JP3773519B2 - 生理学的特性の測定された状態を示す測定装置 - Google Patents
生理学的特性の測定された状態を示す測定装置 Download PDFInfo
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- JP3773519B2 JP3773519B2 JP2004323462A JP2004323462A JP3773519B2 JP 3773519 B2 JP3773519 B2 JP 3773519B2 JP 2004323462 A JP2004323462 A JP 2004323462A JP 2004323462 A JP2004323462 A JP 2004323462A JP 3773519 B2 JP3773519 B2 JP 3773519B2
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/08—Detecting, measuring or recording devices for evaluating the respiratory organs
- A61B5/087—Measuring breath flow
- A61B5/09—Measuring breath flow using an element rotated by the flow
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/0002—Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/08—Detecting, measuring or recording devices for evaluating the respiratory organs
- A61B5/087—Measuring breath flow
- A61B5/0871—Peak expiratory flowmeters
-
- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H15/00—ICT specially adapted for medical reports, e.g. generation or transmission thereof
-
- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
- G16H40/60—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices
- G16H40/63—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for local operation
-
- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
- G16H10/60—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records
-
- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
- G16H40/60—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices
- G16H40/67—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for remote operation
-
- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10S128/00—Surgery
- Y10S128/904—Telephone telemetry
Description
ピークフローメータが出回るようになってもう何年にもなる。多くの臨床医が、毎日のPEFR測定によって喘息の発生を早期に警告することができることを認識している。しかし、毎日のピークフロー監視を勧める自己管理プログラムは、未だに標準ではなくむしろ例外的である。喘息治療の予防的アプローチを支持するにあたって、全国喘息教育プログラムは、喘息の管理に対して介入ではなくむしろ予防的アプローチを取り入れるように臨床医および患者に勧めている。
一般に個人用肺活量計は、最大吸息状態から最大限の努力をして吐き出しの最初の1秒間に個人によって吐き出される空気の量として定義される強制的吐出し量(FEV1)を含む数種の呼吸パラメータを測定する。FEV1はリットル単位で測定される。
・現在の薬物治療の投与方法の効果を検討する
・上昇または下降する個人の最高PEFおよびFEV1の傾向である季節的パターンを検出する
・多期間にわたっての気道の安定性を評価する
・毎日のピークフロー監視を含む自己管理プログラムの順守度を評価する
・良く管理プログラムに従って事への褒美として医者および/または親が用いることのできる奨励システムのための基準を設定する
際にいくつかの利点を得ることができる。
機械式ピークフローメータにおいては、息がストリング抑制式デフレクタを変位させ、これがポインタを目盛にそって動かして検査の結果を示す。ほとんどの機械式メータは装置間の精確さおよび再現性が比較的低い成形プラスチック部材の単なる集まりにすぎない。それらが使われていた頃には、それらの装置は、特に絶対的な結果よりも比較的な成績がより重要である場合に、ある程度精確な示度を得るために有用であった。ある期間にわたった記録を作れるかは、全く利用者の自制心および注意次第であった。
最も初期の型の電子式ピークフローメータおよび個人用肺活量計においては、設計者は、機械式装置のスプリング抑制式デフレクタを肺流速計センサに置き換えただけであった。すべての型が計算を取り扱うためのマイクロプロセッサおよびテスト結果の数字を表すための液晶表示装置を用いている。
1.それらは元来低コストに設計されていないので高価である。
2.装置の対人インタフェースを介して直ちに入手可能な記憶装置に残るある期間にわたっての記録を生じず、毎日の監視の一連の手順の不便さを最小限のものにできないでいる。
3.先行の検査の結果を示すことによって傾向についての情報を表すことをしない。
4.利用者の注意を気道の状態および傾向に計画的に向けさせることがなく、それらの対人インタフェースは小さな子供が用いるのには適していない。
5.利用者がテストの結果のいずれかを薬物治療後の結果として明示することを可能にしていない。
6.時宜にかなってかつ効率的に医者に臨床情報を届けることのできる低コストのメカニズムを利用者に提供していない。
7.健全、迅速な判読および適切な医療判断を容易にするようにデザインされた明確な図表を用いた記録表を医者に提供するものではない。
8.データを収集、精査するために医者がコンピュータを必要とすることを無くしていない。
9.管理プランへの順守度を医者が追跡する必要があることについて、あるいは喘息管理プランの効率を調べる系統的な方法についても取り組んでいない。
10.統計的分析のための検査結果の系統的収集の手段が講じられていない。
患者によって測定がされた時に生理学的特性の現在の測定された状態を示す値を有する現在測定パラメータデータ要素を生成する患者センサ装置と、
データを書き込みかつ読み出すためのデータメモリであって、ターゲットパラメータデータ要素を記憶し、且つターゲットパラメータデータ要素に対して相対的な成績のゾーンを定義する複数の所定ゾーンを記憶する前記メモリと、
前記成績のゾーンの固有の1つに各表示領域が対応する複数の表示領域に区分された表示面を有する表示装置と、
測定された生理学的特性に関する前記パラメータを患者が測定した時に前記現在測定パラメータデータ要素を受信するために前記センサに結合し、且つ前記データメモリおよび前記表示装置に結合する処理手段であって、最初の測定によって開始される測定最高値判定時間間隔を設定する手段と、前記測定最高値判定時間間隔内の前記現在測定パラメータデータ要素の測定最高値を前記データメモリに格納する手段とを備え、前記データメモリから前記測定最高値、前記ターゲットパラメータデータ要素および前記ゾーン定義パラメータデータ要素を検索し、これら検索された前記測定最高値、前記ターゲットパラメータデータ要素および前記ゾーン定義パラメータデータ要素を処理して前記測定最高値に従った生理学的特性の現在の測定された状態を示す現在の成績のゾーンを判定し、前記現在の成績のゾーンに対応する表示領域を表示状態にする前記処理手段と、
を備える。
データ管理装置24は、データベース20と、会話型音声応答システム25等の各種の入出力ブロックおよび制御ブロックとをインタフェースする。この会話型音声応答システムは、医療従事者がリポートの種類のメニューの選択に基づいてリポートを要求することを可能にしている。モニタモジュール12からの入力データは、電話システムとインタフェースを有する入力データコムフロントエンド26において受信され、入力コミュニケーションサーバ28を介してデータ管理装置24の入力データポートに転送される。
患者がモニタモジュール12からデータ記録をダウンロードすることを望む場合、患者は、電話インタフェース44のRJ−11C電話ジャックに電話線を接続し、利用者インタフェースのボタンを押すだけである。そうすると、マイクロコントローラは、データ記録をRAM42から検索し、ディジタルデータをアナログ信号に変換し、遠隔リポーティングシステム14に接続するために電話インタフェース回路を制御するため、および遠隔リポーティングシステム14に検索したデータ記録を転送するために、アプリケーションプログラムを実行する。
患者が喘息を管理するのを助けるために、NIHによって刊行された専門家パネル報告書は、ピークフローゾーンのシステムを提供している。このゾーンモデルにおいては、それぞれのテスト結果が、利用者がその気道がきれいなときに通常到達する最高のピークフローレベルとして定義される各個人の最高値に対するパーセントとして表現される。これらのゾーンは交通信号に類似−すなわち緑、黄色、および赤−しており、覚えやすくなっている。各ゾーンは個人の最高値に対するパーセントを見分けるのに役立つ。緑ゾーンは個人ベストの80%−100%、黄色ゾーンは50%−80%、赤ゾーンは50%未満である。個人の最高値および各ゾーン間の境界は、患者が調整することのできる適合可能な値である。どのような調節も医者の特別な許可によってなされるべきものである。
好ましい実施例においては、ゾーンチャートが、5列9欄のアレーのドットでなっている。緑ゾーン56および黄色ゾーン54は、それぞれ、表示装置50のゾーンチャート部分上に2列のドットを有している。これらの2列がゾーンを2分して、より良く見分けが付くようにしている。したがって、緑ゾーンが個人の最高値の80−100%をカバーする場合、下側が80−90%に相当し、上側の列が90−100%に相当する。同様に、黄色ゾーン54が50−80%をカバーする場合、下側が50−65%に相当し、上側の列が65−80%に相当する。
操作を簡単にするためにボタンが3つだけ設けられている;
その表示装置(LCD)は以下に列挙する複数の機能領域を用いる:
測定結果および計算された値を報告する数字ライン;
位置および色の符号化されたドットを用いてゾーンステイタスを報告するゾーンチャート;
報告された気道状態情報の意味をその動作および表現が補強するアニメーションキャラクター「ウェルビー」;
表示装置の他の部分に表された情報の項目を注釈し(例えばリットル/分やリットル等の測定の単位、AM,PM,個人最高値のクラウン、赤ゾーンのクロス、電話等)、または特別なメッセージを伝える(例えば電池の電圧低下表示)各種シンボル。
Claims (8)
- 患者の測定された生理学的特性に関するパラメータの値を測定し、その値の大きさがその生理学的特性の測定された状態を示す測定装置であって、監督されていない患者によって用いられる前記測定装置において、
患者によって測定がされた時に生理学的特性の現在の測定された状態を示す値を有する現在測定パラメータデータ要素を生成する患者センサ装置と、
データを書き込みかつ読み出すためのデータメモリであって、ターゲットパラメータデータ要素を記憶し、且つターゲットパラメータデータ要素に対して相対的な成績のゾーンを定義する複数の所定ゾーンを記憶する前記メモリと、
前記成績のゾーンの固有の1つに各表示領域が対応する複数の表示領域に区分された表示面を有する表示装置と、
測定された生理学的特性に関する前記パラメータを患者が測定した時に前記現在測定パラメータデータ要素を受信するために前記センサに結合し、且つ前記データメモリおよび前記表示装置に結合する処理手段であって、最初の測定によって開始される測定最高値判定時間間隔を設定する手段と、前記測定最高値判定時間間隔内の前記現在測定パラメータデータ要素の測定最高値を前記データメモリに格納する手段とを備え、前記データメモリから前記測定最高値、前記ターゲットパラメータデータ要素および前記ゾーン定義パラメータデータ要素を検索し、これら検索された前記測定最高値、前記ターゲットパラメータデータ要素および前記ゾーン定義パラメータデータ要素を処理して前記測定最高値に従った生理学的特性の現在の測定された状態を示す現在の成績のゾーンを判定し、前記現在の成績のゾーンに対応する表示領域を表示状態にする前記処理手段と、
を備える測定装置。 - 前記表示装置は液晶表示装置(LCD)である請求項1に記載のシステム。
- 前記表示装置は陰極線管(CRT)である請求項1に記載のシステム。
- 前記表示装置は第2の複数の別個の表示領域を含み、前記第2の複数の各別個の表示領域は前記成績のゾーンの固有の1つに対応し、
前記データメモリは以前の成績のゾーンの識別を符号化した以前ゾーンデータ要素を格納し、
前記処理手段は成績の前記以前ゾーンに対応する前記第2の複数の表示領域の1つの表示領域を表示状態にする
請求項1に記載のシステム。 - 前記生理学的特性は患者の肺からの空気流量に関わる呼吸特性であり、
前記センサは空気流量の大きさを示す値を有する測定されたパラメータデータ要素を生成し、
前記ターゲットパラメータデータ要素は特定の患者に対する空気流量の大きさの望ましい値を示す値を有する
請求項1に記載のシステム。 - 前記データメモリに選択されたゾーン定義パラメータデータ要素および選択されたターゲットデータ要素を記憶するために装置をプログラムする手段をさらに備える請求項1に記載の測定装置。
- 前記表示装置は、
健康の質の変更可能な図表的標識を含む手段と、
前記処理手段に応答し、前記現在の成績のゾーンを示すために前記標識を変更する手段と、
を備える請求項1に記載の測定装置。 - 前記測定最高値判定時間間隔内の測定最高値が、PEFまたはFEV1の最高値である請求項1に記載の測定装置。
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US08/247,727 US5704366A (en) | 1994-05-23 | 1994-05-23 | System for monitoring and reporting medical measurements |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP53050795A Division JP3697260B2 (ja) | 1994-05-23 | 1995-05-22 | 医療測定値を監視し且つ報告するための改良されたシステム |
Publications (2)
Publication Number | Publication Date |
---|---|
JP2005095646A JP2005095646A (ja) | 2005-04-14 |
JP3773519B2 true JP3773519B2 (ja) | 2006-05-10 |
Family
ID=22936105
Family Applications (3)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP53050795A Expired - Lifetime JP3697260B2 (ja) | 1994-05-23 | 1995-05-22 | 医療測定値を監視し且つ報告するための改良されたシステム |
JP2004323463A Expired - Lifetime JP3699469B2 (ja) | 1994-05-23 | 2004-11-08 | 呼吸機能センサ装置 |
JP2004323462A Expired - Fee Related JP3773519B2 (ja) | 1994-05-23 | 2004-11-08 | 生理学的特性の測定された状態を示す測定装置 |
Family Applications Before (2)
Application Number | Title | Priority Date | Filing Date |
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JP53050795A Expired - Lifetime JP3697260B2 (ja) | 1994-05-23 | 1995-05-22 | 医療測定値を監視し且つ報告するための改良されたシステム |
JP2004323463A Expired - Lifetime JP3699469B2 (ja) | 1994-05-23 | 2004-11-08 | 呼吸機能センサ装置 |
Country Status (8)
Country | Link |
---|---|
US (4) | US5704366A (ja) |
EP (1) | EP0765507B1 (ja) |
JP (3) | JP3697260B2 (ja) |
AU (1) | AU703391B2 (ja) |
CA (1) | CA2190283C (ja) |
DE (1) | DE69519166T2 (ja) |
ES (1) | ES2151067T3 (ja) |
WO (1) | WO1995032480A1 (ja) |
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EP0765507A1 (en) | 1997-04-02 |
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CA2190283A1 (en) | 1995-11-30 |
EP0765507B1 (en) | 2000-10-18 |
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AU703391B2 (en) | 1999-03-25 |
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DE69519166D1 (de) | 2000-11-23 |
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