WO2018181714A1 - Ophthalmological information processing system - Google Patents

Abstract

The technical problem addressed by the present invention is to provide an ophthalmological information processing system that makes it possible to effectively use ophthalmological information collected via a network. This ophthalmological information processing system comprises a user terminal and a server that can communicate with each other via a network. The ophthalmological information processing system is characterized in that: the user terminal includes a specification means for specifying a creation item for a database to be created by the server, and a first transmission means for transmitting the creation item specified by the specification means to the server via the network; and the server includes a reception means for receiving the creation item transmitted by the user terminal, and a creation means for creating the database corresponding to the creation item.

Description

Ophthalmology information processing system

The present invention relates to an ophthalmologic information processing system for processing ophthalmologic information of an eye to be examined.

In recent years, ophthalmologic information that transmits examination data obtained by an ophthalmic apparatus at each medical facility to a server via a network, performs data analysis processing at the server, and then transmits a processing result to each medical facility via the network. A system has been proposed (Patent Document 1).

JP 2013-081601 A

However, in conventional ophthalmologic information processing systems, it cannot be said that examination data collected from each medical facility by a server can be effectively utilized.

In view of the conventional problems, the present disclosure is to provide an ophthalmologic information processing system that can effectively use ophthalmologic information collected via a network.

In order to solve the above problems, the present disclosure is characterized by having the following configuration.

An ophthalmologic information processing system comprising a user terminal and a server that can communicate with each other via a network, wherein the user terminal includes a designation unit that designates a database creation item created by the server, and the designation unit. First transmission means for transmitting the designated creation item to the server via the network, the server receiving the creation item transmitted from the user terminal; Creating means for creating the database corresponding to the creation item.

It is a schematic block diagram showing an example of composition of an ophthalmology information processing system concerning an example. It is a schematic block diagram showing an example of composition of an ophthalmology information processing system concerning an example. It is a schematic block diagram showing an example of composition of an ophthalmology information processing system concerning an example. It is a flowchart showing an example of operation | movement of the ophthalmologic information processing system which concerns on an Example. It is a figure which shows an example of the image analysis result using a database. It is a schematic diagram which shows an example of the utilization method of the ophthalmic information processing system which concerns on an Example.

The ophthalmologic information processing system according to the present embodiment processes, for example, ophthalmologic information of an eye to be examined obtained by an ophthalmologic apparatus. The ophthalmologic information processing system 1 includes an ophthalmologic information processing server 200 and a user terminal 100 (see FIG. 1). The ophthalmologic information processing server 200 is connected to a plurality of user terminals 100 (user terminal 100A, user terminal 100B, user terminal 100C, etc.) through a network so that they can communicate with each other. The user terminal 100 can acquire patient medical information, for example. The medical information is, for example, examination information acquired by a medical examination apparatus (for example, various ophthalmologic apparatuses, CT, MRI, thermometer, weight scale, blood pressure monitor, etc.), doctor diagnosis information, or patient medication information, medical history, age Includes patient information such as gender, region, and race.

Note that the medical information may include ophthalmic information related to the patient's eye. The ophthalmologic information includes, for example, ophthalmic examination information, ophthalmologic diagnosis information, eye information to be examined, and the like. The ophthalmic examination information includes, for example, image data acquired by the ophthalmologic apparatus, examination results, date and time (or season) when the examination (or photographing) was performed, and the like. Examples of image data include anterior eye image and fundus image data obtained by a slit lamp, fundus image and fluorescence image data obtained by a fundus camera, and an anterior eye portion obtained by an optical coherence tomometer. And tomograms of the fundus, 3D image data, corneal endothelium image data acquired by a specular microscope, corneal image data acquired by a keratometer, anterior eye image acquired by an ultrasound diagnostic apparatus And image data of the fundus image. The ophthalmologic diagnosis information is, for example, a diagnosis result by an ophthalmologist such as a disease name and a medical condition. The eye information is, for example, the axial length, viewing angle, intraocular pressure, left / right information of the eye, and the like.

The network is configured to include a wide area network (Wide Area Network: WAN) N such as the Internet. In the present embodiment, the user terminal 100A installed in the medical facility A is connected to the wide area network N via the hospital server 150 so as to be able to communicate with each other via a LAN (Local Area Network: LAN). Part or all of the network may be a wired communication line or a wireless communication line. Note that the network is not limited to such a form, and it is sufficient that bidirectional communication is possible between each user terminal and the ophthalmologic information processing server.

The user terminal 100 is, for example, a computer used by a user (such as a doctor) to browse various medical information or edit an electronic medical record. For example, the user terminal 100A, the user terminal 100B, and the user terminal 100C are arranged in different facilities and used for different users.

The in-hospital server 150 is a computer that manages various information processing in the medical facility A. The in-hospital server 150 functions as various systems such as an electronic medical record system, for example.

The ophthalmologic information processing server 200 is installed in the data center D and provides a service provided by the ophthalmologic information processing system 1 to each user terminal.

Hereinafter, each configuration of the ophthalmologic information processing system 1 will be described. Since the hospital server 150 can be a general computer, detailed description thereof is omitted. Since the basic configurations of the user terminals 100A, 100B, and 100C may be the same, only the user terminal 100A will be described in detail.

{User terminal}
The user terminal 100A includes, for example, a control unit 101, a communication unit 102, a storage unit 103, a display unit 104, an operation unit 106, an item designation unit 107, and an analysis processing unit 110 (see FIG. 2). .

[Control unit]
For example, the control unit 101 controls each unit of the user terminal 100A. The control unit 101 includes, for example, a CPU, a ROM, a RAM, and the like. The CPU executes predetermined control processing and arithmetic processing based on a program stored in a storage device such as a ROM and a RAM.

[Communication Department]
The communication unit 102 performs data communication with the hospital server 150. For example, the communication unit 102 performs a process of transmitting data to the hospital server 150 and a process of receiving data transmitted from the hospital server 150. The communication unit 102 has a configuration based on a network constructed in the medical facility A, and includes a communication device such as a LAN adapter, for example. Note that the communication unit 102 may directly communicate with the server 200 via the network N without using the hospital server 150.

[Storage unit]
The storage unit 103 stores various data processed by the user terminal 100. This data includes, for example, image data of the eye to be examined acquired by the ophthalmologic apparatus. The storage unit 103 is, for example, a nonvolatile storage device that can write and read data. For example, data writing and reading processing is executed by the control unit 101.

Note that the storage unit 103 may be a storage device connected to a computer that functions as the user terminal 100. The storage unit 103 may be provided in the hospital server 150. The storage unit 103 only needs to be able to read the stored information from the user terminal 100 at an arbitrary timing.

[Display section]
The display unit 104 displays various information, for example. The display unit 104 is, for example, a liquid crystal display or an organic EL display. The information displayed on the display unit 104 is, for example, an image of an eye to be examined, an electronic medical record, or various operation screens. Data for displaying these is stored in the storage device of the control unit 101, for example.

[Operation section]
The operation unit 106 is used for instruction input and information input. The operation unit 106 is an arbitrary operation device such as a keyboard, a mouse, a trackball, a joystick, or an operation panel. The operation unit 106 is used when a user inputs a creation item when the ophthalmologic information processing server 200 creates a database. The database will be described later.

[Item specification part]
The item designation unit 107 designates a database creation item. The created items include, for example, any of disease name, medical condition, age, sex, region, race, and the like. The item designation unit 107 designates a creation item selected by the user, for example. In this case, the user uses the operation unit 106 to select a desired one of the creation item options displayed on the display unit 104, for example. In addition, the user may input a desired item into the predetermined input field displayed on the display unit 104 using the operation unit 106. The control unit 101 transmits a database creation instruction (DB creation instruction) corresponding to the selected content and input content to the ophthalmologic information processing server 200.

Note that the item specifying unit 107 may automatically specify the created item. In this case, for example, the server 200 designates a creation item corresponding to the medical information transmitted from the user terminal 100. For example, the item designation unit 107 may designate the disease name of the eye to be examined as a creation item based on the diagnosis information. In addition, creation items such as age, sex, region, and race may be designated based on patient information.

[Analysis processing section]
For example, the analysis processing unit 110 executes various types of analysis processing on medical information including image data acquired by a medical examination apparatus. The analysis processing unit 110 stores a program for executing each analysis process. The analysis processing executed by the analysis processing unit 110 includes all known image processing performed on image data.

{Ophthalmology information processing server}
The ophthalmologic information processing server 200 includes a control unit 201, a communication unit 202, an information storage unit 210, an analysis processing unit 220, a database storage unit 223, an update processing unit 225, and the like (see FIG. 3).

[Control unit]
For example, the control unit 201 controls each unit of the ophthalmologic information processing server 200. The control unit 201 includes, for example, a CPU, a ROM, a RAM, and the like. The CPU executes predetermined control processing and arithmetic processing based on a program stored in a storage device such as a ROM and a RAM.

[Communication Department]
The communication unit 202 performs data communication with each of the user terminals 100A, 100B, and 100C (including a plurality of user terminals) via the network N. This data communication includes a process for transmitting data to each user terminal 100 and a process for receiving data transmitted from each user terminal. The communication unit 202 has a configuration conforming to the network N and includes a communication device such as a modem.

[Information storage unit]
The information storage unit 210 stores a large number of medical information transmitted from each user terminal 100, for example. For example, medical information of a large number of patients with different ages, genders, races, and diseases is stored. A large amount of medical information accumulated in the information storage unit 210 is used to create a database.

[Analysis processing section]
The analysis processing unit 220 performs various analysis processes on medical information including image data and the like. For example, the analysis processing unit 220 acquires a database related to medical information from the database storage unit 223 and analyzes the medical information based on the database.

[Database creation section]
For example, the database creation unit 226 creates a database based on a DB creation instruction received from a user terminal. The database creation unit 226 collects medical information related to the creation item specified in the DB creation instruction from the information storage unit 210 and creates a database. For example, the database creation unit 226 performs image analysis processing on a plurality of image data obtained for a plurality of eyes to be examined by an ophthalmologic apparatus to obtain a plurality of analysis result data, and statistically processes the analysis result data. Generate a database with The database is used for analysis of medical information.

[Database storage unit]
The database storage unit 223 stores a database created by the database creation unit 226. The database includes representative values (average value, median value, etc.) of a plurality of analysis result data, or variation information (standard deviation, variance, etc.). An example of the database is a normal eye database in which the thickness of a predetermined layer of the fundus of a normal eye is converted into a database.

[Update processing section]
The update processing unit 225 updates the database stored in the database storage unit 223 based on analysis information based on new medical information obtained by the ophthalmologic apparatus. New medical information or analysis information is input to the ophthalmologic information processing server 200 via the communication unit 202, for example. When new medical information is input, the analysis processing unit 220 generates analysis information from the medical information.

The update processing unit 225 may reflect new analysis information in the current database, or replace the current database with a new database.

{Action}
The operation of the ophthalmologic information processing system 1 will be described. Although the case where the user terminal 100A performs processing is described below, any user terminal 100 may perform similar processing.

Database customization
First, an operation for creating a database based on a designated creation item in the ophthalmologic information processing system 1 according to the embodiment will be described. FIG. 4 is a flowchart for creating a database. In the following example, a case where ophthalmic information is used as medical information for creating a database will be described. However, the creation of the database is not limited to ophthalmic information, and other medical information may be used.

(Step S1: Selection of creation item)
The user selects a database creation item using the user terminal 100A. Therefore, the control unit 101 causes the display unit 104 to display a predetermined user interface. The user interface is, for example, a list display of created items, a pull-down menu display, an icon display, or the like. The user performs an operation of selecting a database creation item using the user interface and the operation unit 106. For example, the user selects age, sex, region, race, disease name, symptom, imaging region, and the like as creation items of the database.

(Step S2: Specification of creation item)
The item designation unit 107 designates a database creation item based on the user selection received by the operation unit 106. For example, when the age and disease name are selected by the user, the item designating unit 107 designates the age and disease name as the creation items.

(Step S3: Transmission of creation instruction)
The control unit 101 controls the communication unit 102 to cause the ophthalmologic information processing server 200 to transmit a DB creation instruction including the creation item specified in step S2 and a terminal ID for identifying the user terminal.

(Step S4: Reception of creation instruction)
The communication unit 202 of the ophthalmologic information processing server 200 receives the DB creation instruction transmitted from the user terminal 100A.

(Step S5: Database creation)
The ophthalmologic information processing server 200 creates a database corresponding to the DB creation instruction received from the user terminal 100A. For example, the database creation unit 226 collects corresponding ophthalmic information from the information storage unit 210 based on the creation item specified in the DB creation instruction, and creates a database.

(Step S6: Database transmission)
The control unit 201 acquires the address (IP address or the like) of the user terminal 100 based on the terminal ID received in step S4. Here, in the ophthalmologic information processing server 200 (for example, the information storage unit 210), information in which a terminal ID is associated with an address is stored in advance, and the control unit 201 specifies a target address with reference to this information. To do. Instead of referring to the terminal ID, the address of the user terminal 100A used in the transmission / reception processing in steps S3 and S4 may be used as a reply destination. The control unit 201 transmits the database to the acquired address.

(Step S7: Database reception)
The communication unit 102 of the user terminal 100 receives the database transmitted from the ophthalmologic information processing server 200.

(Step S8: Analysis using database)
The control unit 101 of the user terminal 100A causes the storage unit 103 to store the database received by the communication unit 102. The control unit 101 analyzes image data using a database stored in the storage unit 103.

For example, the control unit 101 can perform analysis using a diseased eye database created based on ophthalmic information classified for each disease. In this case, for example, in the fundus image to be analyzed, a color map image in which the type of disease at each position and the probability thereof are color-coded may be created (see FIG. 5). From this color map image, the user can easily grasp which disease is likely to occur in each part of the eye to be examined. Moreover, the control part 101 may graph the probability that each disease has developed based on the image to be analyzed.

As another example of analysis, when a database for each disease stage (severity) is created, the control unit 101 may display which stage corresponds to the probability based on the image data.

(Step S9: Analysis result display)
The display control unit 105 causes the display unit 104 to display the analysis result of step S8.

As described above, the ophthalmologic information processing system 1 according to the present embodiment can create a database classified into various items based on a large number of ophthalmologic information collected by the network. For example, it is possible to classify stages of diseases by collecting test results on eyes having the same disease and creating a database. Accordingly, not only whether or not the eye to be examined is a normal eye as in the prior art, but also when diagnosing the disease name or the progression of disease, etc., the ophthalmic information acquired in the past can be used effectively. Further, more effective information can be obtained by classifying the database based on patient information such as age, sex, race, region, etc. in addition to classification by disease name.

In addition, as described above, since a database is created in accordance with an instruction input by the user using the operation unit 106 or the like, even if the database is a classification database that is not stored in the database storage unit 223, the information storage unit 210 A database desired by the user can be created in real time from the accumulated ophthalmologic information. For example, the user can make use of it for medical research by creating various databases, or improve the diagnostic accuracy by creating a database suitable for each patient.

In the above example, the user specifies a database creation item using the operation unit 106, but the present invention is not limited to this. For example, the item specifying unit 107 may automatically specify a database creation item. For example, the item specifying unit 107 may automatically specify an item that is determined to be relevant based on ophthalmologic information transmitted as an analysis target from the user terminal 100 and instruct the creation of a database. For example, the item designating unit 107 may designate the creation item of the corresponding disease database based on the findings data obtained by analyzing the image data of the eye to be examined. The item designating unit 107 may instruct the creation of a further classified database by designating items such as the age, sex, race, and region of the patient. Further, the item specifying unit 107 may automatically specify a database creation item based on the characteristics of a large number of ophthalmologic information accumulated in the information storage unit 210. As described above, the item designating unit 107 automatically designates a creation item, so that a required database can be automatically used even if the user does not designate the creation item.

In the above embodiment, the database is received (downloaded) from the ophthalmic information processing server 200 and the analysis processing is performed on the user terminal 100. However, the analysis processing may be performed on the ophthalmic information processing server 200. Good. In this case, the user terminal 100 transmits ophthalmologic information to be analyzed to the ophthalmologic information processing server 200, and the ophthalmologic information processing server 200 sends the analysis result obtained by analyzing the received ophthalmic information to the user terminal 100. Send.

Note that the ophthalmologic information processing server 200 does not need to create a database when there is little ophthalmologic information regarding the designated creation item in the information storage unit 210. In this case, an error signal indicating that the database cannot be created due to insufficient information may be transmitted to the user terminal 100. When the user terminal 100 receives the error signal, the user terminal 100 may display the fact on the display unit 104 to notify the user. In addition, the user terminal 100 may notify the user of a message that prompts the user to send the missing information to the ophthalmologic information processing server 200. The user who has received the message acquires the missing information by the ophthalmologic apparatus or the like and actively sends it to the ophthalmologic information processing server 200, thereby making it possible to create a database and prompting the utilization of ophthalmologic information.

Of course, the ophthalmologic information processing server 200 may create a database even when there is little ophthalmologic information regarding the designated creation item. In this case, the user may be warned that the number of data used for database creation is small.

Database normalization
The ophthalmologic information processing server 200 may include a normalization processing unit 222 (see FIGS. 3 and 6). For example, it is assumed that ophthalmic devices from different manufacturers are used in the medical facilities A, B, and C, respectively. In this case, the ophthalmologic information processing server 200 normalizes ophthalmologic information received from the user terminals A, B, and C of each medical facility by the normalization processing unit 222, and creates a normalization database DB0 based on the normalized ophthalmologic information. You may create it. This makes it possible to create a database that does not depend on the type of apparatus.

For example, when ophthalmic information is transmitted from the user terminal 100 to the ophthalmologic information processing server 200, device information is added to the ophthalmic information by the user terminal 100. The normalization processing unit 222 normalizes the ophthalmologic information received from the user terminal 100 according to the specifications of each device based on the device information given by the user terminal 100. Further, when transmitting the database to the user terminal 100, for example, the normalized database DB0 is converted into a database corresponding to the specification of each device based on correspondence information in which each user terminal 100 is associated with device information. As a result, even when devices of different manufacturers are used in each facility, ophthalmic information can be shared as a database and effectively utilized between facilities.

Update database
Processing for updating the database will be described.

When new ophthalmic information is input to the ophthalmologic information processing server 200, the control unit 201 sends new ophthalmic information to the update processing unit 255. The update processing unit 255 updates the database stored in the database storage unit 223 based on the new ophthalmologic information.

The database storage unit 223 stores a database generated by statistically processing a plurality of pieces of analysis information obtained by performing analysis processing on a plurality of pieces of ophthalmologic information obtained for a plurality of eyes to be examined by the ophthalmologic apparatus. ing. The update processing unit 225 updates the database stored in the database storage unit 223 based on analysis information based on new image data obtained by the ophthalmologic apparatus.

The ophthalmologic information processing server 200 may include a determination unit 221 (see FIG. 3). For example, when receiving new ophthalmic information, the determination unit 221 may determine whether the new ophthalmic information is appropriate data as compared with a database stored in the database storage unit 223. For example, when the new ophthalmic information is significantly different from the database stored in the database storage unit 223, the determining unit 221 may determine that the new ophthalmic information is not appropriate and may not use it for updating the database. Thereby, even when erroneous ophthalmologic information due to an inspection error or the like is received, it is possible to prevent the validity of the database from being impaired.

Also, the determination unit 221 may determine whether or not the ophthalmic information is appropriate data based on the review information. For example, the ophthalmologic information processing server 200 transmits the ophthalmic information transmitted by the user terminal 100A used in a certain medical facility A to the user terminal 100B used in another medical facility B, and the effectiveness of the ophthalmic information is confirmed. Review information may be acquired. For example, the control unit 201 transmits inspection data and diagnosis results received from the user terminal 100A to the user terminal 100B. The user of the user terminal 100B inputs the suitability of the received examination data and diagnosis result through the operation unit 106. The control unit 101 transmits review information based on the input to the ophthalmologic information processing server 200 through the communication unit 102. The determination unit 221 determines the suitability of ophthalmic information from the user terminal 100A based on the review information received from the user terminal 100B. In this manner, the validity of the database is guaranteed by confirming the validity of the ophthalmologic information in other medical facilities.

[Prediction of retinal structure]
Note that the analysis processing unit 110 or the analysis processing unit 220 may predict how the retinal structure changes using the feature database. The feature database is, for example, a database of not only retinal thickness information but also disease features. For example, machine learning is used to create the feature database. Examples of the machine learning algorithm include a neural network, random forest, boosting, support vector machine (SVM), and the like. As a method for imaging the predicted retinal structure using deep learning, for example, a technique called DCGAN (Deep Convolutional Generative Adversarial Networks) can be used. For example, in the follow-up, the analysis processing units 110 and 220 image the retinal structure with DCGAN based on the analysis information predicted from the past analysis information by machine learning (or simple linear regression).

Also, the ophthalmologic information processing system 1 may automatically present the predicted retinal structure to the user from other parameters of the body. For example, it is possible to create a database of associations with other parameters of the body other than the eye, and present the risk of eye diseases based on the other parameters of the body. For example, a predicted retinal structure in the case of diabetic retinopathy may be presented to a patient with high blood pressure.

Note that the analysis processing unit 110 or the analysis processing unit 220 may analyze the cause of the disease by statistical analysis (principal component analysis or regression analysis). For example, the analysis processing units 110 and 220 automatically analyze which parameter has a strong correlation with the disease from among many parameters obtained by image analysis, such as information on the age and sex of the patient. The cause of the disease may be analyzed. The analyzed factors may be useful for disease research and the like.

DESCRIPTION OF SYMBOLS 1 Ophthalmic information processing system 100 User terminal 101 Control part 102 Communication part 103 Storage part 104 Display part 106 Operation part 107 Item designation part 110 Analysis processing part 150 Hospital server 200 Ophthalmology information processing server 201 Control part 202 Communication part 210 Information storage part 220 Analysis processing unit 221 Judgment unit 222 Normalization processing unit 223 Database storage unit 225 Update processing unit 226 Database creation unit A, B, C Medical facility D Data center N Network

Claims (13)

An ophthalmologic information processing system comprising a user terminal and a server that can communicate with each other via a network,
The user terminal is
A designation means for designating a database creation item created by the server;
First creation means for sending the creation item designated by the designation means to the server via the network;
The server
Receiving means for receiving the creation item transmitted from the user terminal;
Creating means for creating the database corresponding to the created item;
An ophthalmologic information processing system characterized by comprising: 2. The ophthalmologic information processing system according to claim 1, wherein the server further comprises second transmission means for transmitting the database created by the creation means to the user terminal via the network. The user terminal includes an operation means for receiving a user operation,
3. The ophthalmologic information processing system according to claim 1, wherein the designation unit designates the creation item based on an operation signal output by the operation unit. The ophthalmologic information processing system according to claim 1 or 2, wherein the designating unit automatically designates the creation item based on medical information received from the user terminal. The user terminal is
An acquisition means for acquiring medical information of a patient; and transmitting the medical information acquired by the acquisition means to the server by the first transmission means;
The server
Receiving the medical information transmitted from the user terminal by the receiving means;
3. The ophthalmologic information processing system according to claim 1, wherein the database is created based on the medical information. The server further comprises determination means for determining the suitability of the medical information received from the user terminal,
The creation unit updates the database based on the medical information when the determination unit determines that the medical information is suitable, and the determination unit determines that the medical information is not suitable The ophthalmologic information processing system according to claim 4 or 5, wherein the database is not updated based on the medical information. The user terminals are first and second user terminals,
The server receives review information about the medical information acquired by the first user terminal from the second user terminal,
The ophthalmologic information processing system according to claim 6, wherein the determination unit determines whether or not the medical information is appropriate based on the review information. Further comprising normalization means for normalizing the medical information transmitted from the user terminal,
8. The ophthalmologic information processing system according to claim 4, wherein the creating unit creates the database based on the medical information normalized by the normalizing unit. The ophthalmologic information processing system according to any one of claims 4 to 8, further comprising shape prediction means for predicting a future retinal shape of the eye to be examined based on the database. 10. The ophthalmologic information processing system according to claim 9, wherein the shape predicting means predicts the retinal shape using an algorithm trained by machine learning. The ophthalmologic information processing system according to claim 1, wherein the database is at least one of a normal eye database based on normal eye medical information and a disease eye database based on sick eye medical information. The ophthalmologic information processing system according to any one of claims 4 to 10, wherein the medical information is ophthalmologic information including at least one of ophthalmic examination information, ophthalmic diagnosis information, and eye information to be examined. 13. The ophthalmologic information processing system according to claim 1, wherein the created item is at least one of a patient's age, sex, race, region, examination date and disease name.

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