WO2003021525A2 - Verfahren zur entnahme einer probe aus einem system - Google Patents
Verfahren zur entnahme einer probe aus einem system Download PDFInfo
- Publication number
- WO2003021525A2 WO2003021525A2 PCT/AT2002/000257 AT0200257W WO03021525A2 WO 2003021525 A2 WO2003021525 A2 WO 2003021525A2 AT 0200257 W AT0200257 W AT 0200257W WO 03021525 A2 WO03021525 A2 WO 03021525A2
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- WO
- WIPO (PCT)
- Prior art keywords
- data
- sample
- client
- laboratory
- order
- Prior art date
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
- G16H10/40—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for data related to laboratory analysis, e.g. patient specimen analysis
Definitions
- the invention relates to a method for taking a sample from a system and a method for creating order data records for at least one sample to be analyzed in accordance with the features in the preambles of claims 1 and 2.
- a patient should contact a doctor if they have physical or psychological complaints to find the causes of the complaint.
- personal data such as first name, surname, date of birth, insurance number, health insurance company, etc. are recorded by the patient in a clinic or doctor's office and stored as master data, preferably in a data management system, which can be called up.
- the doctor creates a preliminary diagnosis for the patient to be examined and, to confirm this diagnosis, will take a sample according to the specialist knowledge of the doctor, e.g. a blood sample taken from the patient.
- sample containers for temporary storage of the sampling are provided with a data carrier, in particular a 1-D barcode, via which the contents of the sample container are clearly assigned to the request form transmitted by the doctor and to the patient.
- the analysis results are then also assigned to this data carrier.
- labels together with a wide variety of lists such as lists of requirements for the desired parameters, are generated from data from a so-called patient card, combined with data from a data memory of a central computer.
- These labels are glued directly onto the sample vessel and contain on the one hand information data fields with machine-readable data that enable automatic sorting in the laboratory using a unique identification code and on the other hand a second machine-readable code from which the examinations to be carried out for the sample are specified.
- Detailed information, readable by humans can be taken from further numerical or alphanumeric character strings attached to the label.
- DE 199 55 729 A discloses a communication system for the interaction of medical laboratories and medical treatment facilities, in which all the laboratories and treatment facilities involved are networked with a central laboratory central database via a data transmission device.
- the required patient and examination data are recorded on an input module of a data input device at the treatment facility and coordinated via the laboratory central database to the responsible laboratory via a data output device in the responsible laboratory.
- Thieves- Pre-booked test orders are activated when the sample arrives in the laboratory.
- the examination data are transmitted to the treatment device via the data transmission device.
- the object of the invention is to provide a method by means of which the process reliability during the removal and analysis of the sample can be increased.
- the object of the invention is achieved independently of one another by the measure of claim 1.
- the advantage resulting from the characterizing parts of these claims can be seen in the fact that a customer can access a wealth of information, such as research results or empirical values or expert advice, via information catalogs, and thereby very easily clearly defines at least the type of sample container to be used becomes.
- This also results in a significant time advantage for the client, since, for example, an intensive study of specialist literature with regard to sample containers and / or sizes to be determined from samples and a manual recording of data, in particular test requirements, which the parameters to be analyzed by the laboratory or Can contain parameters and / or analysis requirements, can be omitted.
- the object of the invention is also solved independently in claim 2.
- the advantage resulting from the characterizing part of this claim is to be seen in the fact that, in addition to the advantages already described for claim 1, all the data required to process an order are processed or combined to form a uniform order data record that can be processed by a person and for this reason are further processed Data results in a shortening of the access time, since it is not necessary to process several different data formats or representations of data, or to read or query different storage media. It is also advantageous that a clear separation between the There is patient data and the order data record and only the order data record is transmitted to the commissioned laboratory.
- the data of the system for example the patient data
- a data management facility especially a database, which is provided especially for this purpose
- an identification number is defined for the system, which is used to refer to the others
- System data for example the last name, first name, date of birth, gender, status, e.g. pensioner, co-insured, etc.
- the order data record only the system's identification number is forwarded to the laboratory and not all of the data stored behind this identification number.
- the order data required for the further analysis of the sample and a clear assignment of the sample or the sample container to the system and client are passed on to the laboratory or a central administration system, which results in a reduction in the amount of data in the laboratory or in a central administration system .
- the client entering the identification number into the input device, for example a PC
- the further system data associated with the identification number are called up.
- the patient data are transferred to the computer system manually or automatically.
- the order data record is created, the continuous, unmistakable order number is assigned the preferably unmistakable container data, the unmistakable identification number and the test requirements.
- the unmistakable, unique identification number can be formed by a multi-digit, in particular four-digit, code number or 1D, 2D barcode, etc., thereby reliably avoiding the risk of confusing the large number of containers assigned to the different order numbers.
- the measure according to claim 3 is also advantageous in that the client is informed of the type of sample to be taken if a suspected diagnosis is selected, which supports process reliability.
- the client is informed of the type of sample to be taken if a suspected diagnosis is selected, which supports process reliability.
- there is a significant time advantage for the client since, for example, an intensive study of specialist literature with regard to the sampling required for a suspected diagnosis and the sizes to be determined, as well as manual recording of data, in particular test requirements, which the quantities to be analyzed by the laboratory or Parameters and / or analysis requirements can be omitted.
- An embodiment according to claim 4 is also possible.
- the resulting advantage can be seen in the fact that the entry of the suspected diagnosis and / or the analysis request is how the information catalog can be output using components that are not susceptible to malfunction and have been tried and tested, which significantly increases user acceptance of the method.
- the use of a user interface or a screen mask also creates the possibility of taking data from the information catalog for further applications, for example for generating order data records.
- the measure in claim 5 achieves the advantage that the client is given the at least one sample container to be used and thereby effectively prevents the removal of a sample in a sample container which is not suitable for this purpose.
- this could be the erroneous taking of a blood sample into a blood sample tube with unsuitable reagents or the like.
- a procedure according to claim 6 is also possible.
- the resultant advantage can be seen in the fact that the client precisely predefines the type of sample to be taken, that is to say the material which the client is to take, and thereby further the number of possible samples obtained by mistake can be reduced.
- a procedure according to claim 7 shows the advantage that the client is advised of special sampling conditions, for example a specific sampling temperature or a specific sampling location or a specific condition of the system from which the sample is to be taken, or the client is informed of the consideration attention is drawn to certain factors.
- a procedure according to the measure of the characterizing part of claim 8 is also possible and very advantageous. Since there is a large number of possible sizes to be determined for almost all samples to be examined, it is of great importance to the client according to his suspected diagnosis of the usual or recommended to specify determining sizes in order to save the client a very time-consuming search in specialist literature. For example, several thousand sizes can be determined in the analysis of blood and even the specialist working in this specialist area will not know all possible sizes or tests to be carried out in detail and it is therefore very important to give the client a suggestion as to which sizes are to be submitted.
- the measure according to claim 9 has the advantage that further information, which are important for sample treatment, sample storage, sample processing or sample dispatch or an expected waiting time before receiving analysis results can be announced to the client.
- the procedure according to claim 11 is advantageous, since with reference to the sizes to be determined, a possible laboratory, which can determine all these sizes, is determined and announced, or the client can also be made aware of this, that not all sizes to be determined can be analyzed in a laboratory.
- the advantage is achieved that the forwarding of unnecessary information is avoided and the information catalog can thus be constructed in a compact manner.
- a sample container manufacturer used by the client can be made known to the database, and only that information catalog which contains sample containers of only this manufacturer is proposed below, if possible.
- the procedure according to claim 13 describes an advantageous possibility for transmitting the information about the sample containers available to the client to the database.
- the procedure according to claim 15 has the advantage that the commissioned laboratory can better adapt to the expected order, for example analysis keep capacities free or prepare analysis stations for the expected order.
- test requirements are stored in a machine-readable manner by storing the test requirements on a data carrier.
- Claim 20 describes an embodiment of the 2D barcode, which has proven to be trouble-free and easy to read in practice.
- a process design according to claim 23 has the advantage that data from the information catalog can be explained to the client in an audiovisual manner.
- the procedure according to claim 24 advantageously ensures that the data present in the information catalog are up-to-date, and this data can be changed by one or more maintenance centers.
- the advantage is achieved that the client is made aware of the need to fill several identical sample containers with a sample or the sample amount required by the laboratory is defined.
- a configuration according to spoke 26 is also possible.
- the advantage resulting from this is to be seen in the fact that standard further steps are proposed for standard tasks or simple suspected diagnoses.
- the measure according to claim 27 is also advantageous since, due to the user guidance made possible via the container data, mix-ups of the sample containers can be almost completely ruled out. It is therefore also possible to simplify the handling of these sample containers by offering the client menu-controlled options for further process steps. In this way it is possible, in particular in the event that the sample container is a blood collection tube, that the client is given appropriate instructions by the computer system and the data can only be entered by confirming this. With the detection device, the container data required for generating the order data record can be read in automatically, so that manual input of the container data can be omitted.
- the measure according to claim 28 is advantageous because in the first method step in the menu-controlled program, in particular a control and / or processing program, the test requirements for the laboratory analyzing the at least one sample are manually entered via the input device or electronically recorded via the detection device, which already read container data of the specified sample container provided and the data of the system previously stored in the database, for example the patient data such as first name, last name, date of birth, gender etc., are read from the database or manually entered by the client via the input device or via the recording device from a Chip card are recorded electronically and preferably for this order at least one order number is created by the computer system and / or after the completion of the first method step in a further method step from the test requirements, de n Container data, the system data and, if applicable, the order number are combined or processed fully automatically by the computer system into a common, uniform, machine-processable order data record.
- a further development of the method according to claim 29 has the advantage that the client or the person who takes the sample is also stored on the order data record and thereby, for example, when determining certain sizes of the sample, in particular in the case of contagious diseases and the like Client or the person can be informed about it.
- the measure according to approach 30 achieves the advantage that various data carriers known and tried and tested from the prior art can be used for storing the order data record, thereby making it unresponsive to reading or reading. Write cycles can be increased.
- a procedure according to approach 37 is also possible, whereby the advantage is achieved that the meaning of all data is unmistakably fixed and it is therefore almost impossible for data to be present whose meaning cannot be determined beyond doubt.
- Claim 38 describes a particularly advantageous possibility of user guidance. This ensures that no important procedural step is overlooked or ignored and that the sequence in which the procedural steps are processed is always the same.
- a procedure according to Claim 45 is also possible.
- the resultant advantage is that it can be checked whether prior information has already been received electronically for incoming order data records and, if necessary, preparatory work has been carried out to carry out the order, such as adapting an analysis apparatus for carrying out the order order.
- An embodiment according to approach 46 advantageously achieves the fact that the time required for a pre-sorting or an assignment to analysis stations in the laboratory can be reduced.
- a further development of the method according to Claim 47 achieves the advantage that data from the laboratory, such as analysis results, are transmitted to the client in a very quick way, and customer acceptance for the method according to the invention can thereby be further increased.
- FIG. 1 shows a sample management system for a sample to be handled between a client and a laboratory with physical data transmission in a flow-chart, schematic representation
- FIG. 2 shows a data carrier, in particular an order form, in a schematic representation
- FIG. 3 shows a sample management system for a sample to be handled between a client and a laboratory, in particular with Internet-based data transmission, in a flow-chart, schematic representation.
- Fig. 1 shows a flow chart representation of a sample management system, starting from the recording of a laboratory order with the client 1, in particular a doctor's office, medical center, nursing staff etc., research center for soil ecology, until the analysis of samples in a laboratory 2.
- samples from a System in particular from a biological and / or chemical and / or technical system, for example humans, animals or chemical or technical systems.
- the client 1 is a person, in particular a doctor.
- the client 1 can of course also be formed by an ecologist etc.
- the input and / or output device 5 is formed by a PC and has these means for manual and / or automatic input of patient data and a storage device or a data management device for storing or managing the same, as well as means for outputting additional data. at least the patient data that can be called up in the storage device or in the data management device.
- the means for input can be formed by a control panel, for example a touch screen, keyboard etc., or, as shown, by a terminal 6, in particular a reading device, for example a card reader, transponder reader, barcode reader, scanner, etc.
- the terminal 6 can also form an integral component of the input and / or output device 5.
- the terminal 6 forms its own unit and is arranged, for example, in the entrance area of a doctor's office and can transmit the patient identification number and / or personal patient information or patient data read out from the patient card by means of the terminal 6 to the input and / or output device 5 via a data line 8 become.
- the personal patient information or patient data are formed, for example, by the surname, first name, date of birth, gender, race, status, for example pensioners, co-insured persons, etc. and the patient identification number by the insurance provider, social security number, etc.
- the patient data recorded for the first time are stored in the data management device 9, so that the patient 3 is uniquely identified solely by entering the patient identification number.
- the data processing device 9 shown in dash-dotted lines in FIG. 1 and connected for data transmission via the connecting line 8 is formed by a master doctor database.
- the terminal 6 can also have biometric sensors which, for the authenticity check of the patient 3, access data or features of the patient 3 identified in the memory or data management device that can be mapped and can thus easily and unambiguously identify the patient be made within the computer system 4. All that is necessary is to read out an insurance number from the patient card, for example, and the additional personal patient information associated with this insurance number is automatically displayed on the output device 5 from the storage and / or data management device.
- This clear assignment for example the insurance number to the data of the patient 3 stored in the data management device 9, can considerably reduce the effort for recording the patient data, since it is sufficient to register the personal data of the patient 3 once and only in the case the change of personal data, to update it in the data management device 9.
- Identification data of the doctor for example first name and surname, the cash register number, etc., are also stored in the memory device or data processing device 9 or doctor master database or are stored in a form which can be scanned.
- a further data management device 10 in particular a database (metadata database), can be provided, which is used to transmit the data read out from the data management device 10 to the input and / or output device 5 via the data line 8 is connected to the input and / or output device 5.
- the data management devices 9, 10 form an integral component of the computer system 4.
- the at least one type of sample to be taken for example blood sample, proposed by the information catalog is output.
- the laboratory 2 parameters and parameters, such as cholesterol values, are to be analyzed further.
- predefined identifiers for example a code number etc.
- the entry of the suspected diagnosis and / or the analysis request is carried out via at least one user interface, for example a screen mask, specified on the input and / or output device 5.
- the type of data contained in the information catalog and how the individual process steps can be carried out is explained in the following description.
- the patient data are transferred manually or automatically into a computer system 4, test requests are generated for the laboratory 2, an information catalog associated with an analysis request and or suspected diagnosis being proposed, the data of which may be supplemented or changed and made up of at least part the supplemented or changed data, the test requirements are generated and container data are determined from at least one sample container 13 defined for the sampling, and a common, uniform, machine-processable order data record is created by the computer system 4 from all of these data.
- Information catalogs and / or data from the information catalog supplemented or changed by the doctor are generated for test requirements for the laboratory 2 and these are stored in the computer system 4 with the system identification number, e.g. patient identification number, research center identification number, hospital ward identification number etc., and with container data and determined via a detection device 11 / or with client-specific identification data, e.g.
- test requests or the order data record are stored or stored on a data carrier, in particular physical data carrier, for example order form etc., or transmitted electronically via a global or local data network, for example Internet or intranet, as shown in FIG. 3 , These can be sent to the commissioned laboratory 2 as preliminary information, regardless of the sample container 13.
- At least one data carrier 14 for the unmistakable identification of the same via container data is arranged on a sample container 13 receiving the sample.
- the method according to the invention can be used for a sample collection vessel, for example a blood collection tube.
- a sample collection vessel for example a blood collection tube.
- Such vessels usually consist of a single- or multi-layered vessel body, preferably made of plastic, and if they are evacuated to provide an automatic suction of the sample, in this case blood, they are provided with a gas-tight cap.
- the closure cap usually comprises a self-closing septum in order to allow piercing with a cannula.
- this sample vessel can also be formed, for example, by a capillary blood collection system, stool vessel, swab set, blood bag etc.
- sample containers 13, for example blood collection tubes Since the number of sizes or parameters to be determined from samples, for example blood, is increasing, the number of different sample containers 13, for example blood collection tubes, is also increasing continuously. The differences lie less in the external shape of these sample containers 13, for example blood collection tubes, but rather in the content, ie in the reagents or reagent mixtures presented therein. For example, further coagulation Onsmittel or controversial anticoagulants, stabilizing reagents, lysis reagents, etc. may be contained in the blood collection tube.
- the client 1 is provided with at least one information catalog from which he receives or can call up user-guided information.
- the client 1 in particular a doctor, is given the required type of sample to be taken and / or the suitable sample container 13 for this suspicion diagnosis and / or analysis request. It can of course be taken into account that the client 1 is only given those sample containers 13 which he also uses by using the sample containers 13 he uses, e.g. of a certain manufacturer, are stored in the information catalog.
- the sample containers 13 are usually removed manually from a storage facility.
- At least one automatic sample dispenser can also be provided, which is set up at the client 1 and which detects the detection device 11, in particular a data reading device, e.g. Has a scanner, barcode reader, CCD camera, via which the sample container 13 is automatically identified while it is being dispensed.
- a data reading device e.g. Has a scanner, barcode reader, CCD camera
- the container data of the sample container 13 are determined via the detection device 11 of the computer system 4 from the data carrier 14 which is preferably already arranged on the sample container 13 by the manufacturer, electronically recorded or read in and transmitted to the computer system 4, after which the data has been taken clear identification of the sample container 13, a menu-driven program or a user interface, for example HTML page or a control and / or processing program is automatically activated, where the client 1 is asked to enter further procedural steps such as entering the test request, order number, system identification number, which then together to form a later, to be described in more detail, Order record can be created.
- FIG. 1 it can be seen that this comparison of the proposed sample container 13 and the manually removed sample container 13 takes place via the detection device 11.
- container data for example identification or type of sample container 13 and / or the production location and / or the expiry date etc. can be read out. If, for example, the expiration date is soon reached or has been reached or has been exceeded, an indication is given automatically before the use of this sample container 13 via the on and / or off device 5 in the program or the user interface that this sample container 13 is not
- the "expired" sample container 13 can be used or is dispensed to a waste container.
- the data carrier 14, which possibly contains the order data record, but expediently only contains at least the machine-readable container data, is designed in the present exemplary embodiment as a one-dimensional ID barcode 15 and is arranged inseparably on the sample container 13.
- the data carrier 14 is designed as an adhesive barcode label.
- data in alphanumeric form can of course also be used or additionally arranged on data carrier 14.
- the ID barcode 14 preferably forms a multi-digit code for identifying the sample container 13 and thus also the container contents.
- This code can, for example, have 12 digits and it is possible for some of these twelve digits to be represented by the respective batch forming the container data, as well as data on production, for example the expiry date, the production location, the dimensioning range, the sample container 13 and the time of production by specifying the production year and month, a doctor number or client-specific identification data and / or test requirements, etc., can be stored on the sample container 13, both of which can also be provided as variable data by input on site.
- this data carrier 14 can also be formed by a transponder known from the prior art with a transmitting and receiving unit, as well as a memory unit or by a rewritable memory chip, if necessary.
- the data carrier 14 can also be designed, for example, as a film chip.
- foil chips which are also available in transponder technology, can be obtained by the meter in the form of foil labels.
- the data carrier 14 can also be formed by the material or the material of the sample container 13. To do this, the data is written directly into the material.
- the sample container 13 is made of a plastic such as PE, PP, PET, PAN, PS or the like.
- PE polyethylene glycol
- PP polypropylene
- PET PET
- PAN polyethylene glycol
- PS polystyrene
- a binary code or the one-dimensional bar code can be realized in this way.
- the labeling ie the material for the sample container 13, can also be carried out by additives so that multiple labeling is possible and that data, in particular container data etc., can also be deleted.
- the data are stored on or in or within the sample container 13.
- the data carrier 16 to be physically transmitted which contains the order data record, is also formed from a plastic, this data carrier 16 changing its properties under the influence of heat and thus, on the one hand, data can be written or deleted. This enables the data carrier 16 to be written to several times. This principle has already been described for the data carrier 14 and is therefore adopted.
- a device for applying or deleting data in this regard is known, for example, from EP 0431 155 B1.
- the at least one data carrier 14, in particular the ID barcode 15, is expediently factory-fitted in the form of a label or a memory component, e.g. Chip, applied or arranged on the sample container 13, so that the client 1 ultimately has no further manipulation effort apart from the scanning.
- the data carrier 14 is sufficient for the identification of the sample container 13 and / or its content, hence the sample.
- the data carrier 14 can also be formed by an engraving.
- alphanumeric data records that can be read by the human eye can also be used and corresponding reading devices for data transmission to the input and / or output device 5 are also available for data configured in this way. Appropriate encryption of this alphanumeric data is of course possible.
- These data on the sample container 13 are read out via the detection device 11, in particular a hand-held scanner, and transmitted to the input and / or output device 5 for further processing or for creating the order data record.
- the detection device 11 For data transmission from the detection device 11 to the input and / or output device 5, these can be connected to one another, for example, permanently via a cable, but variants with infrared interfaces are also conceivable.
- contactless transmission is conceivable, for example again using an infrared interface.
- a permanently installed scanning device or a memory chip reader, etc., as shown in FIG. 1, into which the container 13 is inserted can also be used.
- the order data record also contains, if necessary, client-specific, in particular doctor-specific, identification data, which are preferably recorded and stored once and for the doctor's recognition, biometric features, in particular a fingerprint and or an iris method and / or a face shape are used, whereupon the associated identification data of the doctor are automatically read out and provided or used for the creation of the order data record.
- biomentric features are preferably stored in the memory device or the doctor's master database, preferably write-protected.
- the computer system 4 After entering the suspected diagnosis and / or analysis request, the computer system 4 automatically specifies data relating to the type of sample to be taken and / or at least one sample container 13 required for the suspected diagnosis and / or analysis request and the proposed sample (s) ( n) and / or sample container 13 removed.
- the at least one sample container 13 proposed from the information catalog is provided and identified unambiguously and unmistakably by the detection device 11, and the container data read out with at least the system identification number, e.g. the patient identification number, and the test requirements and / or client-specific, in particular doctor-specific, data created to form at least one order data record.
- the system identification number e.g. the patient identification number
- the test requirements and / or client-specific, in particular doctor-specific, data created to form at least one order data record During or before or after taking the sample, e.g.
- Blood sample a data carrier 16, in particular an order form 17, which can be clearly assigned to this order, is generated via the printer device 12.
- the at least one sample taken is stored for a predetermined period of time in at least one sample container 13 and sent to the laboratory 2 for analysis based on the test requirements.
- a mobile container 18 is provided on the client 1 side for accommodating a large number of devices 18 for preferably a plurality of sample containers 13.
- the order form 17 for the laboratory 2 issued for this order is supplied with each order, possibly including several sample containers 13.
- the box-like container 18 has a plurality of compartments for accommodating a plurality of devices 19 and at least one compartment for inserting the order forms 17 associated with the sample containers 13.
- the device 19 is designed in the exemplary embodiment as a so-called analysis rack. Such racks are already known from the prior art. In the simplest case, such racks are designed as test tube stands.
- the multifunctional racks are also designed to accommodate sample containers 13 with different dimensions, and thus a high degree of flexibility for the physical transmission of several different sample containers 13 from the client 1 to the laboratory 2 is possible.
- the device 19 also expediently has at least one data carrier 14, which is not shown further, which, as already described above, by a 1D or 2D barcode, a transponder, a film chip, the material of the device 19, an engraving, etc. , is formed.
- the order data record in particular container data, system identification number, test requests, doctor's identification data, etc., can also be stored or stored in the data carrier 14 provided on the device 19.
- Fig. 1 there is a spatial separation between the client 1, e.g. Medical practice, and laboratory 2, between which the physical transmission, e.g. Delivery services, the sample container 13 and / or the data e.g. on order form 17.
- the client e.g. Medical practice
- laboratory 2 between which the physical transmission, e.g. Delivery services, the sample container 13 and / or the data e.g. on order form 17.
- order forms 17 can be transmitted with the container 18, but rather also other physical data carriers 16, such as e.g. Magnetic strips and / or memory chip and / or foil chip and / or transponder and / or floppy disk and / or CD-ROMs, are transmitted to the laboratory 2.
- the data available on the physical data carrier 16, in particular order form 17 all the data required by the laboratory are sent together with the sample containers 13 and, due to the storage of the data on the data carrier 14 of the sample container 13, this data is also assigned to the respective sample container 13 possible.
- the received sample containers 13 and / or the devices 19 transmitted to the laboratory 2 are subjected to an incoming inspection by comparing the container data on the sample containers 13 and the order data records on the physical data carrier 16 or on the devices 19 or on the sample container 13.
- the incoming goods inspection is expediently carried out at an order entry point 20, in which the transmitted physical data carriers 16 are processed accordingly.
- this order entry point 20 for example a scanner for the order forms 17 and / or a barcode reader and / or a chip reader and / or a CD-ROM drive etc. with corresponding software modules for further processing of the transmitted data in a for one and / or output device 21 corresponding data format.
- the data read from the physical data carrier 16, as well as the container data of an order, are stored in a laboratory information system 22 or stored in a form that can be scanned.
- the laboratory information system 22 likewise has a database in which the data assigned to the order, in particular order data records and, if appropriate, container data separated from them, are managed.
- a plant control center 23 is connected to the order data stored in the laboratory information system 22 via a data line 24 for data transmission.
- a separation of the laboratory information system 22 and the plant control center 23 has the particular advantage that in the laboratory information system 22 only data management of the data, in particular order data sets and possibly container data separated therefrom, and by means of the plant control center 23 only the control of at least one sorting system 25 and of individual analysis stations 26 is optimized.
- the order entry point 20, the input and / or output device 21, the laboratory information system 22, and the plant control center are all about data acquisition, starting from the receiving containers 18 or devices 19 up to the analysis of the individual sample in the analysis station (s) 26 23, and the sorting system 25 and the analysis stations 26 are connected to one another via the data lines 24 forming a local data network so as to be capable of data transmission.
- the sorting system 25 comprises at least one conveyor device (not shown in FIG. 1), such as a conveyor belt or the like, for the devices 19 or the individual sample container 13, as well as at least one detection device 27, for example a light barrier.
- ken, CCD camera, sensors, etc. with which the data, preferably in machine-readable form, are read in the data carrier 14 and / or data carrier 16 on the sample container 13, in particular the container data and / or the data from the data carrier 14 of the devices 19.
- At least the container data determined via the detection device 27 are read into the laboratory information system 22 and the identified sample container 13 is automatically assigned to the data relating to the test requirements that was transmitted in the system control center 23 at this point in time, and the device 19 or the sample container 13 is automatically assigned the respective analysis station 26 performed.
- the sorting system 25 for the defined forwarding of the samples to be analyzed to the respective analysis station 26, so that multiple storage of data within the laboratory 2 can be omitted.
- the sample containers 13 Due to the data stored in the data carrier 14 on the sample container 13 and / or in the device 19 and / or the physical data carrier 16, e.g. the test requirements specified by the attending physician, the sample containers 13 are divided into individual analysis stations 26, e.g. Luminescence measurements, PCR, pH value determinations, etc. Devices of this type for analyzing individual sizes of samples to be determined are known from the prior art and are already being used in the various laboratories, so that a further listing is not necessary at this point is.
- the plant control station 23 which contains a storage device with a corresponding storage capacity or an integrated database.
- the sorting system 25 covers several functions, for example, in addition to sorting and / or positioning and / or orientation and / or registration of the sample container 13, quality control can also be carried out, for example, according to the level, color and turbidity of the sample or layering when using serum tubes and possibly checking the color and / or turbidity of the individual layers, removing a stopper or generally opening the sample container 13, classifying the analysis racks or the like.
- the sorting system 25 is preferably of modular construction, so that it can be adapted to the respective requirements of the laboratory 2 accordingly.
- the client 1 is preferably also provided with data relating to the required withdrawal amount, for example volume of blood, from the laboratory 2 via the information catalog, so that it is possible to carry out a sequential processing of the analyzes to be carried out in accordance with the specification of the test requirement.
- the doctor is automatically notified in writing, electronically or orally.
- the analysis results are made available as data via the data transmission-capable communication link between the analysis stations 26 and the plant control center 23 and / or the laboratory information system 22.
- These analysis results are preferably stored on a physical data carrier 16, e.g. CD-ROM, diskette, analysis result certificate, fax certificate etc., sent to the client 1, according to the exemplary embodiment to the doctor.
- the transfer of the container 17 from the client 1 to the laboratory 2 or the transfer of the physical data carrier 16 with the results of the at least one analysis of the sample carried out is preferably carried out by post.
- the physical data carrier 16 arriving at the client 1 is read in via the detection device 11 and the analysis results on the output device 5 e.g. displayed on the screen or on the Dracker Hughes 16, made to produce a finding.
- the analysis results made available are stored or stored in the data carrier 14 or a data memory forming the device 19 and / or container 18 and at the client 1 can be read out via the detection device 11.
- the samples After the samples have been analyzed, they can be fed individually or with the devices 18 in an archiving station 28 for further storage, provided that these samples are not discarded anyway.
- the archiving of samples also has the advantage that it is no longer necessary to take a new sample.
- This archiving device 28 can be connected to corresponding devices, e.g. a cooling device, temperature controls, etc., have.
- the analysis results are preferably stored in the laboratory information system 22 over the period of storage of the sample and, after being discarded, are preferably deleted automatically. If necessary, the samples stored in the archiving device 28 in the meantime can be subjected to a repeated analysis or control analysis, if necessary.
- a request in this regard for a further analysis of a sample can be triggered by the client 1 by transmitting to the laboratory 2 a further physical data carrier 16 assigned to this order, for example an order form 17.
- the laboratory information system 22 is also able to process express tasks, for example if samples are to be treated with priority, for which purpose the sorting system 25 and the analysis station 26 or archiving device 28 are controlled by means of the system control station 23.
- data carriers e.g. receives a CD, diskette for an update of the information catalogs and / or application software, in particular the user interface.
- FIG. 2 schematically shows the physical data carrier 16 or the order form 17 forming it. As described in FIG. 1, this physical data carrier 16 is created from a large number of data by means of the drawer device 12 of the computer system 4.
- the order form 17 generated by the client 1 is preferably in A4 format and has two sections 29, 30 connected to one another by a perforation, as shown in dashed lines in FIG. 2.
- the two sections 29, 30 have a large number of data fields 31 to 39, in which, as explained in FIG. 1, the patient data, in particular personal patient information and patient identification number, the identification data of the client 1, in particular contract doctor number or identification data of a person, which takes the sample, and the data of the test requirements and container data, as well as, if applicable, an order number and the acceptance date, in machine-readable form, in particular as graphic data, for example 1D or 2D barcode, and / or contained in alphanumeric form.
- a separate data field 31 to 40 is provided for all data, each of which has a storage capacity. Individual data fields 31 to 40 can have data in machine-readable and in alphanumeric form, as indicated in data field 32.
- data with the aid of which all data required for laboratory handling and further processing of the sample are contained are sent together with the sample container 13, with the container data being stored in the ID barcode 15 the assignment of the sample container 13 to an order is also possible.
- the data includes the system identification number, test requirements, container data, the order number and Possibly identification data of the doctor and possibly the date of acceptance, and these are stored as a uniform, machine-processable order data record in a single data field 35 as a graphic data record, in particular in the form of a 2D barcode.
- All this data is presented as a uniform order data record, therefore in the same data format or in the same form of presentation or as the same interpretation language, and is stored in a 2D barcode so that it can be called up.
- the order data record is divided into a plurality of data blocks 40 which are separate from one another and have a fixed memory size.
- the "PDF-417" is used for the 2D barcode.
- the entirety of the data forming the order data record is broken down into a number of data blocks 40, the memory size of a data block in the range between 100 bytes and 1300 bytes, in particular between 600 and 1100 bytes, for example If the assumption is made that a data block 40, for example 950 bytes, has a storage capacity, the entire order data record can have up to 6, in particular four data blocks 40, each with 950 bytes. Of course, the data block 40 can also have a lower storage capacity , for example half the storage capacity, therefore have 475 bytes The possible storage size of the order data record is thus obtained by multiplying the number of individual data blocks 40 and the storage capacity of each individual data block 40. It can essentially be assumed that 1 byte corresponds to one character.
- the data can be supplied via a hand-held terminal, e.g. Palm-size data terminal, read from the container data and compared with the alphanumeric data on order form 17.
- the container data e.g. 1D barcode contains the order number via which the data, e.g. Sample treatment, sample dispatch, are available.
- patient data and / or identification data of the client, insurance provider, health insurance company, and date of acceptance are entered in alphanumeric form in data field 31, 36.
- analysis requirements and / or suspected diagnosis and / or test requirements and the sizes or parameters of the samples to be determined for this purpose are shown in a separate data field 33 in alphanumeric form.
- a continuous and distinctive order numbers can be stored in machine-readable and / or alphanumeric form. Via this data field 32, a clear assignment between the order form 17 and the sample stored in at least one sample container 13 and / or sample containers 13 and / or the patient and / or the order is thus possible.
- any requirement comments which, for example, provide additional information regarding the sample treatment, e.g. Sterility, storage temperature of the sample, provided.
- These request comments are preferably also presented in alphanumeric form and, if required for data protection reasons, they can be encrypted. It should be pointed out at this point that all data shown in alphanumeric form can be read using the associated software using scanners known from the prior art and corresponding algorithms for data processing programs can be processed.
- a number e.g. three, the barcode labels are automatically generated and output by the computer system 4, as shown in FIG. 1.
- These barcode labels are used only for the unmistakable or unambiguous identification of at least one sample container 13 or for the identification of several, for an analysis request, e.g. large blood count, associated sample container 13.
- At least some of the positions of the one-dimensional bar code can contain the order number, so that a clear assignment of several sample containers 13 provided with these bar code labels to an order is possible.
- an order with a corresponding order number can comprise two, three, four or more sample containers 13.
- the 1D barcode labels belonging to an order are created in data fields 37a, 37b and 37c.
- patient data such as the identification data of the client 1, date of acceptance, patient data etc.
- This data field 39 is designed as an adhesive label and can, for example, for logging, in a doctor's book be glued in.
- the number of data fields 37a to 37c; 39 can be varied by varying the size and thus the storage capacity, which is adapted to the required data content in the data fields 37a to 27c, 39.
- the, in particular continuous, unique, unique order number specified by the client 1 can also be part of the order data record shown in the data field 35.
- the additional information in the data field 38 can also be part of the order data record.
- the sampling system with the client 1 and the laboratory 2 to be analyzed is shown in a greatly simplified and schematic manner.
- the client 1 is a doctor.
- this sample management system is also found in other areas, e.g. in soil ecology for the analysis of samples of biological origin etc., application.
- the client 1 has the computer system 4 that has at least one input and / or output device 5, at least one means for manual and / or automatic input of patient data and at least one storage device or at least one data management device 9 for storing or managing the patient data, and means for outputting at least the patient data stored in the storage device or in the data management device, which can be called up.
- the patient data and, if applicable, the identification data of the doctor are also stored in the data management device 9 or the doctor master database so that they can be scanned.
- the means for entering the patient data consisting of the patient identification number and / or personal patient information and the identification data of the doctor, can be entered using the means already described above.
- at least one detection device 11, in particular a hand-held scanner is provided on the computer system 4 for reading out the container data contained in the data carrier 14 arranged inseparably on the sample container 13.
- the data ascertained by the detection device 11 are transmitted via the data line 8, in particular cables, but variants with infrared interfaces are also conceivable.
- Such detection devices 11 are already known from the prior art and can therefore all these systems for inventive methods are used.
- the further data management device 10 in particular database, which is connected to the computer system 4, contains the data stored in the information catalogs for the analysis requirements and / or suspected diagnosis, for example data about the material to be taken and / or sample container 13 and / or special acceptance conditions and / or the at least one size of the sample to be determined, etc.
- an output device 5 in the form of the printer device 12 in order, for example, to be able to carry out continuous logging, for example in a doctor's book .
- a data carrier 16, in particular a protocol can be created, on which data are contained in alphanumeric or machine-readable form and, as a result, independently of the computer system 4, physical traceability is also possible with regard to the examinations carried out, the patient data etc.
- the laboratory 2 comprises at least one order entry point 20, at least one input and / or output device 21, at least one laboratory information system 22, at least one system control station 23, at least one sorting system 25 with the detection device 27, at least an analysis station 26 and at least one archiving device 28.
- the sample containers 13 or samples and devices 19 entering the laboratory 2 are placed in the sample circulation already described in detail in FIG. 1, which is no longer explained in detail in this figure for reasons of double runs is and is to be applied to this figure as an exemplary explanation of how.
- FIG. 3 differs from FIG. 1 essentially only in the transmission of the data from the system identification number, the container data and the test requirements and possibly the identification data of the client 1, for example a doctor and / or identification data, from a person who takes the sample, Assembled order data record by electronically forwarding them via a global data network 41, for example the Internet, intranet, to the input and / or output device 21 or to the laboratory information system 22 of the laboratory 2. Therefore, the sample container 13 is transmitted or sent independently of the data transmission between the client 1 and the laboratory 2.
- a global data network 41 for example the Internet, intranet
- the client 1 and the laboratory 2 exchange data with one another, for example order data records, analysis results, or communicate with one another, so that direct communica nication the effort of creating physical disks 16 can be omitted.
- the order data sets made available by the client 1 to the laboratory 2 are processed in the input and / or output device 21 in such a way that sample circulation is possible, starting from the receipt of the samples up to the storage of the samples, or these order data sets are temporarily stored in the laboratory information system 22 or stored in a form that can be mapped.
- the order data records stored in the database can be called up at any time by the input and / or output device 21 and processed accordingly for further processing.
- the order data records which can also contain an order number in the form of machine-readable data
- an incoming inspection in the laboratory 2 can be carried out by comparing the data stored in the database, for example order number, with those arranged in the sample container 13 and / or on the device 18 Data carrier 14 contained data take place.
- an additional data carrier 16 in particular an order form 17, on which predetermined data, e.g. Order number, patient data etc., for visual incoming inspection or for any inspection during the transport of the sample container 13.
- the data provided by the doctor via data network 41 and / or data carrier 16 correspond, e.g. Order number and / or container data etc., with those on the sample container 13 and / or the device 19 and / or data carrier 16, can be taken over by the laboratory 2 in the input and / or output device 21 or for the administration of these data in the laboratory information system 22 become.
- at least one reading device e.g. a laser, scanner, barcode laser, etc. is installed, whereby on the one hand the container data present on the sample container 13 can be automatically taken over and on the other hand it becomes possible, if the data were made available by the customer 1 via data network 41, to carry out an automatic incoming inspection '.
- the sample or the sample container (s) 13 can be clearly assigned to the order data records, in particular to the patient 3.
- the samples are processed automatically on the basis of the order data in the input and / or output device 21 or in the laboratory information system 22. For this, they can be sorted according to certain sorting criteria, e.g. the quantities or parameters to be determined, the individual analysis stations 26 or the archiving device 28 are preferably supplied in a clocked manner.
- the variables or parameters ascertained in the analysis stations 26 are stored directly in the input and / or output device 21 after their determination or are stored in the database of the laboratory information system 22 in a manner that can be mapped. Only after determining all the parameters or parameters to be determined, which are specified in the test requirements of the order data record, are all analysis results transmitted to the client 1 in the form of a data packet via the data network 41, with the analysis results in a structured data format for this purpose, which contains both data content and the representation the data is defined, for example created in an XML format, or converted into this.
- the laboratory data record description of the German National Association of Statutory Health Insurance Physicians can also be used as the interpretation language for the 2D barcode.
- the barcode "PDF-417” can be used for the order data record, in particular the 2D barcode. This barcode type is also used by the Federal Association of Statutory Health Insurance Physicians as a standard barcode. It thus becomes reading and / or writing systems that work with this barcode , made easy to decrypt this code too.
- the barcode "PDF-417” can be generated with the following parameters:
- Net data volume in a data block 40 approx. 900, max. 1000 bytes;
- the resulting width for a block approx. 46 mm; the resulting height (depending on the amount of data actually contained): max. approx. 27 mm.
- the data blocks 40 can be rotated 90 ° counterclockwise in the lower part of the order form 17, starting from the left at a distance of 30 mm.
- the laboratory data record description of the German National Association of Statutory Health Insurance Physicians is defined as follows:
- the information about the field length is redundant, since a field is separated with a field separator anyway. This allows the field structure to be defined as follows, for example:
- the client 1 has at least one graphical user interface on the input and / or output device 5, on which the analysis results of the laboratory 2 are automatically read in predetermined data fields.
- the computer system 4 can be formed by a PC, host computer, the input and / or output device 5 being assigned to the computer system 4.
- the input of the analysis request and / or the suspected diagnosis and / or the output of the information catalog can be carried out on at least one website, in particular on an HTML page representing the user interface. This HTML page representing the user interface cannot be changed by the client 1.
- the user interface is formed, for example, by the screen mask, expediently only for inputting data via the input device 5 and outputting the analysis results in the control and / or processing program, where only an interpretation or representation of the analysis results is left, especially when predetermined limit values have been reached Analysis results, and a corresponding output for the client 1 is issued.
- a lower or upper limit value for example the blood sugar value
- treatment or therapy measures are output automatically.
- the client 1 does not require any additional data management device 10 for the information catalogs, but the client 1 can refer to the data stored in the database of the laboratory information system 22 in information catalogs access via the data network 41 and use for themselves. These information catalogs can be continuously updated by Laboratory 2.
- the ascertained analysis results are also stored in the database in the laboratory information system 22 which forms a data archiving device.
- This central administration system 42 comprises at least one computer system, for example a PC, and at least one database, access to this central administration system 42 only being possible, for example, to the database, by authorized persons.
- Such assignments Those entitled to go can be formed, for example, by an association of experts, such as a medical association.
- Such an arrangement enables the information catalogs described above, which are stored in the data management device 10 in the client 1 and / or in the laboratory information system 22 in the laboratory 2, to be stored exclusively in the central administration system 42.
- Such an internet-based solution has the advantage that the time period from the removal to the receipt of the analysis result is reduced to the time the sample is sent and the time period for processing it in the laboratory 2.
- the possibility of access to the information catalogs stored in the central administration system 42 and / or in the laboratory information system 22, as well as the transmission or provision of the data, in particular order data records, analysis results, via data network 41 offers the client 1 the advantage that, on the one hand, the information catalogs and / or the application software used by the client 1 or the laboratory 2, in particular the user interface, centrally, for example can be serviced by the laboratory 2 and / or the central administration system 42.
- changes can be made, for example, to the sample containers 13, for example blood collection tubes, e.g. Modification of the reagents presented, at any time simply from a central point for the entirety of the clients 1 connected to the sample management system, e.g. Medical practices, research centers, laboratories 2 etc.
- a mobile communication device such as the palm-size data terminal mentioned, or a cell phone with WAP technology, radio equipment, etc.
- the data it is also possible for the data to be returned via the data network 41, e.g. the Internet, from client 1, e.g. Doctors e.g. in the case of visits to the sick, but also emergency doctors and ambulances, are sent to Labor 2.
- this communication device is equipped, in particular, with an infrared interface.
- the computer system 4 also provides less experienced users with tips for sample handling, e.g. to be deposited or displayed in the form of a procedural instruction or work instruction.
- These data of a process instruction or work instruction are stored in the information catalog as image and / or sound data and are output on the input and / or output device 5 via the user interface or the control and / or processing program.
- the information catalog can be compiled from a large number of data, which are stored in the database in tables and / or registers, for the respective purpose of use, the respective suspected diagnosis and / or analysis request.
- this information catalog can, for example, contain data relating to several sample container manufacturers and their assortments of different sample containers 13, that is to say, for example, data about blood sample tubes with different reagents and / or urine sample containers and / or stool sample containers and / or tissue sample containers or the like. Include.
- the information catalog can also contain what type of sample should be, i.e. what material should be taken for the specific purpose. In the case of samples of biological origin, this material can be formed, for example, by blood and / or serum and / or urine and / or stool and / or tissue and / or amniotic fluid.
- data or instructions about specific collection conditions of these samples can be stored.
- information catalogs suggest the sizes to be determined, in particular parameters, to a sample.
- this can be, for example, the suggestion for determining a blood sugar value, a cholesterol or triglycerol value or one Hemoglobin level.
- different bacterial cultures could be determined for a stool sample.
- the quantity to be determined is both the presence of a certain substance and its numerical value, i.e. information about a qualitative and / or a quantitative analysis.
- Manufacturer information which can also be included in the information catalog, can include, for example, a reference to a limited shelf life of the sample container 13 or the reagents in the sample container 13 or certain storage conditions, for example a storage temperature.
- the information catalogs that can be output can be adapted to special requirements or analysis options of at least one laboratory 2.
- the sample container 13 or sample container manufacturer to be used by the client 1 can be defined thereby.
- those analysis options can be offered which are actually carried out by this specific laboratory 2.
- the database - of the client 1 or central administration system 42 - selects the available laboratory 2, which can handle the analysis tasks requested by the client 1, and proposes them via the information catalog.
- the information catalog proposes to send the samples to be taken to different laboratories 2 for further analysis in order to enable the samples to be processed quickly.
- the computer system 4 determines the sample containers 13 available at the client 1 and for the computer system 4 to determine the available sample containers 13 become known and, for example, the available sample containers 13 are forwarded to the database when the suspected diagnosis or the analysis request is transmitted. An information catalog that is matched to the available sample containers 13 is then output from the database.
- the information of the available sample container manufacturers can be formed, for example, by the sample container 13 used by the customer 1 with or without restriction of the assortment of the sample container manufacturer.
- the information catalog transmitted by the database merely represents a specification or a proposal which represents the materials to be removed and the sizes to be determined or the sample container 13 to be used for the respective intended use.
- This information catalog can be freely changed by the client 1 according to his wishes or requirements, ie that the materials actually taken and to be analyzed or the sizes of the samples to be determined can be changed, in particular supplemented or reduced, as required.
- the information catalog is used by the client 1 for the more convenient and particularly reliable creation of the order data of samples to be analyzed and expediently contains all the data or information important and to be observed for the client 1.
- the information catalog is generated from a large number of possible information catalogs or from a large number of data stored in tables and / or registers, the database being stored locally in the computer system 4 of the client 1 or also via the data network 41 from a server computer of the central administration system 42 can be called. If the database is stored on a server or PC that can be reached via the data network 41, it is possible that it is serviced by at least one central administration system 42, in particular information catalogs or the tables and / or registers for generating the information catalogs are updated. It is also possible to have the database updated by several central administration systems 42, the range of possible sample containers 13 being expediently updated by the sample container manufacturer (s) and the sizes of the samples to be analyzed being updated by an expert association and / or the laboratory 2.
- the information catalog can also contain image and / or sound data, the output of which can be controlled via the user interface.
- the information catalog suggests several identical sample containers 13 to be used in order to be able to accommodate this larger amount. This is also possible if several sizes of the sample or the material are to be determined, whereby the analysis times in the laboratory 2 can be shortened considerably or a sufficient remainder of the sample or the material is left in the laboratory 2 for any subsequent examinations.
- the client 1 can use a commercially available PC as the computer system 4, which is connected via a data network conclusion, in particular an Internet connection, that is, for example, an HTML browser that uses a protocol, in particular HTTP, can be used.
- the clinical picture or the suspected diagnosis and / or the information catalog can be entered via a website, in particular an HTML page.
- the suspected diagnosis can be entered on the website in such a way that a set of rules is applied to it.
- further selection or input fields can be displayed or released or blocked or hidden.
- the selection field "pregnant yes no” can be hidden or deactivated for samples from male patients.
- the other data in the information catalog can also be supplemented by empirical values, for example.
- empirical values for example.
- a customary time requirement for performing the analyzes can be specified. This is particularly important in bacteriological examinations, since such analyzes often have to accept waiting times of several weeks, to which the client 1 should be informed.
- FIGS. 1; 2; 3 shown embodiments form the subject of independent, inventive solutions.
- the relevant tasks and solutions according to the invention can be found in the detailed descriptions of these figures.
- Order entry point 1 input and / or output device
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Abstract
Description
Claims
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AU2002340600A AU2002340600A1 (en) | 2001-09-05 | 2002-09-05 | Method for taking a sample from a system |
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DE10297152T DE10297152D2 (de) | 2001-09-05 | 2002-09-05 | Verfahren zur Entnahme einer Probe aus einem System |
US10/488,669 US20040267562A1 (en) | 2001-09-05 | 2002-09-05 | Method for taking a sample from a system |
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AT0140201A AT413640B (de) | 2001-09-05 | 2001-09-05 | Verfahren zur entnahme einer probe aus einem system |
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Also Published As
Publication number | Publication date |
---|---|
GB0407598D0 (en) | 2004-05-05 |
GB2397417A (en) | 2004-07-21 |
WO2003021525A3 (de) | 2004-03-18 |
AU2002340600A1 (en) | 2003-03-18 |
AT413640B (de) | 2006-04-15 |
ATA14022001A (de) | 2005-09-15 |
US20040267562A1 (en) | 2004-12-30 |
CH696603A5 (de) | 2007-08-15 |
DE10297152D2 (de) | 2004-10-07 |
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