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BACKGROUND OF THE INVENTION
This invention relates to an automatic medical diagnostic system. This
invention also relates to an associated diagnostic method.
Medical and hospitalization costs are ever increasing. In addition, the
costs and the time needed to educate doctors continue to rise.
Medical testing, particularly the testing of blood, urine and other
specimens, has long been a specialized practice relegated to laboratories.
This centralization reduces costs in part because of the benefits of mass
production, assembly line techniques, and automation. Specialized
labaoratories possess skills and information which isolated doctors and
even entire hospitals may lack.
OBJECTS OF THE INVENTION
An object of the present invention is to provide a medical diagnostic
system and a related diagnostic method.
A more particular object of the present invention is to provide such a
diagnostic system and method which reduces medical diagnosis costs.
Another particular object of the present invention is to provide such a
diagnostic system and method which can be used by persons having less
training than traditional physicians.
A further particular object of the present invention is to provide an at
least partially automated diagnostic system and method.
Another object of the present invention is to provide an automated
diagnostic system which utilizes centralization to provide the benefits of
large amounts of information and data processing capacity.
Another, more particular, object of the present invention is to provide an
automated medical diagnostic system which utilizes image type information.
A further particular object of the present invention is to provide a
medical diagnostic system wherein diagnoses are made by computer.
Yet another particular object of the present invention is to provide such a
diagnostic system wherein the computer is centralized.
SUMMARY OF THE INVENTION
A medical diagnostic system comprises, in accordance with the present
invention, a monitoring device juxtaposable to a patient for collecting
individualized medical data about the patient's condition, and a digitizer
operatively connected to the monitoring device for digitizing the data. A
computer is operatively connected to the digitizer and to a memory which
stores medical data for a multiplicity of previously diagnosed medical
conditions. The computer is operated to compare digitized data about the
patient's condition with the data stored in the memory and to derive a
diagnosis as to the patient's condition. The computer is connected to an
output device, e.g., a printer, for communicating the derived diagnosis to
a user.
Pursuant to another feature of the present invention, the monitoring device
includes a scanner for generating in electrically encoded form a visually
readable image of an organic part of the patient.
An analyzing device may be operatively connected to the scanner for
determining from the image a value of at least one organic parameter
pertaining to the patient.
In accordance with the present invention, the scanner may take the form,
for example, of an MRI apparatus, a CAT scanner, an X-ray machine, an
ultrasonography apparatus, or a video camera with or without magnification
optics for magnifying a sample on a slide.
Pursuant to another feature of the present invention, the monitoring device
includes a measuring device for measuring a predetermined physiological
parameter of the patient. The measuring device may take the form, for
instance, of an electronic thermometer, an electronic blood pressure
gauge, a pulmonary function apparatus, a doppler study apparatus, an EEG
machine, an EKG machine, an EMG machine, or a pressure measurement device.
A medical diagnostic system comprises, in accordance with a specific
embodiment of the present invention, (a) a scanner for generating in
electrically encoded form a visually readable image of an organic part of
the patient, (b) an analyzing device operatively connected to the scanner
for determining from the image a value of at least one organic parameter
pertaining to the patient, (c) a memory for storing a plurality of
previously measured values for each of a multiplicity of predetermined
organic parameters, (d) a computer operatively connected to the memory and
the analyzing device for comparing the value of the one organic parameter
with a plurality of values stored in the memory and for deriving a
diagnosis as to the patient's condition, and (e) an output device
operatively connected to the computer for communicating the derived
diagnosis to a user.
The parameterization of the images enables storage of previously obtained
medical data of the same kind in a local computer. For example, in the
event that the image system is video used, for example, in dermatological
diagnosis, an image of a skin surface of a patient is analyzed to derive
such parameters as percentage of skin covered by abnormal condition, the
range of sizes of individual ulcers, the range of color variation (e.g.,
whether bleeding is symptomatic). These parameters represent a
distillation of the total information content and accordingly require a
substantially reduced storage space.
However, it is within the contemplation of the instant invention that the
memory stores entire images related to different diseases. For example,
images of skin conditions are stored at a dermatological diagnosis and
treatment facility. The computer compares the image of a patient with the
previously stored images, for example, by breaking down the current image
into sections and overlaying the sections with sections of the stored
images, at variable magnification levels. A combination of a
parameterization technique and an image overlay technique is considered
optimal.
A medical diagnostic system comprises, in accordance with another specific
embodiment of the present invention, (a) a measuring device for measuring
a predetermined physiological parameter of a patient and for generating a
digital signal codifying a magnitude of the parameter, (b) a memory for
storing medical data for a multiplicity of previously diagnosed medical
conditions, (c) a computer operatively connected to the memory and the
measuring device for comparing the magnitude, as encoded in the digital
signal, with data stored in the memory and for deriving a diagnosis as to
the patient's condition, and (d) an output device operatively connected to
the computer for communicating the derived diagnosis to a user.
The measuring device is designed to monitor and quantify a predetermined
biological or physiological parameter, such as temperature, blood
pressure, muscle contraction strength (e.g. colonic, esophogeal),
respiration volume or effectiveness, the rate of blood flow, electrical
voltages (brain, heart, muscle), etc.
Pursuant to another feature of the present invention, the computer is a
remote, central computer. The measured and digitized biological or
physiological parameter is transmitted via a telephone line linkage to the
computer, which transmits a diagnosis in electrically encoded form back to
a printer or other output device at the diagnosis station.
Alternatively, the diagnosis may be implemented by a local computer
disposed at the location that the parameter measurement takes place. The
local computer may be connected additionally to a central computer, the
diagnosis being performed by the central computer and communication
therewith being mediated by the local computer.
A medical diagnostic method in accordance with the present invention
comprises the steps of (i) at least partially automatically monitoring a
patient to collect individualized medical data about the patient's
condition, (ii) generating a digitized signal encoding the data, (iii)
automatically comparing the digitized data about the patient's condition
with data stored in an electronic memory to derive a diagnosis as to the
patient's condition, and (iv) communicating the derived diagnosis to a
user.
Pursuant to another feature of the present invention, the step of
monitoring includes the step of scanning the patient to generate in
electrically encoded form a visually readable image of an organic part of
the patient.
Pursuant to an alternative or additional feature of the present invention,
the step of monitoring includes the step of at least partially
automatically measuring a predetermined physiological parameter of the
patient.
Pursuant to a further feature of the present invention, the method also
comprises the step of automatically analyzing the image to determine a
value of at least one organic parameter pertaining to the patient.
A medical diagnostic system and a related diagnostic method in accordance
with the present invention provide many benefits of automation. Large
amounts of information are accessible for making each diagnosis on a
patient. The feature of computer centralization provides for enhanced data
processing capability. An automated medical diagnostic system in
accordance with the present invention may utilize image type information.
Such image processing is useful in making diagnoses from MR images, cat
scanned X-ray images, ultrasonographic images and optical images (slides,
video).
Because diagnoses are made by computer in accordance with the present
invention, it is frequently unnecessary to have a doctor present during
data taking (symptom recording and measurement) and communication of the
diagnosis to the patient. Any assistance may be provided by relatively
unskilled aides.
Even if the patient eventually sees a physician for confirming the
diagnosis, the computer input will facilitate the physician's evaluation
of the patient's condition and reduce the amount of time necessary for the
physician to examine the patient.
Accordingly, a system and method in accordance with the present invention
reduces expense and saves physician time.
BRIEF DESCRIPTION OF THE DRAWING
FIG. 1 is a block diagram of a medical diagnostic system, in accordance
with the present invention.
FIG. 2 is a flow-chart diagram illustrating steps in a mode of operation of
the diagnostic system of FIG. 1.
FIG. 3 is a flow-chart diagram illustrating steps in another mode of
operation of the diagnostic system of FIG. 1.
FIG. 4 a block diagram of a further medical diagnostic system, in
accordance with the present invention.
FIG. 5 is a diagram showing the composition of a data string or module used
in the system of FIG. 4.
FIG. 6 is a block diagram of a computerized slide scanning system, in
accordance with the present invention.
FIG. 7 is a block diagram of a device for measuring a diagnostic parameter
and transmitting the measurement over the telephone lines.
FIG. 8 is a diagram of an ultrasonography device in accordance with the
present invention.
FIG. 9 is a diagram showing a modification of the device of FIG. 8.
DETAILED DESCRIPTION
As illustrated in FIG. 1, a medical diagnostic system comprises a device 20
for monitoring and measuring a biological or physiological parameter.
Monitoring and measuring device 20 is juxtaposable to a patient for
collecting individualized medical data about the patient's condition.
Device 20 may take the form of an electronic thermometer, an electronic
blood pressure gauge, a pulmonary function apparatus, a doppler study
apparatus, an EEG machine, an EKG machine, an EMG machine, or a pressure
measurement device, etc., or include a plurality of such components.
Monitoring and measuring device 20 is connected at an output to a digitizer
22 which converts normally analog type signals into coded binary pulses
and transmits the resulting digital measurement signal to a computer 24.
Digitizer 22 may be incorporated into a housing (not shown) enclosing all
or part of the monitoring and measuring device 20. Moreover, digitizer 22
may be an integral part of monitoring and measuring device 20.
Computer 24 receives instructions and additional input from a keyboard 26.
Keyboard 26 is used to feed computer 24 information for identifying the
patient, for example, the patient's age, sex, weight, and known medical
history and conditions. Such medical conditions may include past diseases
and genetic predispositions.
Computer 24 is also connected to an external memory 28 and an output device
30 such as a printer or monitor. Memory 28 stores medical data for a
multiplicity of previously diagnosed medical conditions which are
detectable by analysis of data provided by monitoring and measuring device
20.
As illustrated in FIG. 2, monitoring and measuring device 20 detects a
magnitude of a predetermined biological or physiological parameter in a
step 32. Digitizer 22 converts the detected magnitude into a
pre-established digital format in a step 34 and transmits the digital
signal to computer 24 in a step 36. Computer 24 is operated in a step 38
to compare the digitized data from monitoring and measuring device 20 with
the data stored in memory 28 and to derive a diagnosis as to the patient's
condition. The diagnosis is then communicated to the user (operator) and
to the patient via output device 30 in a step 40.
If monitoring and measuring device 20 measures a physiological function
characterized by a plurality of different variables, for example, the
electric potential at different points on the patient's body (EEG, EKG,
EMG), these variables may be broken down by computer 24 into one or more
parameters, e.g., a frequency packet. The measured values of the
pre-established parameters are then compared with parameter ranges stored
in memory 28 for the type of parameter and the kind of patient, as
characterized by sex, age, weight, etc. If the measured values of the
pre-established parameters fall within expected ranges, as stored in
memory 28, then computer 24 communicates a "normalcy" finding via printer
30. If, on the contrary, the measured values of one or more parameters
fall outside the normal ranges, then a diagnosis of a possible medical
condition is printed out.
As further illustrated in FIG. 1, the medical diagnostic system may
comprise, in addition to or alternatively to monitoring and measuring
device 20, an image generating apparatus or scanner 42 for generating in
electrically encoded form a visually readable image of an organic part of
the patient. Scanner 42 may take the form of an MRI apparatus, a CAT
scanner, an X-ray machine, an ultrasonography apparatus, or a video camera
with or without magnification optics for magnifying a sample on a slide.
The video camera can be used for obtaining an image of a portion of a
patient's skin.
Scanner 42 is connected via an interface 44 to computer 24.
As shown in FIG. 3, scanner 42 obtains an image of a tissue or organ in a
step 46. The image is digitized, either by scanner 42 or interface 44 in a
step 48, and is transmitted to computer 24 in a step 50. Computer 24 is
operated in a step 52 to analyze the image from scanner 42 and determine
specific values for a multiplicity of predetermined parameters. For
example, in the event that scanner 42 takes the particular form of a video
camera for dermatological diagnosis, an image of a skin surface of a
patient is analyzed by computer 24 to derive such parameters as percentage
of skin covered by abnormal condition, the range of sizes of individual
ulcers, the range of color variation (e.g., whether bleeding is
symptomatic).
The specific values of pre-established parameters calculated by computer 24
from electrically encoded images transmitted from scanner 42 are compared
by computer 24 with previously determined parameter ranges stored in
memory 28. For example, if a pregnant woman's fetus is being scanned by
ultrasonography, the lengths of the fetal appendages, arms, legs, fingers,
etc., are compared with each other and with respective fetal appendage
ranges recorded in memory 28 for the stage of pregnancy, weight of the
fetus, and possibly weight of the mother. In the event that any appendages
are missing or are of abnormal length, a diagnosis as to possible
deformity is printed out. Organs internal to the fetus may be similarly
examined automatically by scanner 42 and computer 24. In more advanced
stages of pregnancy, physiological functions such as the heart rate of the
fetus may be automatically monitored for abnormal conditions.
The analysis performed by computer 24 on the image from scanner 42 will
depend in part on the region of the patient's body being scanned. If a
woman's breast or a person's cortex is being monitored for tumorous
growths, computer 24 is programmed to separate the tissue image into
regions of different textures. The different textured regions are
parameterized as to size, shape and location and the derived parameters
are compared to values in memory 28 to determine the presence of a tumor.
Additional analysis is undertaken to detect lines in an image which may
indicate the presence of an organic body.
A similar analysis is undertaken to evaluate a tissue specimen on a slide.
The texture and line scanning may be repeated at different magnification
levels if, for example, the tissue sample is a slice of an organ wall. On
a high magnification level, the texture and line analysis can serve to
detect microorganisms in blood.
Memory 28 may store entire images related to different diseases. For
example, memory 28 may store images of skin conditions in the event that
scanner 42 takes the form of a video camera at a dermatological diagnosis
and treatment facility. In a step 54 (FIG. 3), computer 24 compares the
image of a patient's skin with previously stored images in memory 28, for
example, by breaking down the current image into sections and overlaying
the sections with sections of the stored images, at variable magnification
levels.
In the event that scanner 42 takes the form of an MRI apparatus or CAT
scanner, the images stored in memory 28 are of internal organic
structures. In step 54 (FIG. 3), computer 24 compares images of a person's
internal organs with previously stored organ images in memory 28. Computer
24 partitions the image from the MRI apparatus or CAT scanner into
subareas and overlays the subareas with sections of the stored images, at
variable magnification levels.
In a final step 56 (FIG. 3), computer 24 communicates the results of its
diagnostic evaluation to a user or patient.
As illustrated in FIG. 4, a medical diagnostic system comprises a plurality
of remote automated diagnostic stations 60a and 60b connected via
respective telecommunications links 62a and 62b to a central computer 64.
Each diagnostic station 60a, 60b may take the form shown in FIG. 1, local
computer 24 communicating via link 62a, 62b with central computer 64.
Alternatively, each diagnostic station 60a, 60b may take the form shown in
FIG. 4 and include a respective plurality of monitoring and measuring
devices 66a, 66b, . . . 66n operatively connected to a local computer 68
via respective digitizer output units 70a, 70b, . . . 70n. Computer 68 is
fed instructions and data from a keyboard 72 and communicates diagnostic
results via a monitor 74 or printer 76. As discussed hereinabove with
reference to monitoring and measuring device 20 of FIG. 1, each monitoring
and measuring device 66a, 66b, . . . 66n is juxtaposable to a patient for
collecting individualized medical data about the patient's condition.
Monitoring and measuring devices 66a, 66b, . . . 66n may resepctively take
the form of an electronic thermometer, an electronic blood pressure gauge,
a pulmonary function apparatus, a doppler study apparatus, an EEG machine,
an EKG machine, an EMG machine, or a pressure measurement device, etc.
Digitizers 70a, 70b, . . . 70n convert normally analog type signals into
coded binary pulses and transmit the resulting digital measurement signals
to computer 68. Digitizers 70a, 70b, . . . 70n may be incorporated into
the housings or casing (not shown) enclosing all or part of the respective
monitoring and measuring devices 66a, 66b, . . . 66n.
Keyboard 72 is used to feed computer 68 information for identifying the
patient, for example, the patient's age, sex, weight, and known medical
history and conditions. Such medical conditions may include past diseases
and genetic predispositions.
As further illustrated in FIG. 4, a plurality of diagnostic image
generating apparatuses or scanners 78a, 78b, . . . 78i are also connected
to central computer 64 via respective telecommunications links 80a, 80b, .
. . 80i. Scanners 78a, 78b, . . . 78i each generate in electrically
encoded form a visually readable image of an organic part of the patient.
Scanners 78a, 78b, . . . 78i may each take the form of an MRI apparatus, a
CAT scanner, an X-ray machine, an ultrasonography apparatus, or a video
camera with or without magnification optics for magnifying a sample on a
slide.
Because of the enormous quantity of data necessary for storing images,
central computer 64 is connected to a bank of memories 82 at a central
storage and information processing facility 84. Diagnosis of patient
conditions may be undertaken by central computer 64 alone or in
cooperation with local computers 24 or 68.
As illustrated in FIG. 5, local computers 24 and 68 transmit information to
central computer 64 in data packets or modules each including a first
string of binary bits 86 representing the transmitting station 60a, 60b, a
second bit string 88 identifying the patient, a bit group 90 designating
the parameter which is being transmitted, another bit group 92 coding the
particular measured value of the parameter, a set of bits 94 identifying
the point on the patient at which the measurement was taken, and another
bit set 96 carrying the time and date of the measurement. Other bit codes
may be added as needed.
As shown in FIG. 6, a computerized slide scanning system comprises a slide
carrier 100 mountable to a microscope stage and a slide positioning device
102 mechanically linked to the slide carrier 100 for shifting the carrier
along a path determined by a computer 104. Computer 104 may be connected
to an optional transport or feed assembly 106 which delivers a series of
slides (not shown) successively to slide carrier 100 and removes the
slides after scanning.
Computer 104 is also connected to an optical system 108 for modifying the
magnification power thereof between successive slide scanning phases.
Light emerging from optical system 108 is focused thereby onto a charge
coupled device ("CCD") 110 connected to computer 104 for feeding digitized
video images thereto.
Computer 104 performs a line and texture analysis on the digitized image
information from CCD 110 to determine the presence of different organic
structures and microorganisms. The different textured regions are
parameterized as to size, shape and location and the derived parameters
are compared to values in a memory to identify microscopic structures. The
texture and line scanning is repeated at different magnification levels.
Computer 104 may be connected to a keyboard 112, a printer 114, and a modem
116. Modem 116 forms part of a telecommunications link for connecting
computer 104 to a remote data processing unit such as computer 64 in FIG.
4.
Image generating apparatus 42 in FIG. 1 may take the form of the
computerized slide scanning system of FIG. 6.
As shown in FIG. 7, a device for measuring a diagnostic parameter and
transmitting the measurement over the telephone lines comprises a
monitoring and measuring device 118 which may take the form, for example,
of an electronic thermometer, an electronic blood pressure gauge, a
pulmonary function apparatus, a doppler study apparatus, an EEG machine,
an EKG machine, an EMG machine, or a pressure measurement device, etc., or
include a plurality of such components. Monitoring and measuring device
118 is connected at an output to a digitizer 120 which in turn is coupled
to a modulator 122. Modulator 122 modulates a carrier frequency from a
frequency generator 124 with the data arriving from monitoring and
measuring device 118 via digitizer 120 and transmits the modulated signal
to an electro-acoustic transducer 126 via an amplifier 128. Transducer 126
is removably attachable via a mounting element 130 to the mouthpiece of a
telephone handset (not shown) and generates a pressure wave signal which
is converted by a microphone in the handset mouthpiece back to an
electrical signal for transmission over the telephone lines. Of course,
transducer 126 may be omitted and modulator 122 connected directly to a
telephone line.
The system of FIG. 7 enables the transmission of specialized medical data
directly over the telephone lines to a central computer (e.g. computer 64
in FIG. 4) which utilizes the incoming data to perform a diagnostic
evaluation on the patient.
Monitoring and measuring device 118 may include traditional medical
instrumentation such as a stethoscope or modern devices such as a CCD.
FIG. 8 shows an ultrasonographic image generating apparatus which may be
used in the medical diagnostic system of FIG. 1 (see reference designation
42) or in the medical diagnostic system of FIG. 4 (see reference
designations 78a, 78b, . . . 78i). A flexible web 132 carries a plurality
of piezoelectric electroacoustic transducers 134 in a substantially
rectangular array. Tranducers 134 are each connectable to an ultrasonic
signal generator 136 via a switching circuit 138. Switching circuit 138 is
operated by a control unit 140 to connect tranducers 134 to signal
generator 136 in a predetermined sequence, depending on the area of a
patient's body which is being ultrasonically scanned.
Web 132 also carries a multiplicity of acoustoelectric transducers or
sensors 142 also arranged in a substantially rectangular array. Sensors
142 are connected to a switching circuit 144 also operated by control unit
140. An output of switching circuit 144 is connected to a sound analyzer
146 via an amplifier 148.
Web 132 is draped over or placed around a portion of a patient's body which
is to be monitored ultrasonically. Control unit 140 then energizes signal
generator 136 and operates switching circuit 138 to activate transducers
134 in a predetermined sequence. Depending on the transducer or
combination of transducers 134 which are activated, control unit 140
operates switching circuit 144 to connect a predetermined sequence of
sensors 142 to sound analyzer 146. Sound analyzer 146 and control unit 140
cofunction to determine three dimensional structural shapes from the
echoes detected by sensors 142.
Control unit 140 is connected to ultrasonic signal generator 136 for
varying the frequency of the generated signal.
FIG. 9 shows a modified ultrasonography web 150 having a limited number of
electroacoustic transducers 152 and generally the same number and
disposition of sensors 154 as in web 132.
Web 132 or 150 may be substantially smaller than illustrated and may
correspondingly carry reduced numbers of transducers 134 and 152 and
sensors 142 and 154. Specifically, web 132 or 150, instead of being a
sheet large enough to wrap around a torso or arm of a patient, may take a
strip-like form which is periodically moved during use to different,
predetermined locations on the patient. Control unit 140 and sound
analyzer 146 are programmed to detect internal organic structures from the
data obtained at the different locations that the web 132 or 150 is
juxtaposed to the patient.
Although the invention has been described in terms of particular
embodiments and applications, one of ordinary skill in the art, in light
of this teaching, can generate additional embodiments and modifications
without departing from the spirit of or exceeding the scope of the claimed
invention. Accordingly, it is to be understood that the drawings and
descriptions herein are proferred by way of example to facilitate
comprehension of the invention and should not be construed to limit the
scope thereof.
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