JP6667240B2 - Apparatus, method, system and program. - Google Patents

Description

  The present invention relates to an apparatus, a method, a system, and a program. In particular, the present invention relates to an apparatus, a method, a system, and a program for performing recording for diagnosis.

  At a medical site, medical treatment may be performed using a medical report that describes a disease name or a treatment policy identified based on a medical image. As the number of medical images used for medical treatment increases, the work of doctors to create such medical reports has increased.

  In Patent Literature 1, network information is created based on the number of associated word / phrase combinations in all existing reports in a database. Then, a part of the structure is displayed from the network information based on the extraction condition specified by the user, and the user can select a word from the displayed part of the structure to assist in the creation of a medical report. It has been disclosed.

JP 2007-140862 A

  When creating a new medical report, a part of the contents of a medical report created in the past may be duplicated and used. If there is a description that is logically related to the description to be duplicated, it may be duplicated at the same time, and the user has to check the entire contents of the medical report created in the past.

  In order to solve the above problem, the invention according to claim 1 includes a medical report including a plurality of pieces of information to be diagnosed and a relational information indicating a relation between a plurality of items included in each of the plurality of pieces of information. An apparatus for supporting creation, comprising: a designation unit that designates one of a plurality of items included in each of a plurality of pieces of information included in a created medical report stored in a storage unit; In response to the specification, at least one item specified by the specifying unit is specified from the items included in the created medical report based on the relationship information relating to the one item specified by the specifying unit. It is characterized by comprising: a specifying unit; and a display control unit that displays the item specified by the specifying unit on a screen for editing a medical report.

  Thus, when a part of items described in a medical report created in the past is used for a newly created report, an item to be referred to at the same time can be easily specified. Therefore, it is possible to reduce the trouble of the user confirming the medical report created in the past.

It is a figure showing an example of composition of a medical report creation device. It is a figure showing an example of composition of a medical report creation device. It is a figure showing an example of the concept of the report created by the medical report creation device. It is a figure showing an example of a database storage format of items and relation information which constitute a medical report. It is a figure showing an example of the function of a medical report creation device. FIG. 6 is a diagram illustrating an example of a GUI of the medical report creation device. FIG. 14 is a diagram illustrating an example of a procedure of a process of automatically determining a type of a relationship between report items. It is a figure showing an example of the procedure of the processing which duplicates the item which constitutes a past report, and related information. FIG. 14 is a diagram illustrating an example of a processing procedure of a duplication range determination unit. FIG. 14 is a diagram illustrating an example of a procedure of a process of expanding a range of items of a past report to be copied. FIG. 14 is a diagram illustrating an example of a detailed procedure of a process of copying a determined copy range to a newly created report. FIG. 9 is a diagram illustrating an example of a correspondence relationship between an image captured in the past and an image captured this time. FIG. 11 is a diagram illustrating an example of a procedure of a process of converting a past image into a corresponding current image when copying the past image. FIG. 14 is a diagram illustrating an example of a screen display when a causal relationship exists between items other than the copy target in the past report of the copy source. It is a figure showing an example of a screen display which confirms whether causal relations are given to duplicate items which had a causal relation in the past report of the duplication source. FIG. 14 is a diagram illustrating an example of the content of a past report that is a copy source when a request for a newly created report is discrimination between good and bad or metastasis search. It is a figure for explaining processing about duplication described in a 7th embodiment. It is a first figure for explaining processing about duplication described in an 8th embodiment. FIG. 25 is a second diagram for describing the processing related to duplication described in the eighth embodiment. It is a figure showing an example of the procedure of the processing of the duplication range deciding part in an 8th embodiment. It is a figure showing an example of the function of the medical report preparation device of a 9th embodiment. It is a figure showing an example of the contents of the past report in the state where a value was assigned to each item by the score calculation decision part in a ninth embodiment. It is a figure showing an example of the function of the medical report creation device of a 10th embodiment. It is an example of a figure for explaining the operation flow of the duplication range decision part in a 10th embodiment. It is a figure showing an example of operation flow of a duplication range deciding part in a 10th embodiment. It is a figure showing an example of the function of the medical report creation device of an eleventh embodiment. It is a figure showing an example of the function of the medical report creation device of a 12th embodiment. It is a figure showing an example of the database storage format of the items which constitute the medical report in the twelfth embodiment. It is a figure showing an example of the conceptual diagram of request purpose selection processing in a 12th embodiment. FIG. 4 is a diagram illustrating an example of a screen in a basic input mode. FIG. 9 is a diagram illustrating an example of a layout screen. It is an example of highlight display in an unstructured interpretation report. It is a figure showing an example of a screen of a time series information window. It is a figure showing an example of a relation prediction table. FIG. 14 is a diagram illustrating an example of a flowchart illustrating a procedure of a process when a diagnostic report item is created or selected by a user. 5 is a flowchart illustrating an example of a process of a duplication range determination unit according to the first embodiment. FIG. 14 is a diagram illustrating an example of a processing procedure of a duplication range determination unit. FIG. 6 is a diagram illustrating an example of a process related to duplication according to the first embodiment. It is a figure showing an example of processing about duplication in a 5th embodiment. It is a flow chart which shows an example of processing in a 4th embodiment. It is a figure showing an example of processing in a 4th embodiment. It is a figure showing an example of processing in a third embodiment. It is a figure showing an example of processing in a third embodiment. It is a figure showing an example of processing in a third embodiment.

  Hereinafter, an apparatus according to an embodiment of the present invention will be described. First, the configuration of a device common to the embodiments and the concept of a medical report created by the device according to the embodiment of the present invention will be described with reference to FIGS. 1 to 6 and FIGS. 30 to 33.

  In the first embodiment, all items directly or indirectly associated with specified items of a medical report created in the past can be specified and used for a newly created medical report. A description will be given by exemplifying FIG. 8, FIG. 11, FIG. 36, and FIG.

  In the second embodiment, relation information between items can be obtained from the type of the specified item. This will be described with reference to FIG.

  In the third embodiment, if there are items having an exclusive relationship with each other, a recommendation frame corresponding to the items can be presented. This will be described with reference to FIGS. 34 and 35.

  In the fourth embodiment, when the contents described in the medical report created in the past are duplicated and used, at the time when a series of processes relating to the duplication is completed, the contents and display form of the duplication target are copied to the duplication destination. It can be in a suitable state. This will be described with reference to FIGS.

  In the fifth embodiment, a part of an item associated with an item specified by the specifying unit can be specified and copied. In addition, when a part is specified and copied, a part that is not copied can be easily copied later, or an item that has been separately copied can be easily related. A description will be given by exemplifying FIG. 9, FIG. 10, FIG. 14, FIG. 15, and FIG.

  In the sixth embodiment, the duplication range can be specified according to the type of the designated item.

  In the seventh embodiment, it is possible to specify a range to be copied from a report that has been created in the past, according to the purpose for which the creation of a medical report was requested. This will be described with reference to FIGS. 16 and 17.

  In the eighth embodiment, it is possible to specify a range to be duplicated from a report that has been created in the past according to the description status of a newly created medical report and the content of the assumed description. This will be described with reference to FIGS.

  In the ninth embodiment, for each of the report items, an evaluation value is given based on the relation information, and the duplication range can be specified according to the evaluation value. This will be described with reference to FIGS. 21 and 22.

  In the tenth embodiment, for each of the report items, an evaluation value is given based on the related information, and the duplication range can be specified according to the evaluation value. This will be described with reference to FIGS. 23 to 25.

  In the eleventh embodiment, the method for specifying the duplication range can be switched. This will be described with reference to FIG.

  In the twelfth embodiment, an item corresponding to the purpose of requesting the creation of a medical report created in the past is specified by duplicating the purpose of requesting the creation of a medical report created in the past to a newly created medical report. Can be copied to a newly created medical report. This will be described with reference to FIGS. 27 to 29.

  The details will be described below.

  At medical sites, medical treatment is performed using images obtained by various imaging devices and various examinations. The image data acquired by the imaging device is referred to as a medical image here. An image obtained by subjecting image data to image processing or the like for obtaining an image suitable for diagnosis is also included in the medical image. The imaging apparatus is, for example, a computed tomography apparatus (CT: Computed Tomography), a nuclear magnetic resonance imaging apparatus (MRI: Magnetic Resonance Imaging), or a radiation imaging apparatus (DR: Digital Radiography) that captures a two-dimensional radiation image. Taking the image data acquired by the CT apparatus as an example, the CT apparatus acquires a one-dimensional distribution of relative X-ray absorption coefficient values called CT values as image data. Then, a process called image reconstruction is performed on the image data to obtain a three-dimensional image. Further, a MIP image created by a maximum intensity projection (MIP) from a three-dimensional image and a two-dimensional image of an arbitrary tomographic plane are acquired. These image data and various images obtained from the three-dimensional image and the three-dimensional image are included in the medical image.

  Diagnosis using medical images is called image interpretation. In image interpretation, a doctor who specializes in image diagnosis observes medical images. When a request for instructing photographing and interpretation of a medical image is issued by the attending physician to be diagnosed, a technician photographs an appropriate medical image, and the medical image is provided for interpretation. Then, information and advice obtained based on the captured medical image, information on the diagnosis target, and the like are transmitted from the specialist to the attending physician. Hereinafter, a doctor who requests image interpretation is referred to as a requesting doctor, and a doctor specializing in image diagnosis is referred to as an image interpretation doctor. The result of the interpretation is often described in an interpretation report and transmitted to the requesting doctor. The interpretation report is managed as electronic data. The interpretation report may be described and managed in the electronic medical record. In another example, the interpretation report is recorded and managed on a medium such as paper.

  The interpretation report contains information called findings that describe the events and phenomena discovered by a doctor when a doctor observes a medical image of a patient, and information that is called diagnosis that describes suspected diseases based on the findings. included. Further, the information may include information describing advice to the requesting doctor, such as a treatment policy. Further, a medical image is attached to the interpretation report. The medical image may be replaced with a thumbnail image of the medical image or information for referring to the medical image. Findings and diagnoses and their relationships are often described in natural sentences, and the manner in which they are described depends on the physician who created the report. Therefore, it may take time for the requesting doctor to grasp the contents of the interpretation report.

  In recent years, there has been proposed a method for expressing the relationship between multiple items included in information such as medical images, findings, and diagnosis, which is information for diagnosis described in interpretation reports, and creating a structured interpretation report. Have been. Each item includes the content input by the radiologist. This makes it possible to clearly express, for example, the relationship with a plurality of findings and diagnosis described in the interpretation report. By structuring the interpretation report, the workload of the interpreting doctor to be created is reduced, and the requesting doctor can easily understand the contents.

  When describing the interpretation report, the interpreting doctor creates the related information by associating the input items as necessary, and creates a structured interpretation report. In the interpretation report creation support system according to the embodiment of the present invention, such a structured interpretation report can be created.

[First embodiment]
FIG. 1 shows a configuration diagram of a medical report creation device. The medical report creation device 1 is a device for an image interpretation doctor to browse images to be interpreted and create an image interpretation report. The medical report creation device 1 is connected to an in-hospital system via an in-hospital local area network 9. Other information systems connected to the hospital system include, for example, HIS2, RIS3, medical image capturing device 4, and PACS5. HIS (Hospital Information System) 2 is a comprehensive system including a medical office accounting system, a medical appointment system, a medical information system, and the like. The HIS 2 has an electronic medical record DB (Database) 6 and an interpretation report DB (Database) 7. The electronic medical record DB 6 stores electronic medical records in which medical information of patients is recorded. The radiology report DB 7 stores information on radiology reports created by radiology doctors. The RIS (Radiologic Information System) 3 is a system for performing appointment of examination and treatment by a radiological device, managing examination results, managing stock of materials, and the like. Note that the interpretation report DB 7 may be managed by the RIS 3. The medical image photographing device 4 is, for example, a CT device, an MRI device, an ultrasonic diagnostic device, a PET device, and a DR device. A PACS (Picture Archiving and Communication System) 5 is a system for electronically storing, retrieving, and communicating medical images captured by the medical image capturing apparatus 4. The PACS 5 has a medical image DB (Database) 8 as a storage destination of the medical image.

  FIG. 2 shows a specific configuration diagram of the medical report creation device 1. The input device 11 is, for example, a mouse, a digitizer, or a keyboard, and is used for inputting a user's instruction to the medical report creating apparatus 1. The output device 12 is, for example, an LED (Light Emitting Diode) panel or a liquid crystal panel that displays the state of the apparatus and processing details. A CPU (Central Processing Unit) 13 reads a program stored in the secondary storage device 15 into the primary storage device 14. Further, the CPU 13 integrally controls the apparatus by executing the read program, performs calculations, and controls display of a UI (User Interface). The primary storage device 14 is mainly a memory such as a RAM (Random Access Memory). The secondary storage device 15 stores a medical report creation program necessary for operating the medical report creation device 1. The secondary storage device 15 is, for example, a storage medium such as a hard disk or a flash memory, but it goes without saying that the present invention does not depend on a specific storage medium. Generally, the capacity of the primary storage device 14 is smaller than the capacity of the secondary storage device 15, and programs and data that cannot be stored in the primary storage device 14 are stored in the secondary storage device 15. In addition, data and the like that must be stored for a long time are also stored in the secondary storage device 15. The communication IF (Interface) 16 is connected to the in-hospital local area network 9 and is a communication interface between various in-hospital systems, the HIS 2, the RIS 3, the imaging device 4, and the PACS 5.

  FIG. 3 is a diagram illustrating the concept of a report created by a medical report creation device according to one embodiment of the present invention. The medical report includes a plurality of pieces of information to be diagnosed, and includes relationship information indicating a relationship between a plurality of items included in each of the plurality of pieces of information. The plurality of pieces of information to be diagnosed include, for example, four types of information such as site, findings, diagnosis, and treatment. In the report items included in the part information, a sentence or image capable of specifying the body part is input. In FIG. 3, one of the report items included in the part information is indicated by a frame 71. The image input to the report item of the region is, for example, a soft copy of an image to be diagnosed or address information for accessing an image to be interpreted. The soft copy of the image to be diagnosed may be a thumbnail image of the image. At this time, parameters of image processing to be applied when browsing an image and information of examination such as information of a photographing area and a device at the time of photographing the image may be input together. In the finding report item, a sentence describing one or more lesions is input. In the diagnosis report item, text describing one or more diseases is input. In the action report item, a sentence describing one or more actions is input. The relation information includes, for example, a correspondence relation, a causal relation, an exclusive relation, and a transition relation indicating a time-series relation according to the relation between report items. In FIG. 3, the correspondence relationship is indicated by a straight line 72, the causal relationship is indicated by an arrow line 73, and the exclusive relationship is indicated by a double arrow line 74. The correspondence relationship means that the two report items are related to each other. The causal relationship means that two report items are connected in a relationship of cause and effect. It is shown in the direction of the arrow from the causal item to the resulting item. An exclusive relationship means that two report items are in conflict and the contents of the two report items are not valid at the same time. It should be noted that, at the time of creating a report, it is not possible to determine which report item is inappropriate when the report is created. Means that it will be deleted as One report item can have relation information with other report items. That is, the relationship between report items is a many-to-many relationship.

  FIG. 5 is a functional block diagram for explaining main functions of the medical report creation device 1. The image browsing unit 101 reads an image to be interpreted from the medical image DB 8 via the PACS 5, and displays the image on the output device 12. In addition, in accordance with an operation of a user, a radiologist, via the input device 11, various processes related to image browsing, such as changing a display image and performing image processing, are executed. The report display control unit 109 causes the output device to display an editing screen for a newly created report, and displays a past report on the output device in accordance with the operation of the radiologist. The report item creation unit 102 creates a report item and assigns an item ID for uniquely identifying the report item. Further, the report item creation unit 102 automatically assigns a report ID for uniquely identifying the report to which the report item belongs and the type of information to be diagnosed to which the report item belongs, as shown in FIG. It is stored in the item table 701. The report item content editing unit 103 edits the content of the report item according to the content input by the radiologist through the input device 11, and saves the edited result in a corresponding portion of the item table 701. The relation information creation unit 104 creates relation information between arbitrary report items. The relationship information includes a relationship ID for uniquely identifying the relationship information, IDs of two report items related by the relationship information, and a type of the relationship. Note that the relation information creation unit 104 causes the output device 12 to display a screen for allowing the user to select the type of relation between report items. The relation information creation unit 104 acquires the type of relation between report items input by the user. The relationship information storage unit 105 saves the relationship information created by the relationship information creation unit 104 in the relationship table 702 shown in FIG. When the type of the relationship is a causal relationship, the item ID of the report item indicating the cause is stored as the report item ID1, and the item ID of the report item indicating the result is stored as the report item ID2. The request tag assigning unit 114 assigns an arbitrary word or sentence representing the request content to an arbitrary report item as a request tag, and stores it in the item table 701. A plurality of request tags can be assigned to one report item. Note that the request content is a communication item from the requesting doctor who has requested the image reading doctor to create an image reading report, and includes a complaint and symptoms of the patient, a diagnosis name suspected by the requesting doctor, and the like. The requesting doctor may preliminarily divide the request contents into individual items and input them, and the interpreting doctor may select the input request item as a request tag for each report item. Further, a sentence including a plurality of request contents may be manually or automatically divided into individual items. By providing a request tag, a corresponding report item can be indicated for each of the request contents. The past report selection unit 108 displays a list of reports created in the past (hereinafter, referred to as past reports), and newly creates a report (hereinafter, this time) in response to the operation of the interpreting physician via the input device 11. Report to be used). A list of past reports is extracted based on the value of the report ID in the item table 701. Furthermore, based on the information corresponding to each report ID, for example, a list of reports on all report IDs, a list of reports on patients targeted this time, and a list of reports created by a certain interpreting doctor in the past are displayed. it can. The report display control unit 109 displays the contents of the past report selected by the user. The duplication range determination unit 110 determines a range to be duplicated in the current report among items (parts, findings, diagnosis, treatment, related information, etc.) constituting the report displayed by the report display control unit 109. The duplication range determination unit 110 is a specification unit that receives a user's operation input and specifies items included in a past report. Further, the duplication range determination unit 110 is a specifying unit that specifies an item included in the past report based on the specified item and the related information. Further, the duplication range determination unit 110 is a duplication unit that duplicates the item specified by the specifying unit in the current report. The duplication process is performed based on the information on the duplication range determined by the duplication range determining unit 110, based on the above-described report item creation unit 102, relationship information creation unit 104, relationship information storage unit 105, and copy relationship information creation unit. 106, which is performed by the copy relation information storage unit 107. The copy relation information creation unit 106 creates information indicating the relationship between the copy source and the copy destination (hereinafter, referred to as copy relation information) when the items configuring the past report are copied to a newly created report. I do. The copy relationship information storage unit 107 stores the copy relationship information created by the copy relationship information creation unit 106 in the copy relationship table 703 shown in FIG. Note that the relation ID 1 and the relation ID 2 are relation IDs of the relation table 702, and the relation ID 1 is stored as the relation ID of the copy source, and the relation ID 2 is stored as the relation ID of the copy destination. The relation information presentation unit 111 displays the relation between report items on the output device 12 according to the contents of the relation table 702 and the copy relation table 703. The report storage unit 112 stores the contents of the item table 701, the relation table 702, and the copy relation table 703 as report data in the interpretation report DB 7 via the HIS2. The format of the report data does not matter as long as it has the same information as the item table 701, the relation table 702, and the replication relation table 703. For example, the data may be converted into a report data format defined by XML or the like and stored. The storage unit 113 temporarily stores the item table 701, the relation table 702, and the replication relation table 703. Here, it is assumed that the report item ID, the report ID, and the relation ID are assigned values so as to be serial numbers when stored in the item table 701 and the relation table 702, respectively.

  FIG. 6 is a diagram showing an outline of a GUI of the medical report creation device 1. FIG. 6A is an example of a report input screen. The medical image browsing screen 131 displays an image of a diagnosis target to be interpreted. The radiologist performs an operation input on the content displayed on the medical image browsing screen 131, and realizes the function of the image browsing unit 101. In the patient information display area 132, information of a patient who is a diagnosis target and is a subject of an image is displayed. For example, a patient ID for uniquely identifying a patient, a name, an age, a past medical history, and the like correspond to the patient information. The request information display area 133 displays the department information of the request source, the requested examination, and the contents of the request from the requesting doctor. The report creation area 134 is divided into areas of parts, findings, diagnosis, and treatment, and a report item input box 135 for inputting the contents of report items included in each information and a report item input box 135 for adding an input box. An input frame addition button 136 is displayed. The report item input frame 135 corresponds to one report item, and accepts an operation input for editing the contents. The function of the report item content editing unit 103 is realized through an operation on the report item input frame 135. In response to the operation input of pressing the input frame addition button 136, the function of the report item creation unit 102 is executed, and a new report item is created. At the same time, a report item input frame 135 corresponding to the created report item is displayed. The input frame addition button 136 is prepared for each type of item, and creates a corresponding type of report item according to the pressed button. Note that the addition of the input frame may be performed by a key operation via the input device 11. For example, a diagnosis report item may be created by pressing the TAB key while editing the content of the finding report item. Similarly, a report item of another finding may be created by pressing the RETURN key twice consecutively while editing the content of the report item of the finding. The report item input box 135 is selected via the input device 11. Multiple input frames can be selected at the same time. When the selected input frame is dragged and dropped to another input frame, the relation information creating unit 104 associates the report item corresponding to the drag source input frame with the report item corresponding to the drop destination input frame. It is determined that the input is an operation input for instructing. In response to the operation input for instructing the relation, the relation information creating unit 104 displays a dialog box for selecting the type of the relation. In the report creation area 134, the relation information presenting unit 111 displays the relation between the report items as a line connecting the report item input frames 135. If the type of the relationship is a correspondence, it is displayed as a simple line connecting the input frames. When the type of the relationship is a causal relationship, it is displayed as an arrow from the input frame of the report item causing the cause to the input frame of the report item resulting. When the type of relationship is an exclusive relationship, the input frames of two or more report items having an exclusive relationship are displayed such that both ends are connected by straight lines indicated by arrows. When an image is dragged and dropped from the medical image browsing screen 131 to the report creation area 134, the report item creation unit 102 creates a report item included in the part information and displays an input frame of the report item. . At the same time, a report item of a finding having a correspondence with the report item of the created part is created, and the input frame is displayed. When an image is dragged and dropped from the medical image browsing screen 131 to the existing report item input frame 135, a soft copy of the image is registered as the content of the report item at the drop destination. When a request tag is dragged and dropped from the request information display area 133 to the report item input frame 135, the function of the request tag assigning unit 114 is executed, and the drag source request tag is assigned to the drop destination report item. In each of the following embodiments, a request tag is displayed on each report item input frame 135 so that the contents of the request tag assigned to each report item can be understood. In the impression input area 139, a summary of the report is displayed in text. The text is input by the user, a radiologist, via the input device 11. The contents of the impression input area 139 may be automatically created and inserted based on the contents of the report creation area 134. For example, the contents of the diagnosis and treatment report items may be automatically inserted as text. At this time, a report item corresponding to the description content of the cursor position may be highlighted according to the cursor position in the impression input area 139. Here, the highlight display is, for example, a display in which the color in the input frame of the report item and the thickness of the line indicating the input frame are different from those of other items, or the input frame of the report item blinks.

  When the past report button 137 is pressed, the processing of the past report selection unit 108 is executed, and a list of past reports is displayed. When a report is selected from the report list by the radiology doctor via the input device 11, the past report selected by the processing of the report display control unit 109 is displayed. The screen in FIG. 6B is an example of a result of screen transition when the processing of the report display control unit 109 is performed. In FIG. 6B, the contents of FIG. 6A before the screen transition are displayed below the boundary line 144. That is, a patient information display area 132, a request information display area 133, a report creation area 134, a report item input frame 135, and an input frame addition button 136 for the report currently being created are displayed. The radiologist can perform an input operation similar to that on the screen in FIG. FIG. 6B shows an example in which various buttons and input frames 138 to 144 are not displayed from the viewpoint of screen efficiency. In an area above the boundary line 144, the contents of the past report are displayed by the report display control unit 109. The patient information display area (past report) 145 shows information of a patient targeted by the selected past interpretation report. The patient information display area (past report) 145 is the information of the patient information display area 132 when the past report was described in the past. The request information display area (past report) 146 displays the department information of the request source, the examination requested, and the contents of the request from the requesting doctor when the past report is created. The request information display area (past report) 146 is information of the request information display area 133 when the past report was described in the past. The past report item / relationship information display area 147 is an area for displaying report items constituting the past report and the relationship between the report items. In the past report item input box 148, the contents of the report items constituting the past report are input. However, the past report item input frame 148 is read-only, and cannot be edited by the report item content editing unit 103. The past report item / related information display area 147 has a layout that divides and displays a region, a finding, a diagnosis, and a treatment area, similarly to the report creation area 134. The doctor interprets and uses a desired range of the contents displayed in the past report item / relationship information display area 147 for a newly created report. The specific procedure of the copying process will be described in detail in the description of each embodiment. Note that the past report button 137 is a toggle button, and the display of FIG. 6B and the display of FIG. 6A can be switched by button operation.

  When the basic input screen display button 140 is pressed, the report display control unit 109 switches the display of the report creation area 134 to the basic input mode. FIG. 30A shows an example of a screen in the basic input mode. In the basic input mode, the contents of report items of findings, diagnosis, and treatment are displayed so that they can be input in a natural sentence. When the detail input screen display button 141 is pressed, the report display control unit 109 switches the display of the report creation area 134 to the detail input mode. FIG. 30B shows an example of the screen in the detailed input mode. In the detail input mode, the content of the report item is displayed so that it can be input as a correspondence table between attributes and values. At this time, a list for selecting information indicating the attribute may be displayed so as to be associated with another report item or attribute. Thereby, a more detailed relationship can be expressed. When the mode is switched from the basic input mode to the detailed input mode, attributes and values may be automatically extracted from natural sentences by language processing. Also, when switching from the detailed input mode to the basic input mode, a natural sentence may be automatically generated from the attribute-value correspondence table. When the layout display button 142 is pressed, the report display control unit 109 lays out and displays the contents of the report creation area 134 and the impression input area 139. FIG. 31 shows an example of the layout screen. Here, items to which a request tag is attached, that is, report items created as a response to the request, are laid out at the top. Further, based on the contents of the item table 701 and the relation table 702, a label indicating a relation between items is created and displayed. For example, when the diagnosis is described as cancer and there is a causal relationship with another diagnosis, it is predicted that the cancer is a primary or metastatic lesion, and each is displayed as a label. When there are a plurality of combinations of primary lesions and metastatic lesions as in the case of double cancer, each combination may be distinguished by the label name or color. Note that the layout method can be changed depending on the requesting doctor who views the report, the device used for viewing, and the like. For example, as shown in FIG. 32, it may be displayed in the form of an unstructured interpretation report. At this time, items related to the selected item may be highlighted to make the correspondence easy to understand. Further, for example, when displaying on a mobile terminal, report items may be sequentially switched and displayed. Here, the basic input screen display button 140, the detailed input screen display button 141, and the layout display button 142 operate exclusively as radio buttons, and are operated while switching screens. Of course, each button may be depressed simultaneously, and a plurality of screens may be displayed simultaneously.

  When the time series display button 143 is pressed, the report display control unit 109 displays a time series information window. In the time-series information window, the contents of the report items selected in the report creation area 134 are arranged and displayed in order of inspection date. The contents displayed in the time-series information window are switched according to the basic input mode or the detailed input mode. FIG. 33 shows an example of the screen of the time-series information window in the detailed input mode. Regardless of the report item selected in the report creation area 134, an image representing a part may be displayed. It is assumed that the relationship information between the report items having different inspection dates is provided simultaneously with the duplication of the report items performed on the screen in FIG. That is, relationship information indicating a time-series relationship is automatically added to the report item of the past report of the copy source and the report item of the current report of the copy destination. Alternatively, in a state where the past report and the current report are displayed, a time-series relationship may be manually set by a user operation. The function of the report storage unit 112 is executed in response to an operation input for pressing the report storage button 138.

  As described above, the medical report creating apparatus 1 displays the relationship between the site, the findings, the diagnosis, and the treatment, for example, by connecting the report items with a straight line and an arrow line, and structures the report. This makes it possible to express the flow of logic indicating the connection between the site, the diagnosis, and the treatment in an easy-to-understand manner.

  With reference to FIGS. 8, 11, 36, and 37, a specific description will be given of a process performed by the medical report creation device 1 according to the first embodiment to copy the contents of a past report to a current report. FIG. 8 is a flowchart illustrating a process of copying and using report items and related information constituting a past report in a current report. S801 and S802 are processed by the past report selection unit 108. In step S801, a list of past reports is displayed. The medical report creation device 1 connects to the HIS 2 via the communication IF 16 and obtains, for example, a list of past interpretation reports stored in the interpretation report DB 7. Using a database query language such as SQL (Structured Query Language), for example, a condition for acquiring only a report relating to a patient currently being interpreted is specified, and acquisition and display of the report are performed. In S802, the selection of the report by the user is received via the input device 11, and the report ID for specifying the selected past report is transmitted to the report display control unit 109. Note that the past report selecting unit 108 may estimate the optimal past report according to the information of the current report, and may automatically perform the processing of S801 and S802. In step S803, based on the report ID transmitted from step S802, the report display control unit 109 displays report items constituting a past report and information on the relationship between the report items. Specifically, in the item table 701, a record whose report ID matches the transmitted report ID is extracted, and the corresponding past report and the contents of the report item of the past report are displayed via the output device 12. . At the same time, the related information related to the report item of the past report is extracted from the related table 702, and the related information presenting unit 111 displays the related information between the report items. In S804, the duplication range determination unit 110 receives the selection of the report item by the operation input via the input device 11, and acquires the report item ID for specifying the selected report item. In S805, based on the acquired report item ID, the duplication range determination unit 110 specifies report items and related information to be duplicated in the current report. In step S806, the item specified in step S805 is displayed on the edit screen of the current report by the duplication range determination unit 110. Then, the report item creation unit 102, the related information creation unit 104, the related information storage unit 105, and the copy relationship information creation unit 106 and the copy relationship information storage unit 107 copy the current report.

  FIG. 36 is a flowchart illustrating a process for specifying items to be included in the duplication range in the first embodiment. In step S3601, the duplication range determination unit 110 specifies the report item whose designation has been received in S804 as at least an item to be included in the duplication range. That is, the report item selected in S804 is included in the duplication range. In S3602, the duplication range determination unit 110 executes the function SelectItem shown in FIG. 37 using the report ID of the report item included in the duplication range in S3601 as an argument.

  Here, the function SelectItem will be described with reference to FIG. The function SelectItem specifies an item associated with a certain item, and also specifies an item associated with each of the specified items. Thus, all items directly or indirectly related to a certain item can be specified. Hereinafter, processing by the function SelectItem will be described. The report item whose report ID is x can be referred to by the function ITEM (x). Further, the relation information whose relation ID is x can be referred to by the function RELEATION (x). In S3701, the value of the report ID, which is the argument of the function SelectItem, is substituted for the variable i. In S3702, 1 is substituted for the variable j. In S3703, the report item ID1 of the related information obtained by RELECTION (j) is substituted for the variable m. In S3704, the report item ID2 of the related information obtained by RELECTION (j) is substituted for the variable n. In step S3705, the values of the variable i and the variable m are compared. If they are the same, the process proceeds to S3706, and if they are different, the process proceeds to S3707. In step S3706, the value of the variable n is substituted for the variable p, and the flow advances to step S3709. In S3707, the values of the variable i and the variable n are compared. If they are the same, the process proceeds to S3708, and if they are different, the process proceeds to S3712. In S3708, the value of the variable m is substituted for the variable p, and the flow advances to S3709. In S3709, it is determined whether ITEM (p) is already included in the duplication range. If the result of the determination is true, the flow proceeds to S3710. If the result of the determination is false, the process proceeds to S3712. If the value of p is blank (null), the result of the determination is false, and the process proceeds to S3712. In S3710, the process advances to S3711 after including ITEM (m) as the duplication range. In step S3711, the function SelectItem is executed using p, which is the value of the report item ID, as an argument. That is, the function SelectItem is recursively called. In S3712, the variable j is incremented. In S3713, it is determined whether the value of the variable j is larger than the number of records in the relation table. If the result of the determination is false, the process returns to S3703, and the above processing is repeated again. If the result of the determination in S3713 is true, the function SelectItem ends.

  In the process of the function SelectItem illustrated in FIG. 37, the processes of S3703 to S3711 are performed on all the relationship information stored in the relationship table 702 of FIG. 4B. In another example, the target for performing the processing of S3703 to S3711 is narrowed down in advance, and the processing of the function SelectItem is performed. That is, the relationship information in the relationship table 702 is narrowed down to the relationship information belonging to the past report in which both the report item ID1 and the report item ID2 are selected in S804, and the processes of S3703 to S3711 are performed only for the narrowed relationship information. . Thereby, the processing speed can be improved.

  In the processing of the function SelectItem illustrated in FIG. 37, the report item ID specified as the argument of the function specifies the relationship information included in the relationship table 702 as the report item ID1 or the report item ID2. An example of another process for specifying such relation information is, for example, a process using a graph structure. In S803 shown in FIG. 8, based on the item ID and the relationship ID acquired when displaying the items constituting the past report and the relationship between those items, the graph structure between the report items constituting the past report is primarily changed. It is stored in the storage device 14. Then, based on the graph structure, a report item that is directly or indirectly related to the report item specified in S804 is specified. Specifically, a “report item” class that represents a report item is defined by a program that operates the medical report creation device 1. The class defined here is based on a general concept of object-oriented programming. The defined “report item” class has, as a member variable, an array that stores an instance of the “report item” class. That is, in S803, the duplication range determination unit 110 creates an instance of a “report item” class corresponding to each report item to be displayed. Further, an instance of the report item directly related to the report item corresponding to each instance is stored in the array of each instance. In this way, by creating an instance group as a graph structure in advance, when a report item is specified in S804, the array of the corresponding instance can be referred to, and the report item directly related can be efficiently specified. . Further, by recursively referring to the instances stored in the array corresponding to the report items directly related to each other, it is possible to efficiently identify the report items indirectly associated with the report items in S804.

  Returning to the description of FIG. In S3603, the relation information between the report items identified as the duplication range in S3601 and S3602 is included in the duplication range. Specifically, for all records in the relation table 702, relation information in which both report items corresponding to the report item ID1 and the report item ID2 are specified as a duplication range is extracted and set as a duplication target. When only one report item is included in the duplication range, report information ID1 is the duplication source report item ID, report item ID2 is blank (null), and type is blank (null). This is the related information to be copied. If there is no relationship information in the relationship table 702 with the report item ID 1 as the copy source report item ID, the report item ID 2 as blank (null), and the type as blank (null), a new unique relationship ID is created. To be copied.

  The concept of the item specified as the duplication range by the duplication range determination unit 110 of the medical report creation device 1 according to the first embodiment will be described with reference to FIG. For example, when the item of the finding 5 shown in FIG. 38 is designated in S804 shown in FIG. 8, the duplication range is the part 3, finding 4, finding 5, part 4, part 5, finding 5, diagnosis 4, treatment 5, There are eight pieces of related information that are related information between the diagnosis 5, the treatment 6, and the report items. In the case where the finding 5 and the part 6 of FIG. 38 are simultaneously specified in S804 shown in FIG. 8, first, as the report item, the finding 3, the finding 4, the finding 5, the part 4, Site 5, findings 5, diagnosis 4, treatment 5, diagnosis 5, and treatment 6 are identified as replication ranges. Further, eight pieces of relation information, which are relation information between those report items, are included in the duplication range. Further, in response to the designation of the part 6, three pieces of related information, which are related information between the part 6, the findings 6, the diagnosis 6, the treatment 7, and the report items, are included in the duplication range. When the duplication range is specified by the duplication range determining unit 110, the report display control unit 109 causes the specified item to be displayed on the editing screen of the current report. That is, the report display control unit 109 functions as a display control unit.

  Whether or not the item specified as the duplication range by the duplication range determination unit 110 is to be duplicated in the current report is determined according to the user's operation input. For example, when the user selects one item included in the past report, the report display control unit 109 causes the output device 12 to display a screen for instructing the user whether or not to copy. When the user instructs duplication, the duplication range determination unit 110 specifies the selected item in response to the user's operation input, and the duplication range is specified by the above-described processing. The operation input for instructing the duplication may be performed by a key operation. The item specified as the duplication range is displayed by the report display control unit 109 on the editing screen of the current report. Furthermore, the report display control unit 109 displays an icon for instructing the user to copy the item displayed on the report editing screen this time near the item. When the user performs an operation input on an icon for instructing duplication, the duplication is determined. As a mode of displaying the item specified as the duplication range on the editing screen of the current report, the item is displayed in the current report so as to be distinguished from other report items already created. For example, distinction is made by the transparency or color of the input frame of the item specified as the duplication range. The item specified as the duplication range may be displayed at a position linked to the display of a mouse pointer, which is an example of the input device 11. For example, drag one item of the past report to the edit screen of the current report. In response to the drag operation input, the duplication range determination unit 110 specifies the duplication range by the above-described processing. The report display control unit 109 displays the item dragged on the editing screen of the current report and the item specified by the duplication range determination unit 110 near the mouse pointer. If the drop is dropped on the report edit screen this time, it is regarded as an instruction to determine the copy, and the report item is copied at or near the position where the drop operation input is matched. A display combining these examples may be performed.

  Based on FIG. 11, the process of copying the item specified as the copy range in S806 shown in FIG. 8 to the current report will be described in detail. FIG. 11 is a diagram illustrating a flowchart of the copying process. In step S8061, the report item creation unit 102 copies all report items identified as the copy range in step S805 to the current report. When copying, the report item creation unit 102 creates an item for registering the content to be copied in the current report. The created item has the same item type and content as the item specified in S805, but the item ID is newly assigned a unique number in the item table 701, and the report ID is the ID corresponding to the current report. . In step S8062, the relation information creation unit 104 copies all the relation information related to the item specified in step S805, and the relation information storage unit 105 stores the copied relation information in the relation table 702. The relationship ID of the relationship information to be copied is newly assigned a unique number in the relationship table 702, and the report item ID1 and the report item ID2 are the item IDs copied and newly assigned in S8061. In S8063, the copy relation information creation unit 106 creates copy information for each record of the copied relationship table 702 based on the copy source relation ID and the corresponding copy destination relation ID, and stores the copy relation information. The unit 107 stores it in the replication relationship table 703. The content copied as described above is displayed on the editing screen of the current report by the related information presenting unit 111, and the content can be edited by the report item content editing unit 103.

  In the present embodiment, the report items of findings, diagnosis, and treatment are created on the interpretation report, but may be obtained from another system. For example, the items stored in the electronic medical record may be acquired and related. At this time, the patient's symptoms, medical history, living environment, and the like may be similarly related as items. Further, in the present embodiment, the request content is given as a tag, but may be related by another method. For example, the contents of the request may be created as report items representing findings, diagnoses, treatments, and the like, and may be related similarly to other report items. Further, in the HIS ordering system, identification information for managing each order, for example, an order number may be described in association with the interpretation report.

  Further, in the present embodiment, the target to be copied is limited to the information in the report creation area 134, but other information may be set as the target to be copied. For example, information in the request information display area 133 is also treated as a report item. By dragging and dropping an item in the request information display area 133 to the request information area (past report) 146, the request item of the past report may be duplicated as the request item of the current report.

[Second embodiment]
In the second embodiment, a method of automatically determining the type of the relationship between report items based on the user's operation input in the relationship information creating unit 104 will be described with reference to FIGS.

  FIG. 7 is a flowchart illustrating a procedure of processing for automatically determining the type of the relationship between report items in the relationship information creating unit 104. Note that, in the flowchart in FIG. 7, only the correspondence and the causal relationship among the types of the relationships are automatically determined. The user manually specifies the conflict, and the time-series relationship is described above. It is specified in the time series information window. Here, as an example, a description is given assuming that drag and drop of an input frame is an operation input for instructing association between report items. It is assumed that a plurality of drag source report items and a plurality of drop destination report items are selected. It is assumed that the n-th report item in the set of drag source report items can be referred to by the function DRAG (n). It is assumed that the n-th report item in the set of report items at the drop destination can be referred to by the function DROP (n). Here, the n-th item in a certain set is the n-th number given to a plurality of items included in the set with serial numbers that can be distinguished from each other. In S701, 0 is substituted for a variable i. In S702, the type of the report item obtained by DRAG (i) is substituted for the variable Ki. In S703, 0 is substituted for the variable j. In S704, the type of the report item obtained by DROP (j) is substituted for the variable Kj. In S705, the type Ki of DRAG (i) and the type Kj of DROP (j) are compared. If the types of the items are the same, the process proceeds to S706. If not, the process proceeds to S707. In S706, it is determined that the relationship between DRAG (i) and DROP (j) is a causal relationship having DRAG (i) as a cause and DROP (j) as a result. In S707, it is determined whether one of the type Ki of DRAG (i) and the type Kj of DROP (j) is a finding and the other is a diagnosis. If one is a finding and the other is a diagnosis, the process proceeds to S708. Otherwise, the process proceeds to S709. In S708, the relationship between DRAG (i) and DROP (j) is determined. It is assumed that, of DRAG (i) and DROP (j), the causal relationship is such that the item type is a finding and the item type is a diagnosis. In S709, it is determined whether one of the type Ki of DRAG (i) and the type Kj of DROP (j) is a diagnosis and the other is a treatment. If one is a diagnosis and the other is a treatment, the process proceeds to S710. Otherwise, the process proceeds to S711. In S710, the relationship between DRAG (i) and DROP (j) is determined. Of DRAG (i) and DROP (j), it is assumed that the causal relationship is such that the item type is diagnosis and the item type is treatment. In S711, it is determined whether one of the type Ki of DRAG (i) and the type Kj of DROP (j) is a site and the other is a finding. If one is a site and the other is a finding, the process proceeds to S712. Otherwise, the process proceeds to S713. In S712, the relationship between DRAG (i) and DROP (j) is determined as a correspondence. In S713, it is determined that there is no direct relationship between DRAG (i) and DROP (j), and no relationship information is created. In S714, 1 is added to the variable j. In S715, the variable j is compared with the number of report items at the drop destination. If the variable j is equal to or greater than the number of report items at the drop destination, the process proceeds to S716. Otherwise, the process proceeds to S704. In S716, 1 is added to the variable i. In S717, the variable i is compared with the number of report items of the drag source. If the variable i is equal to or greater than the number of report items at the drag source, the process ends. Otherwise, the process proceeds to S702.

  In the above example, new relationship information indicating a conflict can be created by a user's operation input. Further, the relationship information indicating the correspondence and the causal relationship automatically created by the flow illustrated in FIG. 7 can be corrected to the relationship information indicating the conflict by the user's operation input. In another example, the creation of conflicts may be automated. For example, in step S706, if both Ki and Kj are types of diagnosis, the contents of report items obtained by DRAG (i) and DROP (j) are analyzed using a well-known morphological analysis or medical dictionary. I do. It is determined whether or not there is a conflict based on the result of collating the analysis result with a relation prediction table 3401 prepared as illustrated in FIG. 34 prepared in advance. If it is determined that there is a conflict, relationship information indicating the conflict is created between DRAG (i) and DROP (j). The details of the process of determining whether there is a conflict between report items using the relationship prediction table illustrated in FIG. 34 will be described in the description of the third embodiment.

  As described above, the type of the relationship between report items can be automatically selected by the medical report creation device according to the second embodiment. As a result, it is possible to reduce the trouble of the operation of the radiologist in creating the structured report.

[Third embodiment]
In the third embodiment, a method of suggesting input of a necessary report item to a user based on a relationship between report items will be described with reference to FIGS.

  In the medical report creation device according to the third embodiment, when a report item is created or selected by the user, the relationship information creation unit 104 predicts the relationship with another report item that has already been input. As a result of the prediction, if there is a conflicting diagnosis, the report item creation unit 102 creates a report item for writing a recommendation, and prompts the user to enter the recommendation. An opposition is a hypothesis of multiple conflicting findings or diagnoses, for example, for the same observation. If there are contradictory hypotheses, those hypotheses are described as candidates for the time being, and the hypothesis to be adopted as a definitive diagnosis in later verification work is determined. Therefore, a procedure for determining the name of a diagnostic disease may be described in an image interpretation report. In the present embodiment, when a plurality of hypotheses present different diagnostic disease names, an item of a treatment recommended to determine the diagnostic disease name is displayed in the current report. In the medical report creation device according to the third embodiment, it is assumed that a relation prediction table 3401 illustrated in FIG. 34 is prepared in advance. In the relation prediction table 3401, a combination of two types of words (hereinafter referred to as a word set), a type of relation between words, and a probability of relation are stored in association with each other. If the type of the relationship is a causal relationship, it is assumed that the word set 1 is stored as a cause and the word set 2 is stored as a result. The contents of the relation prediction table 3401 may be updated based on the contents of the past report item table 701 and the relation table 702.

  FIG. 35 is a flowchart illustrating a procedure of a process when a user creates or selects a report item in the present embodiment. The description content of the n-th report item in the item table 701 can be obtained by the function Obj (n). In S3501, if the content of the report item specified by the user's operation input for selecting a report item is a text, the related information creating unit 104 analyzes the content and extracts words such as a diagnosis name included in the text. . The analysis of the sentence is performed using a known morphological analysis, a medical dictionary, or the like. A combination of a plurality of words extracted here is treated as a word set A. In S3502, a word set corresponding to the word set A, a type of relation, and a probability are extracted with reference to the relation prediction table 3401. There may be a plurality of pieces of information corresponding to the word set A. The extracted information group is made into a list and handled as a list L. It is assumed that the n-th element among the plurality of elements included in the list L can be accessed by L (n). In S3503, 0 is substituted for the variable i. Hereinafter, all report items described in the item table 701 are referred to by the variable i, and items satisfying the following conditions are extracted. In the processing from S3504 to S3506, in the report including the selected report item, the report items of the diagnosis other than the report item selected by the user are extracted. In S3504, it is determined whether Obj (i) is different from the selected report item. If Obj (i) is different from the selected report item, the process advances to step S3505. Otherwise, the process proceeds to S3515. In S3505, it is determined whether the report ID corresponding to Obj (i) is different from the report ID corresponding to the selected report item. The ID corresponding to each report item is specified from the report ID column of the item table 701. If the report ID corresponding to Obj (i) is different from the report ID corresponding to the selected report item, the process proceeds to S3506. Otherwise, the process proceeds to S3515. In S3506, it is determined whether Obj (i) is a diagnosis. If Obj (i) is a diagnosis, the process proceeds to S3507. Otherwise, the process proceeds to S3515. In step S3507, when the content of Obj (i) is a text, the content is analyzed to extract words such as finding names and diagnosis names included in the text. The combination of a plurality of words extracted here is treated as word set B. In S3508, 0 is substituted for the variable j. With reference to the variable j, all word sets included in the list L are referred to, and it is determined whether or not the following condition is satisfied. By the processing in S3509 to S3011, it is determined whether or not there is any list L that is included in the word set B and that is predicted as a conflict based on the probability allowed by the user. In S3509, it is determined whether the word set of the element of L (j) and the word set B are the same. If the word set of L (j) and the word set B are the same, the process proceeds to S3510. Otherwise, the process proceeds to S3513. In S3510, the value of the probability of L (j) is compared with a threshold value Rt. It is assumed that the value of the threshold value Rt is set in advance. If the probability of L (j) is equal to or greater than the threshold value Rt, the process proceeds to S3511. Otherwise, the process proceeds to S3513. In S3511, it is checked whether the type of the relationship of L (j) is an opposition relationship. If the type of the relationship of L (j) is a conflict, the process proceeds to S3512. Otherwise, the process proceeds to S3513. In step S3512, an input frame of a recommended report item related to the selected report item is automatically generated, and is highlighted so that the correspondence with the report item of Obj (i) can be understood. At this time, the display method may be changed according to the value of the probability in the relation prediction table 3401. Further, in S3512, the related information creating unit 104, the related information storing unit 105, and the related information presenting unit 111 automatically create related information indicating that the selected report item and Obj (i) are in conflict. The relation information may be stored in the relation table 702 and the relation information may be displayed on the screen. In another example of S3512, a screen for prompting the user to specify whether to create a recommended report item related to the selected report item is displayed on the display unit. When the user specifies to create a recommended report item by operation input, a recommended report item is created in this report. In S3513, 1 is added to the variable j. In S3514, j is compared with the number of elements of the list L. If the variable j is equal to or greater than the number of elements in the list L, all the word sets included in the list L have been referenced, and the flow advances to S3515. Otherwise, the process proceeds to S3509. In S3515, 1 is added to the variable i. In S3516, the variable i is compared with the number of report items included in the item table 701. If the variable i is equal to or greater than the number of report items, the process ends. Otherwise, the process proceeds to S3504.

  42 to 44 are diagrams illustrating an example of display on the display unit in the process illustrated in FIG. In FIG. 42, images 4201, 4202, 4203, and 4204 are displayed as the items of the parts. The finding item 4205 is associated with the image 4201 and the image 4202. The finding item 4206 is associated with the image 4203 and the image 4024. The diagnosis item 4207 is associated with the finding item 4205. The diagnosis item 4208 is associated with the finding item 4206. FIG. 42B is an example of the display on the display unit when the treatment item 4209 is created by the processing shown in FIG. The diagnosis 4207 and the diagnosis 4208 are in an exclusive relationship. The treatment item 4209 is created by the report item creation unit 102, and the report display control unit 109 displays a highlight frame 4210 for displaying the item 4209 so as to be distinguishable from other items. FIG. 43 is another example of the display on the display unit in the process shown in FIG. As shown in FIG. 35, when one item in a conflict is selected by an input device, the other item in a conflict may be displayed so as to be distinguishable from the other items. For example, a case where a diagnosis item 4207 is clicked with a mouse as an example of the input device 11 or a case where a mouse pointer indicating a mouse operation position is displayed on the item 4207 will be described. The report display control unit 109 displays a highlight frame 4302 for displaying a diagnosis item 4208 including a description that is in conflict with the diagnosis item 4207 so as to be distinguishable from other items. FIG. 44 is another example of the display on the display unit in the process shown in FIG. The report display control unit 109 causes an arrow 4402 indicating a conflict to be displayed between the items 4401 and 4301 of the conflicting diagnosis. As a result, the user can easily grasp the conflicting items. Note that the display methods illustrated in FIGS. 42 to 44 may be executed simultaneously.

  That is, the duplication range determination unit 110 functions as a specifying unit that specifies at least two items that are included in the information on the diagnosis of the diagnosis target and that have an exclusive relationship among the plurality of items of the image interpretation report. . In addition, the report display control unit 109 is an action display unit that displays an item associated with the item specified by the specifying unit and included in the information indicating the action on a screen for creating an interpretation report. Function. In another aspect, the report display control unit 109 displays a screen that allows the user to specify whether to create an input box that is an item related to the item specified by the specifying unit and that is included in the information indicating the treatment. It functions as treatment display means for displaying on the display unit.

  As described above, in the medical report creation device according to the third embodiment, when there is a diagnostic report item that is in conflict with the selected diagnostic report item, the input frame of the recommended report item is automatically set. Is created and presented to the user. As a result, it is possible to prevent omission of a recommended entry.

  In the description with reference to FIG. 35, the target for predicting the relationship is limited to the report item of the diagnosis, but the same processing may be performed including the report item of the finding related to the diagnosis. This makes it possible to more accurately predict the relationship between items. In addition, by performing the same processing for all report items, it becomes possible to predict the relationship between the items and present it to the user.

  In the description with reference to FIG. 35, the target for predicting the relationship is limited to the report items in the report in which the selected diagnosis report item is described, but the report belonging to another report described in the past is described. May be extended to items. For example, the relationship prediction target may be extended to a report item in a past report of a patient to be described in a report in which the report item of the selected diagnosis is described. In this case, a conflict between the diagnosis described in the past and the content of the diagnosis described this time can be automatically detected, and a mistake in the description by the radiologist can be prevented.

  In the description using FIG. 35, the type of the relationship between the diagnoses is predicted using the relationship prediction table 3401, but another method may be used. For example, the relationship between the diagnoses may be predicted from the content of the findings and the manner in which the relationship between the findings and the diagnosis is established. For example, if the lesion is a nodule or mass, there is a high possibility that one diagnosis will be given. When a plurality of report items of a diagnosis are associated with a report item of a finding in which a nodule or a tumor is described, it can be determined that each diagnosis has an exclusive relationship. On the other hand, when the findings are other localized abnormalities, diffuse abnormalities, and systemic abnormalities, a plurality of diagnosis names may be given, and thus a plurality of diagnosis report items may be present. In that case, the type of relationship between diagnoses is predicted using the method described with reference to FIG.

  Note that the above may be used as a restriction when relating the findings to the diagnosis. For example, if nodules or masses are described in the findings, only one diagnosis may be associated.

[Fourth embodiment]
In the fourth embodiment, when the contents described in the past report are duplicated and used, at the time when a series of processes relating to the duplication is completed, the contents and display form of the duplication target are set to a state suitable for the duplication destination. Can be. For example, when an item including an image from a past report is duplicated in the current report, the image corresponding to the request content of the current report is displayed instead of the image taken when the past report was created. In another example, when duplicating an item containing a description of the size of a lesion from a past report, the size of the lesion may have changed at the time this report was created. Highlight the item that contains the description.

  The medical report creation device according to the present embodiment supports efficiently checking and correcting the description contents copied from the past report to the current report in the current report. The objects to be confirmed and corrected include, for example, an examination image, a measurement value related to a lesion, a diagnosis name, a volume of an organ, and the like. In the following, a description will be given in detail using some objects. However, the objects to be confirmed and corrected below are merely examples, and the objects to be confirmed and corrected are not limited to the following examples.

  An example in which an image is included in an item specified as a duplication range by the duplication range determining unit 110 will be described. The soft copy of the medical image displayed in the past report is likely to be different from the image that was taken when the past report was created and should be displayed in the current report that is currently being edited. Therefore, even if an image is included in the item specified as the duplication range, the image is not duplicated in the current report. Then, a medical image corresponding to the medical image attached to the past report is attached to the current report, and its soft copy is displayed. The report item creation unit 102 acquires information on the examination that captured the image of the past report specified as the duplication range. For example, it is information on the imaging region of the patient to be diagnosed and the device used for the imaging. The report item creation unit 102 acquires a corresponding medical image from the medical image DB 8 based on the information on these examinations. That is, the report item creation unit 102 functions as an image acquisition unit. When the image attached to the past report (hereinafter, referred to as a past image) is a cross-sectional image of a three-dimensional image, attribute information such as a slice position may be acquired as examination information. In the present embodiment, when the item including the image is duplicated in the processing of S8061 shown in FIG. In other words, an image that is captured by the same image capturing device as the past image and is in the same image capturing area is obtained as an image to be observed in creating the current report. Then, a copy process is performed using the soft copy of the acquired image as a report item. Processing relating to image replacement will be described with reference to FIGS.

  In FIG. 12, reference numeral 71d denotes a set of slice data of a medical image captured by one modality in a past examination. 71a is one slice image of 71d. Reference numeral 71e denotes a set of slice data of a medical image captured by one modality in this examination. 71b is one slice image of 71e. Reference numeral 71e denotes an image group in the same shooting area as 71a, which is shot by the same modality. Reference numeral 71c denotes a conceptual line for associating each slice image 71a constituting 71d with each slice image 71b constituting 71e, and the correspondence is as shown in Table 71f. The table 71f indicates, for example, that the current image 71b corresponding to the (N + 2) -th past image 71a belonging to the past image data 71d is the third medical image in the current image data 71e.

  FIG. 13 is a flowchart for replacing the copy content with the soft copy of the current image when the content of the report item to be copied is a soft copy of the past image. In S131, the report item creation unit 102 acquires information on the past image data 71d to which the past image 71a, which is the source of the soft copy of the past image to be copied, belongs from the medical image DB 8 via the PACS5. For example, the information of the inspection at the time when the past image was taken is acquired. The information on the examination includes, for example, information on an imaging start position, an imaging end position, a slice thickness, an imaging region, and a modality. From these pieces of information, the photographing position of each slice of the past image can be estimated. In S132, the current image data 71e of the same imaging region and modality is specified from among the images obtained by the newer examination than the past image, and the imaging position of each slice is grasped from the information of the imaging position end position and the slice thickness. . A table of 71f is created together with the information obtained in S131, and a current image 71b having the same (or closest) imaging position as the medical image 71a as a source of the soft copy of the past image is extracted. The extraction of the current image 71b is not limited to the above-described method, and may be performed by, for example, image analysis. In S133, the annotation added to the past image and the image processing parameters applied to the past image are applied to the extracted current image. That is, when the specified past image is annotated with the annotation information indicating the annotation, the current image is also displayed with the annotation information. Accordingly, it is possible to reduce the trouble of the image interpreting physician who creates the image interpretation report to re-annotate the report to be displayed in the current report and change the image processing parameters. The report item creation unit 102 saves the soft copy of the current image 71b obtained by the processing up to S133 in the item table 701 as the content of the report item to be duplicated in the current report. If there is no current image corresponding to the past image in S132, it is preferable that only the report item input frame is created, and that the image interpretation doctor applies an appropriate image manually. That is, the report display control unit 109, which is a display control unit, displays an area for displaying an image corresponding to the image of the past report on the screen for creating the current report in association with the item specified as the duplication range. . The report creation unit may create an item of the part associated with the duplicated item, and accept that the user manually attaches an image to the item of the part. In S8062 illustrated in FIG. 11, the related information creating unit 104 copies all the related information to be copied determined in S805, and stores it in the related table 702 by the related information storage unit 105. At the time of duplication, a unique number is newly assigned to the relation ID in the relation table 702. The report item ID1 and the report item ID2 are replaced with the item IDs newly assigned when the respective report items are duplicated. In S8063, the copy relation information creation unit 106 creates copy information for each record of the copied relationship table 702 based on the copy source relation ID and the corresponding copy destination relation ID, and stores the copy relation information. The unit 107 stores it in the replication relationship table 703. The content copied as described above is displayed in the current report by the related information presenting unit 111, and the content can be edited by the report item content editing unit 103.

  In the medical report creation device according to the present embodiment, the past image and the current image can be easily compared. For example, when an operation input is performed on the current image by double-clicking a mouse, which is an example of the input device 11, the image browsing unit 101 displays the current image and the past image side by side on the medical image browsing screen 131. That is, the past image specified by the specifying unit and the current image obtained by the image obtaining unit are displayed on the screen.

  As another example of the process when the image of the past report is specified as the duplication range, the image may not be acquired this time, and only the report item input frame for displaying the image may be created. In other words, all the images to be displayed in the report may be prompted to be manually attached to the user, a radiologist. These settings can be appropriately changed by the user.

  Next, a description will be given of a copy process in a case where information having an attribute that may change when the past report is copied to the current report is included in the description of the item to be copied.

  FIG. 40 is a flowchart illustrating an example of a process of identifying a description that may be changed when a previous report is copied to a current report, and displaying an input frame for the user to input. In step S4001, the report item content editing unit 103 analyzes the content of the report item to be duplicated specified by the duplication range determination unit 110. For example, a report item included in the finding information may include a character string representing the size or measured value of the lesion, which is an objective fact of the lesion. In addition, a report item included in the diagnosis information may include a character string representing a diagnosis name. In step S4002, based on the result of the analysis in step S4001, the report item content editing unit 103 determines whether or not a character string including the size and measured value of the lesion is included. If it is determined that the size or the measured value is included, the process advances to step S4003. If it is determined that the size or the measured value is not included, the process advances to step S4004. In step S4003, if the report item to be duplicated includes a character string representing the size, measured value, or diagnosis name of the lesion, the report item to be duplicated does not duplicate the character string in the current report. Perform character string processing. In step S4003, the report item content editing unit 103 enters an input box for inputting a character string suitable for the content of the current report in the position of the size or measurement value of the lesion in the item of the past report specified as the duplication range. Perform character string processing to provide. The report item creation unit 102 creates report items for the current report. The report display control unit 109 causes the display unit to display the items subjected to the character string processing by the report item content editing unit 103. In step S4004, based on the result of the analysis in step S4001, the report item content editing unit 103 determines whether or not a character string representing a diagnosis name is included. If it is determined that a character string representing the diagnosis name is included, the process advances to step S4005. If it is determined that a character string representing the diagnosis name is not included, the processing shown in FIG. 40 ends. In step S4005, the report item content editing unit 103 sets an input box for inputting a character string suitable for the contents of the current report at the position of the character string of the diagnosis name in the item of the past report specified as the duplication range. Perform character string processing to provide. The report item creation unit 102 creates report items for the current report. The report display control unit 109 causes the display unit to display the items subjected to the character string processing by the report item content editing unit 103. In S8061 shown in FIG. 11, a character string representing the size / measured value of a lesion or a diagnosis name is automatically extracted from a natural sentence to be copied using a medical dictionary, language processing, or the like, and these are input into an empty input space. And then perform the duplication process. The user can set the size, measurement value, and diagnosis name of the lesion, which are attributes that may change, as predetermined attributes. The size, measured value, and diagnosis name of the lesion at the time of creating the past report are not necessarily the same at the time of creating this report. Thereby, it is possible to assist the user so as not to overlook the character string that may be changed. Note that the determination in step S4002 and the determination in step S4004 may be performed simultaneously, and in that case, the character string processing in steps S4004 and S4005 may be performed simultaneously. Further, the processing of steps S4004 and S4005 may be performed before the processing of steps S4002 and S4003.

  FIG. 41 shows an example of display on the display unit in the process shown in FIG. An example will be described in which the duplication range determination unit 110 specifies a site item 4101, a finding item 4102, and a diagnosis item 4103 as a duplication range. The finding item 4102 includes a description about the size “size is 15 to 20 mm”. By the processing shown in FIG. 40, a character string 4107 that has been subjected to character string processing, “size is □□ to □□ mm”, is displayed in the finding item 4105 copied in this report. The diagnosis item 4103 includes a description expressing a diagnosis name “lymphadenomas”. By the processing shown in FIG. 40, a character string 4108 that has been subjected to character string processing as “□□□□□” is displayed in the diagnosis item 4106 copied this time in the report.

  After duplication, the user manually enters a character string suitable for the current report into the empty input space. Information having an attribute such as the size of a lesion includes, for example, a measurement value measured based on an image of a diagnosis target. For example, when a nodule is recognized in a chest X-ray image or a CT image, a diagnosis may be performed according to a manner of change in size compared to a past image. That is, information having an attribute such as the size of a lesion in a past report may be changed in the present report. In another example, information having attributes such as progress and the degree of progress of a lesion may have changed since the time when the past report was created. The information having such an attribute includes expressions such as “progress” and “healing” for expressing progress, and staging. In yet another example, information having attributes such as the volume of an organ may have changed since the previous report was created. The information having such an attribute is, for example, a lung volume. For example, attention may be paid to changes in lung volume as a sign of a certain disease such as diffuse lung disease. If attention is paid to the change in the follow-up observation, the description of information having such an attribute as the volume of the organ may be changed. Further, even when the user does not pay attention to the change, it can be suggested to the user as one sign. For example, the user can set so that information of an attribute that is likely to be overlooked is displayed in this manner.

  In the present embodiment, the user can set in advance what character strings are to be included in the report that is not to be copied this time. For example, information on the size of the lesion, information on the degree of progress of the lesion, and information on the volume of the organ are set as predetermined attributes. The report display control unit 109 displays information having a predetermined attribute or an item including information having a predetermined attribute, separately from other items. Here, as a form to be distinguished and displayed, in addition to replacing with the empty input space as described above, a form in which information having a predetermined attribute is changed in color, font, or marker from other descriptions is displayed. Is mentioned. Alternatively, for information having a predetermined attribute, a screen may be displayed that allows the user to select whether to enter a description to be changed or to use the description of the past report as it is.

  In another example, the description of the information having the predetermined attribute may be automatically replaced by the system by determining a character string suitable for the current report. Further, the report display control unit 109 copies the item including the information having the predetermined attribute to the current report regardless of whether the information having the predetermined attribute is replaced with an empty input space or another character string. At the time, it is displayed separately from other items. The user can confirm the displayed items separately and change the description of information having a predetermined attribute as necessary. Further, the report display control unit 109 displays an icon for inputting an instruction to complete the report creation on the report editing screen. If there is an operation input for completing the creation of the current report being edited without changing the description of the information having the predetermined attribute, the report display control unit 109 displays a dialog indicating a warning. As a result, the user can easily check the description that may cause a change, and it is possible to reduce omission of the change.

  In the above-described example, the processing has been described in which only a certain range in the description of the item specified as the duplication range is not duplicated. In the present embodiment, the contents of all report items specified as the duplication range are not duplicated, and only the logical structure of the report items can be duplicated. That is, the empty new input frames and their related information are duplicated in the current report. In S8061 shown in FIG. 11, the report item creation unit 102 copies only the input frame of the report item identified as the copy range in S805 to the current report. When duplicating, only the type of item is the same as the duplication target specified in S805, the item ID is newly assigned a unique number in the item table 701, and the report ID is the ID corresponding to the current report. Here, it is assumed that nothing is described in the content of the item regardless of the content of the item of the copy source. In S8062, the relation information creation unit 104 copies all the relation information to be copied determined in S805, and the relation information storage unit 105 stores it in the relation table 702. At the time of duplication, a new unique number is assigned to the relation ID in the relation table 702, and the report item ID1 and the report item ID2 are replaced with the item IDs newly allocated at the time of duplication. In the above explanation, the duplication process was performed after replacing the contents of all report items to be duplicated with empty, but the duplication was performed after replacing only the contents of some report items to be duplicated with empty. Processing may be performed. By setting in advance, it is possible to replace the content of the item of the predetermined information with an empty one and copy it.

[Fifth embodiment]
In the fifth embodiment, an example will be described in which the duplication range is specified by processing different from the first to fourth embodiments. That is, the specific processing in S805 shown in FIG. 8 is different from the above-described embodiment. A description will be given based on FIGS.

  FIG. 9 shows a flowchart of the duplication range determination processing in the present embodiment. In this process, first, an item having relation information with a designated item, that is, an item directly related is specified. Further, for each item directly related to the specified item, the related item is specified. However, for items that are directly related to the specified item, items that are in a logical relationship not related to the specified item are not specified. Items specified by the duplication range determination processing in this embodiment will be described with reference to FIG. In S804 shown in FIG. 8, for example, when the site 4, which is the item shown in FIG. 39, is selected, the five relationships between the site 4, the finding 5, the diagnosis 4, the treatment 5, the diagnosis 5, the treatment 6, and their report items The information is specified as a duplication range. For items such as site 3 and finding 4 that are indirectly related to the specified item, site 4, the findings are derived from the information of the site, the diagnosis is derived from the information of the finding, and the treatment is performed from the information of the diagnosis. Is not related to the part 4 in the logical relationship that Therefore, in the duplication range determination processing in the present embodiment, a part of all items directly or indirectly related to the specified item is specified.

  In S901, the report item selected in S804 is specified as a duplication range. In S902, the function SelectLeftItem shown in FIG. 10 is executed using the report ID of the report item included in the duplication range in S901 as an argument. The function SelectLeftItem specifies an item associated with an upstream side of the above-described logical relationship with respect to an item serving as an argument. The process of the function SelectLeftItem will be described with reference to FIG. By the function ITEM (x), the report item with the report ID x can be referred to. If the value of x is blank, ITEM (x) does not exist, but the type of ITEM (x) at that time is defined as "no type". Further, the relation information of the relation ID x can be referred to by the function RELEATION (x). In S1001, the type of ITEM (i) is substituted for a variable Ki. Note that the variable i is an argument of the function SelectLeftItem and is a value of the report ID. In S1002, 1 is substituted for a variable j. In S1003, the report item ID1 of RELEATION (j) is substituted for the variable m, and the type of ITEM (m) is substituted for the variable Km. In S1004, the report item ID2 of RELEATION (j) is substituted for the variable n, and the type of ITEM (n) is substituted for the variable Kn. In step 1005, the values of the variable n and the variable i are compared. If they are the same, the process proceeds to S1006, and if they are different, the process proceeds to S1011. In S1006, it is determined whether the type Km of the report item with the item ID m is the site and the type Kn of the report item with the item ID n is the finding. If the determination value is true, the process proceeds to step 1007, and if the determination value is false, the process proceeds to S1009. In step S1009, it is determined whether the type Km of the report item having the item ID m is a finding and the type Kn of the report item having the item ID n is diagnosis. If the judgment value is true, the process proceeds to step 1007, and if the judgment value is false, the process proceeds to S1010. In S1010, it is determined whether the type Km of the report item whose item ID is m is diagnosis and the type Kn of the report item whose item ID is n is treatment. If the determination value is true, the process proceeds to step 1007, and if the determination value is false, the process proceeds to S1011. In step 1007, after including ITEM (m) as the duplication range, the process proceeds to S1008. In step S1008, the function SelectLeftItem is executed with the item ID value m as an argument. That is, the function SelectLeftItem is recursively called. In S1011, the variable j is incremented. In S1012, it is determined whether the value of the variable j is larger than the number of records in the relation table. If the result of the determination is false, the process returns to S1003, and the above processing is repeated again. If the determination result in S1012 is true, the function SelectLeftItem ends. In other words, in the function SelectLeftItem, only items that are associated with a certain item and that are upstream of the logical relationship are specified. The item of the site related to the item of the finding, the item of the finding related to the item of the diagnosis, and the item of the diagnosis related to the item of the treatment are specified. From another viewpoint, in the function SelectLeftItem, when the order of the information of the site, the finding, the diagnosis, and the treatment is set to the forward direction, the first process for specifying the item related to the certain item in the backward direction is performed. Do. Then, the item related to the item specified in the first process is specified by the first process.

  Returning to the description of FIG. In S903, the function SelectRightItem shown in FIG. 10 is executed using the report ID of the report item specified as the duplication range in S901 as an argument. The function SelectRightItem specifies an item related to a downstream side of the above-described logical relationship with respect to an item serving as an argument. The processing of the function SelectRightItem will be described with reference to FIG. 10B. In step S1101, the type of ITEM (i) is substituted for a variable Ki. Note that the variable i is an argument of the function SelectRightItem, and the actual state is the value of the report ID. In S1102, 1 is substituted for a variable j. In S1103, the report item ID1 of RELEATION (j) is substituted for the variable m, and the type of ITEM (m) is substituted for the variable Km. In S1104, the report item ID2 of RELEATION (j) is substituted for the variable n, and the type of ITEM (n) is substituted for the variable Kn. In step 1105, the values of the variables m and i are compared. If they are the same, the process proceeds to S1106, and if they are different, the process proceeds to S1111. In S1106, it is determined whether the type Km of the report item with the item ID m is the site and the type Kn of the report item with the item ID n is the finding. If the determination value is true, the process proceeds to step 1107, and if the determination value is false, the process proceeds to S1109. In S1109, it is determined whether the type Km of the report item whose item ID is m is a finding and the type Kn of the report item whose item ID is n is a diagnosis. If the determination value is true, the process proceeds to step 1107, and if the determination value is false, the process proceeds to S1110. In S1110, it is determined whether the type Km of the report item whose item ID is m is diagnosis and the type Kn of the report item whose item ID is n is treatment. If the determination value is true, the process proceeds to step 1107, and if the determination value is false, the process proceeds to S1111. In step 1107, after including ITEM (n) as the duplication range, the process proceeds to S1108. In S1108, the function SelectRightItem is executed with the item ID value n as an argument. That is, the function SelectRightItem is recursively called. In S1111, the variable j is incremented. In S1112, it is determined whether the value of the variable j is larger than the number of records in the relation table. If the result of the determination is false, the process returns to S1103, and the above processing is repeated again. If the result of the determination in S1112 is true, the function SelectRightItem ends. In other words, in the function SelectRightItem, only items that are associated with a certain item and that are downstream of the logical relationship are specified. The item of the treatment related to the item of the diagnosis, the item of the diagnosis related to the item of the finding, and the item of the finding related to the item of the site are specified. From another viewpoint, in the function SelectRightItem, when the order of the information of the site, the findings, the diagnosis, and the treatment is set to the forward direction, the second process for specifying the item that is related in the forward direction with respect to a certain item is performed. Do. Then, an item associated with the item specified in the second processing is specified by the second processing.

  In the processing of the SelectLeftItem function and the SelectRightItem function shown in FIG. 10, all the relation information stored in the relation table 702 in FIG. The processing of S1003 to S1008 and the processing of S1103 to S1108 are performed on all the related information. However, in actual operation, from the viewpoint of processing speed, targets for performing these processes may be narrowed down in advance. For example, the relation information in the relation table 702 is narrowed down to the relation information belonging to the past report in which both the report item ID1 and the report item ID2 are selected in S804. Then, S1003 to S1008 and S1103 to S1108 may be performed only for the narrowed relation information. Further, a graph structure as described in the first embodiment may be used.

  Returning to the description of FIG. In S904, the relation information between the report items specified as the duplication range by the processing of S901, S902, and S903 is included in the duplication range. Specifically, for all the records in the relationship table 702, the relationship information in which both the report items corresponding to the report item ID1 and the report item ID2 are included in the duplication range is extracted and set as the duplication target.

  The items specified by the above-described duplication range determination unit 110 will be described with reference to FIG. In step S804 in FIG. 8, for example, when the site 4 in FIG. 39 is selected, the replication range includes the site 4, the finding 5, the diagnosis 4, the treatment 5, the diagnosis 5, the treatment 6, and the five relationship information between the report items. Is specified. In S804 of FIG. 8, when the user selects and designates two of the diagnosis 5 and the finding 6 of FIG. 39, the part 4, the part 5, the finding 5, the diagnosis 5, and the treatment are performed according to the designation of the diagnosis 5. 6 is specified as the duplication range. Further, in response to the designation of the finding 6, the site 6, the finding 6, the diagnosis 6, and the treatment 7 are specified as the duplication range. Further, as the related information, eight pieces of related information including the causal relationship between the diagnosis 5 and the diagnosis 6 are included in the duplication range as the related information between the report items.

  According to the replication range determination processing described in the present embodiment, unlike the replication range determination processing described in the first embodiment, all report items directly or indirectly related to the report item selected in S804 are copied items. And not. It is possible to determine the duplication range in a potable manner by limiting only the items required to understand the report item selected in S804 and the report items required to understand the report item selected in S804. . In the copy range determination process exemplified in the present embodiment, report items that are in conflict with report items to be copied are excluded from the copy range. In actual operation, report items that are in conflict may be appropriately included in the duplication range according to some criteria.

  In the following, a description will be given of a method of streamlining the editing work by the user after performing the duplication processing when a part of the item associated with the designated item is specified and duplicated in the present embodiment. . Efficiency is realized by using the relationship information between report items. For example, when the related information presenting unit 111 displays the duplicated report item on the screen, the report display control unit 109 displays a message indicating that there is an item that has not been duplicated among the items associated with the designated item. I do. Items that are not duplicated among the items associated with the specified item can be extracted by referring to the duplication relationship table 703 and the relationship table 702. FIG. 14 is a conceptual diagram of the contents of the report creation area 134 when the part 4 of the past report as illustrated in FIG. 39 is specified, and the part 4, the finding 5, the diagnosis 5, and the treatment 6 are duplicated in the current report. is there. In the past report illustrated in FIG. 39, there is a causal relationship between findings 4 and 5, and a diagnosis 5 and diagnosis 6, respectively. As a display suggesting the existence of the finding 5, which is an item that is associated with the finding 4 but has not been copied, a mark indicating that there is a causal relationship is displayed as shown by an arrow dotted line L141 in FIG. When the radiologist duplicates the part 4, the findings 5, the diagnosis 5, and the treatment 6, and then wants to duplicate the diagnosis 6 that is the basis of the diagnosis 5, he double-clicks the dotted arrow L141 associated with the diagnosis 5 to operate. Make the input. By this operation input, the same processing as selecting the diagnosis 6 on the past report content display screen and performing the duplication processing can be performed. That is, the site 6, the findings 6, the diagnosis 6, and the treatment 7 are duplicated in the current report. When the part 6, the finding 6, the diagnosis 6, and the treatment 7 are duplicated by this operation, a causal relationship is automatically given to the duplicated diagnosis 5 and diagnosis 6.

  As another input support method using the replication relationship table 703, items that have been separately replicated from the past report can be presented so as to be able to be understood when the relationship originally exists in the past report. For example, when there is a past report as shown in FIG. 39, by selecting the part 4, the part 4, the part 5, the diagnosis 5, and the treatment 6 are duplicated in the current report, and thereafter, the part 6 is selected. Suppose that the site 6, the finding 6, the diagnosis 6, and the treatment 7 were duplicated. At that time, in the past report of FIG. 39, there is a causal relationship between the diagnosis 5 and the diagnosis 6, and therefore, there is a high possibility that the diagnosis 5 and the diagnosis 6 are related in this report. For this reason, the related information presenting unit 111 displays the message 151 shown in FIG. 15, and enables the causal relationship between the diagnosis 5 and the diagnosis 6 by pressing the “Yes” button by the radiologist. Thereby, it is possible to prevent a causal relationship from being forgotten.

[Sixth embodiment]
14 shows an example of a sixth embodiment of the present invention. In the present embodiment, the duplication range determination unit 110 specifies, as the duplication range, some of the items directly or indirectly associated with the designated item based on the type of the designated item. .

  For example, the range to be copied is specified from the part to the report item specified in S804 shown in FIG. That is, an item located upstream in the above-described logical relationship is specified from the designated item. Specifically, in the flowchart illustrated in FIG. 9, the duplication range determination unit 110 does not perform the processing of S903, but performs the processing of S901, S902, and S904, thereby specifying such an item.

  Also, a description will be given of a process in which the duplication range determination unit 110 specifies a duplication range when a report item of a diagnosis type is specified. In interpretation reports, a diagnosis based on one finding may be a basis for a diagnosis based on another finding. It is also important that the interpreting physician, when presenting the diagnosis to the requester, indicate on what basis the diagnosis has been presented. Therefore, in the present embodiment, when a report item of the type of diagnosis is selected in S804, the duplication range determination unit 110 performs a process for setting another report item that is the basis of the specified report item as the duplication range. Specifically, the duplication range determination unit 110 refers to the relation table 702, and performs processing using the SelectLeftItem function in S902 on other diagnostic report items that are the basis of the selected diagnostic report item. . Since it is not necessary to include the report item of the treatment linked to the report item of the other diagnosis, the process using the SelectRightItem function in S903 is not performed for the report item of the other diagnosis. Next, the duplication range when the report item of the treatment type is selected will be described. The description related to the procedure may include a content that can be related to any diagnostic content, such as “Please perform CT imaging from another angle” or “Please scrutinize”. Therefore, in the present embodiment, when the user intentionally selects the type of treatment in S804, the contents of the report item included in the information of the site, findings, and diagnosis associated with the report item of the treatment are duplicated in the current report. Instead, only the details of the procedure will be duplicated in this report. If the type of the report item specified in S804 is “treatment”, the duplication range determination unit 110 specifies only the selected report item. Specifically, the processing using the SelectLeftItem function in S902 is not performed, and the duplication range is specified by performing the processing using the SelectRightItem function in S901 and S903 and S904. If the type of the report item selected in S804 is site or finding, the duplication range determination method described in the first embodiment is used as it is. By the above-described processing, for example, when the finding 2 is specified in the past report shown in FIG. 39, the site 2, the finding 2, the diagnosis 2, and the treatment 2 are specified as the duplication range. In the past report shown in FIG. 39, when the diagnosis 2 is designated, the diagnosis 1, the finding 1, and the site 1 are specified as the duplication range in addition to the site 2, the finding 2, the diagnosis 2, and the treatment 2. In the past report shown in FIG. 39, when the treatment 2 is selected, only the treatment 2 is specified as the duplication range.

[Seventh embodiment]
13 shows an example of a seventh embodiment of the present invention. In the present embodiment, the duplication range determination unit 110 duplicates some of the items that are directly or indirectly associated with the specified item based on the purpose of the current report creation request, which is the duplication destination. Identify the range. In the present embodiment, processing for replacing a soft copy of a medical image of a copy source with a soft copy of a medical image suitable for a copy destination as described in the second embodiment is applied. In other words, if the type of the duplication target is the site in S8061, and the content is a soft copy of the medical image, the duplication process is performed after replacing the soft copy of the medical image captured this time corresponding to the medical image. I do. The purpose of requesting the creation of an interpretation report includes metastasis search, treatment effect determination, close examination, good / bad discrimination (screening), and follow-up. In the following, some examples are taken up and specific contents are described.

  First, the range of duplication when the purpose of this report request is metastasis search or good / bad discrimination will be described. Metastasis search aims to search for tumor metastases. The discrimination between good and bad is intended to determine whether the tumor is benign or malignant. In interpretation for metastasis search or discrimination between good and bad, diagnosis may be made based on findings derived from CT images and PET images. In addition, regarding metastasis search, in addition to the description of the discovered metastatic cancer, the description of the primary cancer that causes the metastatic cancer is often described with a causal relationship. Therefore, when the request purpose is metastasis search and good / bad discrimination, if either the CT image or the PET image is specified as the duplication range, the other related image is also included in the duplication range. Similarly, when either the metastatic cancer or the primary cancer is included in the replication range, the other related item is also included in the replication range. FIG. 16A shows the contents of the past report displayed in the past report item / related information display area 147 when writing the current report for the purpose of requesting good / bad discrimination. For example, when the CT image of FIG. 16A is selected in S804, the CT, finding 1, diagnosis 1, and treatment 1 are included in the duplication range by S901, S902, and S903 illustrated in FIG. Here, the duplication range determination unit 110 determines that the PET image and the item derived from the CT image have the causal relationship information and any report item derived from the PET image. An item derived from the PET image is specified as a duplication range. In FIG. 16A, the items of PET and finding 2 are also included in the duplication range. FIG. 16B shows the contents of the past report displayed in the past report item / related information display area 147 when the current report for requesting the transfer search is written. For example, if the image of the metastatic cancer in FIG. 16B is selected in S804, the metastatic cancer, finding 1, diagnosis 1, and treatment 1 are included in the replication range by S901, S902, and S903 shown in FIG. Here, when there is a report item derived from the primary cancer, if the item has a causal relationship with any one of the metastasis cancer and the finding 1, diagnosis 1, and treatment 1 derived from the metastasis cancer, And the report items derived from the primary cancer items are specified as duplication ranges. In FIG. 16B, the primary cancer, finding 2, and diagnosis 2 are also included in the replication range.

  Although an example in which both CT and PET are used for diagnosis has been described above, the present embodiment is not limited to this. A set of types of inspection images that are frequently used at the same time, such as a metastasis search and a discrimination between good and bad, may be set in advance, and the above-described processing may be performed.

  Next, the duplication range in the case where the purpose of requesting this report is follow-up observation or treatment effect determination will be described. In both the follow-up observation and the treatment effect determination, the state of the part at the time of the previous examination is often compared with the state of the part at the time of the present examination. Therefore, the current report may include both the medical image obtained by the current examination and the previously inspected medical image (described in the past report) to be compared. The duplication range determination unit 110 of the present embodiment first examines the image of the past report when the purpose of requesting the creation of the current report is follow-up observation or treatment effect determination, and when the image of the past report is specified as the duplication range. Get the information of. Then, the report item creation unit 102 acquires the image inspected this time based on the information of the inspection. The report display control unit displays the image of the past report and the image inspected this time side by side on the edit screen of the current report. By displaying the images of the past report and the corresponding images of the current report side by side, the requesting doctor who views the interpretation report can easily compare these images. FIG. 17A is a conceptual diagram of the contents of the past report displayed in the past report item / related information display area 147. FIG. 17B shows an example of a copy result of the present report when the report item 170 is specified in S804 when the purpose of requesting the present report is follow-up observation or treatment effect determination. The report item 171 is a soft copy of a medical image showing the same contents as the report item 170. The report item 172 is a soft copy of the medical image taken in the current examination corresponding to the part of the report item 170. The report item 172 is created through the processing of S131, S132, and S133 described in FIG. In this way, by attaching both the soft copy of the medical image taken in the past and the soft copy of the medical image taken this time side by side in advance, the operation of attaching the medical image taken this time by the interpreting doctor is omitted. be able to. Note that the photographing date may be automatically displayed like 173 or 174 so that it is easy to determine which of the pasted images is the past and which is the current medical image.

[Eighth Embodiment]
An eighth embodiment will be described. In the present embodiment, the duplication range determination unit 110 determines whether or not some of the items directly or indirectly associated with the specified item are described in the current report as the duplication destination or in the future. Identify the duplication range according to the content that is considered to be. In the present embodiment, processing for replacing a soft copy of a medical image of a copy source with a soft copy of a medical image suitable for a copy destination as described in the second embodiment is performed. In other words, if the type of the duplication target is the site in S8061, and the content is a soft copy of the medical image, the duplication process is performed after replacing the soft image of the medical image captured this time corresponding to the medical image. I do.

  FIG. 18 shows a first example of the present embodiment. FIG. 18A shows the contents of the past report displayed in the past report item / related information display area 147. FIG. 18B shows the contents of the current report being edited in the report creation area 134. Report item 180 is a soft copy of the past image, and report item 181 is a soft copy of the current image corresponding to it. The report item 180 and the report item 181 are associated with each other as shown in a table 71f of FIG. The report item 181 is associated with the finding 2 of the report item. In such a situation, it is assumed that the user has selected the report item 180 as a copy target in S804. In this embodiment, since the site 1 and the finding 2 are already described in the duplication destination report, the duplication range is only diagnosis 1 and treatment 1. FIGS. 18C1 and C2 both show examples of the contents of the report creation area 134 after the duplication processing. As shown in FIG. 18 (c1), the diagnosis 1 and the treatment 1 to be duplicated are automatically associated with the finding 2 associated with the report item 181 corresponding to the report item 180. 18 (c2). For example, as shown in FIG. 18 (c2), the finding 2 related to the report item 181 corresponding to the report item 180 includes the finding 1 and the diagnosis included in the copying range. 1. Merge treatment 1. In the above, the case where the report item of the type of the region is selected as the duplication target is taken as an example. However, when the report item of another type is selected as the duplication target, the duplication process is performed based on the same idea. May be implemented.

  FIG. 19 shows a second example of the present embodiment. FIG. 19A shows the contents of the past report displayed in the past report item / related information display area 147. FIG. 19B shows the content of the current report being edited in the report creation area 134, and is an example of the result of specifying the finding 1 in FIG. 19A and duplicating the specified duplication range. FIG. 20 is a diagram showing a replication range determination flow by the replication range determination unit 110 in the second example of the present embodiment. Steps S901 to S904 are the same as those illustrated in FIG. 9, and the processing of steps S905 and S906 is added. For example, it is assumed that the progress of a plurality of sites is continuously interpreted by follow-up observation or the like. In the first follow-up, as shown in FIG. 19A, for example, the content of “No change in any of the parts 1, 2, and 3” is collectively described in the finding 1. At this time, it is assumed that a report has been created this time for the second follow-up observation. When the finding 1 of FIG. 19A is designated in S804, the processing described in S901 to S904 causes the site 1, the site 2, the site 3, the finding 1, the diagnosis 1, the treatment 1, and the processing 1 in FIG. Relationship information between them is specified as a duplication range. In step S <b> 905, image analysis by CAD (Computer Assisted Diagnostics) is performed on the past image that is the basis of the soft copy of the past image, that is, the site 1, the site 2, and the site 3, and the corresponding current image. As a result, for example, it is assumed that no change is observed between the past image and the current image for the site 1 and the site 2, but the lesion is significantly deteriorated for the site 3. In such a case, even if the site 3 is duplicated in this report, it is highly likely that the site 3 is not related to the content of “No change in any of the findings 2”. Therefore, in S906, an operation is performed so that the same related information as in the past report, which should not be maintained in S905, is not specified as the duplication range. In the above example, the relationship information 191 that is the relationship between the site 3 and the finding 1 in FIG. 19A is not specified as the duplication range. The report item of the part 3 remains included in the copy target. When the duplication target determined in the duplication range determination flow shown in FIG. 20 is duplicated in the current report, a result as shown in FIG. 19B is obtained, for example. The site | part 1, site | part 2, site | part 2 of FIG. 19 (a) by the process of S806 in Embodiment 1 with the site | part 1, site | part 2, finding 1, diagnosis 1, procedure 1 and those are shown in FIG. , Findings 1, diagnosis 1, treatment 1, and related information between them. Also, the part 3 in FIG. 19B is a copy of the part 3 in FIG. 19A by the processing of S806 described in the first embodiment. On the other hand, the report item 192 and the relationship information between the report item 192 and the part 3 are automatically created after S806. The report item 192 is in a state where the column “content” of the item table 701 is not registered, that is, the report item input frame 135 is empty. The interpreting physician describes the findings of the site 3 in the report item 192, and adds a diagnosis and a treatment as necessary. As in the second example of the present embodiment, by adjusting the duplication range in advance in accordance with the contents described in the current report after duplication, it is possible to save a doctor's trouble of operating after duplication. In the above example, the removal of unnecessary related information has been described. However, the present embodiment is not limited to the related information, and report items may be removed as necessary. Further, in the above example, the duplication range is adjusted by deleting unnecessary duplication items, but may be adjusted by adding necessary duplication items.

[Ninth embodiment]
A ninth embodiment will be described. The present embodiment has an evaluation unit that gives an evaluation value to each report item, and the duplication range determination unit 110 specifies the duplication range according to the result of comparison between the evaluation value of each item and a predetermined threshold. .

  FIG. 21 is a functional block diagram for explaining main functions of the medical report creation device 1 according to the present embodiment. Functional blocks 101 to 112 shown in FIG. 21 are the same as those in FIG. In S805, the score calculation determination unit 115 acquires the evaluation values of the item specified in S804 and the items directly or indirectly related to the item specified in S804. When determining whether or not the duplication range determining unit 110 specifies each item as the duplication range, the threshold value determining unit 116 uses a value for comparing with the evaluation value assigned to each item by the score calculation determining unit 115. Determine a certain threshold. In step S805, the duplication range determination unit 110 in the present embodiment compares the evaluation value assigned to each item with a threshold, and specifies, for example, an item having an evaluation value smaller than the threshold as the duplication range. FIG. 22 shows the contents of the past report displayed in the past report item / related information display area 147. When the item specified in S804 is finding 1, the score assigned to each item by the score calculation determination unit 115 is displayed. In the example of FIG. 22, the score calculation determination unit 115 sets the evaluation value of the item directly related to the item specified in S804 to be small, and the evaluation value becomes larger as the item is more indirectly related. The method of acquiring the evaluation value is not limited to this. When the threshold value determined by the threshold value determination unit 116 is 2, the duplication range determination unit 110 specifies the site 1, the finding 1, and the diagnosis 1 as items to be duplicated. When the threshold value determined by the threshold value determination unit 116 is 3, the duplication range determination unit 110 specifies the site 1, the finding 1, the diagnosis 1, the treatment 1, and the finding 2 as items to be copied.

  An example of a method in which the threshold value determination unit 116 determines a threshold value will be described.

  In the first example, the threshold value is determined according to the request purpose. As described in the seventh embodiment, when the purpose of requesting this report is metastasis search or discrimination between good and bad, diagnosis may be made based on findings of both CT and PET. For example, consider a case where the item selected in S804 is a site, the content is a soft copy of a medical image, and the medical image is CT. In such a case, if an item related to the PET image used for diagnosis together with the medical image of the selected CT matches the past report item / related information display area 147, the threshold size is set so that the item is included in the duplication range. To expand. In both the follow-up observation and the treatment effect determination, the state of the part at the time of the previous examination is often compared with the state of the part at the time of the present examination. Therefore, the size of the threshold is expanded so that at least one part directly or indirectly related to the item selected in S804 is included.

  In the second example, the threshold is determined according to the type or combination of any one of the lesion, the site, and the modality. In this case, in addition to the functional blocks described in FIG. 21, there is provided a determination unit that determines any type or combination type of the lesion, the site, or the modality described in the content of the item designated in S804. For example, when the content of the item specified in S804 includes a word related to a lesion that requires complicated examination, the report is often examined based on information including many items. Therefore, when a word related to a lesion that requires complicated examination is included, the threshold value is increased in order to specify more items as the duplication range than otherwise.

[Tenth embodiment]
A tenth embodiment will be described. In the present embodiment, the process of giving an evaluation value to each item by the score calculation determination unit 115 and the process of comparing the evaluation value of each item with the threshold value determined by the threshold value determination unit 116 are sequentially performed for each item. The items to be included in the duplication range are sequentially specified according to the comparison result.

  FIG. 23 is a functional block diagram for explaining main functions of the medical report creation device 1 according to the present embodiment. The functional blocks 101 to 116 are the same as in FIG. The score calculation determination unit 115 in the present embodiment acquires the evaluation value of each item based on the evaluation value of the item directly related to the item. Next, the judgment target item determination unit 117 is given an evaluation value by the score calculation determination unit 115, and determines an item to be compared with the threshold. FIG. 25 exemplifies a flow of processing by the duplication range determination unit 110 in the present embodiment. FIG. 24 exemplifies the contents of the past report item / related information display area. Here, as an example, it is assumed that the score calculation determination unit 115 acquires the evaluation value of each item by adding 1 to one of the evaluation values of the items directly related to the item. In FIG. 25, in S2501, a threshold value is determined by the threshold value determination unit 116. Here, the threshold is set to 4 as an example. In S2502, the score calculation determination unit 115 assigns a value to the item specified in S804. When the item specified in S804 is the item of the finding 2 shown in FIG. 24A, for example, the score 1 is assigned to the finding 2. In S2503, the evaluation value of the item specified in S804 is compared with a threshold value, and it is determined whether or not the item specified in S804 is specified as a duplication range. In FIG. 24A, since the score 1 assigned to the finding 2 is smaller than the threshold 4, the duplication range determination unit 110 specifies the finding 2 as the duplication range. In FIG. 24, items surrounded by a thick frame indicate items for which the evaluation value of the item is compared with the threshold value, and items shaded in gray indicate that the item is specified as a duplication range. In S254, for each item specified as the duplication range, it is determined whether or not the evaluation value has been obtained and the evaluation value has been compared with the threshold value for all items directly related to the item. If all items have been performed, the process advances to step S2508 to end the process. If all items have not been performed, the process advances to step S2505. In FIG. 24A, since the acquisition of the evaluation value by the score calculation determination unit 115 for the part 2, the part 3, and the diagnosis 2 directly related to the finding 2 and the comparison with the threshold have not been completed, the process proceeds to S2505. In step S2505, the determination target item determination unit 117 determines an item for determining whether to specify the next copy range. The determination target item determination unit 117 selects from items that are directly related to the item specified as the duplication range, for which no evaluation value has been given, and for which threshold comparison has not been performed. In FIG. 24A, one of the part 2, the part 3, and the diagnosis 2 is selected by the determination target item determining unit 117. Here, it is assumed that diagnosis 2 is selected. In S2506, the score calculation determination unit 115 acquires the evaluation value of the item selected by the determination target item determination unit 117 in S2506. In the present embodiment, as shown in FIG. 24B, the evaluation value of the diagnosis 2 is 2 obtained by adding 1 to the score 1 assigned to the finding 2. In step S2507, the value acquired in step S2506 is compared with the threshold value, and it is determined whether the item selected in step S2505 is included in the duplication range. In FIG. 24B, since the value 2 assigned to the diagnosis 2 is smaller than the threshold 4, the diagnosis 2 is specified as the duplication range. After the processing in S2507, the process returns to S2504 and the above processing is repeatedly performed. In FIG. 24C, the evaluation value of the item of the treatment 2 is acquired as 3 and is smaller than the threshold 4, so that the treatment 2 is specified as the duplication range. In FIG. 24D, the evaluation value of the item of the diagnosis 1 is acquired as 3 and is smaller than the threshold 4, so that the diagnosis 1 is specified as the duplication range. In FIG. 24E, the evaluation value of the treatment 1 is acquired as 4 and is not smaller than the threshold 4, so that the treatment 1 is not specified as the duplication range. In FIG. 24F, the evaluation value of the finding 1 is acquired as 4 and is not smaller than the threshold 4, so that the finding 1 is not specified as the duplication range. Since the finding 1 is not included in the duplication range, the site 1 is not selected by the determination target item determining unit 117 in S205. In FIG. 24G, the evaluation value of the item of the part 2 is acquired as 2, and since the evaluation value is smaller than the threshold value 4, the part 2 is specified as the replication range. In FIG. 24H, the evaluation value of the item of the part 3 is acquired as 2 and is smaller than the threshold value 4, so that the part 3 is specified as the duplication range. At this point, for all items that are directly related to each of the items specified as the duplication range, it is determined that the evaluation value has been obtained and the evaluation value has been compared with the threshold value. . Therefore, the duplication range determination unit 110 specifies the finding 2, the diagnosis 2, the treatment 2, the diagnosis 1, the site 2, and the site 3 as duplication targets.

  In the above example using FIG. 24, the value assigned to each item by the score calculation determination unit 115 is obtained by adding 1 to one value assigned to a value directly related to the item. It may be obtained by a method. For example, a method of determining a value to be added according to the type of item specified in S804 may be used. Further, the value to be added may be changed successively in accordance with the type of the relationship with the item directly related to the item to which the score calculation determining unit 115 assigns the value. Further, as described in the ninth embodiment, the threshold value determining means can determine the threshold value by various determination methods.

[Eleventh embodiment]
An eleventh embodiment will be described. In the present embodiment, the method by which the duplication range determination unit 110 specifies the duplication range can be selected. FIG. 26 is a functional block diagram for explaining main functions of the medical report creation device 1 according to the present embodiment. This is a configuration in which a mode selection unit 118 is added to the configuration illustrated in FIG. The mode selection unit 118 provides means for selecting the method by which the duplication range determination unit 110 specifies the duplication range.

For example, the following method is used as a determination method according to the duplication range.
(1) A method in which the radiologist manually selects items to be duplicated one by one, and the duplication range determination unit regards only the selected items as duplication targets.
(2) The method according to the first embodiment, in which the item selected by the radiologist and all other items that are directly or indirectly related to the item are set as the duplication range.
(3) The method according to the fifth embodiment, in which an item selected by the radiologist and a part of other items that are directly or indirectly related to the item are set as a duplication range.
(4) The method according to the sixth embodiment, wherein the duplication range is determined based on the type of item selected by the radiologist.
(5) The method according to the seventh embodiment, wherein the duplication range is determined according to the request purpose of the duplication destination.
(6) The method according to the eighth embodiment, wherein the duplication range is determined according to the description status of the duplication destination.

  The mode selection unit 118 operates at any timing before S804 in FIG. 8, and displays, for example, a list of options of the above-described (1) to (6) duplication range determination methods. Then, the interpreting physician selects which duplication range determination method is to be adopted by specifying the selection items via the input device 11. In S805 in FIG. 8, the duplication range is determined by the selected duplication range determination method.

  It should be noted that a configuration in which a mode selection unit 118 is added to the functions described in the ninth embodiment or the tenth embodiment and illustrated in FIGS. In this case, the mode selection unit 118 determines what algorithm each of the score calculation determination unit 115 and the threshold value determination unit 116 operates.

[Twelfth embodiment]
A twelfth embodiment will be described. In the present embodiment, when the request purpose described in the past report is selected in S804 of FIG. 8 in the first embodiment, the duplication range determination unit 110 determines the duplication range based on the selected request purpose. .

  FIG. 27 is a functional block diagram for explaining main functions of the medical report creating apparatus 1 according to the present embodiment, and includes a request item creating unit 119 and a request item assigning unit 120 in addition to the functions shown in FIG. Is done. The request item creation unit 119 creates the request purpose related to the interpretation work transmitted from the requesting doctor to the interpreting doctor as an item constituting the request information described in the report (hereinafter, referred to as a request item). Further, the request item creation unit 119 automatically assigns an ID for uniquely identifying the created request item, and stores the ID in the request table 2801 shown in FIG. There may be a plurality of request purposes described in one report, and in that case, records of a plurality of request items are created in the request table 2801. The contents of the request table are stored in the storage unit 113. The request item assigning unit 120 performs tagging for associating report items related to the request items described in the request table 2801 with each other. For example, as shown in FIG. 28B, a request ID column is added to the item table 701, and the ID of the corresponding request item is stored in the record of each report item as the value of the request ID column. FIG. 28B omits the certainty column and the request tag column of the item table 701. The request item and the report item related thereto may be determined by a user's operation input, or may be automatically determined by analyzing the contents of the request item and the report item by language processing analysis.

  Hereinafter, a method of determining a duplication range by the duplication range determining unit 110 in the present embodiment will be described. In the present embodiment, when a portion corresponding to a request item is specified as an item constituting a past report in S804, a duplication range is specified by a method described below. First, referring to the item table shown in FIG. 28B, the report item having the request ID in the request table 2801 of the request item selected in S804 in the request ID column in the item table is specified. For example, as shown in FIG. 29, when there are two request purposes in the request information display area 146, that is, when the request (1) and the request (2) in the figure are present, the request (2) is made by the user to the report creation area 134. Let's say you drag and drop to In this case, when the content of the request (2) corresponds to the request ID = 1 in FIG. 28A, that is, when the request (2) is “confirmation of left renal cancer and postoperative progress”, FIG. The report items corresponding to the item IDs 3 and 6 in the item table are extracted. In S805 in this embodiment, the duplication range is specified by regarding the extracted report items as the items specified in S804 in the first embodiment. To specify the duplication range, the duplication range is determined by using the method described in any of the first to seventh embodiments.

  In the present embodiment, the request item creation unit 119, the request item assignment unit 120, the request table 2801, and the request ID column have been added and described. However, the same processing as described above may be performed using the “request tag” column of the item table 701 and the request tag assigning unit 114 described in the first embodiment.

  In the replication range determination method according to the present embodiment, when the interpretation contents related to the request purpose described in the past report are duplicated and used in the current report, it can be used with a simple operation, and the medical report is efficiently created. can do.

[Modification]
In the structured report as described in the first to twelfth embodiments, the report item content editing unit 103 also applies a template to the item content created by the report item creation unit 102. Good. The report display control unit 109 causes the display unit to display the description of the template applied by the report item content editing unit 105. That is, the report item content editing unit 103 functions as an estimating unit that estimates information described in items of a newly created interpretation report based on the contents of a past interpretation report. Further, the report display control unit 109 functions as a display control unit that causes the display unit to display the description estimated by the report display control unit 109 that is the estimation unit. For example, when the report item of the past report is copied to the current report, the report item content editing unit 103 applies a template based on the description content of the item of the copy source to the item of the copy destination. The template may be applied to all the items specified as the duplication range by the duplication range determination unit 110, or the user may specify an item to which the template is applied among the items specified as the duplication range.

  For example, as shown in FIG. 41, the item 4102 of the finding in the previous report that “swelling frequently occurs in the right renal lymph node. The size is 15 to 20 mm in size and considered to be significant” is shown in FIG. Suppose it is duplicated in the report. When the image diagnosis for follow-up observation is made in the current report, the same description is often made in the finding item of the current report. Therefore, the report item content editing unit 103 describes the content of the item 4105 of the current report at the duplication destination as “multiple swelling of the right renal lymph node is recognized. The size is recognized as □□ to □□ mm, I think it's a significant size. " The duplication destination item to which the template is applied is displayed on the display unit by the report display control unit 109. This is an example in which a template for facilitating user input of a change in the size of a lesion for follow-up observation is applied. Thus, the example described in the fourth embodiment is an example of a template from another viewpoint.

  Application of the template is not limited to follow-up observation. The report item content editing unit 103 may apply a template for making it easier for the radiologist to enter items to be described based on the request information of the radiology report, and display it on the display unit by the report display control unit 109. Good. For example, when a stage diagnosis of primary lung cancer has been requested, a template “Infiltration into the chest wall and large blood vessels is □□□□” is added to the item of the finding associated with the FDG-PET image. Apply. This makes it easier for the user to enter a description that matches the request. The report item content editing unit 103 is provided to facilitate the input of items to be described by the radiologist based on the conditions for capturing the image and the contents of the order for the items associated with the image. A template may be applied and displayed on the display unit by the report display control unit 109. Alternatively, the report item content editing unit 103 creates an input frame for the item to which the interpreting doctor is related, and based on the input description, a template for facilitating input of information to be described in an uninput item. And the display may be displayed on the display unit by the report display control unit 109. For example, it is assumed that a finding item and a diagnosis item associated with the FDG-PET image are created by the user. It is assumed that a user, a radiologist, has entered a description about bones in the finding item. The report item content editing unit 103 applies the template “Bone metastasis □□□□” to the diagnosis item associated with the finding based on the content input to the finding. Further, the items to which the template is applied by the report item content editing unit 103 are not limited to report items that have been created in advance, and the report item creation unit 102 may be controlled to create new items. For example, it is assumed that the description “suspicious of bone metastasis” is input in the item of diagnosis associated with the FDG-PET image. The report item creation unit 102 creates a recommended item associated with the diagnosis item. The report item content editing unit 103 applies the template “Consider performing a biopsy” to the recommended items created by the report item creation unit 102. That is, the report item content editing unit 103 functions as an estimating unit that estimates information described in an item related to the item based on information input to the item included in the image interpretation report. In addition, the report item creation unit 102 functions as a creation unit that creates a report item based on information input to an item included in the image interpretation report. The report display control unit 109 functions as a display control unit that displays the description estimated by the report item content editing unit 103 as the estimation unit and the items created by the report item creation unit 102 on the display unit.

  In the structured report as described in the first to twelfth embodiments, when a certain item is selected by the input device 11 by the user, the report display control unit 109 associates the selected item with the selected item. The attached item may be highlighted so as to be distinguishable from other items. The item associated with the selected item is not limited to an item included in the same report as the item. When the item is an item copied from a past report, a related item in the past report may be highlighted together with an item included in the same report as the item. Also, if the item is copied to a newly created item, some items will be included in the copy destination report. The item may be highlighted together with the item included in the same report. As a result, items related to a certain item can be easily grasped for items included in a report other than the report including the item, which is useful, for example, for comparing in time series. The related items may include an item indicating request information and a request tag in addition to the site, findings, diagnosis, and treatment items. As a result, it is possible to easily grasp the correspondence relationship with the contents of the request from the requesting doctor.

  For the structured report as described in the first to twelfth embodiments, analysis using big data may be applied, and the result may be used.

  The devices according to the first to third embodiments are not limited to support for creating a medical report. The present invention can be used to assist in verifying conflicting hypotheses in various reports that are structured to logically state the basis for analysis and consideration. For example, as information systems used in offices and the like, there are systems for information sharing such as accounting, inventory management of goods, and storage and retrieval of documents. In addition, systems for coordinating individual tasks, such as procedures for receiving and paying deposits, ordering and obtaining and delivering products, and analyzing sales, are increasing. In some cases, such information systems are used to create reports and reports that describe the results of analysis based on advanced knowledge and experience, and consideration of measures. Reports and reports are often accompanied by electronic data, digital photographs, and images. In order to show the validity of the results of the analysis and response studies, it is necessary to logically describe the basis of these analyzes and studies. For such a problem, the structured report creation support of the present invention can be used.

  The present invention supplies a program for realizing one or more functions of the above-described embodiments to a system or an apparatus via a network or a storage medium, and one or more processors in a computer of the system or the apparatus read and execute the program. This processing can be realized. Further, it can also be realized by a circuit (for example, an ASIC) that realizes one or more functions.

  The diagnostic report creation device in each of the above embodiments may be realized as a single device, or may be configured to execute the above-described processing by combining devices including a plurality of information processing devices so as to be able to communicate with each other. Is also included in the embodiment of the present invention. The above processing may be executed by a common server device or server group. The diagnostic report creation device and the plurality of devices constituting the diagnostic report creation support system need only be able to communicate at a predetermined communication rate, and need not be in the same facility or in the same country.

  According to an embodiment of the present invention, a software program for realizing the functions of the above-described embodiment is supplied to a system or an apparatus, and a computer of the system or apparatus reads and executes the code of the supplied program. Including form.

  Therefore, the program code itself installed in the computer in order to realize the processing according to the embodiment by the computer is also one of the embodiments of the present invention. Also, based on instructions included in the program read by the computer, the OS or the like running on the computer performs part or all of the actual processing, and the functions of the above-described embodiments can also be realized by the processing. .

  An embodiment in which the above embodiments are appropriately combined is also included in the embodiments of the present invention.

1 Medical report preparation device 2 HIS
3 RIS
4 Medical imaging device 5 PACS
6 Electronic medical record DB)
7 Image interpretation report DB
8 medical image DB
9 In-hospital local area network 71 Report items 72 Correspondence relationship between report items 73 Causal relationship between report items 74 Exclusive relationship between report items 131 Medical image browsing screen 132 Patient information display area 133 Request information display area 134 Report creation area 135 Report Item input frame 136 Input frame addition button 137 Past report button 138 Report save button 139 Impression input area 140 Basic input screen display button 141 Detailed input screen display button 142 Layout display button 143 Time series display button 144 Display area for past report and current report Border 145 Patient information display area (past report)
146 Request information display area (past report)
147 Past report item / related information display area 148 Past report item input frame 71a Medical image 71b taken at the time of creating the past report Medical image 71c taken at the time of creating the current report 71c FIG. 71d is a conceptual diagram showing slice data 71e of a medical image taken at the time of creating the past report 71e Slice data 71f of a medical image taken at the time of creating the current report 71f A table showing the correspondence between the past report and the medical image taken at the time of creating the current report

Claims (34)

An apparatus that supports the creation of a medical report that includes a plurality of pieces of information to be diagnosed and includes relation information indicating a relation between a plurality of items included in each of the plurality of pieces of information,
Specifying means for specifying one of a plurality of items included in each of a plurality of pieces of information included in the created medical report stored in the storage unit;
Specifying, in accordance with the specification by the specifying unit, an item to be duplicated in the medical report among the items included in the created medical report, based on relation information relating to one item specified by the specifying unit; Means,
Display control means for displaying a specific item, the screen for editing the medical report by the specifying means,
An apparatus comprising:   2. The display control unit according to claim 1, wherein the information having a predetermined attribute and the information not having the predetermined attribute included in the item specified by the specifying unit are displayed separately. 3. Equipment.   The predetermined attributes include information on the size of the lesion to be diagnosed, information on the volume of the organ to be diagnosed, information on the degree of progression of the lesion to be diagnosed, and the stage classification of the diagnosis target. The device of claim 2, comprising at least one. The display control means further displays an icon for performing an operation input indicating that the creation of the medical report has been completed,
4. The display control unit according to claim 2, wherein the display control unit displays a warning when an operation input to the icon is performed without changing the information having the predetermined attribute. An apparatus according to claim 1. Acquiring an image to be displayed on the medical report, further as information for checking captured the image, further comprises said diagnostic object imaging region, an image obtaining means for obtaining the information of the device, a used for the shooting The apparatus according to any one of claims 1 to 4, characterized in that: By the specifying means, when the image included in the created medical report is identified,
The image acquisition unit acquires information on an examination that has captured an image specified by the identification unit, and, based on the information on the inspection, the diagnostic object that has captured an area corresponding to the image identified by the identification unit. The apparatus according to claim 5, wherein an image is obtained.   The display control unit, on a screen for editing the medical report, in response to an operation input on the image of the diagnosis target corresponding to the image specified by the specifying unit, the image specified by the specifying unit, The apparatus according to claim 6, wherein the image acquired by the image acquiring unit is displayed on a screen. When the image specified by the specifying unit is attached with annotation information indicating an annotation,
The apparatus according to claim 6, wherein the display control unit displays the image acquired by the image acquisition unit with the annotation information added thereto. Wherein the specifying unit, if the even if an image contained in a previously created medical report is identified, and can not acquire the diagnosis target images corresponding to the specified image by the specifying means,
7. The display control unit according to claim 6, wherein, on the screen for editing the medical report, an item associated with the item specified by the specifying unit is displayed as an item for displaying an image. Apparatus according to any one of the preceding claims.   10. The information on a diagnosis target includes information on a part including an image of the diagnosis target, information on findings, information on diagnosis, and information on a treatment. An apparatus according to any one of the preceding claims.   The specifying unit specifies at least one item specified by the specifying unit among the items included in the generated medical report based on information for requesting generation of the medical report. The apparatus according to any one of claims 1 to 10, wherein When the information for requesting the creation of the created report is designated by the designation unit,
The apparatus according to claim 1, wherein the specifying unit specifies an item included in the created report corresponding to the information for requesting. In the case where the creation of the medical report has been requested for the follow-up of the diagnosis target, and when the image of the created medical report is included in the item specified by the specifying unit,
The image obtaining means obtains an image based on information of an examination that has taken an image of the created medical report and the request,
The method according to claim 5, wherein the display control unit displays the image specified by the specifying unit and the image obtained by the image obtaining unit side by side on a screen for editing the medical report. The described device. In the case where the created report includes an image specified by the specifying unit, and an image captured to correspond to the same request as the specified image is included in the generated report,
14. The image processing apparatus according to claim 1, wherein the specifying unit specifies at least an image specified by the specifying unit and an image captured in response to the same request as the specified image. An apparatus according to any one of the preceding claims.   The specifying means, when the item of the site is specified by the specifying device, the item of the site specified by the specifying device, the item of the finding associated with the item of the site, and the item of the finding The apparatus according to any one of claims 1 to 14, wherein a diagnostic item associated with the diagnostic item and a treatment item associated with the diagnostic item are specified. .   The specifying means, when the finding item is specified by the specifying means, the finding item specified by the specifying means, the item of the site associated with the finding item, and the finding item The apparatus according to any one of claims 1 to 15, wherein a diagnostic item associated with the diagnostic item and a treatment item associated with the diagnostic item are specified. .   The specifying means, when a diagnostic item is specified by the specifying means, a diagnostic item specified by the specifying means, a finding item associated with the diagnostic item, and a finding item The apparatus according to any one of claims 1 to 16, wherein an item of a site associated with the item and a treatment item associated with the item of the diagnosis are specified. .   The specifying means, when a treatment item is designated by the designation means, a treatment item designated by the designation means, a diagnosis item associated with the treatment item, and a diagnosis item The apparatus according to any one of claims 1 to 17, wherein an item of a finding associated with the item of the finding and an item of a site associated with the item of the finding are specified. .   19. The apparatus according to claim 1, wherein the specifying unit specifies only the specified item when an item of the treatment is specified by the specifying unit.   When the order of the information of the site, findings, diagnosis, and treatment is set to the forward direction, the specifying unit performs a first process for specifying an item that is related in a reverse direction with respect to a certain item; Perform a second process for specifying the items that are related in the forward direction, further, specify the items that are related to the item specified by the first process by the first process, The apparatus according to claim 1, wherein an item related to the item specified by the second process is specified by the second process. The specifying means, site, findings, diagnosis, when the order of the information of the treatment is the forward direction, perform a first process for specifying an item that is related in the reverse direction for a certain item,
When any one of the item of the site or the item of the finding or the item of the diagnosis is specified by the specifying means, the first processing is performed on the specified item, and further, the first processing is performed. The apparatus according to claim 1, wherein an item associated with the specified item is specified by the first processing.   The specifying means directly associates an item specified by the specifying means, an item associated with the item specified by the specifying means, and an item associated with the item specified by the specifying means. 22. The apparatus according to any one of claims 1 to 21, wherein the apparatus specifies an item that is indirectly related to the item.   23. The apparatus according to claim 1, wherein the specifying unit specifies an item to be duplicated in the medical report based on an item already described in the medical report.   24. An apparatus according to claim 1, further comprising an evaluation unit configured to evaluate, for each of the items related to the certain item, the strength of the relationship with the certain item based on the relation information. An apparatus according to any one of the preceding claims. The evaluation unit is configured to determine, for each of the one item designated by the designation unit and the item associated with the one designated item, the strength of the relationship between the one designated item and the one item. Give an evaluation value,
25. The apparatus according to claim 24, wherein the specifying unit specifies an item whose evaluation value given by the evaluating unit is within a predetermined range.   The apparatus according to any one of claims 1 to 25, wherein the display control unit causes the item specified by the specifying unit to be displayed on the screen by duplicating the item on the medical report.   27. The apparatus according to claim 26, wherein the display control unit displays an icon for copying an item associated with the item specified by the specifying unit on the medical report on a screen.   The apparatus according to any one of claims 1 to 27, wherein the specifying unit further includes a selecting unit that selects a method of specifying an item. The specifying means further specifies information having a predetermined attribute among the items to be copied in the specified medical report ,
Wherein the display control unit, wherein among the items to be replicated to medical report, be displayed on a screen for editing distinguishably the medical report and no information of the predetermined attribute information having the predetermined attribute Apparatus according to claims 1 to 28, characterized in that: A method for supporting the creation of a medical report including a plurality of pieces of information to be diagnosed, and including relation information indicating a relation between a plurality of items included in each of the plurality of pieces of information,
A designation step of designating one of a plurality of items included in each of a plurality of pieces of information included in the created medical report stored in the storage unit;
A specifying step of specifying an item to be duplicated in a medical report among the items included in the created medical report, based on relation information relating to one item specified in the specifying step;
A display control step of displaying the item specified in the specifying step on a screen for editing a medical report,
A method comprising: The specifying step, among the items to be copied to the specified medical report, further specifies information having a predetermined attribute,
Wherein the display control step, wherein among the items to be replicated to medical report, be displayed on a screen for editing distinguishably the medical report and no information of the predetermined attribute information having the predetermined attribute 31. The method of claim 30, comprising: A system that supports the creation of a medical report including a plurality of pieces of information to be diagnosed, and including relation information indicating a relation between a plurality of items included in each of the plurality of pieces of information,
Display control means for displaying a screen for editing a medical report,
Specifying means for specifying one of a plurality of items included in each of a plurality of pieces of information included in the created medical report stored in the storage unit;
Specifying, in accordance with the specification by the specifying unit, an item to be duplicated in the medical report among the items included in the created medical report, based on relation information relating to one item specified by the specifying unit; Means,
Display control means for displaying the item specified by the specifying means on the screen,
A system comprising: The specifying means further specifies information having a predetermined attribute among the items to be copied in the specified medical report ,
Wherein the display control unit, wherein among the items to be replicated to medical report, claim 32, characterized in that to distinguishably display a no information said predetermined attribute information having the predetermined attribute on the screen System.   A program for causing a computer to execute the method according to any one of claims 30 and 31.

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