JP5028537B1 - Medical examination support equipment - Google Patents

Abstract

When displaying a time series of inspection values such as MD values in a graph, an arbitrary partial inspection value is selected from the entire inspection value time series and a graph of the approximate function is displayed. To provide a medical examination support device.
When an instruction signal instructing to select a part of inspection values from a plurality of inspection values of a scatter diagram displayed on a display unit is generated in the instruction input unit, the part of inspection values is generated. A regression analysis process is executed on the display unit 203, and a graph of the approximate function for the part of the inspection values is displayed on the display unit 203 based on the constant of the approximate function calculated as a result of the regression analysis process. Thereby, an arbitrary partial test value can be selected from the entire test values in the scatter diagram, and a graph of the approximate function can be displayed.
[Selection] Figure 16

Description

  The present invention relates to a medical examination support apparatus that supports medical examination work in a hospital, and more particularly, to a medical examination support apparatus that displays a graph of a time series of test values indicating the results of a medical examination.

  The results of medical examinations provide the most basic information for determining a patient's treatment policy, and are extremely important in doctor's examination work. The following patent documents describe a computer system that presents medical examination results to a doctor in an easily understandable manner.

Japanese Patent Application No. 2010-270955

  For example, in ophthalmology, a Humphrey (registered trademark) perimeter is typically used as a measuring instrument for measuring a visual field of a patient such as glaucoma. The Humphrey perimeter is a measuring device that randomly displays light spots of various intensities around the patient's viewpoint and asks the patient whether or not each light spot has been viewed, thereby examining the state of visual field loss. It is. The Humphrey perimeter outputs a numerical value in decibel units called MD (mean division) indicating the degree of overall visual field defect in addition to a graph (grayscale) representing the distribution of visual field defect. The MD value is a numerical value indicating how much the degree of visual field loss is deviated from the age-corrected average value of a normal person, and as the MD value increases on the negative side, the visual field is compared with a normal person of the same age. The degree of loss increases.

  In the case of glaucoma in which the visual field defect gradually progresses over a long period of time, a graph showing the change over time in the MD value is used as a guide for making a treatment plan. In general, the change in MD value with time is approximated by a straight line, and the progress of visual field loss is grasped from the inclination. Further, a future MD value is predicted by extrapolation of the approximate straight line.

  MD values are important data especially for glaucoma diagnosis, but errors are likely to occur depending on the patient's condition at the time of the examination. There is a problem that it will change greatly. For example, since the measurement of the MD value is continuously performed in parallel with medication or surgery, the tendency of the MD value to change over time may change depending on the effect of treatment. However, if such a change in tendency is ignored and the whole period is approximated by a single straight line, there is a possibility that a graph that correctly represents the patient's medical condition cannot be obtained. Further, when it is determined that the MD value is not reliable from the state of the patient at the time of the examination, it is desirable to exclude such MD value from the approximation target.

  The present invention has been made in view of such circumstances, and an object of the present invention is to display an arbitrary partial test from the entire test value time series when displaying a time series of test values such as MD values in a graph. An object of the present invention is to provide a medical examination support apparatus capable of selecting a value and displaying a graph of its approximate function.

A medical examination support apparatus according to the present invention is a medical examination support apparatus that displays a graph of a time series of test values indicating the results of a medical examination, and relates to examination information, examination information, and treatment that include the examination values. A storage unit that stores a time series of medical information in which at least one of information, information about surgery, and information about prescription drugs is associated with date information; a display unit that displays an image according to an input display signal; When the instruction input unit that generates an instruction signal corresponding to a predetermined instruction input operation by a user and the instruction signal that instructs to display a scatter diagram of the inspection value is generated in the instruction input unit, the storage based on the time series of the test values in the time series of the stored the medical information in parts, one coordinate axis represents the numerical value corresponding to the examination date or an examination date, the other one of the coordinates A first processing unit for generating the display signal for displaying a scatter diagram showing the inspection values on the display unit, and selecting a part of the inspection values from a plurality of inspection values in the scatter diagram displayed on the display unit Then, when the instruction signal instructing to display the graph of the approximate function based on the partial test value is generated in the instruction input unit, the time series of the partial test value is regressed. The second processing unit that executes the analysis process and the two medical information consecutive in the time series of the medical information stored in the storage unit are respectively compared before and after the test value based on the comparison result. And a third processing unit for determining a day on which a factor that may change the trend of the series has occurred.
The third processing unit is the medical information on a date that is later than the day and closest to the day for each day on which the change factor is determined to have occurred, and includes the test value For each day on which the medical information is searched or it is determined that the change factor has occurred, the medical information is the same date as the date or before the date and the date closest to the date. The medical information including the test value is retrieved.
The first processing unit changes the test value included in the medical information searched for each day when the change factor is determined to have occurred in the third processing unit, and the time-series tendency of the test value changes The display signal for displaying on the display section the scatter diagram expressed so as to be identified as an inspection value serving as a standard of the boundary to be generated is generated.
The second processing unit displays the inspection date or a range of numerical values corresponding to the inspection date when a scatter diagram is displayed on the display unit so as to identify the inspection value serving as a guideline for the boundary. When the instruction signal is generated in the instruction input unit to specify a plurality and specify to display a graph of the approximate function for the inspection value belonging to the range for each of the plurality of ranges, the inspection date or the The regression analysis process is performed for each of the plurality of ranges with respect to a time series of test values whose numerical values corresponding to the test date belong to the range.
The first processing unit displays a plurality of graphs of the approximate functions on the display unit based on constants of the approximate functions calculated as a result of the regression analysis process executed for each of the plurality of ranges. The display signal to be generated is generated.

  Preferably, the second processing unit specifies at least one test value from the plurality of test values of the scatter diagram displayed on the display unit, and the remaining test values excluding the specified test value When the instruction signal instructing to display the graph of the approximate function is generated in the instruction input unit, the regression analysis process may be performed on the time series of the remaining inspection values.

Preferably, the pre-Symbol first processing unit, to specify one of the test values in the scatter diagram displayed on the display unit, and instructs to display the medical information related to the test values of the one said When an instruction signal is generated in the instruction input unit, information on the examination belonging to the same medical information as the one examination value in the storage unit, information on the examination, information on the treatment, information on the surgery, and You may produce | generate the said display signal which displays at least 1 of the information regarding the said prescription medicine on the said display part.

Preferably, the pre-Symbol first processing unit may generate the display signal to display information about the date of the change factor in the third processing unit is determined to have occurred on the display unit.

  Preferably, the third processing unit compares prescription drug information included in the two consecutive medical information, and based on the comparison result, the change factor is generated on the date when the prescription drug is changed. You may judge it as a day.

  Preferably, the first processing unit includes information about pre-change and post-change prescription drugs on the display unit as information incidental to the information on the day when the change factor is determined to have occurred in the third processing unit. The display signal to be displayed may be generated.

  Preferably, the third processing unit searches for medical information including information indicating that a predetermined operation or treatment has been performed in a time series of the medical information stored in the storage unit, and the search result Based on the above, the day on which the operation or treatment is performed may be determined as the day on which the change factor occurs.

  Preferably, the first processing unit displays the information on the operation or treatment performed on the day as information incidental to the information on the day on which the change factor is determined to have occurred in the third processing unit. The display signal to be displayed on the unit may be generated.

  Preferably, the medical examination support apparatus searches the medical information including the test value from the time series of the medical information stored in the storage unit, and the reliability of the test included in each searched medical information. A fourth processing unit that determines whether or not the test value included in each of the medical information is a candidate to be excluded from the regression analysis target based on information on sex. The first processing unit may generate the display signal for displaying, on the display unit, information on the inspection value determined as the exclusion candidate by the fourth processing unit.

  According to the present invention, when displaying a time series of test values such as MD values in a graph, an arbitrary partial test value is selected from the entire time series of test values, and a graph of its approximate function is displayed. Can be displayed.

It is a figure which shows an example of the whole structure of the examination work assistance apparatus which concerns on this embodiment. It is a figure which shows an example of a structure of a server apparatus. It is a figure for demonstrating the structure of the medical data memorize | stored in a patient database part. It is a figure for demonstrating the structure of test | inspection data. It is a figure which shows an example of a structure of the terminal device for diagnosis. It is a flowchart for demonstrating the process in the case of displaying a medical chart screen. It is a figure which shows an example of the display screen of the electronic medical chart which a doctor utilizes. It is a figure which shows an example of the scatter diagram of MD value displayed on the screen of a display part. It is a figure which shows the graph of the regression line calculated based on the range (start point and end point) of the inspection date designated in FIG. It is a 1st figure which shows an example of the screen which displays the estimated years until a test value reaches a predetermined value. It is a 1st figure which shows an example of the screen which displays the estimated years until a test value reaches a predetermined value. It is a figure for demonstrating an example of operation which changes the unit of the horizontal axis of a scatter diagram to age. It is a figure for demonstrating an example of operation which excludes a part of test value from the object of regression analysis. It is a figure which shows the graph of the regression line re-calculated except the test value of 2 points | pieces designated in FIG. It is a figure for demonstrating an example of operation which designates the range of several inspection days, and performs a regression analysis process about each range. It is a figure which shows the graph of the regression line in the range of two inspection dates designated in FIG. It is a figure for demonstrating an example of operation which displays the supplementary information regarding a test value on a screen. It is a figure which shows the example which displays the standard of the boundary where the time-sequential tendency of a test value changes in a scatter diagram. It is a flowchart for demonstrating the process which determines the generation | occurrence | production date of the factor from which the time-sequential tendency of a test value changes. It is a flowchart for demonstrating the process which determines the test value used as the standard of the boundary where a time-sequential tendency changes. It is a figure for demonstrating the specific example which determines the test value of the standard of the boundary where a time-sequential tendency changes based on the generation day of the change factor which can change the time-sequential tendency of a test value. It is a figure which shows the example which displays the candidate of the test value excluded from the object of regression analysis in a scatter diagram. It is a flowchart for demonstrating the process which determines the test value of the candidate excluded from the object of regression analysis. It is a figure which shows an example of the screen which displayed the scatter diagram of the related some test value side by side. It is a figure which shows an example of the screen which displayed the supplementary information of the test value side by side on the same time axis as the scatter diagram of the test value.

FIG. 1 is a diagram illustrating an example of the overall configuration of the examination work support apparatus according to the present embodiment.
The examination work support apparatus shown in FIG. 1 includes a server apparatus 1, a plurality of examination terminal apparatuses 2, an inspection terminal apparatus 4, and a visual field inspection apparatus 5. The examination terminal device 2 and the inspection terminal device 4 are connected to the server device 1 via the communication network 3.

[Server device 1]
The server device 1 is a device that manages data that is commonly used / referenced by each examination terminal device 2 and the examination terminal device 5 in the examination work support device, and includes a staff database unit 11 and a patient database unit 12.
In this specification, the staff database unit 11 and the patient database unit 12 may be collectively referred to as “database unit”.

FIG. 2 is a diagram illustrating an example of the configuration of the server device 1.
The server apparatus 1 illustrated in FIG. 2 includes a processing unit 101, a communication unit 102, a display unit 103, an instruction input unit 104, a storage unit 105, and a work memory 106.

  The communication unit 102 is a circuit for performing communication with the terminal device 2 via the communication network 3. For example, signal processing and control for performing communication conforming to a predetermined standard such as Ethernet (registered trademark), wired or It modulates / demodulates signals transmitted wirelessly, encodes / decodes data, processes packets, adjusts transmission / reception timing, and the like.

  The display unit 103 displays a screen corresponding to the display signal generated by the processing unit 101. For example, the display unit 103 includes a display device such as a liquid crystal display, an EL panel display, or a CRT.

  The instruction input unit 104 is an apparatus for inputting a user instruction, and generates an instruction signal corresponding to a predetermined instruction input operation. For example, a keyboard, a mouse, operation buttons, a keypad, a touch sensor, and the like are included.

  The storage unit 105 stores a low-level program (such as BIOS) used for initialization and control of the processing unit 101 and peripheral hardware (102 to 104), a file operating system, an application program, and the like. At the same time, data used in these programs is stored. For the storage unit 205, for example, a non-volatile memory such as a hard disk or a flash memory, an optical disk such as a DVD, a magneto-optical disk such as an MO, a magnetic tape, a programmable ROM, a mask ROM, or the like is used.

The storage unit 105 is used as a storage area for the staff database unit 11 and the patient database unit 12, respectively.
The staff database unit 11 manages various information related to hospital staff such as doctors, nurses, inspectors, and office staff.
The patient database unit 12 manages various information related to the patient, and in particular manages medical information (medical chart) related to the examination and treatment of the patient.
The storage unit 105 is an example of a storage unit in the present invention.

  The working memory 106 is a relatively high-speed memory that is temporarily accessed by the processor of the processing unit 101 to store programs and data, and includes a semiconductor memory such as a dynamic RAM and a static RAM.

  The processing unit 101 controls the overall operation of the server device 1. That is, the communication unit 102 communicates with the diagnostic terminal device 2, generates a display signal to be supplied to the display unit 103, inputs an instruction from the user in the instruction input unit 104, and the like in the storage unit 105 and the work memory 106. Control based on the stored program. For example, the processing unit 101 includes a processor (CPU) that performs processing based on a program, a circuit that controls peripheral hardware (102 to 106), a bus for exchanging data with the peripheral hardware, and a bus control circuit (bus bridge). Circuit), cache memory, and the like.

  The processing unit 101 includes a staff database processing unit 111 that executes processing related to the staff database unit 11 and a patient database processing unit 112 that executes processing related to the patient database unit 12 as functional blocks.

The staff database processing unit 111 stores various data related to staff in the storage unit 105 in a predetermined data structure, and a request from the diagnostic terminal device 2 requesting access to staff data is received by the communication unit 102. In response to the request, data search, read, write, rearrangement, etc. are executed.
Similarly, the patient database processing unit 112 stores various data related to the patient in the storage unit 105 in a predetermined data structure, and a request from the examination terminal device 2 requesting access to the patient data is received in the communication unit 102. When it is received, processing such as retrieval corresponding to this request is executed.

FIG. 3 is a diagram for explaining the structure of medical data stored in the patient database unit 12.
The patient database unit 12 stores various information related to the patient, and stores medical data 52 related to the examination and treatment of the patient as a part thereof. The medical data 52 is associated with the patient identification data 42 and the date 51 on which the medical practice was performed.
For example, as shown in FIG. 3, the medical data 52 includes identification data 41 of the doctor in charge, inspection data 53 related to the medical examination result, findings data 54 related to the doctor's examination findings, medicine prescribed by the doctor, and instructions from the doctor. And prescription data 55 and operation record data 56 in which information about the operation is recorded. However, the medical data 52 does not necessarily include all of these data. If some medical actions (examination, surgery, etc.) are not carried out, the data (examinations) of the medical practice that has not been carried out. Data 53, operation record data 56, etc.).
In this specification, the contents of one medical data 52 corresponding to one (one date) medical record may be simply referred to as “medical record”.

FIG. 4 is a diagram for explaining the data structure of the inspection data 53.
The examination data 53 includes examination result data 533 performed on the patient. The inspection result data 533 is data such as characters (numerical values) and images, for example, and is associated with the inspection type code 531 and the incidental information 532. The examination type code 531 indicates the type of examination performed on the patient. The incidental information 532 includes incidental information such as the inspection date, the identification data of the inspector in charge of the inspection, the communication items recorded by the inspector, and the evaluation rank regarding the reliability of the inspection.

[Terminal device 2 for examination]
FIG. 5 is a diagram illustrating an example of the configuration of the diagnostic terminal device 2.
The diagnostic terminal device 2 shown in FIG. 5 includes a processing unit 201, a communication unit 202, a display unit 203, an instruction input unit 204, a storage unit 205, and a work memory 206.
The display unit 203 is an embodiment of the display unit in the present invention.
The instruction input unit 204 is an embodiment of the instruction input unit in the present invention.

  The communication unit 202 is a circuit for communicating with the server device 1 via the communication network 3, and has the same configuration as the communication unit 102 described above, for example.

  The display unit 203 is a device that displays a screen corresponding to the display signal generated in the processing unit 201, and has the same configuration as the display unit 103 described above, for example.

  The instruction input unit 204 is a device for inputting a user instruction, and has the same configuration as the instruction input unit 104 described above, for example.

  The storage unit 205 stores a low-level program (such as BIOS) used for initialization and control of the processing unit 201 and peripheral hardware (202 to 204), a file operating system, an application program, and the like. At the same time, data used in these programs is stored. The storage unit 205 has the same configuration as the storage unit 105 described above, for example.

  The work memory 206 is a relatively high-speed memory that is temporarily accessed by the processor of the processing unit 201 to store programs and data, and has the same configuration as the work memory 106 described above, for example.

  The processing unit 201 is a circuit that controls the overall operation of the diagnostic terminal device 2, and controls peripheral hardware (202 to 204) and data processing based on programs stored in the storage unit 205 and the work memory 206. I do. For example, the processing unit 201 has the same configuration as the processing unit 101 described above, for example.

The processing unit 201 includes a database request processing unit 210, a display processing unit 211, a regression analysis processing unit 212, a change factor determination processing unit 231, and an exclusion candidate determination processing unit 214 as functional blocks.
The display processing unit 211 is an example of a first processing unit in the present invention.
The regression analysis processing unit 212 is an example of a second processing unit in the present invention.
The change factor determination processing unit 213 is an example of a third processing unit in the present invention.
The exclusion candidate determination processing unit 214 is an example of a fourth processing unit in the present invention.

  The database request processing unit 210 accesses the staff member database unit 11 and the patient database unit 12 of the server device 1 in accordance with a user instruction input in the instruction input unit 204, and performs data retrieval, reading, writing, and the like. . The database request processing unit 210 temporarily stores data read from the staff database unit 11 or the patient database unit 12 in one or both of the work memory 206 and the storage unit 205.

The display processing unit 211 generates a display signal for an image displayed on the display unit 203 in accordance with a user instruction input in the instruction input unit 204. For example, when an instruction signal indicating that a predetermined instruction is input is input from the instruction input unit 204, the display processing unit 211 displays an image (data corresponding to data read from the staff database unit 11 or the patient database unit 12). A display signal for displaying medical chart information, a test result graph, and the like on the display unit 203 is generated.
In this specification, the generation of a display signal for displaying an image on the display unit 203 by the display processing unit 211 may be simply described as “the display processing unit 211 displays an image on the display unit 203”. .

  When the scatter diagram corresponding to the time series of the test values stored in the patient database unit 12 is displayed on the display unit 203, the regression analysis processing unit 212 performs a partial test from a plurality of test values in the scatter diagram. When an instruction signal is generated in the instruction input unit 204 for selecting a value and instructing to display a graph of the approximate function based on the partial test value, a time series of the partial test value is generated. The regression analysis process is executed to calculate the approximate function constant.

For example, the regression analysis processing unit 212 designates an examination date or a range of numerical values (such as a patient's age) corresponding to the examination date, and instructs to display a graph of an approximate function for the examination values belonging to the designated range. When the instruction signal to be generated is generated in the instruction input unit 204, a regression analysis process such as a least square method is executed on the examination date or the time series of the examination values whose numerical values corresponding to the examination date belong to the specified range.
Further, for example, the regression analysis processing unit 212 designates at least one test value from a plurality of test values of the scatter diagram displayed on the display unit 203, and approximates the remaining test values excluding the designated test value. When an instruction signal for instructing to display the function graph is generated in the instruction input unit 204, a regression analysis process is performed on the time series of the remaining test values.
The display processing unit 211 displays a graph of this approximate function on the display unit 203 based on constants (such as polynomial coefficients) of the approximate function calculated as a result of the regression analysis processing by the regression analysis processing unit 212.

  The change factor determination processing unit 213 compares the two consecutive medical data 52 in the time series of the medical data 52 (FIG. 3) stored in the patient database unit 12, and displays the display unit based on the comparison result. A day when a factor (change factor) that can change the time-series tendency (for example, the slope of the graph) of the inspection value (MD value or the like) displayed as a scatter diagram in 203 is determined.

For example, the change factor determination processing unit 213 compares information on prescription drugs included in two consecutive medical data 52 in the time series of the medical data 52 (FIG. 3), and the prescription drug is changed based on the comparison result. It is determined that the changed day is the day on which the change factor has occurred.
Further, the change factor determination processing unit 213 searches the medical data 52 including information indicating that a predetermined operation or treatment has been performed in the time series of the medical data 52 stored in the patient database unit 12, and Based on the search result, it is determined that the day on which the operation or treatment is performed is the day on which the change factor has occurred.
The display processing unit 211 displays information on the day when the change factor determination processing unit 213 determines that the change factor has occurred on the display unit 203. This information is a guideline for determining the range of inspection values to be subjected to regression analysis processing.

The exclusion candidate determination processing unit 214 searches the medical data 52 including a predetermined test value from the time series of the medical data 52 (FIG. 3) stored in the patient database unit 12, and is included in each searched medical data 52. Based on the information on the reliability of the test to be performed, it is determined whether or not the test value included in each searched medical data 52 is a candidate to be excluded from the target of the regression analysis process. For example, when the medical data 52 includes information indicating that the reliability of the test is equal to or less than a predetermined standard, the exclusion candidate determination processing unit 214 extracts the test value belonging to the medical data 52 from the regression analysis target. It is determined as an exclusion candidate.
The display processing unit 211 displays on the display unit 203 information related to the inspection value determined as an exclusion candidate by the exclusion candidate determination processing unit 214. This information is a guideline for determining test values to be excluded from the regression analysis processing target.

  Here, the operation of the examination work support apparatus according to the present embodiment having the above-described configuration will be described.

FIG. 6 is a flowchart for explaining processing when a medical chart screen is displayed in the examination work support apparatus according to the present embodiment.
When opening a patient's electronic medical chart, the doctor first performs an operation for logging in to the server device 1 in the instruction input unit 204 of the medical examination terminal device 2. When processing unit 201 inputs an instruction signal corresponding to this operation, processing unit 201 performs a process of logging in to server apparatus 1 (ST100). At this time, the processing unit 201 inputs a doctor's ID (doctor identification data 41) from the instruction input unit 204, and stores the storage unit 205 or work memory 206 (hereinafter, these may be collectively referred to as “memory”). To store.

  When logging in to the server device 1, the database request processing unit 210 transmits the doctor identification data 41 stored in the memory to the staff database unit 11 of the server device 1, and an environment setting (screen) associated with the doctor identification data 41. Data related to display customization information) is read from the staff database unit 11 (ST105).

  In addition, after logging in, the display processing unit 211 displays a screen for requesting input of information for specifying a patient (for example, patient identification data 42) on the display unit 203. When prompted by this screen and information specifying a patient is input to the instruction input unit 204 (ST110), the database request processing unit 210, based on the input information, information specific to the patient (name, age, Gender etc.) and medical data 52 are requested to the patient database unit 12, and the data acquired in response to the request is stored in the memory (ST115).

  The medical data 52 acquired from the patient database unit 12 may acquire all data about the corresponding patient or may be limited to a part. By storing more medical data 52 in the memory, the delay associated with the reading process from the patient database unit 12 can be reduced, so that the display process in the display unit 203 can be speeded up. However, if the memory capacity is limited, for example, an upper limit may be set for the number of days of the consultation date to be acquired, and medical data 52 including the latest medical data 52 and less than the upper limit number of days may be acquired.

  When the processing unit 201 acquires necessary data from the patient database unit 12, the processing unit 201 displays an electronic medical record on the screen of the display unit 203 based on the acquired data (ST120).

  FIG. 7 is a diagram showing an example of a display screen of an electronic medical chart used by a doctor in the examination work support apparatus according to the embodiment of the present invention. In the examination work support apparatus according to the present embodiment, as shown in FIG. 7, charts of a plurality of examination days of the same patient are arranged in order of date and displayed on the screen.

In FIG. 7, “A1”, “A1-1”, and “A1-2” each indicate a display area of a chart related to one examination. The area A1 shows the current (latest) chart, the area A1-1 shows the previous (one time before) chart, and the area A1-2 shows the previous (two times before) chart. A series of three-day charts including the latest chart are displayed side by side.
And in the display area (A1, A1-1, A1-2) of each chart, there are areas (A11, A11-1, A11-2) where information related to examination results are displayed and information related to doctor's examination findings. There are provided areas (A12, A12-1, A12-2) to be displayed and areas (A13, A13-1, A13-2) in which information on prescription drug information and doctor instructions is displayed.
In addition, on the upper side of the chart display area, there is provided a display area A2 that extends horizontally for displaying unique information about the patient (patient ID, name, age, sex, address, contraindications, allergies, etc.). Yes.
Further, on the right side of the area A2, there is provided an area A3 in which buttons for changing to other information screens (such as an operation history screen, a prescription history screen, and a related contact screen) are arranged. .
In this way, a series of multiple examination date charts including the latest chart are displayed at a time in order of date, so operations such as clicking and scrolling are performed like a paper chart or a conventional electronic chart that mimics this. It is possible to grasp the progress of the patient's condition at a glance without performing it.

  When the electronic medical chart screen as shown in FIG. 7 is displayed on the display unit 203, the processing unit 201 waits for input of an instruction signal generated by a user's instruction input operation in the instruction input unit 204 (ST125). When the instruction signal is input, the processing unit 201 executes processing for updating the screen, data recording processing to the database unit (11, 12), and the like (ST130). (ST125).

  For example, in an example of this embodiment, a touch sensor is provided as the instruction input unit 204 on the screen of the display unit 203. When the touch sensor detects that a pen or the like has touched or approached the surface of the screen, the processing unit 201 performs various processes according to the contact position (or proximity position) of the pen or the like.

  Specifically, for example, as shown in FIG. 7, on the screen in which the charts for three days are displayed side by side, when the contact position of the pen or the like is slid to the left or right so as to cross the boundary between the chart and the chart, The processing unit 201 updates the display of the two charts positioned at the center and the left end while fixing the display of the latest chart positioned at the right end. In other words, the processing unit 201 replaces the charts for two consecutive days with charts for two days shifted by one day before or after the time series, and arranges the replaced charts in date order in the center and the left end of the screen. indicate. As a result, the past two charts and the latest chart can be compared on one screen while shifting the charts on the screen in order of date as if turning pages.

  When an inspection result image or text (numerical value) included in the inspection result display area (A11, A11-1, A11-2) is clicked with a pen or the like, the processing unit 201 displays the clicked inspection result. An image is enlarged and displayed, or a new window in which a time series of clicked inspection values (for example, MD values) is graphed is generated and displayed on the screen (FIG. 8 and the like).

  When a signal for instructing logoff is generated in the instruction input unit 204 (for example, when a logoff button on the screen is touched with a pen or the like), the processing unit 201 executes a predetermined logoff process and ends the operation. (ST135).

  Next, processing for displaying a time-series graph of test values on the screen of the display unit 203 based on the medical data 52 of the patient stored in the patient database unit 12 will be described.

  For example, an operation of clicking on a specific inspection value (MD value or the like) with a pen or the like on the electronic medical record screen described above is performed, and thereby an instruction signal for instructing to display a scatter diagram from the time series of the inspection value. When generated in the instruction input unit 204, the database request processing unit 210 selects the test value clicked from the group of medical data 52 (FIG. 3) recorded in the patient database unit 12 for the patient being displayed. Get the series. The display processing unit 211 displays, on the display unit 203, a graph that represents changes over time in test values based on the time series of test values acquired from the patient database unit 12. For example, the display unit 211 displays on the display unit 203 a scatter diagram in which the horizontal axis indicates the inspection date and the vertical axis indicates the inspection value.

FIG. 8 is a diagram illustrating an example of a scatter diagram 61 of MD values displayed on the screen of the display unit 203.
For example, when the MD value (inspection value) display area is clicked with a pen or the like on the screen of the electronic medical chart shown in FIG. 7, a new window 60 is opened in front of the electronic medical chart, and a scatter diagram shown in FIG. 61 is displayed. The horizontal axis of the scatter diagram 61 indicates the day when the visual field inspection is performed by the Humphrey perimeter, and the vertical axis indicates the MD value (unit dB).

  When displaying a graph of an approximate function (for example, a linear function, a regression line) on the scatter diagram 61 in the examination work support apparatus according to the present embodiment, for example, as shown in FIG. Specify the range. Specifically, for example, a predetermined menu is obtained by bringing the tip of the pen 80 into contact with a target MD value point in the scatter diagram 61 and holding the contact state for a certain period of time or clicking a button provided on the pen 80. Is displayed on the screen, and an operation for setting the inspection value to “start point” or “end point” is performed in this menu.

  The instruction input unit 104 receives an instruction signal that designates the inspection date range (start point and end point) by the above-described operation and displays a regression line graph for the inspection values (MD values) belonging to the range. When generated in the (touch sensor), the database request processing unit 210 reads from the patient database unit 12 a time series of test values belonging to the range of the specified test date. The regression analysis processing unit 212 executes a regression analysis process such as a least square method on the time series of the test values read from the patient database unit 12, and calculates a regression line constant (slope, intercept). The display processing unit 211 displays a regression line graph on the display unit 203 based on the calculated regression line constant.

  FIG. 9 is a diagram showing a regression line graph calculated based on the inspection date range (start point and end point) designated in FIG. For example, as illustrated in FIG. 9, the display processing unit 211 displays the regression line 62 calculated by the regression analysis processing unit 212 on the scatter diagram 61 and displays information 63 regarding the slope of the regression line 62 as a scatter diagram. Display in the corner of 61.

Further, for example, as shown in FIG. 9, the display processing unit 211 displays buttons 64 and 65 for performing calculation of the number of years until the MD value reaches a predetermined value (−15 dB, −25 dB) beside the scatter diagram. .
As shown in FIG. 10, when an instruction signal indicating that the button 64 written with “−15 dB” is touched with the tip of the pen 80 is generated in the instruction input unit 104 (touch sensor), the display processing unit 211 is displayed. Based on the approximate function (regression line) calculated by the regression analysis processing unit 212, the day when the MD value reaches “−15 dB” is obtained, and the number of years from the present to that day is calculated. The display processing unit 211 displays information 66 of the calculated number of years (9 years in the example of FIG. 10) on the screen. The MD value “−15 dB” represents a standard for causing inconvenience in daily life.
On the other hand, as shown in FIG. 11, when an instruction signal indicating that the button 65 written with “−25 dB” is touched with the tip of the pen 80 is generated in the instruction input unit 104 (touch sensor), the display processing unit 211 obtains the day when the MD value reaches “−25 dB” based on the approximate function (regression line) calculated by the regression analysis processing unit 212, and calculates the number of years from the present to that day. The display processing unit 211 displays information 66 of the calculated number of years (19 years in the example of FIG. 11) on the screen. The MD value “−25 dB” represents a measure of social blindness.

  In the examples of FIGS. 10 and 11, the horizontal axis is the examination date, but as shown in FIG. 12, the horizontal axis may be displayed by the age of the patient. For example, in the state where the tip of the pen 80 is in contact with the horizontal axis of the scatter diagram 61, an operation of holding this contact state for a certain time or clicking a button provided on the pen 80 is an instruction input unit 104 (touch sensor). The display processing unit 211 displays a menu 75 for performing various settings on the horizontal axis on the screen. In this menu, when the unit of the horizontal axis is set to the age of the patient, the display processing unit 211 displays the date data of each test value displayed on the scatter diagram and the date of birth of the patient acquired from the patient database unit 12. Based on the data, a scatter diagram 61 in which the scale on the horizontal axis is changed from the examination date to the age is constructed and displayed on the screen. In this case, when the buttons 64 and 65 are operated with the pen 80, the display processing unit 211 sets the MD value to a predetermined value (−15 dB, −25 dB) based on the regression line calculated by the regression analysis processing unit 212. The age of the patient at the time of reaching is calculated, and the information 66 is displayed on the screen. In the example of FIG. 10, the age at which the MD value “−15 dB” is reached is predicted to be 60 years old.

  Next, processing for excluding some inspection values from the target of regression analysis will be described.

  When a graph of an approximate function (regression line) is displayed on the scatter diagram 61 in the medical examination work support apparatus according to the present embodiment, for example, as shown in FIG. Can be excluded. Specifically, for example, in a state where the tip of the pen 80 is in contact with a point of the MD value to be excluded, a predetermined menu is obtained by an operation of holding the contact state for a certain period of time or an operation of clicking a button provided on the pen 80. Is displayed on the screen, and an operation for excluding the MD value from the regression analysis target is performed in this menu.

  The display processing unit 211 displays the inspection values designated to be excluded by the operation of the pen 80 on the screen in a manner different from other inspection values. For example, in FIG. 13, the inspection value points designated to be excluded are triangles filled with a gray color, and the other inspection value points are triangles drawn with black lines.

An instruction signal for instructing to display some regression line graphs for the remaining inspection values excluding the specified inspection value is designated by the instruction input unit 104 (touch). When the data is generated in the sensor), the regression analysis processing unit 212 again executes a regression analysis process such as a least squares method on the time series of the remaining test values excluding the test values designated to be excluded, and constants of the regression line Calculate (slope, intercept). The display processing unit 211 displays a regression line graph on the display unit 203 based on the calculated regression line constant.
FIG. 14 is a diagram showing a regression line graph recalculated excluding the two inspection values (MD values) designated in FIG. The regression line 62 shown in FIG. 14 has a slightly smaller slope than that of FIG.

  Next, processing for designating a plurality of ranges on the horizontal axis (examination date, age, etc.) of the scatter diagram and calculating an approximate function (regression line) for each range will be described.

  When symptoms change by changing prescription drugs or performing surgery, the time-series trend of test values may change discontinuously. For example, in the case of glaucoma, the MD value decreases (the visual field loss increases) with the passage of time, but when the symptoms improve due to changes in eye drops or surgery, the decrease in the MD value becomes gentle (slope) May become smaller). In the examination work support apparatus according to the present embodiment, in order to be able to represent the tendency of the inspection value with an appropriate approximation function even when the time-series tendency of the inspection value changes discontinuously, the inspection date ( A regression analysis process is performed for each age range, and a graph of the approximate function for each range is displayed.

FIG. 15 is a diagram illustrating an example of an operation for specifying a plurality of examination date ranges and executing regression analysis processing for each range. In the example of FIG. 15, two sets of start points and end points (start point 1 and end point 1, start point 2 and end point 2) are set. A method of setting a desired inspection value as a start point or an end point by operating the pen 80 is the same as in the case of FIG.
As shown in FIG. 15, the instruction input unit designates a plurality of examination date ranges (start point 1 and end point 1, start point 2 and end point 2), and instructs to display a regression line graph of each range. When generated in 104 (touch sensor), the regression analysis processing unit 212 performs a regression analysis process on the time series of inspection values in each specified range, and calculates a regression line constant (slope, intercept), respectively. To do. The display processing unit 211 displays a regression line graph of each range on the display unit 203 based on the calculated regression line constant of each range.

  FIG. 16 is a diagram showing graphs of regression lines 62-1 and 62-2 in the range of the two examination dates specified in FIG. In the example of FIG. 16, the slope of the regression line 62-2 in the second half range is gentler than the regression line 61-1 in the first half range, suggesting that the progression of symptoms is suppressed. The

  Next, a process for displaying supplementary information on each inspection value in the scatter diagram on the screen will be described.

  When determining the range of test values to be subjected to regression analysis (FIGS. 8 and 15) or determining test values to be excluded from the target of regression analysis (FIG. 13), supplementary information on test values is required. May be. For example, the chart information on the day of the examination, prescription drug information before and after the examination, and information on the reliability of the examination recorded by the inspector when determining the scope of the regression analysis target or determining the examination value to be excluded It will be helpful. In the examination work support apparatus according to the present embodiment, by specifying an arbitrary test value on the scatter diagram by operating the pen 80, necessary supplementary information is displayed on the screen from the medical data 52 (FIG. 3) related to the test value. Can be displayed above.

FIG. 17 is a diagram illustrating an example of an operation for displaying supplementary information related to the inspection value on the screen. In the state where the tip of the pen 80 is in contact with a point of a desired inspection value in the scatter diagram 61, the operation of holding this contact state for a certain period of time or clicking a button provided on the pen 80 is performed by the instruction input unit 104 (touch When input is made in the sensor), the display processing unit 211 displays a menu 67 for selecting supplementary information related to the inspection value on the screen. In this menu 67, for example, measurement environment information recorded in the incidental information 532 of the inspection data 53 (FIG. 4), information on measurement reliability, information on various inspection results recorded in the inspection result 533, medical data 52 (FIG. 3) information of medical chart (FIG. 7) consisting of examination data 53, finding data 54, prescription data 55, information on surgery included in operation record data 56, information on prescription drugs included in prescription data 55, etc. It can be selected as supplementary information.
When supplementary information is selected in the menu 67, the display processing unit 211 selects from the information included in the medical data 52 (FIG. 3) that is the same as the one examination value designated by the operation of the pen 80. Acquired supplementary information is displayed on the screen. For example, the display processing unit 211 displays a new window related to the selected supplementary information on the screen.

  Next, as reference information for determining the range of test values to be subjected to regression analysis (FIGS. 8 and 15), a process of displaying a standard of a boundary where the time-series tendency of test values (MD values) changes. explain.

FIG. 18 is a diagram illustrating an example in which a standard of a boundary at which a time-series tendency (inclination of a graph or the like) of inspection values (MD values) changes is displayed in a scatter diagram 61.
For example, as shown in FIG. 18, the display processing unit 211 includes a button 68 for displaying test value (change point) candidates whose chronological tendency of test values (MD values) changes. To display. When an instruction signal of the instruction input unit 204 (touch sensor) indicating that the button 68 has been pressed by the pen 80 is generated, the change factor determination processing unit 213 receives the medical data 52 ( The two consecutive medical data 52 in the time series of FIG. 3) are respectively compared. The change factor determination processing unit 213 can search for a day when the predetermined information included in the medical data 52 has changed by this comparison process, and change the time series tendency of the test value (MD value). Judged as the day when the factor (change factor) occurred.

  For example, the change factor determination processing unit 213 compares the prescription data 55 (FIG. 3) included in the two consecutive medical data 52 before and after, and based on the comparison result, indicates the date when the prescription drug was changed. Judged as the date of occurrence. That is, when the prescription drugs recorded in the prescription data 55 do not match in the two consecutive medical data 52 before and after, the date associated with the subsequent medical data 52 in the two medical data 52 is the occurrence date of the change factor. judge.

  In addition, the change factor determination processing unit 213 includes medical record data 56 (FIG. 3) that includes surgical record data 56 (FIG. 3) indicating that a predetermined operation or treatment has been performed in the time series of the medical data 52 acquired from the patient database unit 12. The data 52 is searched, and based on the search result, the day when the predetermined operation or treatment is performed is determined as the occurrence day of the change factor.

  FIG. 19 is a flowchart for explaining processing for determining the occurrence date of a factor that causes a change in the time-series tendency of test values.

  The change factor determination processing unit 213 selects one medical data 52 in order of date from the time series of the medical data 52 acquired from the patient database unit 12 (ST200). For example, the change factor determination processing unit 213 selects the medical data 52 one by one in order of date from the medical data 52 having the second oldest date in time series.

The change factor determination processing unit 213 compares the prescription data 55 included in the medical data 52 selected in step ST200 with the prescription data 55 included in the medical data 52 immediately before the medical data 52 (ST205). As a result of this comparison, when the prescription drugs do not match (ST210), the change factor determination processing unit 213 determines the date of the medical data 52 selected in step ST200 as the occurrence date of the change factor (ST220). Further, the change factor determination processing unit 213 determines whether or not the medical record 52 (FIG. 3) relating to a predetermined operation or treatment is included in the medical data 52 selected in step ST200 (ST215), and the corresponding operation record data. If 56 is included, the date of the medical data 52 selected in step ST200 is determined as the occurrence date of the change factor (ST220).
When the processes of steps ST205 to ST220 are performed, the change factor determination processing unit 213 determines whether or not the last medical data 52 in the time series has been reached (ST225). 52 is selected (ST230), and the processes after step ST205 are repeated.

  When the occurrence date of the change factor is specified as described above, the change factor determination processing unit 213 next specifies a test value that serves as a standard for a boundary where the time-series tendency of the test value changes. That is, the change factor determination processing unit 213 is the medical data 52 for each day on which it is determined that a change factor has occurred, the medical data 52 of the date that is later than the date and closest to the date, and the test value (MD The medical data 52 including (value) is searched.

  The display processing unit 211 configures a scatter diagram that represents the test value (MD value) included in the medical data 52 searched by the change factor determination processing unit 213 so that the test value can be identified as a guide value of the boundary. Is displayed on the display unit 203. For example, in the example of the scatter diagram 61 in FIG. 18, the display processing unit 211 surrounds the inspection value serving as the reference of the boundary with a diamond-shaped mark 70 so that it can be distinguished from other inspection values.

  The test value specified in the change factor determination processing unit 213 is the first test value obtained after the change factor occurrence date, and is the head of the time series of test values that change with a certain tendency after the change factor occurrence date. It is expected. Therefore, the inspection value specified by the change factor determination processing unit 213 is a candidate of “starting point” when setting the regression analysis range as shown in FIG. As shown in the example of FIG. 18, the user can refer to the “start point” candidates displayed so as to be identifiable from other test values, and therefore, it is easy to set an appropriate regression analysis range.

FIG. 20 is a flowchart for explaining processing for determining a test value that serves as a standard of a boundary where a time-series tendency changes in the change factor determination processing unit 213.
When one or more change factor occurrence dates are specified in the flowchart of FIG. 19, the change factor determination processing unit 213 selects one change factor occurrence date among them (ST300). For example, the change factor determination processing unit 213 selects one change factor occurrence date in order of date from the oldest date.

  The change factor determination processing unit 213 selects the medical data 52 associated with the date after the change factor occurrence date selected in step ST300 from the time series of the medical data 52 acquired from the patient database unit 12 (FIG. 3). Are selected in order of date from those associated with the oldest date (ST305).

The change factor determination processing unit 213 determines whether or not a predetermined test value (MD value) is included in the test data 53 of the medical data 52 selected in step ST305 (ST310). If the selected medical data 52 includes a predetermined test value, the change factor determination processing unit 213 determines that this test value is a test value that serves as a standard for a boundary where the time-series tendency changes (ST315). . On the other hand, if the selected medical data 52 does not include a predetermined test value, the change factor determination processing unit 213 determines whether the currently selected medical data 52 is the last medical data 52 in time series ( If it is not the last medical data 52 in time series (ST320), the process returns to step ST305.
When it is determined in step ST315 that the test value for the boundary at which the time-series tendency changes is determined, or when it is determined in step ST320 that the last medical data 52 in the time-series is selected, the change factor determination processing unit In step ST305, 213 determines whether all change factor occurrence dates have been selected (ST325). If there is a change factor occurrence date that has not yet been selected, the change factor determination processing unit 213 selects the change factor occurrence date (ST330) and returns to the process of step ST305.

  FIG. 21 is a diagram for explaining a specific example of determining a test value for a boundary at which a time-series trend changes based on the occurrence date of a change factor that may change the time-series trend of test values. is there.

In the example of FIG. 21, May 15, 2007 when the predetermined operation was performed and March 22, 2008 when the eye drops were changed from “A” to “B” are the occurrence dates of the change factors, respectively. Determined.
After the change factor occurrence date on May 15, 2007, the first test value is obtained on July 30, 2007, and thus the test value obtained on this day is determined as a guideline for the boundary. .
In addition, after the change factor occurrence date of March 22, 2008, the first test value is obtained on March 10, 2009, so the test value obtained on this date is determined as a guideline for the boundary. Is done. The inspection value obtained on the change factor occurrence date on March 22, 2008 is not determined as a standard for the boundary.

  Next, a process for displaying test value candidates to be excluded from the regression analysis target will be described.

FIG. 22 is a diagram illustrating an example of displaying in the scatter diagram 61 candidates for inspection values to be excluded from the regression analysis target.
For example, as shown in FIG. 22, the display processing unit 211 displays a button 69 for displaying a candidate for an inspection value (exclusion point) to be excluded from the regression analysis target in the window 60 of the scatter diagram 61. When an instruction signal of the instruction input unit 204 (touch sensor) indicating that the button 69 has been pressed by the pen 80 is generated, the exclusion candidate determination processing unit 214 receives the medical data 52 ( The medical data 52 including the examination value (MD value) displayed in the scatter diagram 61 is searched from the time series of FIG. When the exclusion candidate determination processing unit 214 retrieves the medical data 52 including the examination value (MD value), each of the retrieved candidate data is determined based on information on the reliability of the examination included in each retrieved medical data 52. It is determined whether or not the test value included in the medical data 52 is a candidate to be excluded from the regression analysis target. For example, when the information recorded by the inspector in charge of the inspection about the reliability evaluation rank of the inspection result is included in the incidental information 532 (FIG. 4) of the inspection data 53, the reliability rank is equal to or lower than a predetermined standard. The test value is determined as a candidate for exclusion from the regression analysis target.

  The display processing unit 211 displays on the display unit 203 information related to the inspection value determined as an exclusion candidate by the exclusion candidate determination processing unit 214. For example, in the example of the scatter diagram 61 in FIG. 22, the display processing unit 211 surrounds the inspection value of the candidate for exclusion from the regression analysis target with a circular mark 71 so that it can be identified from other inspection values.

  FIG. 23 is a flowchart for explaining processing for determining candidate test values to be excluded from the regression analysis target.

  The exclusion candidate determination processing unit 214 selects one medical data 52 in order of date from the time series of the medical data 52 acquired from the patient database unit 12 (ST400). For example, the change factor determination processing unit 213 selects the medical data 52 one by one in order of date from the oldest medical data 52 in time series.

The exclusion candidate determination processing unit 214 determines whether or not a predetermined test value (MD value) is included in the test data 53 of the medical data 52 selected in step ST400 (ST405). When the inspection data 53 includes a predetermined inspection value, the exclusion candidate determination processing unit 214 acquires an evaluation rank for the reliability of the inspection result included in the incidental information 532 (FIG. 4) of the inspection data 53 (ST410). ), It is determined whether or not the reliability evaluation rank is equal to or lower than a predetermined standard (ST415). When the reliability evaluation rank is equal to or lower than the predetermined criterion, the exclusion candidate determination processing unit 214 determines that this inspection value is a candidate to be excluded from the regression analysis target (ST420).
When the processing of steps ST405 to ST420 is performed, the exclusion candidate determination processing unit 214 determines whether or not the last medical data 52 in the time series has been reached (ST425), and if the final medical data 52 has not been reached, the next medical data is determined. 52 is selected (ST430), and the processes after step ST405 are repeated.

As described above, according to the examination work support apparatus according to the present embodiment, the instruction signal instructing to select a part of the inspection values from the plurality of inspection values of the scatter diagram displayed on the display unit 203 is instructed. When generated in the input unit 204, a regression analysis process is performed on the partial test value, and the partial test value is calculated based on a constant of the approximate function calculated as a result of the regression analysis process. Is displayed on the display unit 203.
This makes it possible to select any part of the test values from the whole test value in the scatter diagram and display a graph of the approximate function, so the time series trend of the test value according to the treatment effect etc. Even when discontinuously changes, it is possible to create a graph of an approximate function that more appropriately represents the patient's medical condition.

  In addition, according to the examination work support apparatus according to the present embodiment, by specifying the range (start point, end point) of the test date (or age, etc.) in the scatter diagram, the range of the test value to be subjected to the regression analysis process is set. Easy to specify. For example, the target range of the regression analysis process can be easily specified by specifying the inspection value of the start point and the end point using a touch sensor (instruction input unit 204) that detects an object that touches or approaches the screen of the display unit 203. it can.

  In addition, according to the examination work support apparatus according to the present embodiment, it is possible to easily specify the inspection value to be excluded from the regression analysis target by individually specifying the inspection value in the scatter diagram. For example, by directly specifying the inspection value on the screen using the touch sensor (instruction input unit 204), the exclusion target of the regression analysis process can be easily specified.

  In addition, according to the examination work support apparatus according to the present embodiment, by individually specifying the examination values in the scatter diagram, additional information relating to the examination values (information relating to examination, information relating to examination, information relating to treatment, information relating to surgery, Information on prescription drugs, etc.) can be easily displayed on the screen of the display unit 203. This makes it possible to easily check on the screen of the display unit 203 information necessary for determining the range of the examination date or the like to be subjected to the regression analysis process or for determining the test value to be excluded from the regression analysis process target.

  In addition, according to the examination work support apparatus according to the present embodiment, two medical data 52 that are consecutive in the time series of the medical data 52 stored in the patient database unit 12 are respectively compared, and based on the comparison result. The occurrence date of a factor (change factor) that can change the time-series tendency of the inspection value is determined, and the information is displayed on the display unit 203. This provides reference information for determining the range of test values to be subjected to regression analysis processing, making it easy to obtain an appropriate approximate function graph and improving the efficiency of medical examination work.

  Further, according to the examination work support apparatus according to the present embodiment, based on the information on the reliability of the test results recorded for each test value in the scatter diagram, the test value that does not reach the predetermined reliability standard is subjected to regression analysis. It is determined as the inspection value of the candidate for exclusion from the processing target. Thereby, reference information for determining the test value to be excluded from the regression analysis processing target can be obtained, so that it is easy to obtain a graph of an appropriate approximation function, and the efficiency of the examination work can be improved.

  In addition, according to the examination work support apparatus according to the present embodiment, since a plurality of charts are displayed side by side in the order of examination dates, special operations such as clicking and scrolling are unnecessary when referring to the plurality of charts, The efficiency of the examination work can be increased.

  In addition, according to the examination work support apparatus according to the present embodiment, the display of the past chart can be changed in a state where the latest chart display that is necessarily required in the examination is fixed. It is possible to reduce operations such as clicking and scrolling to be displayed on the screen.

  In addition, this invention is not limited only to embodiment mentioned above, The other various variation is included.

  In the above-described embodiment, a linear function (regression line) is given as an example of an approximation function obtained by regression analysis processing, but the present invention is not limited to this, and other various approximation functions are obtained. It is also applicable to cases.

In the above-described embodiment, when the test value serving as a standard for the boundary where the time-series tendency of the test value changes is specified in the change factor determination processing unit 213, for each day on which it is determined that the change factor has occurred, Although the medical data 52 that is later than the date and has the closest date to the date and the medical data 52 including the test value is searched, the present invention is not limited to this.
That is, in the above-described embodiment, the beginning of a series of inspection values after occurrence of the change factor is determined as a “boundary guideline”, but in other embodiments of the present invention, the date before the occurrence date of the change factor is determined. The end of a series of inspection values may be determined as a “boundary guideline”.
For example, the change factor determination processing unit 213 is the medical data 52 of the date closest to the day that is the same day as or before the day for each day on which the change factor is determined to have occurred. Alternatively, the medical data 52 including the test value may be searched, and the test value included in the medical data 52 may be determined as a “boundary guideline”. Specifically, in step ST <b> 305 in the flowchart of FIG. 20, the change factor determination processing unit 213 may select a series of medical data 52 before the change factor occurrence date in order of date from the newest medical data 52. In this case, the test value specified by the change factor determination processing unit 213 is a candidate for “end point” when setting the regression analysis range as shown in FIG.

In the above-described embodiment, when the change factor determination processing unit 213 determines the occurrence date of the change factor, a mark or the like for identifying the inspection value of the above “border standard” specified based on the occurrence date is displayed on the screen. Although displayed (FIG. 18, FIG. 22), this invention is not limited to this.
In another embodiment of the present invention, various other information related to the occurrence date of the change factor determined by the change factor determination processing unit 213 may be displayed on the display unit 203. For example, the display processing unit 211 may display a mark (such as an arrow) indicating the date of occurrence of the change factor on or near the horizontal axis of the scatter diagram.
In addition, the display processing unit 211 includes, as information incidental to the change factor occurrence date, information on the prescription drug before the change and the prescription drug after the change, information such as an operation performed on the occurrence date of the change factor, Information regarding the content of the change factor may be displayed on the display unit 203. For example, an instruction signal indicating that a predetermined time or more has elapsed with the pen 80 placed on the above-described mark indicating the date of occurrence of the change factor, or that the button of the pen 80 has been clicked in that state is displayed in the instruction input unit. When generated in 204 (touch sensor), the display processing unit 211 may display a pop-up window in which the accompanying information is described on the display unit 203. In the pop-up window, for example, specific changes such as “prescription drug A → prescription drug B” regarding the change of the prescription drug may be displayed, or the technique of the performed operation may be displayed.

In the above-described embodiment, an example in which a scatter diagram based on a time series of inspection values is displayed alone is given, but the present invention is not limited to this.
In another embodiment of the present invention, a time-series scatter diagram of a plurality of related inspection values may be displayed side by side. For example, as illustrated in FIG. 24, the display processing unit 211 may display an intraocular pressure scatter diagram 72 side by side with the MD value scatter diagram 61.
In another embodiment of the present invention, supplementary information may be displayed side by side on the same time axis as the scatter diagram, along with the time-series scatter diagram of the test values. For example, as shown in FIG. 25, the display processing unit 211 may display information 73 regarding eye drops and information 74 regarding the date of performing the surgery, arranged in a scatter diagram 61 of MD values and a scatter diagram 72 of intraocular pressure. .
In this case, the display processing unit 211 may be able to arbitrarily select the type of the inspection value and the type of supplementary information displayed on the screen according to the instruction signal generated by the instruction input unit 204. The arrangement order may be arbitrarily selected.

In the above-described embodiment, an example in which the information on the reliability evaluation rank recorded by the inspector is used as the information on the reliability of the inspection result referred to in order to determine the inspection value candidate to be excluded. However, the present invention is not limited to this. In other embodiments of the present invention, information about the inspector's ability and skill evaluation rank may be used.
For example, information related to the inspector in the staff database unit 11 stores information related to the inspector's ability and skill evaluation rank in association with the inspector's identification number. Includes identification data of an inspector involved in the inspection.
When an instruction signal of the instruction input unit 204 (touch sensor) indicating that an operation for obtaining display of an exclusion candidate (for example, pressing of the button 69 (FIG. 22)) has been generated, the exclusion candidate determination processing unit 214 The medical data 52 including the examination value (MD value) displayed in the scatter diagram 61 is searched from the time series of the medical data 52 (FIG. 3) acquired from the database unit 12. When medical data 52 including a test value (MD value) is searched for in the exclusion candidate determination processing unit 214, the database request processing unit 210 uses the staff database unit based on the identification data of the inspector involved in the test. 11 to obtain information on the evaluation rank of the inspector's ability / skill. If the acquired ability / skill evaluation rank is equal to or lower than a predetermined reference, the exclusion candidate determination processing unit 214 determines that the inspection value is an exclusion candidate from the regression analysis processing target.

  In the embodiment described above, for the convenience of illustration, an example in which only one eye test value is displayed on the scatter diagram is given, but the present invention is not limited to this, and both eye test values are displayed. You may display on the same scatter diagram, and may display the scatter diagram of the test value for each eye side by side.

  In the above-described embodiment, the MD value is given as an example of the test value in the medical examination. However, the present invention is not limited to this, and the medical examination support that displays the results of other various medical examinations in a graph. Widely applicable to devices.

  In the embodiment described above, the database unit is provided in the server device, but the present invention is not limited to this. In another embodiment of the present invention, the database unit may be provided in the terminal device, in which case the server device may be omitted.

  The server device may be composed of a plurality of computers connected by a communication network. For example, the staff database unit 11 and the patient database unit 12 may be configured by separate computers.

  DESCRIPTION OF SYMBOLS 1 ... Server apparatus, 2 ... Examination terminal apparatus, 3 ... Communication network, 4 ... Examination terminal apparatus, 5 ... Visual field measurement apparatus, 11 ... Staff database part, 12 ... Patient database part, 61 ... Scatter chart, 62 ... Regression Straight line, 80 ... pen, 101,201 ... processing unit, 102,202 ... communication unit, 103,203 ... display unit, 104,204 ... instruction input unit, 105,205 ... storage unit, 106,206 ... work memory, 210 ... Database request processing unit, 211 ... Display processing unit, 212 ... Regression analysis processing unit, 213 ... Change factor determination processing unit, 214 ... Exclusion candidate determination processing unit, 41 ... Doctor identification data, 42 ... Patient identification data, 52 ... Medical Data, 53 ... Examination data, 54 ... Finding data, 55 ... Prescription data, 56 ... Surgery record data, 531 ... Examination type code, 532 ... Additional information, 533 ... Examination Data of the results.

Claims (9)

A medical examination support device that displays a graph of a time series of test values indicating the results of a medical test,
A storage unit that stores a time series of medical information in which at least one of information related to a test including the test value, information related to a diagnosis, information related to treatment, information related to surgery, and information related to a prescription drug is associated with date information;
A display unit for displaying an image corresponding to the input display signal;
An instruction input unit that generates an instruction signal according to a predetermined instruction input operation by a user;
When the instruction signal for instructing to display a scatter diagram of the test values is generated in the instruction input unit, the time series of the test values included in the time series of the medical information stored in the storage unit A first processing unit that generates the display signal for displaying on the display unit a scatter diagram in which one coordinate axis indicates an inspection date or a numerical value corresponding to the inspection date and another one coordinate axis indicates the inspection value; ,
The instruction signal for instructing to select a part of the inspection values from the plurality of inspection values in the scatter diagram displayed on the display unit and to display a graph of the approximate function based on the part of the inspection values. A second processing unit that, when generated in the instruction input unit, executes a regression analysis process on the time series of the partial test values;
In the time series of the medical information stored in the storage unit, two consecutive medical information items are compared, and a factor that may change the time series tendency of the test value is generated based on the comparison result. A third processing unit for determining the date
Have
The third processing unit includes:
For each day on which it is determined that the change factor has occurred, whether or not to search for the medical information that is after the day and that is closest to the day and that includes the test value ,
Or
For each day on which it is determined that the change factor has occurred, the medical information is the medical information on the same date as that day or before that date, and on the date closest to that date, including the test value Search for information
The first processing unit changes the test value included in the medical information searched for each day when the change factor is determined to have occurred in the third processing unit, and the time-series tendency of the test value changes Generating the display signal for displaying the scatter diagram represented on the display unit so that it can be identified as an inspection value that is a standard of the boundary to be
The second processing unit displays the inspection date or a range of numerical values corresponding to the inspection date when a scatter diagram is displayed on the display unit so as to identify the inspection value serving as a guideline for the boundary. When the instruction signal is generated in the instruction input unit to specify a plurality and specify to display a graph of the approximate function for the inspection value belonging to the range for each of the plurality of ranges, the inspection date or the Executing the regression analysis process for each of the plurality of ranges with respect to a time series of test values whose numerical values corresponding to the test dates belong to the range;
The first processing unit displays a plurality of graphs of the approximate functions on the display unit based on constants of the approximate functions calculated as a result of the regression analysis process executed for each of the plurality of ranges. Generating the display signal,
Medical examination support device. The second processing unit designates at least one test value from the plurality of test values of the scatter diagram displayed on the display unit and approximates the remaining test values excluding the specified test value When the instruction signal instructing to display the graph is generated in the instruction input unit, the regression analysis process is executed on the time series of the remaining inspection values.
The examination work support apparatus according to claim 1 . The first processing unit designates one test value in the scatter diagram displayed on the display unit, and the instruction signal for instructing to display the medical information related to the one test value is the When generated in the instruction input unit, in the storage unit, information relating to the examination belonging to the same medical information as the one examination value, information relating to the examination, information relating to the treatment, information relating to the operation, and information relating to the prescription drug Generating the display signal for displaying at least one of information on the display unit;
The examination work support apparatus according to claim 2 . The first processing unit generates the display signal for displaying information on a day on which it is determined that the change factor has occurred in the third processing unit on the display unit.
The examination work support apparatus according to claim 2 or 3 . The third processing unit compares information on prescription drugs included in the two consecutive medical information, and determines, based on the comparison result, a date when the prescription drug is changed as a day when the change factor occurs To
The examination work support apparatus according to claim 4 . The first processing unit displays information related to pre-change and post-change prescription drugs on the display unit as information incidental to information on the day when the change factor is determined to have occurred in the third processing unit. Generate a display signal,
The examination work support apparatus according to claim 5 . The third processing unit searches for medical information including information indicating that a predetermined operation or treatment has been performed in the time series of the medical information stored in the storage unit, and based on the search result , Determining the day on which the surgery or treatment was performed as the day on which the change factor occurred,
The examination work support apparatus according to any one of claims 4 to 6 . The first processing unit displays, on the display unit, information on an operation or a treatment action performed on the day as information incidental to information on a day on which the change factor is determined to have occurred in the third processing unit. Generating the display signal,
The examination work support apparatus according to claim 7 . The medical information including the test value is searched from the time series of the medical information stored in the storage unit, and the respective information on the reliability of the test included in each searched medical information is used. A fourth processing unit that determines whether or not the test value included in the medical information is a candidate to be excluded from the regression analysis target;
The first processing unit generates the display signal for displaying information on the inspection value determined as the exclusion candidate in the fourth processing unit on the display unit.
The examination work support apparatus according to any one of claims 4 to 8 .