means that the test result does not vary substantially.

  As described above, according to the test sequence table 63, in the case of the general test, the specific variation of the specified disease and its differential disease group is determined by using the test item and the same type (onset condition, etc.) centered on the specified disease. List systematically for each characteristic variation. In particular, in the case of a general test, the designated disease and the differential disease are displayed in the test sequence table 63 in a display mode that compares the inherent variations (fixed inherent variation and accompanying inherent variation) for each inspection item.

[Search means]
The clinical diagnosis support system further includes search means (not shown). In any of the above-described symptom tests and general tests, a desired disease name and its inherent variation in the test sequence table 63 can be searched, extracted, and displayed by designating a desired disease name by the search means. Thereby, when conducting a multiple item comparison study, the search means designates and searches for a specific disease name in the test sequence table 63, so that all related disease names and test item contents (inherent variation, etc.) Can be confirmed in a short time, or a plurality of inherent variations related to a specified disease can be confirmed together by a list display etc., and a multi-item comparison study using a test sequence table 63 for diagnosing a specific disease Can be done easily.

[Test sequence list and explanation of symptoms and diseases]
In addition, the test sequence table 63 displays the name of the combined disease for each onset condition and its inherent variation for each test item, and displays information necessary for a definitive diagnosis by a multiple item comparison study or the like. In order to provide users with more detailed and easy-to-understand information on disease information, information such as specific comorbidities, specific types of affected organs, and the history from the time of onset to the end stage are examined and distributed for each disease and symptom. It is displayed as a disease summary description 65 or a symptom summary description 62 in the vicinity (upper position, etc.) of the column table 63. Thus, the user confirms the disease to be confirmed together with the type of test item and the test trend (inherent variation of the disease) according to the test sequence table 63 and the additional information by the disease summary description 65 or the symptom summary description 62. It is possible to easily assume the entire medical information about the disease.

Next, an embodiment in the case where the clinical diagnosis support system having the above configuration is more specifically configured and implemented will be described.
1. Description of processing with reference to user interface (GUI) FIGS. 10 to 13 show screen configurations when various tests and various searches are performed using the user interface of the clinical diagnosis support system according to an embodiment of the present invention. Indicates. As shown in FIGS. 10 to 13, a medical information database apparatus (hereinafter, simply referred to as “medical information DB”) as a clinical diagnosis support system of the present embodiment has a graphical user interface ( By simply selecting necessary items step by step using a GUI), the computer is caused to execute processing for providing desired medical information. Here, the medical information DB is not shown, but the hardware (CPU, ROM, RAM, HDD, etc.) of a computer device such as a personal computer is provided with various functions as in the case of a normal computer application system and database system. Various functions are realized as (logic item means corresponding to an event driving button or the like in the window), and the computer executes various processes (processes) described later. That is, the medical information DB is normally stored in an external storage device such as a hard disk (HDD) of a computer device as a database system in which a software program (application program) for processing described later is mounted, and is used when used. By calling from, various functions corresponding means are realized by various function realization means using hardware such as CPU and RAM. Of course, a part of the function of the medical information DB can be realized by hardware logic instead of a software program.

1) General Table In detail, on the operation screen where the medical information DB is activated, only the general table window 110 is first displayed on the screen among the various windows shown in FIG. The control table window 110 includes a general examination button 111, a symptom examination button 112, first to third abnormal value selection boxes 113 to 115 including pull-down menus arranged in three upper and lower stages, a single disease button 116, and a related disease button 117. , Limited disease button 118, symptom selection box 119 consisting of pull-down menu, abnormal value selection box 120 consisting of pull-down menu, execution button 121, miss button 122, term input box 123, execution button 124, disease name input box 125, search button 126, an erase button 127, and a cancel button 128 are arranged in order from the top. As shown below, the control table window 110 performs various examinations such as examination of disease names and test items from disease name classification and symptom classification, search of disease values and examination items from abnormal values (= abnormal test values) and symptoms, etc. It is used for searching and is always displayed on the screen.

2) General inspection processing window (screen structure)
FIG. 10 shows a screen configuration at the time of general examination processing by the medical information DB of this embodiment. Details of each process described below will be described later together with a flowchart and a data structure. First, as shown in FIG. 10, a general inspection process (the above-described differential inspection process) is executed by selecting and executing a general inspection button 111 in the overall table window 110 by clicking or the like. FIG. 10 shows a state where the general inspection button 111 is clicked. In the general examination process, first, a disease name classification information providing process is executed, and a disease name classification window 130 is displayed on the screen. The disease name classification window 130 extracts all the disease name classifications (from the corresponding master files such as the inherent variation table and the clinical master file), lists them in the disease name classification table 131, and displays the list. The disease name classification is a rough classification of disease names, and includes, for example, classifications such as respiratory organs, circulatory organs, and blood diseases. Next, each row in the disease name classification table 131 of the disease name classification window 130 is freely selectable by clicking or the like, and is displayed with a specific different color (for example, yellow) to indicate that the selection is freely executable. (Shown with diagonal lines in the figure). Then, by clicking and executing one of the rows (any disease name classification) in the disease name classification table 131 of the disease name classification window 130, the disease name table of contents information providing process is executed, and the disease name table of contents window 140 is displayed on the screen. Is displayed. FIG. 10 shows a state in which “whole body” which is a specific disease name classification in the disease name classification table 131 is clicked. The disease name table of contents window 140 extracts all the disease names belonging to the disease name category selected in the disease name classification table 131 (from the corresponding master file such as the inherent variation table and clinical master file) and stores them in the disease name table 141 as the disease name table of contents. Enumerate and display a list. FIG. 10 shows a state where disease names (such as “glycogen”) are displayed as a list when “whole body” is selected in the disease name classification table 131.

  Next, each row in the disease name table 141 of the disease name table of contents window 140 can be selected and executed by clicking or the like, and is displayed with a specific different color (for example, yellow) to indicate that the selection can be executed. (Shown with diagonal lines in the figure). Then, by clicking on any row (any disease name) in the disease name list 141 of the disease name table of contents 140 and executing the selection, examination item information provision processing (examination table information provision processing and examination summary) Information provision processing), disease summary information provision processing, and differential disease information provision processing (differential disease name index information provision processing and differential disease summary information provision processing) are executed. That is, as shown in FIG. 10, by selecting and executing any disease name in the disease name list 141 of the disease name table of contents window 140, a test sequence table window 150, a disease summary window 160, and a differential disease table of contents window 170 are displayed simultaneously. Is displayed. The inspection arrangement table window 150 displays the inspection item column 151, the inspection trend display column 152, and the check column 153 in a table format. The test item column 151 extracts data (from a corresponding master file such as an inherent variation table and a clinical master file) corresponding to the disease name selected in the disease name list 141 (all used for the disease of the disease name). And list them. In addition, the test trend display column 152 extracts data of the test trend explanation text (from the corresponding master file such as the inherent variation table and clinical master file) corresponding to the test item in the test item column 151 in the left column. And list them. That is, the test sequence table window 150 is a table for each test item showing the types of tests meaningful for each disease and their test trends. And the test | inspection arrangement | sequence list window 150 has described the disease fundamentally, contrasting with a differential disease (≒ similar disease), and is a fundamental component in this medical information DB with the corresponding | compatible data structure mentioned later. Note that FIG. 10 shows a state in which “glycosylosis”, which is a specific disease name in the disease name list 141, is clicked. Check boxes 154 are each provided with a check box. By checking or unchecking the check box, whether or not the corresponding inspection item in the inspection item field 151 in the right column is to be a target of storage processing to be described later. Can be selected. In the initial setting (default), in the examination item column 151, a plurality of unique examination items are listed for each disease name selected from the disease name window 140, and an initial examination item (described above) among the examination items is described. A check box in the check field 153 is pre-checked for an inspection item that corresponds to a standard inspection). In addition, the user can freely check or uncheck the check boxes in the check column 153 including the check of the initial inspection items. FIG. 10 shows that when “Glycogenosis” is selected in the disease name list 141, all test items (such as “* CBC”) that can be used in the “Glycogenosis” test are displayed in the test item column 151. The list is displayed, and the inspection trend display column 152 shows a state in which explanations of those inspection trends are respectively displayed. At this time, the check box in the check column 153 corresponding to the initial inspection item (* CBC) or the like is checked in advance.

  Here, in the inspection item column 151 of the inspection arrangement table window 150, in addition to the inspection item, one of three kinds of type symbols indicating the inspection type is added and displayed at the head (left side) of the inspection item. The That is, this medical information DB classifies and stores the test items into three types of test items: a positive test item, a negative test item, and a detailed test item (corresponding to the whole body test described above). The positive test item is a test item in which the presence of the corresponding disease (the disease with the disease name selected in the disease name table of contents window 140) is affirmed when the test item becomes positive. On the other hand, when a test item for negative is positive, the presence of a disease that is affirmed by the test item is estimated. This is a test item for which the existence of (disease) is denied. The inspection items for examination are inspection items other than the affirmative inspection items and the negative inspection items, and are inspection items for observing (checking) the patient's general condition. This inspection for inspection includes very important inspection items among all inspection items. That is, the examination items for scrutiny include many high-priced and high-inspection tests that are widely used to distinguish candidate diseases mainly from each differential disease. For example, in addition to the specific blood test as the specific test, an image test, a physiological test, a pathological test, a bacterial test, an endoscopic test, an isotope test, and the like correspond to the examination for detailed examination. In addition, even in the same disease, the test value varies depending on the subtype and the situation. Therefore, a necessary test according to the medical condition is included in the examination for examination. As shown in FIG. 10, the medical information DB includes “* (flower-shaped symbol)” for a positive test item and “-( “(Bold minus sign)” is added, and a blank (space) symbol is added to the inspection item for inspection (that is, nothing is added on the display). In addition, at the upper end of the test item column 151 and the like of the test sequence table window 150, the explanatory text of the mark (... "*" Is for affirmation, "-" is for denial, and " A display field for displaying ..) is arranged.

  A check release button 154 and a save button 155 are arranged at the lower end of the inspection arrangement table window 150. By selecting and executing the check release button 154 by clicking or the like, all the check boxes in the check column 153 are released (removed). In addition, each check box in the check field 153 can be selected by using a mouse or the like and individually checked or unchecked.

  The disease summary window 160 is displayed on the screen near the disease name table of contents window 140 (such as the right side) when the disease summary information providing process is executed, and the disease name display column 161 and the disease summary display column 162 are moved up and down. Are arranged and displayed. At this time, the disease name display field 161 extracts and displays the selected disease name (from a corresponding master file such as an inherent variation table, a clinical master file, and a disease name master file (not shown)). The disease summary display field 162 stores a disease summary of the disease name displayed in the disease name display field 161 (a disease name master file (not shown) or the like, associated with a disease-specific medical book description (disease summary)). Data is extracted from the corresponding master file and displayed. The disease summary explains the disease state and corresponds to the disease summary described in a general medical book. FIG. 10 shows a state in which, when “Glycogenosis” is selected in the disease name list 141, the disease name is displayed in the disease name display column 161, and an explanatory text of the disease overview is displayed in the disease summary display column 162. Further, a disease name memo button 163 is arranged at the upper end of the disease summary window 160. When an arbitrary disease name is selected in the disease name list 151 of the disease name table of contents window 150, the differential disease table of contents window 170 is displayed on the screen below the vicinity of the disease name table of contents window 140 when the process of providing the differentiated disease information is executed. Is. At this time, the differential disease table of contents window 170 extracts and differentiates all the differential disease names (belonging to the same differential disease group) related to the disease name selected in the disease name list 141 (from the corresponding master file such as the differential master file). Listed in the disease name list 171 as a list. That is, the differential disease table of contents window 170 displays similar diseases that are easily mistaken as a list each time one disease is selected in the disease name table of contents window 140. FIG. 10 shows a state in which a differential disease (such as “insulin-producing tumor”) of the disease is displayed in the differential disease name list 171 when “glycogen” is selected in the disease name list 141.

  Next, each row in the inspection item column 151 of the inspection arrangement table window 150 can be selected and executed by clicking or the like, and is displayed in a specific different color (for example, yellow) to indicate that the selection can be executed. Yes (indicated by diagonal lines). Then, as shown in FIG. 10, the inspection summary information providing process is performed by clicking and clicking on any row (any inspection item) in the inspection item column 151 of the inspection arrangement table window 150. As a result, the examination summary window 180 is displayed on the screen in the vicinity (for example, the right side) of the examination sequence table window 150. The inspection summary window 180 displays the inspection item display field 181 and the inspection summary display field 182 arranged vertically. At this time, the examination item display field 181 is an examination item field (from a corresponding master file such as an examination master file (not shown) or the like stored in association with the examination item-specific medical book item (examination summary)). The inspection item name selected in 151 is extracted and displayed, and the inspection summary display column 182 extracts and displays an outline (description) of the inspection content of the inspection item name in the inspection item display column 181. It is like that. In other words, when an examination item (examination name) in the examination arrangement table window 150 is clicked, the examination summary window 180 displays the purpose of the examination, the target disease, the trend of the examination value, etc. as an explanatory text. Primarily for blood tests. FIG. 10 shows a state where “Ca” is clicked in the inspection item column 151, and the inspection item name is displayed in the inspection item display column 181, and an explanatory text of the inspection summary is displayed in the inspection summary display column 182.

  Each row in the differential disease name list 171 of the differential disease table of contents window 170 can be selected and executed by clicking or the like, and is displayed in a specific different color (for example, yellow) to indicate that the selection can be executed. Yes (indicated by diagonal lines). Then, as shown in FIG. 10, by selecting and executing any row (any differential disease name) in the differential disease name list 171 of the differential disease table of contents window 170, the differential disease summary window 190 is displayed. Displayed on the screen. The differential disease summary window 190 displays the differential disease name display column 191 and the differential disease summary display column 192 arranged vertically when the differential disease summary information provision process is executed. At this time, the differential disease name display field 191 includes a differential name related to the selection (from a corresponding master file in which a disease-specific medical book description item (disease summary) is stored in association with a disease, such as a disease name master file (not shown)). The disease name (that is, the disease name in the master file) is extracted and displayed, and the differential disease summary display column 192 is the differential disease overview of the differential disease name in the differential disease name display column 191 (that is, the corresponding disease in the master file). Outline) is extracted and displayed. FIG. 10 shows a state in which, when “insulin-producing tumor” is selected in the differential disease name list 191, the same disease name is displayed in the differential disease name display column 191, and a description of the disease overview is displayed in the differential disease overview display column 192. Show. Further, a disease name memo button 193 is arranged at the upper end of the differential disease summary window 190. Thus, the differential disease summary window 190 has the same configuration as the disease summary window 160.

  Next, as described above, in the state of FIG. 10 in which any one or more check boxes in the check column 153 of the inspection sequence table window 150 are checked, the save button 155 is clicked and executed. Thus, the inspection item temporary storage process (inspection item storage process) is executed, the checked inspection item is temporarily stored in the corresponding memory, and the inspection storage table window 200 is displayed on the screen. At this time, the inspection storage table window 200 extracts all the stored inspection items from the corresponding memory, lists them in the storage inspection item list 201, and displays the list. The inspection storage table window 200 has an erase button 202 arranged at the lower end. By selecting and executing the deletion button 202 by clicking or the like, all the stored inspection items are deleted, and the inspection storage table window 200 is closed. FIG. 10 shows a state in which inspection items (usually initial inspection items) that are checked in the check column 53 are temporarily stored among the inspection items for “glycosylosis” and are listed in the storage inspection item list 201. Indicates.

  On the other hand, as shown in FIG. 10, a disease name temporary storage process (disease name storage process) is executed by clicking and executing a disease name memo button 163 in the disease overview window 160, and the disease name is stored in the corresponding memory. The data is saved and the disease name storage table window 210 is displayed on the screen. At this time, the disease name storage table window 210 extracts all stored disease names from the corresponding memory, lists them in the stored disease name list 211, and displays the list. The disease name storage table window 210 has an erasure window 212 at the lower end. By clicking and deleting the deletion window 212 or the like, all the stored disease names are deleted, and the disease name storage table window 210 is closed. FIG. 10 shows a state in which “glycogen” in the disease overview window 160 and “insulin-producing tumor” in the differential disease overview window 190 are temporarily stored and listed in the stored disease name list 211. Furthermore, each row in the stored disease name list 211 of the disease name storage table window 210 can be selected and executed by clicking or the like, and is displayed with a specific different color (for example, yellow) to indicate that the selection can be executed. (Indicated by diagonal lines in the figure). The disease name classification window 130, the disease name table of contents window 140, the test sequence table are selected and executed by clicking any row (any disease name) in the stored disease name list 211 of the disease name storage table window 210. The window 150, the disease summary window 160, the differential disease table of contents window 170, the examination summary window 180, and the differential disease summary window 190 are all closed and their contents are erased to correspond to the disease name selected in the stored disease name list 211. Then, the test item information providing process, the disease summary information providing process, and the differential disease information providing process are newly executed, and the test sequence table window 150, the disease summary window 160 corresponding to the newly selected disease name, and The differential disease table of contents window 170 is simultaneously displayed on the screen.

  In FIG. 10, all the windows are displayed on the screen. However, as described above, only the control table 110 is displayed on the initial screen, and the other windows are displayed each time according to the operation (processing). The

  On the other hand, when another disease name classification in the disease name classification table 130 is clicked and executed from the state of FIG. 10, all windows after the disease name table of contents window 140 displayed so far are closed. For example, in the case of FIG. 10, the disease name table of contents window 140, examination sequence table window 150, disease summary window 160, differential disease table of contents window 170, examination summary window 180, and differential disease summary window 190 displayed for the disease name classification “whole body” are all included. Closed. The examination storage table window 200 and the disease name storage table window 210 are not closed and are continuously displayed. Then, for the newly selected disease name classification, a new disease name table of contents window 140 is displayed on the screen by the same processing as described above. When “endocrine” is newly clicked as the disease name classification, all disease names belonging to the disease name classification “endocrine” are listed in the disease name table of contents window 140. When an arbitrary disease name in the disease name table of contents window 140 is clicked and executed, the examination sequence table window 150, the disease summary window 160, and the differential disease table of contents window 170 are simultaneously displayed for the selected disease name by the same processing as described above. Is displayed. For example, when the disease name “growth hormone secretion deficiency” is clicked in the disease name table of contents window 140, contents specific to the disease name are displayed in the windows 150, 160, and 170. Next, when a disease name memo button 163 in the disease overview window 160 is pressed, the disease name is newly added to the disease name storage table window 210.

  Next, when an arbitrary disease name is clicked and executed in the disease name storage table window 210, the examination sequence table window 150, the disease summary window 160, and the discrimination are performed by the same processing as when the disease name is clicked in the disease name table of contents window 140. A disease table of contents window 170 is simultaneously displayed on the screen. For example, when a disease name “insulin-producing tumor” is clicked in the disease name storage table window 210, contents specific to the disease name are displayed in the windows 150, 160, and 170. Further, when the save button 155 of the test sequence table 150 is pressed, all test items displayed in the test sequence table 150 in that state are added to the test storage table window 200. Further, when the delete button 202 of the inspection storage table window 200 is pressed, all the stored contents (storage inspection items) of the inspection storage table window 200 until then are deleted, and the inspection storage table window 200 is also closed. Similarly, when the delete button 212 in the disease name storage table window 210 is pressed, all the stored contents (stored disease names) in the disease name storage table window 210 are deleted and the disease name storage table window 210 is also closed.

3) Symptom examination processing window (screen structure)
FIG. 11 shows a screen configuration during the symptom examination process by the medical information DB of the present embodiment. As shown in FIG. 11, the symptom test process is executed by selecting and executing the symptom test button 112 in the overall table window 110 by clicking or the like. This symptom test process can be executed at an arbitrary timing such as an initial state in which only the control table window 110 is displayed on the screen, and a state in which various windows of the general test process are displayed. For example, as shown in FIG. 11, when the symptom test button 112 in the summary table window 110 is selected and executed, first, in the symptom test process, a symptom classification information providing process is executed. All the displayed windows (such as the disease name table of contents window 140 and the examination storage table window 150) are closed, and a new symptom classification window 230 is displayed on the screen as shown in FIG. If the examination storage table window 200 or the disease name storage table window 210 is displayed, the examination storage table window 200 and the disease name storage table window 210 are continuously displayed without being closed. The symptom classification window 230 extracts all the symptom classifications (from a corresponding master file such as a symptom master file), lists them in the symptom classification table 231 and displays them in a hierarchical list. The symptom classification is a rough classification of symptoms such as impaired consciousness, abnormal liver function, anemia, and the like. In addition to normal symptoms, the symptom classification window 230 also includes an abnormal value (an abnormal value of a specific test item that becomes positive when the test value goes up or down (increase or decrease)). , Extracted from the corresponding master file, listed as one of the symptoms, and listed in the symptom classification table 231. In other words, the medical information DB can check for abnormal values as one of the important symptoms as well as the symptoms.

  Next, each row in the symptom classification table 231 of the symptom classification window 230 can be selected and executed by clicking or the like, and is displayed with a specific different color (for example, yellow) to indicate that the selection can be executed. (Shown with diagonal lines in the figure). Then, as shown in FIG. 11, a symptom table of contents window 240 is displayed on the screen by selecting and executing any row (any classification item) in the symptom classification table 231 of the symptom classification window 230. The The symptom table of contents window 240 extracts data (from a corresponding master file such as a syndrome master file) to which all the symptoms of the symptom classification selected in the symptom classification list 231 fall within the symptom classification list 241. Enumerate and display a list. Here, the symptom disease name list 241 displays a list of all disease names corresponding to the selected symptom as a disease name table of contents, and displays the symptoms to which the disease name group belongs above (the top row) of the disease name group “[base ] "Symptom". Similarly, the symptom disease name list 241 also displays a list of all disease names corresponding to the selected abnormal value as an abnormal value (examination item related to abnormality) as a disease name table of contents, and the upper side (topmost) of those disease name groups. The abnormal value to which the disease group belongs is displayed as “[base] abnormal value”. That is, in the disease name list 241, disease names that cause one symptom or one abnormal value are listed, and an average of about several tens of diseases is listed for one symptom, and one abnormal value is more than this. In many cases, the number of diseases is listed. FIG. 11 shows that when “vertigo” is selected in the symptom classification table 231, the selected symptom (“[base] vertigo” as the [base] symptom) and the symptom belong to the symptom disease name list 241. The disease name group and the subordinate symptoms ([[base] hypoglycemia], [[base] anemia] etc. as the [base] symptom) of the selected symptom (“dizziness”) and the disease name group belonging to the symptom Indicates the state displayed in the list.

  Next, each row in the symptom list window 241 of the symptom table of contents window 240 can be selected and executed by clicking or the like, and is displayed in a specific different color (for example, yellow) to indicate that the selection can be executed. Yes (indicated by diagonal lines). Then, by clicking on any row ([base] symptom or disease name) in the symptom table name window 241 of the symptom table window 240 and performing selection, the same examination item information as in the disease name table window 140 is executed. Providing process, symptom / disease summary information providing process and differential disease information providing process (slightly different from the case of the disease name table of contents window 140) are executed. As shown in FIG. A window 160 and a differential disease table of contents window 170 are simultaneously displayed on the screen. Here, the symptom / disease summary information providing process is a process corresponding to the disease summary information providing process of the general examination process (details will be described later), and the disease summary window 160 is located near the symptom table of contents window 240. (Right side etc.) is displayed on the screen. At this time, when a symptom or abnormal value (top position), which is an item prefixed with [group] in the symptom list 2401 of the symptom table of contents window 240, is clicked, the disease summary display field 162 of the disease summary window 160 is displayed. Is a summary of all the diseases related to the symptom or abnormal value (diseases with the disease name listed below the symptom or abnormal value) and examination notes (such as disease name master file, symptom master file, etc.) The data is extracted from the corresponding master file in which the medical book description items (disease summary) unique to the disease group are associated and stored. At the same time, a test sequence table window 150 is displayed below the disease summary window 160. In the test item column 151 of the test sequence table window 150, test items and the like considering all the diseases are displayed. Are listed and displayed (extracted from a corresponding master file such as a clinical master file). In addition, when any disease name (listed under the symptoms or abnormal values) is clicked in the symptom table 2401 of the symptom table of contents window 240, the disease summary name is displayed in the same manner as the disease summary information providing process of the general examination process. Are displayed in the test sequence table window 150, the disease summary of the disease name is displayed in the disease overview window 160, and the differential disease of the disease name is displayed in the differential disease table of contents window 170.

  FIG. 11 shows a list of test items (such as “CBC”) corresponding to the test item column 151 of the test sequence table window 150 when “[base] dizziness” is selected in the symptom disease list 241. The state in which the explanatory text of the inspection trend corresponding to the display field 152 is displayed is shown. At this time, the check box in the check column 153 corresponding to the initial inspection item (such as “CBC”) is checked in advance. FIG. 11 shows that when “[base] dizziness” is selected in the symptom disease name list 241, the same symptom name is displayed in the disease name display field 161 of the disease summary window 160, and the disease related to the symptom is displayed in the disease summary display field 162. The state where the summary explanation is displayed. As shown in FIG. 11, when a symptom such as “[base] dizziness” is selected in the symptom disease name list 241, the diseases listed after the symptom “[base] dizziness” correspond to differential diseases. In the differential disease table of contents window 170, no option is displayed, and “the disease group” is displayed. Next, as in the case of the general inspection process, with one or more check boxes in the check column 153 of the inspection sequence table window 150 checked, click the save button 155 as shown in FIG. Thus, the inspection item temporary storage processing (inspection item storage processing) is executed, and the checked inspection item is temporarily stored as data, and the inspection storage table window 200 is displayed on the screen. As other processes, the display process of the examination summary window 180, the display process of the disease name storage table window 210, and the like can be freely executed as described in the section of the general examination process.

  On the other hand, when another symptom classification in the symptom classification table 230 is selected and executed in the state shown in FIG. 11, all windows after the symptom table of contents window 240 displayed so far are closed. For example, the symptom table of contents window 240, examination sequence table window 150, disease summary window 160, and differential disease table of contents window 170 of FIG. 11 displayed for the disease name classification “dizziness” are all closed. At this time, if the inspection storage table window 200 is displayed, the inspection storage table window 200 is not closed and the display is continued as in the case of the general inspection processing. Further, even when the disease name storage table window 210 is displayed, the disease name storage table window 210 is continuously displayed. Then, a new symptom table of contents window 240 is displayed on the screen for the newly selected symptom classification by the same processing as described above.

4) Single disease search processing window for 3 item search processing (screen configuration)
A three-item search process by the medical information DB of this embodiment will be described. As shown in FIG. 12, predetermined abnormal value items are selected from those displayed in a list (pull-down display) in the first to third abnormal value selection boxes 113 to 115, respectively, and a single disease button 116 and a related disease button 117 are selected. Alternatively, a single disease search process, a related disease search process, or a limited disease search process of a three-item search process is executed by selecting and executing one of the limited disease buttons 118 by clicking or the like. This three-item search process can be executed at an arbitrary timing even in an initial state where only the control table window 110 is displayed on the screen, and in a state where various windows such as the general examination process and the symptom examination process are displayed. is there. The abnormal values displayed in the first to third abnormal value selection boxes 113 to 115 are abnormal values exceeding the normal value (or normal value range) in a predetermined inspection item (indicated by an upward arrow “↑”), This is a test item in which a test abnormality such as an abnormal value (indicated by a downward arrow “↓”) or a positive value (indicated by a plus mark “+”) less than a normal value (or a normal value range) is confirmed. In the three-item search process, when the single disease button 116 or the like is selected and executed in a state where various windows such as the general examination process and the symptom examination process are displayed, the control table window 110, the examination storage table window 200, and the disease name storage table window Except for 210, the disease name table of contents window 140 and the like displayed so far are all closed, and a new disease name table of contents window 140 is displayed on the screen. The newly displayed disease name table of contents window 140 corresponds to three selected abnormal values (one of three abnormal values for single disease search, two for related disease search, and three for limited disease search). All the disease names that are estimated to exist at the time are extracted (from the corresponding master file such as a clinical master file), listed in the disease name list 141, and displayed as a list. FIG. 12 shows that “ESR ↑”, “TP ↑”, and “Cr ↑” are selected in the first to third abnormal value selection boxes 113 to 115 of the control table window 110 and the limited disease button 116 is pressed. In the case where all of these three items are applicable, all the diseases (disease names) that are estimated to exist are extracted, and the disease name list 141 of the disease name table of contents window 140 lists the disease names of those diseases. Indicates.

  Next, in the display state of the disease name table of contents window 140 by the three-item search process, for example, in the state of the single disease search process, the related disease search process or the limited disease search process, any of the disease name list 141 in the disease name table of contents window 140 By clicking and clicking on a row (any disease name) or the like, the examination item information providing process, the disease summary information providing process, and the differential disease information providing process are executed in the same manner as described above. For example, when an arbitrary disease name in the disease name table of contents window 140 is clicked in the state of limited disease search processing, the examination sequence table window 150, the disease summary window 160, and the differential disease table of contents window 170 having unique contents corresponding to the disease name are simultaneously displayed on the screen. Is displayed. FIG. 12 corresponds to the test item column 151 of the test sequence table window 150 when “multiple myeloma (MM)” is selected in the disease name list 141 of the disease name index window 140 in the state of limited disease search processing. Inspection items (such as “* CBC”) are displayed in a list, an explanatory note of the inspection trend corresponding to the inspection trend display column 152 is displayed, and a check column 153 indicates a state in which the check for the initial test item is checked. Similarly, FIG. 12 shows that when “multiple myeloma (MM)” is selected in the disease name list 141, the disease name is displayed in the disease name display column 161 of the disease summary window 160, and the disease summary is displayed in the disease summary display column 162. Indicates that the explanation is displayed. Similarly, FIG. 12 shows that when “multiple myeloma (MM)” is selected in the disease name list 141, the differential disease (“malignant neoplasticity”) in the differential disease name list 171 of the differential disease table of contents window 170 is selected. This shows a state where “high Ca blood” is displayed.

In addition, as in the above example, normally, the abnormal values of the three items in the first to third abnormal value selection boxes 113 to 115 are selected, and each button 116 to 118 is pressed to perform a three item search process (single disease search process). The related disease search process and the limited disease search process) are preferably executed, but only one abnormal value may be selected and executed (in this case, a single disease search process is possible), 2 Processing may be executed by selecting only abnormal values (in this case, single disease search processing and related disease search processing are possible). The options (abnormal values) in the first to third abnormal value selection boxes 113 to 115 are all the same.

5) Term search window (screen configuration)
As shown in FIG. 12, a term search process is executed by inputting an arbitrary term (medical term) into the term input box 123 of the control table window 110 and selecting and executing it by clicking the execution button 124 or the like. In the term search process, a term search form window 250 is newly displayed on the screen. The term search form window 250 extracts data from a corresponding master file (such as a disease name master file) of a set of a disease summary including the input term and a disease name having the disease summary, and the disease name is described in the term column 251 as a term explanation. A summary of the disease is displayed in a column 252. When there are a plurality of sets (records) of disease outlines including the input terms and their disease names, all of the disease outlines and disease names are extracted. In other words, the term search form window 250 has a page break portion 253 arranged at the lower end portion, and the next page is clicked on the next page, the back button, the last page button, or the top page button. You can open the previous page, jump to the last page or top page. As described above, the term search process is a process for searching for an explanation of a medical term whose contents are not understood during a diagnosis work. The term search process is a process that can be executed at an arbitrary timing regardless of the above-described processes. In the term search process, since “disease overview” of all diseases including the term input in the term input box 123 is displayed in the term search form window 250, the term search is performed on the term search window 250, It is possible to easily search the description part of the term. For example, in the state of FIG. 12, “multiple myeloma (MM)” is displayed as a candidate disease on the disease summary window 160 and the content is confirmed. In this case, the user relates to the disease. As a term, when it is desired to confirm the content of “T cell”, “T cell” is entered in the term input box of the control table window 110 and the execute button 124 is pressed. As a result, all disease outlines and disease names including the term “T cell” in the sentence are extracted and sequentially displayed in the term search form window 250 by operating the page breaker 253.

6) Syndrome search processing combined search window (screen configuration)
The composite search process of the symptom search process by the medical information DB of the present embodiment will be described. As shown in FIG. 13, a predetermined symptom (the same item as the symptom classification 230 is listed) is selected in the symptom selection box 119 of the control table window 110, and an abnormal test item (3-item search) is selected in the abnormal value selection box 120. The same item as the abnormal value is displayed in a list), and by selecting and executing by clicking the execution button 121 or the like, a composite search process which is one of the symptom search processes is executed. This composite search process can be performed at any timing even in the initial state in which only the control table window 110 is displayed on the screen, or in the state in which various windows such as the general test process, the symptom test process, and the three-item search process are displayed. It can be executed with. In the combined search process, when the execution button 121 is selected and executed in a state where various windows such as a general test process, a symptom test process, and a three-item search process are displayed, the control table window 110, the test storage table window 200, and the disease name storage Except for the table window 210, all the disease name table of contents windows 140 and the like that have been displayed are closed. For example, from the state of FIG. 12, when a predetermined symptom is selected in the symptom selection box 119 and an abnormal test item is selected in the abnormal value selection box 120 and the execution button 121 is selected and executed, as shown in FIG. The displayed disease name table of contents window 140 and the like are all closed, and a new disease name table of contents window 140 is displayed on the screen. This newly displayed disease name table of contents window 140 is a data (from the corresponding master file such as a clinical master file) of all disease names that are estimated to exist when both the selected symptom and abnormal value (both conditions) are met. These are extracted and listed in the disease name list 141 and displayed as a list. FIG. 13 shows that both conditions are met when the user selects “Thirsty” and “K ↓” in the symptom selection box 119 and the abnormal value selection box 120 in the control table window 110 and presses the execution button 121, respectively. Diseases (disease names) that are sometimes presumed to be extracted are all extracted, and the disease name list 141 in the disease name table of contents window 140 displays the names of those diseases (such as “tubule acidosis (RTA)”). Show.

  Next, in the display state of the disease name table of contents window 140 by the combined search process, for example, in the state of FIG. 13, click on any row (any disease name) in the disease name list 141 of the disease name table of contents window 140 to select it. By executing, the process for providing the test item information, the process for providing the disease summary information, and the process for providing the differential disease information are executed. For example, as shown in FIG. 13, when an arbitrary disease name in the disease name table of contents window 140 is clicked, the examination sequence table window 150, the disease summary window 160, and the differential disease table of contents window 170 having unique contents corresponding to the disease name are simultaneously displayed on the screen. Is done. FIG. 13 shows a list of test items (such as “* Na · K”) corresponding to the test item column 151 of the test sequence table window 150 when “Barter syndrome” is selected in the disease name list 141 of the disease name table of contents window 140. An explanation of the inspection trend corresponding to the inspection trend display column 152 is displayed, and the check column 153 shows a state in which the check for the initial test item is checked. Similarly, FIG. 13 shows that when “Bartter's syndrome” is selected in the disease name list 141, the disease name display field 161 of the disease summary window 160 displays the disease name and the disease summary description field 162 displays the disease summary description. Indicates the state. Similarly, FIG. 13 shows that when “Bartter's syndrome” is selected in the disease name list 141, a differential disease (“primary aldosteronism” or the like) of the disease is included in the differential disease name list 171 of the differential disease table of contents window 170. Indicates the displayed state.

7) Window during missed inspection processing (screen structure)
The miss search process of the symptom search process by the medical information DB of the present embodiment will be described. By selecting a predetermined symptom from the symptom selection box 119 of the control table window 110 and selecting and executing it by clicking the miss button 122 or the like, an oversight inspection process which is one of the symptom search processes is executed. . In the missed inspection process, selection in the abnormal value selection box 120 is not necessary. This missed search process is not limited to the initial state in which only the control table window 110 is displayed on the screen, the state in which various windows such as the general examination process, the symptom examination process, and the three-item search process are displayed. It can be executed at the timing. In the missed search process, when the execution button 121 is selected and executed in a state in which various windows such as a general examination process, a symptom examination process, and a three-item search process are displayed, the overall table window 110, the examination storage table window 200, and the disease name Except for the storage table window 210, the disease name table of contents window 140 and the like displayed so far are all closed. For example, when a predetermined symptom is selected in the symptom selection box 119 from the state shown in FIG. 13 and the miss button 122 is selected and executed, all the disease name table of contents windows 140 and the like that have been displayed are closed, and a new disease name table of contents window is displayed. 140 is displayed on the screen. The newly displayed disease name table of contents window 140 displays all diseases (disease names) that are easily judged as “no abnormality” (easy to be overlooked) when there is no abnormality in the biochemical test when the selected symptom corresponds. Data is extracted (from a corresponding master file such as a clinical master file), listed in the disease name list 141, and displayed as a list. For example, when “dry mouth” is selected in the symptom selection box 119 of the control table window 110 and the miss button 121 is pressed, a test applicable to the symptom and used for the symptom (in this document, Although it is referred to as “general-purpose examination”, details are detailed in the section on missed search processing), and all diseases (sick names) that are presumed to exist (possibly missed) when no abnormal value is output are extracted and disease names In the disease name list 141 of the table of contents window 140, disease names of these diseases (such as “salivary gland enlargement disease”) are displayed as a list.

  Next, from this state, by clicking on any row (any disease name) in the disease name list 141 of the disease name table of contents 140 and executing the selection, the test item information providing process, disease summary information Providing process and differential disease information providing process are executed, and the test sequence table window 150, the disease summary window 160 and the differential disease table of contents window 170 are simultaneously displayed on the screen in the same manner as in the combined search process. For example, when “diarrhea” is selected in the disease name list 141 in the disease name list window 140, the test items (“* Na · K”, etc.) corresponding to the test item column 151 in the test sequence table window 150 are displayed as a list. Then, a description of the inspection trend corresponding to the inspection trend display field 152 is displayed, and a check for the initial inspection item is entered in the check field 153. Similarly, for example, when “diarrhea” is selected in the disease name list 141, the disease name is displayed in the disease name display column 161 of the disease summary window 160, and the disease summary description is displayed in the disease summary display column 162. Similarly, for example, when “diarrhea” is selected in the disease name list 141, a differential disease (“tubulointerstitial nephritis (TIN)) of the disease is included in the differential disease name list 171 of the differential disease table of contents window 170. Is displayed.

  Each process of the general examination process, symptom examination process, three-item search process (single disease search process, related disease search process, limited disease search process), and symptom search process (combined search process, missed search process) As described above, both are processes that can be executed at an arbitrary timing. When a button for the process is pressed, the previous display window is closed and a window specific to the process is newly displayed. . The term search process is also a process that can be executed at an arbitrary timing as described above. In this case, the term search form window 250 is additionally displayed without closing the previous display window.

  Next, as described above, any one of the first to third abnormal value selection boxes 113 to 115, the symptom selection box 119, the abnormal value selection box 120, the term input box 123, and the disease name input box 125 of the control table window 110 is selected. When one or more corresponding data is selected or input and displayed (for example, see FIG. 12 and FIG. 13), the selected contents are selected and executed by clicking the delete button 127 of the control table window 110 or the like. In addition, a process for erasing all input contents is executed.

Here, in this medical information DB, until the erasure button 202 of the examination storage table window 200 is pressed (selection is executed), the symptom examination process, the three-item search process, and the like are executed subsequently to the general examination process. Even if the inspection arrangement table window 150 or the like is closed, the inspection storage table window 200 is continuously displayed, and the storage contents (stored inspection items) are stored and held and are not erased. On the other hand, when the cancel button 128 of the overall table window 110 is pressed or the medical information DB is terminated, the stored contents (stored test items) in the test storage table window 200 are deleted. Therefore, the delete button 202 of the examination storage table window 200 is pressed, the stop button 128 of the management table window 110 is pressed, or the save button 155 of the examination sequence table window 150 is pressed until the medical information DB is terminated. Thus, inspection items can be freely added at any time and stored cumulatively. Similarly, in this medical information DB, until the erasing button 212 of the disease name storage table window 210 is pressed (selection is executed), the symptom inspection process, the single disease search process, and the like are executed by executing the symptom test process and the single disease search process after Even if the disease summary window 160 or the like is closed, the disease name storage table window 210 is continuously displayed, and the stored contents (stored disease names) are stored and not deleted. On the other hand, the stored contents (preserved disease name) in the disease name storage table window 210 are erased by pressing the stop button 128 of the overall table window 110 or ending this medical information DB. Therefore, the delete button 202 of the examination storage table window 200 is pressed, the stop button 128 of the overall table window 110 is pressed, or the disease name memo button 163 of the disease summary window 160 is pressed until the medical information DEB is terminated. Thus, disease names can be freely added at any time and stored cumulatively.
2. Data structure / operation / process of this medical information DB Hereinafter, the operation (each process) of the medical information DB of this embodiment will be described with reference to the flowcharts of FIGS. 14 to 21 and the tables of FIGS. To do. First, the data structure (table structure) of the medical information DB of this embodiment will be described.

1) Data structure of medical information DB The medical information DB of this embodiment includes a master table (master file), an examination master table (examination MT) (not shown) as the examination master file, and a disease name as the disease name master file. As a master table (disease name MT) (not shown), the symptom master file (symptom MT) of FIG. 22 as the symptom master file, a disease group master table (disease group MT) as the disease group master file, and the clinical master file 23, a discrimination master table (discrimination MT) as the discrimination master file, and an abnormal value master table (abnormal value MT) of FIG.

1-1) Inspection Master The inspection master table defines and stores inspection item related data (records) to be displayed in the inspection item column 51 and the inspection summary window 180 of the inspection arrangement table window 150 as master data. The inspection master table has “major classification”, “item name”, “item ID”, “inspection overview”, “display order”, and the like as data items (columns), and individual data items corresponding to these data items. Store data elements (fields) in association (as one record in each row of the table). Among these, “item name” stores all inspection item names used in diagnosis, and “item ID” stores an inspection item ID uniquely identifying the inspection item in association with the inspection item name. The “inspection summary” stores reference texts for explaining the purpose of use, precautions, trends, etc. at the time of inspection of each inspection item in association with each inspection item ID and each inspection item name. When a specific test item in the test item column 151 of the test sequence table window 150 is clicked, a reference text of “test overview” associated with the test item is extracted from the test master table. It is displayed in the examination summary display field 182. Further, “display order” stores alphanumeric characters defining the display order of inspection items in the inspection arrangement table window 150 in association with inspection item names and item IDs, and the extracted inspection items are arranged in ascending order (descending order) according to this order. Are also possible), and are displayed in a list in the inspection sequence table window 150. Information about all existing inspection items is stored in the inspection master table.

1-2) Disease Name Master The disease name master table includes, as master data, the disease name classification displayed in the disease name classification table 131 of the disease name classification window 130, the disease name list 141 of the disease name table of contents window 140, and the disease name display column 161 of the disease summary window 160. The disease name related data (record) such as the disease name to be displayed and the disease summary to be displayed in the disease summary display field 162 of the disease summary window 160 are defined and stored. The disease name master table has, as data items (columns), “classification ID”, “classification (classification name)”, “disease order”, “disease name ID”, “disease name”, “disease summary”, etc. Individual data elements (fields) corresponding to the data items are stored in association (as one record in each row of the table). Then, when the general examination button 111 in the general table window 110 is clicked, the disease name classifications are arranged in ascending order (possible in descending order) according to the order of the classification IDs, and all are displayed in the disease name classification table 131 of the disease name classification window 130. The Furthermore, “disease name” stores all the disease names used in the diagnosis, and one or more of these disease names are selectively displayed in the disease name list 141 of the disease name table of contents 140 or the like. The “disease name ID” is an alphanumeric character that uniquely identifies the disease name, and is stored in association with the disease name ID. Here, in the “disease name”, in addition to the disease name, a symptom name starting with [group] displayed in the symptom table of contents window 240, for example, “[group] anemia” or the like is also stored. Similarly, in addition to the disease name, the “disease name” also stores an abnormal value starting with [group] displayed in the symptom table of contents window 240, for example, “[group] WBC ↓”. In this case, the symptom name ([base] anemia, etc.) or abnormal value (“[base] WBC ↓”, etc.) stored in the “disease name” is associated with the disease name ID prepared specifically for the symptom and abnormal value. Is done. That is, the disease name IDs for symptoms and abnormal values are preferably numbered so as to start from numbers (alphanumeric characters) clearly distinguished from disease name IDs for disease names. Specifically, the disease name ID of the disease name is in the range of “1 to 3000”, for example, according to the number of disease names, and the disease name ID of the [base] symptom and [base] abnormal value is in the range of “6000 to”. The “disease summary” stores a summary sentence explaining an outline of a disease name (in the case of a symptom, the symptom and a summary description of a disease belonging to the symptom) in association with a disease name ID or a disease name. When a specific disease name is clicked in the disease name table of contents window 140, a summary sentence associated with the disease name is extracted from the disease name master table and displayed in the disease summary display field 162 of the disease summary window 160. Similarly, when a specific differential disease name is clicked in the differential disease table of contents window 170, a summary sentence associated with the differential disease name (that is, disease name) is extracted from the disease name master table, and the differential disease summary window 190 is identified. It is displayed in the disease summary display field 192. The “disease order” is an alphanumeric character that defines the display order when the disease name is extracted from the “disease name” and displayed in the disease name table of contents window 140, and according to this disease order, the disease names are displayed in ascending order (descending order) in the disease name table of contents window 140. But it is also possible to display a list. The disease name master table stores information on all existing disease names.

1-3) Symptom Master The symptom master table in FIG. 22 defines and stores symptom related data (record) to be displayed in the symptom classification table 231 of the symptom classification window 230 as master data. The symptom master table has “symptom ID”, “symptom”, and “order” as data items (columns), and associates individual data elements (fields) corresponding to these data items (in each row of the table). Store as one record). Of these, “symptom” is a classification for all symptoms used in diagnosis, and “symptom” stores abnormal values other than symptoms as well as symptoms for use in search processing as described above. . The symptoms and abnormal values are displayed in the symptom classification table 231 of the symptom classification window 230. The “symptom ID” is an alphanumeric character that uniquely identifies a symptom (symptom or abnormal value), and is stored in association with the symptom and abnormal value. Furthermore, “order” stores alphanumeric characters defining the display order of the symptom and abnormal value in the symptom classification window 230 in association with the symptom, abnormal value and symptom ID. When the symptom test button 112 in the management table window 110 is clicked, the symptoms and abnormal values of “symptoms” are arranged in ascending order (possible in descending order) according to the “order” display order in the symptom master table. All of them are displayed in the symptom classification table 131 of the classification window 230. In the symptom master table, information about all the symptoms used is stored, and for abnormal values, abnormal values related to typical test items (mainly biochemical tests) are stored.

1-4) Disease Group Master The disease group master table stores, as master data, the disease name in the disease name master table and the symptom or abnormal value in the symptom master table in FIG. 22 in association with each other. Define the relationship between the related data and the symptom related data in the symptom master table. The disease group master table has “symptom ID”, “symptom”, “internal order”, “disease name ID”, and “disease name” as data items (columns), and individual data elements corresponding to these data items Associate (field) and store (as one record in each row of the table). Among these, “symptom ID” and “symptom” correspond to “symptom ID” and “symptom” of the symptom master table, and the disease group master table stores all the symptom and abnormal values together with the symptom ID. To do. Also, “disease name ID” and “disease name” correspond to “disease name ID” and “disease name” in the disease name master table, and the disease group master table stores all the disease names in the disease name master table together with the disease name ID. Here, as described in the section of the disease name master table, the “disease name” includes, in addition to the disease name, a symptom and an abnormal value ([base] symptom or [base] abnormal value displayed in the symptom table of contents window 240, for example, , [Group] “anemia”, [group] Fe ↓, etc.) are also stored, and the disease name ID for the symptom and abnormal value is stored in association with the symptom and abnormal value. As described above, the disease group master table has, for each symptom and each abnormal value, all the disease name related data whose existence is estimated when the symptom or abnormal value corresponds, that is, when the symptom or abnormal value occurs. (Disease name ID, disease name) is stored in association with the symptom or abnormal value. When a specific symptom or abnormal value is clicked in the symptom classification window 230, a series of disease names (including the symptom and abnormal value) stored in association with the symptom or abnormal value are stored in the disease group master table. It is extracted from the “sickness name” and listed in the symptom and disease name list 241 of the symptom table of contents window 240 with the symptom ([base] symptom) or abnormal value ([base] abnormal value) as the head. In addition, “inner order” is an alphanumeric character that defines the display order of disease names among symptoms or abnormal values having the same symptom ID. Therefore, according to this inner order, a plurality of disease names ([[ [Base] symptoms / [base] abnormal values and disease names) are displayed in a list in ascending order (possible in descending order) in the symptom table of contents window 240. The disease group master table includes all possible combinations between all disease names (including [base] disease and [base] abnormal values) in the disease name master table and all symptoms and abnormal values in the symptom master table. Is stored.

1-5) Clinical Master The clinical master table stores, as master data, examination item related data in the examination master table and disease name related data in the disease name master table in association with each other, and examination item related data in the examination master table. And the disease name related data in the disease name master table are defined. The clinical master table includes “disease name ID”, “disease name”, “class”, “required”, “item ID”, “item name”, “examination trend”, and “abnormal value ID” as data items (columns). And store individual data elements (fields) corresponding to these data items in association with each other (as one record in each row of the table). Among these, “disease name ID” and “disease name” correspond to “disease name ID” and “disease name” in the disease name master table, and the clinical master table stores all disease names in the disease name master table together with the disease name ID. Here, as described in the section of the disease name master table, in the “disease name”, in addition to the disease name, a symptom and an abnormal value are also stored, and a disease name ID for the symptom is stored in association with the symptom or abnormal value. Further, “item ID” and “item name” correspond to “item ID” and “item name” in the examination master table, and the clinical master table includes the item names of all examination items in the examination master table for each disease name. All the corresponding item names are associated with each other, that is, all the item IDs of the item names corresponding to the disease name ID of each disease name are associated and stored. That is, the clinical master table stores, for each disease name, all item names and item IDs corresponding to the disease name (used for diagnosis of the disease of the disease name) in association with the disease name and disease name ID.

  “Class” stores alphanumeric characters corresponding to the type symbol added to the left side of the inspection item in the inspection item column 151 of the inspection arrangement table window 150 in association with the item name and item ID of the inspection item. That is, an alphanumeric “1” is used for the type symbol of the positive inspection item (symbol “*”), and an alphanumeric “#” is used for the type symbol of the negative inspection item (bold minus symbol “−”). “3” is stored as the type symbol (space symbol “”) of the inspection item for scrutiny by assigning alphanumeric “2”. In addition, “necessary” defines whether or not the check box in the check column 153 of the check sequence table window 150 is checked in the basic setting state (that is, whether or not the corresponding check item is set as the initial check item). Check presence / absence information consisting of alphanumeric characters as a flag to be stored is stored in association with the item name and item ID of the inspection item. That is, when the check box of the check column 153 is checked (when the corresponding inspection item is checked), the alphanumeric “-1” (TRUE) is not checked in the check box of the check column 153. In the case (when the check of the corresponding inspection item is turned OFF), alphanumeric “0” (FALSE) is assigned and stored. “Examination trend” is an examination trend explanation (description of fixed intrinsic variation or associated intrinsic variation using a combined disease name) displayed in the examination trend display field 152 of the examination sequence table window 150, and a disease name / disease name. The ID and the inspection item name / item ID are stored in association with each other. When a symptom or disease name in the disease name table of contents window 140 or a symptom or disease name in the symptom table of contents window 240 is clicked, a series of test item names stored in association with the disease name or symptom are extracted from “item names” in the clinical master table. And displayed in the inspection item column 151 of the inspection arrangement table window 150. At this time, in accordance with the definition of “class” (“1”, “2”, “3”) associated with the inspection item, it corresponds to the head of the inspection item name in the inspection item column 151 of the inspection arrangement table window 150. Type symbols (circle-shaped symbol, space (blank), minus symbol) are added and displayed. At this time, the test trend explanation associated with the test item is extracted from the “test trend” in the clinical master table and displayed in the test trend display field 152 of the test sequence table window 150. Further, at this time, a check mark is displayed in a check box of the check box 153 of the check sequence table window 150 for a check item (initial check check item) whose definition (flag) of “necessary” is “0” among the check items. Is done.

  Further, “abnormal value ID” in the clinical master table corresponds to “abnormal value ID” in the abnormal value master table described later, and the clinical master table uses the abnormal value ID in the abnormal value master table as the item name and item of the examination item. Store in association with the ID. Then, as described in the above three-item search process and symptom search process, when any of the buttons 116 to 118, 121, and 122 of the control table window 110 is pressed, the abnormal value selection boxes 113 to 115, 120 are displayed. Corresponding to the abnormal value selected in (the test item related to the abnormality), the disease name associated with the test item is extracted via the test item having the abnormal value ID of the selected abnormal value in the clinical master table, The extracted disease names are displayed as a list in the disease name table of contents window 140. The clinical master table stores information on all possible combinations of all disease names (including [base] disease and [base] abnormal values) in the disease name master table and all examination items in the examination master table. Has been.

1-6) Identification Master The identification master table stores, as master data, the disease name in the disease name master table and the identification disease name (differentiation disease name) belonging to the same identification disease group as the disease name in association with each other. The identification master table has “disease name ID”, “disease name”, “differentiation ID”, and “differentiation disease name” as data items (columns), and individual data elements (fields) corresponding to these data items are mutually connected. Store in association (as one record in each row of the table). Among these, “disease name ID” and “disease name” correspond to “disease name ID” and “disease name” in the disease name master table, and the discrimination master table stores all the disease names in the disease name master table together with the disease name ID. Here, as described in the section of the disease name master table, in the “disease name”, in addition to the disease name, a symptom and an abnormal value are also stored, and a disease name ID for the symptom is associated with the symptom or abnormal value of the “disease name”. Stored. “Differential disease name” stores all disease names (differential disease names) belonging to the same differential disease group for each disease name. “Differential ID” stores a differential ID that uniquely identifies a differential disease name in association with the differential disease name. For each disease name, the differentiation master table stores all the differential disease names belonging to the same differential disease group as the disease name in association with the disease name. That is, in the discrimination master table, for each disease name, all disease names including the disease name are associated as the differential disease names. When a specific disease name is clicked in the disease name table of contents window 140, all of the differential disease names (excluding the disease name) belonging to the same differential disease group as the disease name are displayed in the differential disease name list 171 of the differential disease table of contents 170. Is displayed. In the discrimination master table, information about combinations with all the discrimination disease names existing for all the disease names (including [base] disease and [base] abnormal values) in the disease name master table is stored.

1-7) Abnormal Value Master The abnormal value master table in FIG. 23 includes the abnormal values (in the abnormal value selection boxes 113 to 115 and the abnormal value selection box 120 in the control table window 110) among the inspection item names in the inspection master table. Only the inspection items related to abnormalities) are selectively stored. The abnormal value master table has “order”, “abnormal value ID”, and “abnormal value” as data items (columns), and associates individual data elements (fields) corresponding to these data items ( Store as one record in each row of the table. Among these, “abnormal value” stores the inspection items displayed in the abnormal value selection boxes 113 to 115 and the abnormal value selection box 120 among the inspection items stored in the inspection master table as abnormal values. The “abnormal value ID” is an alphanumeric character that uniquely identifies the abnormal value, and is stored in association with each abnormal value. Furthermore, “order” stores alphanumeric characters defining the display order of abnormal values in the abnormal value selection boxes 113 to 115 and the abnormal value selection box 120 in association with the abnormal value or the abnormal value ID. The abnormal values are arranged in ascending order (or descending order is possible) according to the “order” display order, and are displayed in a list in the abnormal value selection boxes 113 to 115 and the abnormal value selection box 120. In the abnormal value master table, only main items (that is, test items with high test value and frequently used in clinical practice) stored in the test master table are stored as abnormal test item information (abnormal values). ing. The abnormal value ID stored in the clinical master table corresponds to the abnormal value ID stored in the abnormal value master table, and is associated with the item ID of the clinical master table. That is, the inspection item name of the abnormal value of the associated abnormal value ID and the item name (inspection item name) of the item ID are the same.

2) Operation and processing of this medical information DB The medical information DB of the present embodiment has the data structure as described above (examination master table, disease name master table, symptom master table, disease group master table, clinical master table, identification master table). And the abnormal value master table), various functions shown in FIGS. 14 to 21 are executed to realize various medical information providing functions. Specifically, first, in the medical information system, when the computer is turned on and the medical information DB is activated, the overall table window 110 is displayed on the computer activation screen. From this state, the user can perform general examination processing after STEP 101, symptom examination processing after STEP 201, three-item search processing (flow chart is not shown), symptom search processing (combined search processing, flowchart is not shown), and symptoms after STEP 421. Any one of search processing (missing search processing) can be selected and executed. When the user selects and executes one of the processes, various windows (such as the disease name classification window 130) are displayed on the screen corresponding to each process, and medical information is provided. When the medical information necessary for each of the general examination process, the symptom examination process, the three-item search process, and the symptom search process (combined search process or missed search process) is obtained, the user usually performs the following STEP 30. The medical system is terminated without clicking (pushing) the stop button 128 of the control table window 110. On the other hand, when it is desired to cancel the process for some reason, such as when each process is executed again from the beginning without obtaining necessary medical information in these processes, the user presses the cancel button 128 of the summary table window 110 in STEP 30. When the button is pressed, all windows other than the control table window 110 that are expanded on the screen are closed. At the same time, the stored contents of the examination storage table window 200 and the disease name storage table window 210 are all erased, and the examination storage table window 200 and the disease name storage table window 210 are also closed. Also, all the input contents etc. in the control table window 110 are deleted. In this case, the user can execute the general inspection process again.

2-1) General inspection process The case where the general inspection process is selected on the startup screen of the computer will be described with reference to FIG. As shown in FIG. 14, in the general examination process, first, when the general examination button 111 of the overall table window 110 is clicked in STEP 101, all disease name classification information (classification ID, classification) is obtained from the disease name master table in STEP102. In step 103, all classifications (= disease name classifications) are displayed in a list in the disease name classification window 130. Then, in STEP 103, the extracted classification names are listed in the order of classification IDs in the disease name classification table 131 of the disease name classification window 130 (class IDs are not displayed). Next, when one of the disease name classifications displayed in the disease name classification window 130 is clicked and selected in STEP 104, all the disease name information (disease name ID, disease name, order of disease) corresponding to the selected classification is obtained in STEP 105. It is extracted from the master table and displayed in a list in the disease name table of contents window 140 in STEP106. In STEP 106, the extracted disease names are displayed in a list in the disease name list 141 of the disease name table of contents 140 in a predetermined order (order of disease order). At this time, the symptom ([base] symptom) and the abnormal value ([base] abnormal value) associated with the classification ID in the “disease name” of the disease name master table are excluded from the extraction target. That is, in the disease name master table, the symptom and the abnormal value have a disease name ID clearly distinguished from the disease name ID of the disease name. For example, since the disease name ID starts from the 6000 series, in STEP 105, the disease name ID less than 6000 is used Only disease names are extracted.

  Next, when one of the disease names displayed in the disease name table of contents window 140 is clicked and selected in STEP 107, all the examinations that can be used in the examination of the disease name as examination item information corresponding to the selected disease name in STEP 108. The item ID, item name, display order, examination trend, etc. of the item are extracted from the examination master table and the clinical master table, and together with the disease name ID and disease name of the disease name, a common table (not shown) as a work table (temporary storage area) ( Common T). Then, according to the selected disease name, a disease summary information providing process (STEP 110), a differential disease information providing process (STEP 130), and a test item information providing process (STEP 150) are executed. At this time, first, display processing of the disease summary window 160 (first processing of STEP 110), display processing of the differential disease table of contents window 170 (first processing of STEP 130), display processing of the test sequence table window 150 (first processing of STEP 150) Are executed simultaneously. The details of each process of the disease summary information providing process (STEP 110), the differential disease information providing process (STEP 130), and the test item information providing process (STEP 150) will be described.

2-1-1) Provision of disease summary information (for general examination processing)
The disease summary information providing process (STEP 110) in FIG. 14 will be described with reference to FIG. As shown in FIG. 15, in the disease summary information provision process (part 1), based on the disease name ID of the disease name selected in STEP 107 of FIG. 14, in STEP 111, the disease summary of that disease name is “disease summary” in the disease name master table. Is extracted from. Next, in STEP 112, the disease summary of the extracted disease name is displayed in the disease summary window 160. Next, when the disease name displayed in the disease overview window 160 is temporarily saved in STEP 113 (in the case of YES), the user clicks the disease name memo button 163 of the disease overview window 160 in STEP 114. Then, in STEP 115, the disease name ID and disease name in the disease summary window 160 are stored in the disease name storage table (disease name storage T) as a disease name temporary storage area, and in STEP 116, the disease name stored in the disease name temporary storage area is the disease name. It is displayed on the storage table window 210. If the disease name displayed in the disease summary window 160 is not saved in STEP 113 (NO), the process proceeds to STEP 30 stop / end processing. Next, in STEP 117, when there is a disease name (next candidate) for which a disease summary is to be confirmed in addition to the disease name selected in the disease name table of contents window 140, the user clicks another disease name in the disease name table of contents window 140 in STEP 118. Then, the process returns to STEP 111, and in STEP 112, the disease summary of the next candidate disease name is displayed in the new disease overview window 160, and the disease name of the next candidate can be additionally displayed in the disease name storage table window 210. (STEP 113 to STEP 116). Therefore, the user selects the necessary number of disease names from the disease name table of contents window 140, sequentially confirms the disease outline of each disease name in the disease summary window 160, and sequentially adds the necessary disease names to the disease name storage table window 210. Can be displayed. Next, in STEP 119, when another disease name stored and displayed in the disease name storage table window 210 is displayed, the disease summary window 160, the differential disease table of contents window 170, and the test sequence table window 150 are displayed and it is desired to reconfirm the contents (STEP 119). In the case of YES), in STEP 120, a desired disease name is clicked and selected from the disease name storage table window 210. Then, the process shifts simultaneously to STEP 111 (first process of the disease summary information providing process), STEP 121 (first process of the differential disease information providing process), and STEP 131 (first process of the test item information providing process) (FIG. 15). From point B in FIG. 15 to point B in FIG. 15, point B in FIG. 16, point B in FIG. On the other hand, if the user confirms and saves all necessary disease names and determines that there is no disease name that is the next candidate (NO in STEP 119), the process proceeds to STEP 30 cancellation / end processing.

2-1-2) Differentiation Disease Information Provision Processing The differentiation disease information provision processing in FIG. 14 will be described with reference to FIG. As shown in FIG. 16, in the process of providing differential disease information, based on the disease name ID of the disease name selected in STEP 107 of FIG. 14, in STEP 131, all the differential disease names belonging to the same disease group as the disease name, their differential IDs, etc. (Differential disease information) is extracted from the identification master table. At this time, since the selected disease name (“iron deficiency anemia (IDA)”) itself belongs to the differential disease group, the same disease name ID (“1”) as the selected disease name is used so that the selected disease name is not extracted. The differential disease name having the differential ID (“1”) is excluded from the extraction target. That is, the differential disease names stored in the differential master table have a one-to-one correspondence with the disease names stored in the differential name master table, and those belonging to the same differential disease group are stored in the differential master table in association with each disease name in the disease name master table. Has been. Therefore, when the identification disease name is the same as the disease name, the identification ID is the same number as the disease name ID of the disease name.

  Next, all the differential disease names extracted in STEP 131 are displayed in a list on the differential disease table of contents window 170 in STEP 132 in the order of the identification ID. Next, when one of the differential disease names in the differential disease table of contents window 170 is clicked and selected in STEP 133, based on the differential ID of the selected differential disease name in STEP 134, the same disease name ID as the differential ID is selected. The disease summary of the disease name it has is extracted from the “summary” of the disease name master table. In STEP 135, the extracted disease summary of the differential disease name is displayed in the differential disease overview window 190. That is, the disease outline of the differential disease name displayed in the differential disease outline window 190 has the same content as the disease outline of the disease name displayed in the disease outline window 160. Next, when the differential disease name displayed in the differential disease overview window 190 is temporarily saved in STEP 136 (in the case of YES), the user clicks the disease name memo button 193 of the differential disease overview window 190 in STEP 137. Then, in STEP 138, the differential disease name differential ID (= disease name ID) and the differential disease name (= disease name) displayed in the differential disease summary window 190 are stored in the disease name storage table as the disease name temporary storage area. In STEP 139, The disease name stored in the disease name temporary storage area is displayed in the disease name storage table window 210. Note that the display processing of the differential disease summary information in STEP 133 to STEP 135 can be executed sequentially for all the differential disease names displayed in the differential disease table of contents window 170, and can be executed any number of times for the same differential disease name. Further, the display process of the differential disease summary information in STEP 133 to STEP 135 is not an essential process, but is a process arbitrarily executed by the user, and can be omitted. Further, the differential disease name storage process of STEP 136 to STEP 139 can be executed for each differential disease summary information display process (STEP 133 to STEP 135). If the differential disease name displayed in the differential disease overview window 190 in STEP 136 is not saved (in the case of NO), the process proceeds to STEP 30 stop / end processing.

2-1-3) Inspection Item Information Provision Processing The inspection item information provision processing of FIG. 14 will be described with reference to FIG. As shown in FIG. 17, in the inspection item information provision process, all inspection item information stored in the common table in STEP 108 of FIG. 14 is extracted in STEP 151, and all inspection item information is extracted in STEP 152 in the inspection sequence table window. 150 is displayed as a list. Based on the disease name ID of the selected disease name, in STEP 151, all examination item information corresponding to the selected disease name is extracted from the common table. That is, firstly, using the disease name ID of the selected disease name as a key, the examination item information (“class” examination item type symbol, “required” check presence / absence information, “item name” examination item) Name, order of “display order”, inspection trend description of “inspection trend”, etc.) are extracted for all rows (records). Next, the extracted inspection item information of each row is provided for display in the inspection arrangement table window 150 in STEP 152. That is, the inspection item name “item name” is displayed in order from the top in the inspection item column 151 in the “display order” order (ascending order) corresponding to the item ID. Further, the type symbol (“*”, “−”, “”) of the “class” inspection item is added to the head of the corresponding inspection item name displayed in the inspection item column 51 and displayed. In addition, according to the “necessary” check presence / absence information (“0”, “−1”), a check mark in the check column 153 corresponding to the inspection item name displayed in the inspection item column 151 is displayed (“0”). In this case, the check is OFF, and when “−1”, the check is ON). Further, the inspection trend explanation of “inspection trend” is displayed in the inspection trend display column 152 corresponding to the inspection item name displayed in the inspection item column 151.

  Next, when any inspection item name displayed in the inspection item column 151 of the inspection arrangement table window 150 is clicked and selected in STEP 153, based on the item ID of the selected inspection item name in STEP 154, The inspection summary of the inspection item having the item ID is extracted from “reference” in the inspection master table. Then, in STEP 155, the inspection summary of the extracted inspection item is displayed in the inspection summary window 180. The display processing of the inspection summary information in STEP 153 to STEP 155 is not an indispensable process, but can be omitted because it is a process that is arbitrarily executed by the user. On the other hand, when the inspection items checked in the check column 153 among the inspection items displayed in the inspection arrangement table window 180 in STEP 156 are temporarily saved (in the case of YES), the user selects the inspection summary window 180 in STEP 157. Click the save button 155. In this case, in STEP 158, the item ID and item name of the inspection item checked in the inspection arrangement table window 150 are stored in the inspection storage table (inspection storage T) as a temporary storage area for inspection. The inspection items stored in the temporary storage area are displayed in the inspection storage table window 200. When none of the inspection items displayed in the inspection arrangement table window 150 in STEP 156 is stored (in the case of NO), the process proceeds to the cancellation / termination process of STEP 30.

2-2) Symptom Examination Processing A case where symptom examination processing is selected on the computer startup screen will be described with reference to FIG. As shown in FIG. 18, in the symptom test process, first, when the symptom test button 112 in the overall table window 210 is clicked in STEP 201, all symptom information (symptom ID, symptom and abnormal value) is displayed from the symptom master table in STEP 202. ) Are extracted, and in STEP 203, all symptoms are listed in the symptom classification window 230. Then, in STEP 203, the extracted symptoms and abnormal values are displayed in a list in the symptom classification table 231 of the symptom classification window 230 in the order of “order” (symptom ID is not displayed). Next, when one of the symptoms or abnormal values displayed in the symptom classification window 230 is clicked and selected in STEP 204, all the symptom / disease name information (symptom ID, Symptoms or abnormal values, disease name ID, disease name, disease order) are extracted from the disease name master table and the disease group master table, and are displayed in a list on the symptom table of contents window 240 in STEP 206. The extracted disease name at this time includes the symptom ([base] symptom) or abnormal value ([base] abnormal value) of the symptom ID. Then, in STEP 206, all the extracted disease names are listed in the symptom disease name list 241 of the symptom table of contents window 240 in a predetermined order (in the order of numbers in the inner order) with reference to “inner order” of the disease group master table. Is displayed.

  Next, in STEP 207, when either [base] symptom or [base] abnormal value displayed in the symptom table of contents window 240 is clicked and selected, the selected [base] symptom or [base] abnormal value is selected in STEP 208. As the corresponding test item information, among the test items that can be used in the test of the disease name group (series of disease names) to which the [base] symptom or [base] abnormal value corresponds, the [base] symptom or [base] abnormal value The item ID, item name, test trend, etc. of predetermined representative test items associated in advance for use are extracted from the test master table and clinical master table, and the [base] symptoms or [base] abnormal values and their disease names Along with the ID, it is stored in the common table. Similarly, when one of the disease names displayed in the symptom table of contents window 240 is clicked and selected, in STEP 208, items of all examination items that can be used in the examination of the disease name as examination item information corresponding to the selected disease name. IDs, item names, examination trends, and the like are extracted from the examination master table and the clinical master table, and stored in the common table together with the disease name and the disease name ID.

  After that, according to the selected disease name, the disease summary information provision processing (STEP 210), the differential disease information provision processing (STEP 130), and the examination item information (for [[base] symptoms, [group] abnormal values or disease names) The providing process (STEP 150) is executed. At this time, first, display processing of the disease summary window 160 (first processing of STEP 210), display processing of the differential disease table of contents window 170 (first processing of STEP 130), display processing of the test sequence table window 150 (first processing of STEP 150) Are executed simultaneously. Details of the disease summary information providing process (STEP 210) will be described below. The differential disease information providing process (STEP 130) and the test item information providing process (STEP 150) are the same as those in the general test process. However, regarding the differential disease information provision processing (STEP 130), in the symptom test processing, all the differential diseases having the [base] symptom or [base] abnormal value are already displayed in the symptom table of contents window 240; When the symptom or [group] abnormal value is selected in the symptom table of contents window 240, the differential disease of the [base] symptom or [base] abnormal value is not displayed again in the differential disease table of contents window 170. The disease table of contents window 170 displays “the disease group”.

2-2-1) Provision of disease summary information 2 (for symptom testing)
The disease summary information providing process (STEP 210) in FIG. 18 will be described with reference to FIG. As shown in FIG. 19, in the disease summary information provision process (part 2), the case where [group] symptoms are selected in STEP 207 is shown. In this case, the process proceeds from STEP 211 to STEP 212 and the selected [group] symptoms are displayed. Based on the disease name ID, the disease summary of the [base] symptom is extracted from the “disease summary” in the disease name master table. Next, in STEP 213, the extracted disease summary of the [group] symptom is displayed in the disease summary window 160. Next, when the [base] symptom displayed in the disease summary window 160 is temporarily saved in STEP 214 (in the case of YES), the user clicks the disease name memo button 163 in the disease summary window 160 in STEP 215. Then, in STEP 216, the disease name ID and the [base] symptom of the disease summary window 160 are stored in the disease name storage table (disease name storage T) as the disease name temporary storage area, and in STEP 217, the disease name temporary storage area is stored in the disease name temporary storage area. [Base] The symptoms are displayed in the disease name storage table window 210. That is, in the symptom test process, the [base] symptom is stored in the disease name temporary storage area in the same way as the case of the disease name in the general test process, and displayed in the disease name storage table window 210. If the [base] symptom displayed in the disease summary window 160 is not stored in STEP 214 (in the case of NO), the process proceeds to STEP 30 stop / end processing.

  Next, in STEP 218, when there is a [base] symptom (next candidate) to be confirmed for a disease summary in addition to the [basic] symptom selected in the symptom table of contents window 240, the user selects another [ Click the symptom. Then, the process returns to STEP 212, and in STEP 213, the disease summary of the next candidate [basic] symptom is displayed in the new disease summary window 160, and the next candidate [basic] symptom is further added to the disease name storage table window 210. It is possible to display (STEP 214 to STEP 217). Therefore, the user selects the necessary number of [base] symptoms from the symptom table of contents window 240, sequentially confirms the disease summary of each [base] symptom in the disease summary window 160, and selects the necessary [base] symptoms as the disease name. The storage table window 210 can be sequentially added and displayed. Next, in STEP 220, for another [base] symptom stored and displayed in the disease name storage table window 210, the disease summary window 160 and the test sequence table window 150 are displayed and it is desired to reconfirm the contents (YES in STEP 220). In step 221, click and select a desired [group] symptom from the disease name storage table window 210. Then, the process shifts simultaneously to STEP 212 (first process of the disease summary information providing process), STEP 131 (first process of the differential disease information providing process), and STEP 151 (first process of the test item information providing process) (FIG. 19). The transition from the lower E point to the upper E point in FIG. 19, the E point in FIG. 16, and the E point in FIG. 17). As described above, in the differential disease information provision process (STEP 130), the “disease group” is displayed in the differential disease table of contents window 170 for [base] symptoms. Therefore, in the differential master table, the differential disease name (including the disease name) of the disease name is stored in the “differential disease name” column for each disease name, but in the “differential disease name” column for each [base] symptom. Stores a sentence such as “the disease group”. On the other hand, when the user confirms and saves all necessary [group] symptoms and determines that there is no [group] symptom that is the next candidate (NO in STEP 220), the process proceeds to STEP 30 stop / end processing. .

  On the other hand, when a disease name is selected in STEP 211 in FIG. 19, provision of disease summary information for general examination processing from point B in FIG. 19 through point B in FIG. 15, point B in FIG. 16, and point B in FIG. Processing STEP 110, differential disease information provision processing STEP 130, and examination item information provision processing STEP 150 are executed. Then, in the same manner as in the general examination process, the selected disease name is displayed in the examination sequence table window 150, the examination item information display process, the disease outline display process in the disease outline window 160, and the differential disease name table of contents window 170. The display process of the differential disease name is executed, and further, the display process of the test summary in the test summary window 180 and the display process of the differential disease summary in the differential disease summary window 190 can be executed, and the test storage table window 200 is displayed. The examination item storage process and the disease name storage process in the disease name storage window 210 can be executed.

  In the process of providing the disease summary information, when the [base] abnormal value is selected in STEP 207, the process proceeds from STEP 211 to D231 in FIG. 19 and D point in FIG. 20 to STEP231, and the disease name of the selected [base] abnormal value. Based on the ID, the disease summary of the [base] abnormal value is extracted from “disease summary” in the disease name master table. Next, in STEP 232, the disease summary of the extracted [group] abnormal value is displayed in the disease summary window 160. Next, when the [base] abnormal value displayed in the disease summary window 160 is temporarily saved in STEP 233 (in the case of YES), the user can make a disease summary window in STEP 234 in the same manner as in the case of the above [base] symptoms. 160 disease name memo buttons 163 are clicked. Then, in STEP 235, the disease name ID and the [base] abnormal value in the disease summary window 160 are stored in the disease name storage table. In STEP 236, the [base] abnormal value stored in the disease name storage table is stored in the disease name storage table window 210. indicate. If the [base] abnormal value displayed in the disease summary window 160 is not stored in STEP 233 (in the case of NO), the process proceeds to STEP 30 stop / end processing. Next, in STEP 237, if there is a [base] abnormal value (next candidate) for which a disease summary is to be confirmed in addition to the above [base] abnormal value selected in the symptom table of contents window 240, the user selects another Click the [base] abnormal value of. Then, the process returns to STEP 231, and in STEP 232, the disease summary of the next candidate [group] abnormal value is displayed in the new disease summary window 160, and the [group] abnormal value of the next candidate is displayed in the disease name storage table window 210. Further display is possible (STEP 233 to STEP 236). Therefore, the user selects a necessary number of [base] abnormal values from the symptom table of contents window 240, sequentially confirms the disease summary of each [base] abnormal value in the disease summary window 160, and requires the necessary [base] abnormal values. Values can be sequentially added to the disease name storage table window 210 and displayed. Next, in STEP 239, if another [group] abnormal value stored and displayed in the disease name storage table window 210 is displayed and the disease summary window 160 and the test sequence table window 150 are to be displayed again (YES in STEP 239) In step 240, a desired [group] abnormal value is clicked and selected from the disease name storage table window 210 in STEP 240. Then, the process shifts simultaneously to STEP 231 (first process of the disease summary information providing process), STEP 131 (first process of the differential disease information providing process), and STEP 151 (first process of the test item information providing process) (FIG. 20). From the lower F point to the upper F point in FIG. 20, the F point in FIG. 16, and the F point in FIG. 17). In the differential disease information providing process (STEP 130), as in the case of the above-mentioned [base] symptoms, the “base group” abnormal value is displayed in the differential disease table of contents window 170 as “the above disease group”. On the other hand, when the user confirms and saves all necessary [group] abnormal values and determines that there is no [group] abnormal value as the next candidate (NO in STEP 239), the process is canceled or terminated in STEP 30. Transition.

2-3) Three-item search processing In a state where specific abnormal values are selected in the abnormal value selection boxes 113 to 115 of the control table window 110, the single disease button 116, the related disease button 117, or the limited disease button 118 of the control table window 110. When one of the above is pressed, based on the abnormal value ID of the selected abnormal value, the disease name ID and disease name of the background disease to which the selected abnormal value corresponds (in the case of a single disease search, all disease names to which one abnormal value corresponds) In the case of related disease search, all disease names corresponding to two abnormal values, and in the case of limited disease search, all disease names corresponding to three abnormal values) are all extracted from the clinical master table, and the work table ( (Temporary storage area), that is, a 3-item search disease name table (3-item search disease name T) as a 3-item search storage area.

  And among the disease names stored in the three-item search disease name table, one, two, or three of the selected abnormal values correspond, that is, one in which the same disease name is stored in one, two, or three, The list is displayed in the disease name table of contents window 140. Next, when one of the disease names displayed in the disease name table of contents window 140 is clicked to be selected, in the same manner as the processing after STEP 107 of the general examination processing STEP 100, the examination item information corresponding to the selected disease name is displayed. The item IDs, item names, examination trends, etc. of all examination items that can be used in the examination are extracted from the examination master table and the clinical master table, and stored in the common table together with the disease name ID and disease name of the disease name. Thereafter, in the same manner as in the general examination process STEP 100, according to the selected disease name, the disease summary information provision process (STEP 110), the differential disease information provision process (STEP 130), and the test item information provision process (STEP 150) are executed. Is done.

2-4) Complex Search Process The complex search process will be described. While selecting the symptom in the symptom selection box 119 in the summary table window 110 and selecting the abnormal value in the abnormal value selection box 120, the execution button 121 in the summary table window 110 is pressed. Then, based on the symptom ID of the selected symptom, all the combinations of the disease name ID and disease name of the disease to which the selected symptom falls are extracted from the disease group master table (first processing), and the abnormality of the selected abnormal value Based on the value ID, a set of disease name ID, disease name, item ID, and item name of the disease to which the selected abnormal value corresponds is extracted from the clinical master table (second process). Then, in the next STEP 413, the combination of the disease name ID and disease name extracted in the first process and the combination of the disease name ID and disease name extracted in the second process are compared with an AND condition, and the same disease name ID of them is compared. As a disease (candidate disease) that can be predicted when only the disease name having the name is extracted and both the selected symptom and abnormal value are applicable, a combined search as a work table (temporary storage area), that is, a combined search storage area The disease name table (complex search disease name T) is stored.

  Then, all the disease names extracted and stored in the combined search disease name table are displayed as candidate diseases in the disease name list 141 in the disease name table of contents window 140 in a predetermined order (the disease name ID is not displayed). When one of the disease names displayed in the disease name table of contents window 140 is clicked and selected, it is used in the examination of the disease name as examination item information corresponding to the selected disease name in the same manner as the processing after STEP 107 of the general examination process STEP 100. Item IDs, item names, test trends, etc. of all possible test items are extracted from the test master table and clinical master table, and stored in the common table together with the disease name ID and disease name of the disease name. Thereafter, in the same manner as in the general examination process STEP 100, according to the selected disease name, the disease summary information provision process (STEP 110), the differential disease information provision process (STEP 130), and the test item information provision process (STEP 150) are executed. Is done.

2-5) Missed Search Process The missed search process (STEP 420) will be described with reference to the flowchart of FIG. 21 and the tables of FIGS. As shown in FIG. 21, in step 421, the miss button 122 in the summary table window 110 is pressed in a state where the symptoms in the symptom selection box 119 in the summary table window 110 are selected. Then, in STEP 422, based on the symptom ID of the selected symptom, all combinations of the disease name ID and the disease name corresponding to the selected symptom are extracted from the disease group master table. Next, in STEP 423, based on the extracted disease name ID, the extracted combination of the disease name ID and the disease name is referred to in the clinical master table, and among those disease names (diseases), focusing on specific inexpensive biochemical tests. Select and extract what is diagnosed by the test (referred to as “general-purpose test” in this document). Specifically, the test master table includes serum-related tests (“serum-related”), biochemical test I (biochemical I), biochemical test II (biochemical II), biochemical test III (biochemical III) as test items. Etc., all existing inspection items are stored. (Note that “Biochemical I” and “Biochemical II” used in this specification are different from Biochemical I and Biochemical II, which are handled by insurance.) However, these are broadly divided into inexpensive biochemical tests. An expensive specific test can be divided in two. Among these, the biochemical test is an inspection item that is often included in the test range from the first time because it is inexpensive. On the other hand, the specific test may be used for the test from the first time, but it may be expensive. Generally, it is a test of personality that is often used for the secondary test mainly based on the results of biochemical tests. It is. In the initial inspection, only a general-purpose inspection centering on the inexpensive biochemical inspection may be used.

  Therefore, in this medical information DB, general-purpose tests centering on such inexpensive biochemical tests are specified in advance and set as specific test items for missed search processing. Specifically, in the examination master table, the biochemical examination (“CBC”, “reticulocyte”, “blood image”, “Na · K”, “Cl”, “Ca”, “Mg” of the item ID specified in advance is performed. ”,“ Fe ”,“ Cu ”,“ TP ”with item ID“ 1062 ”,“ Alb ”,“ Cr ”,“ UA ”,“ AST ”,“ ALT ”,“ ALP ”with item ID“ 1063 ” ”,“ T-Bil ”whose item ID is“ 1064 ”,“ D-Bil ”,“ ChE ”,“ γ-GTP ”,“ LDH ”,“ CPK ”,“ AMY ”, whose item ID is“ 1065 ”, "T-Chol", "TG", "BS", "lactic acid", "NH3", etc. are handled as general-purpose inspections.

  Therefore, in STEP 423, first, in order to select all disease names (diseases) that can be diagnosed by the general examination of the specific item ID, the disease names in the clinical master table are referenced using the disease name ID of the disease name extracted in STEP 422 as a key. And the disease name (and disease name ID) which has the item ID of the said specific biochemical test is extracted from the said disease name. This extraction result is the data as shown in the miss search deletion table as a temporary storage area shown in FIG. 24 when “dry mouth (symptom ID = 19)” is selected in the symptom selection box 119. 24 is associated with the symptom ID and symptom selected in STEP 401, the disease name ID and disease name extracted from the clinical master table in STEP 423, and the disease name ID extracted in the clinical master table. Items and item IDs are stored in columns of “symptom ID”, “symptom”, “disease name ID”, “disease name”, “item name”, and “item ID”, respectively. The miss search deletion table further includes a column of “abnormal value ID”, and stores an abnormal value ID associated with the extracted disease name ID in the clinical master table. This “abnormal value ID” is used for data extraction in the missed search process. That is, in the missed search process, prior to the process of STEP 423, all records having an abnormal value ID of zero or more (abnormal value ID> 0) are extracted from the clinical master table, and the process of STEP 423 is executed for this extracted record. The

  In the next STEP 424, the medical information DB refers to the disease name extracted from the disease group master table in STEP 422, referring to the disease name ID of the disease name, and the same disease name as the disease name stored in the miss search deletion table. And the remaining disease names (and disease name IDs) are stored in the missed search disease name table (temporary storage area) as the missed search storage area shown in FIG. That is, since the disease name extracted in STEP424 cannot be diagnosed by the specific biochemical test, it is highly likely to be missed only by the specific biochemical test. And is displayed as a list of disease names that may be missed in the disease name table of contents window 140 in the next STEP 425. The missed search disease name table in FIG. 25 has “disease name ID”, “disease name”, “classification ID”, and “disease order” as columns, and the “disease name ID” and “disease name” are in STEP424. It stores the disease name ID and disease name remaining without being deleted. Specifically, when “Thirsty (symptom ID = 19)” is selected in the symptom selection box 119, the disease name ID and disease name extracted in STEP 422 are as shown in the symptom ID “19” portion of the disease group master table ( Disease name ID “11” “adult T cell leukemia (ATL)”, disease name ID “12” “multiple myeloma (MM)”, and the like. From here, the disease names (“adult T cell leukemia (ATL)”), “multiple disease” having the same disease name ID (“11”, “12”, etc.) as the disease name IDs shown in the miss search deletion table of FIG. When the myeloma (MM) "and the like are deleted, as shown in FIG. 25," salivary gland enlargement disease "with a disease name ID" 904 "," Simmons syndrome "with a disease name ID" 151 ", and a disease name ID" 154 " ”, Diabetes insipidus”, disease name ID “3003” “xerostomia”, disease name ID “3006” “oral candidiasis”, disease name ID “3007” “anemia glossitis”, disease name ID Is “3008” “Behcet's glossitis”, “Drug-sensitive thirst” with a disease name ID “3010”, “Digestive digestive disorders” with a disease name ID “3012”, and a disease name ID “3011” “Psychogenic polydipsia” remains. Therefore, these disease name IDs and disease names are stored in the missed search disease name table of FIG.

  Next, when one of the disease names displayed in the disease name table of contents window 140 is clicked and selected in STEP 426, the examination item corresponding to the selected disease name is obtained in STEP 427 in the same manner as the processing after STEP 107 of the general examination processing STEP 100. As information, item IDs, item names, examination trends, etc. of all examination items that can be used in examination of the disease name are extracted from the examination master table and clinical master table, and together with the disease name ID and disease name of the disease name, the common table Saved in. Thereafter, in the same manner as in the general examination process STEP 100, according to the selected disease name, the disease summary information provision process (STEP 110), the differential disease information provision process (STEP 130), and the test item information provision process (STEP 150) are executed. Is done.

3. Specific Variation Table Creation Processing An example of the inherent variation table creation processing in the clinical diagnosis support system will be described below using actual specific data.
1) Rheumatoid arthritis FIG. 26 is a table showing a case where the corresponding data portion of the eigenvariation master file is created taking the onset condition “organ: heart” of “rheumatoid arthritis” as a disease. FIG. 27 is a table showing the corresponding part of the inherent variation master file when all inherent variations are added by taking “rheumatoid arthritis” as an example of the disease.

  In the case of rheumatoid arthritis, RF and RAPA (both blood tests positive for chronic inflammatory diseases such as rheumatoid arthritis), bone XP (X-ray), ALP (living related to bone metabolism) Chemical tests), ESR (so-called blood sedimentation, elevated in chronic inflammatory diseases), CRP (biochemical tests showing the degree of inflammation), Fe (blood iron concentration) are general tests described in medical books Since these items correspond to the fixed intrinsic fluctuations, they are registered and stored in the intrinsic fluctuation master file 11 in association with rheumatoid arthritis by the intrinsic fluctuation registration / editing means 21. On the other hand, since there is no general description in the medical book about the inherent variation other than the fixed intrinsic variation, the inherent variation for each organ is not included in the associated inherent variation, which is the variation of the test results for individual organs regarding rheumatoid arthritis. get. For example, even in the case of rheumatoid arthritis, there is no specific description in the medical book about the onset condition such as “heart”. To prevent rheumatoid arthritis, we investigate the item names of the test items related to the onset conditions such as “kidney”, “hemoglobinemia”, “absence tendency”, which are medical decisions on rheumatoid arthritis. The test result obtained by examining each test item name for each onset condition is stored in the corresponding test trend data item of the inherent variation table as the accompanying inherent variation of the onset condition. For example, in the case of the organ “heart (chest affliction)”, chest images (chest X-ray and CT), BNP (blood test to measure the degree of heart failure), heart US (new ultrasound) (Inspection), blood gas (blood oxygen concentration, pH, etc.), ECG (electrocardiogram) of the five specific variations (test trends), by using the unique variation registration / editing means 21, the onset condition of the rheumatoid arthritis “heart ( It is registered in the inherent variation master file 11 and stored in association with “chest distress”. FIG. 26 shows the inherent variation data stored in this way. As a result, the inherent variation for these five examination items is added to the inherent variation master file 11 as the accompanying inherent variation of rheumatoid arthritis. FIG. 11 shows a state in which the accompanying inherent variation for each onset condition of rheumatoid arthritis is stored in this manner (only a part is shown due to space limitations). In FIG. 26 and FIG. 27, the associated inherent variation is expressed as the combined disease name by combining the disease name and the onset condition.

  As described above, for each disease, the number of test items that exhibit concomitant inherent variation is greater than the number of test items that exhibit fixed inherent variation. The number of inspection items exhibiting the number of inspection items is larger than the number of inspection items exhibiting fixed intrinsic fluctuations. For example, even in tests that are specific to rheumatoid arthritis, there are few completely specific tests that are positive only for the disease such as RAPA, and many tests are positive for a relatively large number of all diseases. Therefore, even though these tests are specific, they are relatively specific. In addition, for rheumatoid arthritis, the fixed inherent variation for other hematological tests varies for tens to 100 of all the diseases, so even if these test items are used alone, There is little specificity to diagnose rheumatism. However, if the fixed intrinsic fluctuations of these test items are all negative, it can be judged that at least it is not rheumatoid arthritis. Diagnosis by examination can be used as information to deny rheumatoid arthritis when these test items do not change (when they are negative).

  As shown in the example of rheumatoid arthritis, the characteristic variation table is prepared by previously collecting test items related to the onset condition and additionally storing the characteristic variation table in the characteristic variation table. That is, all the accompanying inherent fluctuations are additionally stored in the inherent fluctuation table (in association with the corresponding connected disease name and examination item name) by the same method to prevent the examination item from being overlooked.

2) Symptoms (hyperglycemia)
FIG. 28 is a table diagram for explaining processing in a case where the inherent variation relating to the symptom “hyperglycemia” is stored in the inherent variation master file for the examination item “CBC”. In the inherent variation master file 11, as described above, a plurality of different inherent variations for each disease are stored even for the same examination item, and a plurality of rows (different for each disease) exist for one examination item. Therefore, if the data contents of the records in each row are extracted and displayed in the inspection sequence table 63 as they are, the display rows may become enormous and it may be difficult to grasp the entire contents. Therefore, in the present clinical diagnosis support system, based on the inherent variation master file 11, data of inherent variation across multiple lines for the same examination item for each disease belonging to a certain symptom (for each disease belonging to the symptom for the same examination item) The description of a plurality of different test variations) is stored in the clinical master file 12 as one data (explanation of test variations for each disease belonging to the symptom for the test item). That is, for the same symptom, in the eigenvariation table, a plurality of inherent variation data related to one test item across multiple lines are combined into one data and expressed as a single data, and the same symptom is specified when the symptom is specified. For the test item, the single data is extracted from the clinical master file 12 and displayed in the test sequence table 63. Note that, as described above, this data aggregation processing is performed by combining the data of one inspection item across a plurality of lines into one line by the inspection array table processing and display means 53, and combining a plurality of inherent variations into a single data. And can be displayed in the test sequence table 63.

  For example, the disease group master file is referred to extract all diseases (all disease names) for the symptom “hyperglycemia”, and the extracted disease names are referred to the inherent variation master file and the tests associated with the disease names are extracted. When the item “CBC” and its inherent variation are extracted (when the extracted data portions of these two files are combined), as shown in FIG. 28, regarding the test item “CBC” for the disease group belonging to the symptom “hyperglycemia” In FIG. 28, it is understood that the individual variation master file stores individual variation (total of eight) for the disease group (such as “brown cell type”) belonging to the symptom “hyperglycemia” (FIG. 28). See table below). Therefore, in this clinical diagnosis support system, these inherent variation data are aggregated (single variation (testing trend)) data of the clinical master file as the unique variation (testing trend) of a single data (for the disease group). As the inherent variation regarding the test item “CBC” of the disease group when the symptom “hyperglycemia” is specified, the stored single data is stored in the corresponding record portion of the item (see the upper table of FIG. 28). Is displayed in the inspection trend column of the inspection sequence table 63. Therefore, it is possible to compare and examine a plurality of items only by looking at the inherent variation data (originally consisting of eight inherent variations) displayed as a single item in the test arrangement table 63. Workability is improved compared to the case of item comparison study. In addition, since the contents of the inherent variation of the inherent variation master file 11 are aggregated as they are and the content of the inherent variation of the clinical master file 12 is eliminated, there is no omission of disease names and inherent variation data, and an accurate and specialized syntax is provided. It is possible to display.

3) Pneumonia FIG. 29 is a table for explaining a process in a case where the inherent variation relating to pneumonia is stored in the inherent variation master file for the inspection item “AST”.
Pneumonia is caused by pneumoniae having affinity for the lungs. However, in this clinical diagnosis support system, first, 18 types of pneumoniae are caused as pneumoniae (excluding special viral pneumonia as another symptom). It is stored as a differential disease name in the differential master file 17 using flame bacteria. Then, for example, all differential diseases (all differential disease names) for the disease name “pneumonia” are extracted with reference to the differential master file, and all the extracted disease names are associated with the disease name with reference to the inherent variation master file. When the examination item “AST” and its inherent variation are extracted (when the extracted data portions of these two files are combined), as shown in FIG. 29, the examination item “AST” for the differential disease name group belonging to the disease name “pneumonia” ", The unique variation master file stores individual unique variations (for a total of 14) of differential disease name groups (such as" mycoplasmosis ") belonging to the disease name" pneumonia "(FIG. 29). See table below). Therefore, in this clinical diagnosis support system, these unique variation data are aggregated (single variation (testing trend)) in the clinical master file as the unique variation (testing trend) of single data (for the differential disease name group). As the inherent variation regarding the examination item “AST” of the differential disease name group when the disease name “pneumonia” is designated when stored in the corresponding record portion of the data item (see the upper table of FIG. 29), this aggregated single The inherent variation of the data is displayed in the inspection trend column of the inspection sequence table 63. Therefore, it is possible to compare and examine the inherent variation of the differential disease name only by looking at the inherent variation data (originally consisting of 14 inherent variations) displayed as a single item in the test sequence table 63. Compared with the case where they are compared and examined, the workability is improved. In addition, since the contents of the intrinsic fluctuations in the intrinsic fluctuation master file 11 are aggregated as they are and the contents of the intrinsic fluctuations in the clinical master file 12 are eliminated, there is no leakage of disease names and intrinsic fluctuation data, and an accurate and specialized syntax is provided. It can be displayed.

  Thus, according to the conventional diagnostic method, a bacterial culture test for selecting the optimal antibiotic is performed, and usually 4 to 5 days are required until the result is obtained. In contrast to the start of treatment with an appropriate antibiotic, this clinical diagnosis support system allows the result of a test to be performed even with an inexpensive biochemical test (which can be measured in about 30 minutes) when pneumonia is specified in a general test. Is confirmed by the inherent variation of the corresponding test item in the test sequence table 63, it is possible to distinguish and detect 16 pathogenic bacteria in 18 pathogenic bacteria that develop pneumonia. In addition, the more serious and more urgent it becomes, the more concomitant eigenvariation becomes positive, and as a result, severe pneumonia can be identified before the start of treatment, and the optimal drug can be selected. It can be expected to improve the lifesaving rate. Furthermore, in addition to biochemical tests, specific tests for which results can be found in a short time, image test features, etc. are also displayed in the test sequence table 63 as their inherent variations, so that the first simple test It is possible to distinguish and detect all diseases simply by comparing multiple items.

FIG. 1 is a table for conceptually explaining an example of an inherent variation table used in a clinical diagnosis support system according to an embodiment of the present invention. FIG. 2 is a table for conceptually explaining an example of a disease group master file used in the clinical diagnosis support system according to the embodiment of the present invention. FIG. 3 is a table for conceptually explaining an example of the differential disease master file used in the clinical diagnosis support system according to the embodiment of the present invention. FIG. 4 is a table for conceptually explaining an example of a clinical master file used in the clinical diagnosis support system according to the embodiment of the present invention. FIG. 5 is a table for conceptually explaining an example of a test arrangement table at the time of a symptom test used in the clinical diagnosis support system according to the embodiment of the present invention. FIG. 6 is a table for conceptually explaining an example of a test arrangement table at the time of a differential test used in the clinical diagnosis support system according to the embodiment of the present invention. FIG. 7 is another explanatory diagram for conceptually explaining the cube data structure of the eigenvariation table used in the clinical diagnosis support system according to the embodiment of the present invention. FIG. 8 is a block diagram for schematically explaining the overall configuration of the clinical diagnosis support system according to the embodiment of the present invention as a function realization means for symptom testing. FIG. 9 is a block diagram for schematically explaining the overall configuration of the clinical diagnosis support system according to the embodiment of the present invention as a function realization means for general examination. FIG. 10 is an explanatory diagram showing a screen configuration during a general examination (differential examination) process in the clinical diagnosis support system according to an embodiment of the present invention. FIG. 11 is an explanatory diagram showing a screen configuration during a symptom test process in the clinical diagnosis support system according to the embodiment of the present invention. FIG. 12 is an explanatory diagram showing a screen configuration at the time of three-item search processing in the clinical diagnosis support system according to one embodiment of the present invention. FIG. 13 is an explanatory diagram showing a screen configuration at the time of complex search processing in the clinical diagnosis support system according to one embodiment of the present invention. FIG. 14 is a flowchart showing a general examination process of the clinical diagnosis support system according to the embodiment of the present invention. FIG. 15 is a flowchart showing the disease summary information providing process in the general examination process of the clinical diagnosis support system according to the embodiment of the present invention. FIG. 16 is a flowchart showing the differential disease information providing process of the clinical diagnosis support system according to the embodiment of the present invention. FIG. 17 is a flowchart showing the test item information providing process of the clinical diagnosis support system according to the embodiment of the present invention. FIG. 18 is a flowchart showing the symptom test process of the clinical diagnosis support system according to the embodiment of the present invention. FIG. 19 is a flowchart showing the symptom summary information providing process in the symptom examination process of the clinical diagnosis support system according to the embodiment of the present invention. FIG. 20 is a flowchart showing processing subsequent to FIG. FIG. 21 is a flowchart showing the missed inspection process in the symptom search process of the clinical diagnosis support system according to the embodiment of the present invention. FIG. 22 shows a symptom master table as a symptom master file of the clinical diagnosis support system according to the embodiment of the present invention. FIG. 23 shows an abnormal value master table as an abnormal value master file of the clinical diagnosis support system according to the embodiment of the present invention. FIG. 24 shows a miss search deletion table as a temporary storage area of the clinical diagnosis support system according to the embodiment of the present invention. FIG. 25 shows an overlooked disease name table as a temporary storage area of the clinical diagnosis support system according to the embodiment of the present invention. FIG. 26 is a table showing a case where the corresponding data portion of the inherent variation master file is created taking the onset condition “organ: heart” of “rheumatoid arthritis” as an example. FIG. 27 is a table showing the corresponding part of the inherent variation master file when all inherent variations are added by taking “rheumatoid arthritis” as an example of the disease. FIG. 28 is a table diagram for explaining processing in a case where the inherent variation relating to the symptom “hyperglycemia” is stored in the inherent variation master file for the examination item “CBC”. FIG. 29 is a table for explaining processing in the case where the inherent variation related to pneumonia is stored in the inherent variation master file for the examination item “AST”.

110: General table window, 130: Disease name classification window 140: Disease name table of contents window 150: Examination sequence vote window, 160: Disease summary window 170: Differential disease table of contents window, 180: Examination summary window 190: Differential disease summary window, 200: Exam Storage form window 210: Disease name storage form window, 230: Symptom classification window 240: Symptom table of contents window, 250: Term search form window

Claims (6)

A fixed variation table and inspection array display means,
The fixed variation table is
For each disease, the test item name of the fixed eigenvariable test, which is a test item that can be used to confirm the onset of the disease itself by using the fact that the same test result is always obtained when the disease occurs And a fixed intrinsic variation that is an expression indicating the variation content of the test result of the fixed intrinsic test when the disease has occurred, and is stored in association with the disease,
When the disease occurs, the same test result is not necessarily obtained, but when the onset condition specific to the disease occurs, the same test result is always used to confirm the onset condition specific to the disease Test item name of the associated eigenvariable type test, which is an available test item, and the accompaniment that is the expression indicating the fluctuation contents of the test result of the associated eigenvariable type test when the onset condition specific to the disease occurs Store the intrinsic variation associated with the disease,
As the fixed eigenvariation and the accompanying eigenvariation, both store the subdivided representation of the variation content of the inspection result of the corresponding inspection item to be the minimum unit,
A combined disease in which the disease name of the disease corresponding to the fixed intrinsic variation is stored in association with the fixed intrinsic variation, and the disease name corresponding to the associated intrinsic variation and the onset condition name of the corresponding onset condition are combined Store the name in association with the associated eigenvariation,
The inspection sequence display means includes
For each disease, from the inherent variation table, the test item names of all the fixed intrinsic variation tests associated with the disease and the fixed intrinsic variations thereof, and all the associated inherent variation inspections associated with the disease Extract the item name and its associated eigenvariation, and associate the test item names of all fixed eigenvariable examinations and all of the associated eigenvariation examinations associated with the disease with each disease. The inspection sequence display unit sequentially lists and displays each fixed eigenvariable type inspection item name in association with the fixed eigenvariation and displays it on the inspection sequence display unit. The inspection item name is displayed on the inspection arrangement display unit in association with the accompanying inherent variation,
The fixed intrinsic variation is displayed in association with only the disease name associated with the fixed intrinsic variation, and the associated intrinsic variation is associated with the combined disease name associated with the associated intrinsic variation. And
Furthermore, by extracting at least two or more fixed intrinsic fluctuations for one disease from the intrinsic fluctuation table and listing them on the test sequence display unit, the two or more fixed intrinsic fluctuations for the one disease can be mutually displayed. A clinical diagnosis support system characterized by enabling comparative examination of multiple items for comparison and diagnosis. Furthermore,
Symptom storage means for storing the symptom;
For each symptom stored in the symptom storage means, a disease group storage means for storing a candidate disease that is a disease that is suspected to be activated when the symptom develops in association with the symptom,
A symptom specifying means for specifying a specific symptom among the symptoms stored in the disease group storing means;
Candidate disease extraction means for extracting the candidate disease associated with the designated symptom from the disease group storage means when a specific symptom is designated by the symptom designation means;
When a specific symptom is specified by the symptom specifying means, the test item name of the fixed variable test item and its fixed intrinsic variation associated with each of the candidate diseases extracted by the candidate disease extracting means, and the candidate disease And an inherent variation extracting means for extracting the inspection item name of the associated inherent variation type inspection associated with each of the associated variation and the associated inherent variation from the inherent variation table, respectively.
The inspection sequence display means includes the inherent variation extraction means,
When a specific symptom is specified by the symptom specifying means,
The inherent variation extracting means extracts at least two or more test item names and fixed inherent variations of the fixed variation type test item associated with each of the candidate diseases for each of the candidate diseases extracted by the candidate disease extracting means. And extracting the test item name of the associated variable test item associated with each of the candidate diseases and its associated inherent variation,
The test sequence display means lists all the test item names extracted by the inherent variation extraction means in order from the top to the bottom on the left side of the test sequence table as the test sequence display unit, and On the right side of the column table, the fixed inherent variation and the accompanying inherent variation are listed from the top to the bottom in correspondence with each of the inspection item names listed in the inspection sequence table,
The test sequence display means further displays only the disease name of the disease to which the fixed intrinsic variation corresponds to the fixed intrinsic variation listed and displayed in the test sequence table, and enumerates in the test sequence table. The clinical diagnosis support system according to claim 1, wherein the combined disease name corresponding to the associated inherent variation is displayed in association with the displayed inherent variation. Furthermore,
Differential disease storage means for storing, for each disease stored in the inherent variation table, a differential disease that is a disease that is differentially associated with the disease and that is also a disease that is stored in the inherent variation table in association with the disease; ,
A disease designating means for designating a specific disease among the diseases stored in the inherent variation table;
When a specific disease is designated by the disease designation means, a differential disease extraction means for extracting the differential disease associated with the designated disease from the differential disease storage means;
When a specific disease is designated by the disease designating means, the test item name of the fixed variation type test item associated with the designated disease and its fixed intrinsic variation, and the associated information associated with the designated disease In addition to extracting the test item name of the inherent variation test and its associated inherent variation from the inherent variation table, respectively, the fixed variation test item associated with each of the differential diseases extracted by the differential disease extraction means Inherent variation extracting means for extracting the inspection item name and its associated inherent variation, and the inspection item name of the associated inherent variation type test associated with each of the differential diseases and the associated inherent variation from the inherent variation table, respectively. And
The inspection sequence display means includes the inherent variation extraction means,
When a specific disease is designated by the disease designation means,
The characteristic variation extracting means extracts, for the designated disease, at least two or more fixed variable type test item names associated with the disease and the fixed characteristic variation, and associates with the designated disease. In addition to extracting the test item name of the associated variable test item and its associated inherent variation, the fixed variable type associated with each of the differential diseases for each of the differential diseases extracted by the differential disease extracting means Extract the inspection item name and its fixed inherent variation of the inspection item,
The test sequence display means collects and lists all the test item names extracted by the inherent variation extraction means in order on the left side of the test sequence table as the test sequence display unit, On the right side, the fixed intrinsic variation and the accompanying inherent variation are collected and displayed corresponding to each of the examination item names listed and displayed in the examination sequence table, while the fixed intrinsic extracted for the specified disease is displayed. Collecting and displaying variations, listing and displaying the associated inherent variation extracted for the specified disease, listing and displaying the fixed inherent variation extracted for the differential disease,
The test sequence display means further displays only the disease name of the disease to which the fixed intrinsic variation corresponds to the fixed intrinsic variation listed and displayed in the test sequence table, and enumerates in the test sequence table. The clinical diagnosis support system according to claim 1, wherein the associated disease name corresponding to the associated inherent variation is displayed in association with the displayed inherent variation. Furthermore,
For each disease stored in the eigenvariation table, the test item name of the fixed eigenvariation type test and its fixed eigenvariation, and the test item name of the associated eigenvariation type test and its associated eigenvariation are stored in association with each other. Clinical data storage means;
A disease designating unit for designating a specific disease among the diseases stored in the clinical data storage unit;
When a specific disease is designated by the disease designating means, the test item name of the fixed variation type test item associated with the designated disease and its fixed intrinsic variation, and the accompanying information associated with the designated disease Intrinsic variation extraction means for extracting the test item name of the inherent variation type test and its accompanying inherent variation from the clinical data storage means, respectively,
The clinical data storage means uses the test item name of the fixed eigenvariation type test associated with each disease in the eigenvariation table as the test item name of an affirmative test for confirming the onset of the disease itself. In addition to storing in association with each other, the test item name of the fixed intrinsic variation type test associated with the disease that becomes the differential disease of the disease in the inherent variation table is also confirmed by confirming the onset of the differential disease. Store in association with the disease as a negative test to deny the onset of the disease itself,
The clinical data storage means further includes a fixed intrinsic variation of the fixed intrinsic variation type test associated with each disease in the inherent variation table and the fixed intrinsic variation of the examination to be the affirmative test is a disease of the disease A fixed inherent variation of the fixed inherent variation test associated with a disease that is a differential disease of the disease in the inherent variation table, in addition to storing each associated with a name and a test item name of the positive test The fixed intrinsic variation of the test to be the negative test is also stored in association with the disease name of the disease and the test item name of the negative test and the disease name of the differential disease,
When a specific disease is designated by the disease designation means,
The inherent variation extracting means extracts the test item name of the at least two or more affirmative test items associated with the disease and its fixed inherent variation for the disease designated in the previous period and associates it with the designated disease. In addition to extracting the test item name of the accompanying variable type test item and its associated inherent variation, the test item name of the negative test item associated with the disease and its fixed inherent variation are extracted,
The test sequence display means lists all the test item names extracted by the inherent variation extraction means in order from the top to the bottom on the left side of the test sequence table as the test sequence display unit, and On the right side of the column table, the fixed inherent variation and the accompanying inherent variation are listed from the top to the bottom corresponding to each of the test item names listed and displayed in the test sequence table, while extracting the specified disease The fixed eigenvariations of the positive examinations collected and displayed, and the associated eigenvariations extracted for the designated disease are collected and displayed, and the negative examination extracted for the designated diseases is displayed. Collect and display,
The inspection sequence table display means further includes a positive test type symbol indicating the positive test in the test item name of the positive test in the test sequence table, and the negative for the negative test. 2. The clinical diagnosis support system according to claim 1, wherein a negative test type symbol indicating a test is attached and displayed. If the specified disease is diagnosed by an exclusion diagnosis method, the inherent variation extracting means extracts the negative test item associated with each of the differential diseases of the disease and its fixed inherent variation,
5. The clinical diagnosis support system according to claim 4, wherein the test sequence table display means lists and displays the negative test items extracted by the inherent variation extraction unit in the test sequence table. Furthermore,
Symptom storage means for storing the symptom;
For each symptom stored in the symptom storage means, a disease group storage means for storing a candidate disease that is a disease that is suspected to be activated when the symptom develops in association with the symptom,
Symptom designation means for designating a specific symptom among the symptoms stored in the disease group storage means;
When a specific symptom is designated by the symptom designation means, the candidate disease extraction means for extracting the candidate disease associated with the designated symptom from the disease group storage means,
The clinical data storage means further stores, as the examination item, the item names of all the existing examination items and the item IDs for uniquely identifying the examination items in association with each other. While storing a general test item consisting of a test in association with the specific item ID, storing a specific item ID of the general test item in association with a disease name of a specific disease detectable by the general test item,
Furthermore,
By specifying a specific symptom by the symptom specifying means, after extracting all the diseases associated with the specified symptom, among the extracted diseases, the specific item ID of the general-purpose test item is associated 6. The clinical diagnosis support system according to claim 4, further comprising an overlooked disease extraction / display unit that extracts only diseases other than the specific disease and lists and displays the diseases in the test sequence table.

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