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WO2025053069A1 - Programme d'ordinateur, procédé de traitement d'informations et dispositif de traitement d'informations - Google Patents

Programme d'ordinateur, procédé de traitement d'informations et dispositif de traitement d'informations Download PDF

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Publication number
WO2025053069A1
WO2025053069A1 PCT/JP2024/031187 JP2024031187W WO2025053069A1 WO 2025053069 A1 WO2025053069 A1 WO 2025053069A1 JP 2024031187 W JP2024031187 W JP 2024031187W WO 2025053069 A1 WO2025053069 A1 WO 2025053069A1
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WO
WIPO (PCT)
Prior art keywords
information
patient
peritoneal dialysis
prescription
dialysis
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
PCT/JP2024/031187
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English (en)
Japanese (ja)
Inventor
啓明 高橋
英二 川本
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Terumo Corp
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Terumo Corp
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Filing date
Publication date
Application filed by Terumo Corp filed Critical Terumo Corp
Publication of WO2025053069A1 publication Critical patent/WO2025053069A1/fr
Pending legal-status Critical Current
Anticipated expiration legal-status Critical

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
    • A61M1/28—Peritoneal dialysis ; Other peritoneal treatment, e.g. oxygenation
    • 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
    • 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
    • G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
    • 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
    • G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
    • G16H50/20—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for computer-aided diagnosis, e.g. based on medical expert systems

Definitions

  • This disclosure relates to a computer program, an information processing method, and an information processing device.
  • patent literature discloses a technology that divides the period of dialysis treatment into multiple periods and measures the patient's blood pressure during each period.
  • Patent Document 1 makes it possible to manage changes in blood pressure during dialysis, but it does not allow for the proposal of dialysis prescriptions for peritoneal dialysis patients.
  • the object is to provide a computer program, an information processing method, and an information processing device that can propose dialysis prescriptions for peritoneal dialysis patients.
  • the computer program disclosed herein is a computer program for causing a computer to execute a process of acquiring information about a peritoneal dialysis patient, including at least one of edema, urine volume, and amount of water removed, inputting the acquired information into a learning model that has been trained to output information related to a dialysis prescription for the peritoneal dialysis patient when the information about the peritoneal dialysis patient is input, executing a calculation using the learning model, generating a dialysis prescription based on the information output from the learning model, and outputting the generated dialysis prescription.
  • the dialysis prescription includes at least one of the type of peritoneal dialysis fluid to be prescribed and the number of peritoneal dialysis sessions per day.
  • any one of the computer programs (1) to (3) above it is preferable to have the computer execute a process of generating an image showing the bodily fluid status of a peritoneal dialysis patient based on the acquired information about the patient, and outputting the generated image.
  • the information further includes at least one of information regarding hANP (human atrial natriuretic peptide), cardiothoracic ratio, bioimpedance, transperitoneal sodium removal, and urinary sodium excretion.
  • hANP human atrial natriuretic peptide
  • the learning model is a language generation model trained to output sentences related to peritoneal dialysis prescriptions, and the computer is caused to execute a process of outputting the sentences related to the peritoneal dialysis prescriptions by inputting acquired information into the language generation model.
  • the information processing device disclosed herein includes at least one processor, which acquires information about a peritoneal dialysis patient including at least one of edema, urine volume, and amount of water removed, inputs the acquired information into a learning model that has been trained to output information related to a dialysis prescription for the peritoneal dialysis patient when the information about the peritoneal dialysis patient is input, executes a calculation using the learning model, generates a dialysis prescription based on the information output from the learning model, and outputs the generated dialysis prescription.
  • the patient information acquired by the server device 10 may further include information regarding at least one of hANP, cardiothoracic ratio, bioimpedance, transperitoneal sodium removal, and urinary sodium excretion. This information is managed for each patient, and may be entered, for example, from the doctor's terminal 30 and preregistered in the server device 10.
  • the patient information registered in the server device 10 may further include information regarding antihypertensive drugs, diuretics, blood pressure, etc., and may further include information regarding urinary cortisol, urinary creatinine, skin sodium, Na-MRI, etc.
  • the control unit 11 includes, for example, a CPU (Central Processing Unit), a ROM (Read Only Memory), and a RAM (Random Access Memory).
  • the ROM included in the control unit 11 stores control programs and the like that control the operation of each piece of hardware included in the server device 10.
  • the CPU in the control unit 11 reads and executes the control programs stored in the ROM and computer programs (described below) stored in the memory unit 12, and controls the operation of each piece of hardware, causing the entire device to function as the server device 10 (information processing device) of the present disclosure.
  • the RAM included in the control unit 11 temporarily stores data used during the execution of calculations and control.
  • control unit 11 is configured to include a CPU, ROM, and RAM, but the configuration of the control unit 11 is not limited to the above.
  • the control unit 11 may be, for example, one or more control circuits or arithmetic circuits including a GPU (Graphics Processing Unit), an FPGA (Field Programmable Gate Array), a DSP (Digital Signal Processor), a quantum processor, volatile or non-volatile memory, etc.
  • the control unit 11 may also have functions such as a clock that outputs date and time information, a timer that measures the elapsed time from when an instruction to start measurement is given to when an instruction to end measurement is given, and a counter that counts numbers.
  • the memory unit 12 includes a storage device such as a hard disk drive (HDD) or a solid state drive (SSD).
  • the memory unit 12 stores various computer programs executed by the control unit 11 and various data used by the control unit 11.
  • the computer program (program product) stored in the memory unit 12 includes a prescription generation program PG1 for causing a computer to execute a process of generating a dialysis prescription to be prescribed to a patient using a learning model LM1 described below and outputting the generated dialysis prescription.
  • the prescription generation program PG1 may be a single computer program or a group of programs consisting of multiple computer programs.
  • the prescription generation program PG1 may also partially use an existing library.
  • the prescription generation program PG1 may be executed by a single computer or may be executed by multiple computers working together.
  • the computer program including the prescription generation program PG1 is provided by a non-transitory recording medium RM on which the computer program is recorded in a readable manner.
  • the recording medium RM is a portable memory such as a CD-ROM, a USB memory, or an SD (Secure Digital) card.
  • the control unit 11 reads various computer programs from the recording medium RM using a reading device not shown in the figure, and stores the various computer programs that have been read in the memory unit 12.
  • the computer program including the prescription generation program PG1 may be provided by communication.
  • the control unit 11 acquires the computer program including the prescription generation program PG1 by communication via the communication unit 13, and stores the acquired computer program in the memory unit 12.
  • the memory unit 12 also stores a learning model LM1 that has been trained to output information related to a dialysis prescription for a peritoneal dialysis patient (hereinafter also referred to as prescription information) when information related to at least one of edema, urine volume, and water removal volume is input.
  • the memory unit 12 stores information describing the learned learning model LM1, such as the layer structure of the model, the number and connection relationships of nodes that make up each layer, and weighting coefficients and biases between nodes, as well as trained parameters, for the trained learning model LM1.
  • the communication unit 13 has a communication interface for transmitting and receiving various data to and from an external device.
  • a communication interface conforming to a communication standard such as WiFi (registered trademark), LAN (Local Area Network), Bluetooth (registered trademark), ZigBee (registered trademark), 3G, 4G, 5G, or LTE (Long Term Evolution) can be used.
  • WiFi registered trademark
  • LAN Local Area Network
  • Bluetooth registered trademark
  • ZigBee registered trademark
  • 3G, 4G, 5G, or LTE Long Term Evolution
  • examples of external devices are the patient terminal 20 and the doctor terminal 30.
  • the operation unit 14 is equipped with operation devices such as a touch panel, a keyboard, and switches, and accepts various operations and settings by the user, etc.
  • the control unit 11 performs appropriate control based on the various operation information provided by the operation unit 14, and stores the setting information in the storage unit 12 as necessary.
  • the display unit 15 includes a display device such as a liquid crystal display or an organic EL (Electro-Luminescence) display, and displays the information to be presented in response to instructions from the control unit 11.
  • a display device such as a liquid crystal display or an organic EL (Electro-Luminescence) display, and displays the information to be presented in response to instructions from the control unit 11.
  • FIG. 3 is a block diagram explaining the internal configuration of the patient terminal 20.
  • the patient terminal 20 is a computer such as a smartphone, a tablet terminal, or a personal computer, and includes a control unit 21, a memory unit 22, a communication unit 23, an operation unit 24, and a display unit 25.
  • the control unit 21 includes, for example, a CPU, a ROM, a RAM, etc.
  • the CPU of the control unit 21 controls the operation of the various hardware components described above by expanding into the RAM various programs pre-stored in the ROM or the storage unit 22 and executing them, causing the entire device to function as the patient terminal 20 of the present disclosure.
  • the control unit 21 is not limited to the above configuration, and may be configured as a single piece of hardware (SoC: System On a Chip) that integrates a processor, memory, storage, communication interface, etc.
  • SoC System On a Chip
  • the control unit 21 may also have functions such as a clock that outputs date and time information, a timer that measures the elapsed time from when an instruction to start measurement is given to when an instruction to end measurement is given, and a counter that counts numbers.
  • the storage unit 22 includes storage such as a memory and a hard disk.
  • the storage unit 22 stores various computer programs executed by the control unit 21, and data necessary for executing the computer programs.
  • the computer programs stored in the storage unit 22 include application programs for using the services provided by the server device 10.
  • the programs stored in the memory unit 22 may be provided by a non-transitory recording medium on which the programs are recorded in a readable manner.
  • the recording medium is, for example, a portable memory such as a CD-ROM, a USB memory, or an SD card.
  • the control unit 21 reads the various programs from the recording medium using a reading device (not shown), and installs the various programs that have been read into the memory unit 22.
  • the programs stored in the memory unit 22 may also be provided by communication. In this case, the control unit 21 acquires the various programs through the communication unit 23, and installs the acquired programs into the memory unit 22.
  • the communication unit 23 has a communication interface for connecting to the communication network NW.
  • the communication interface of the communication unit 23 is, for example, a communication interface conforming to a communication standard such as WiFi (registered trademark), LAN, Bluetooth (registered trademark), ZigBee (registered trademark), 3G, 4G, 5G, or LTE.
  • the communication unit 23 transmits various information to be notified to the outside, and receives various information transmitted from the outside to the device itself.
  • the operation unit 24 is equipped with input devices such as a touch panel and operation buttons, and receives various types of operation information and setting information.
  • the operation unit 24 outputs the received operation information and setting information to the control unit 21.
  • the control unit 21 performs appropriate control based on the operation information input from the operation unit 24, and stores the setting information in the memory unit 22 as necessary.
  • the display unit 25 is equipped with a display device such as a liquid crystal display or an organic EL display, and displays information to be presented to the patient based on the control signal output from the control unit 21.
  • a display device such as a liquid crystal display or an organic EL display
  • FIG. 4 is a block diagram explaining the internal configuration of the doctor terminal 30.
  • the doctor terminal 30 is a computer such as a personal computer, a tablet terminal, or a smartphone, and includes a control unit 31, a memory unit 32, a communication unit 33, an operation unit 34, and a display unit 35.
  • the control unit 31 includes, for example, a CPU, a ROM, a RAM, etc.
  • the CPU of the control unit 31 controls the operation of the various hardware components described above by expanding into the RAM various programs pre-stored in the ROM or the storage unit 32 and executing them, causing the entire device to function as the doctor terminal 30 of the present disclosure.
  • the control unit 31 is not limited to the above configuration, and may be configured as a single piece of hardware (SoC: System On a Chip) that integrates a processor, memory, storage, communication interface, etc.
  • SoC System On a Chip
  • the control unit 31 may also have functions such as a clock that outputs date and time information, a timer that measures the elapsed time from when an instruction to start measurement is given to when an instruction to end measurement is given, and a counter that counts numbers.
  • the storage unit 32 includes storage such as a memory and a hard disk.
  • the storage unit 32 stores various computer programs executed by the control unit 31, and data necessary for executing the computer programs.
  • the computer programs stored in the storage unit 32 include application programs for using the services provided by the server device 10.
  • the programs stored in the memory unit 32 may be provided by a non-transitory recording medium on which the programs are recorded in a readable manner.
  • the recording medium is, for example, a portable memory such as a CD-ROM, a USB memory, or an SD card.
  • the control unit 31 reads the various programs from the recording medium using a reading device (not shown), and installs the various programs that have been read into the memory unit 32.
  • the programs stored in the memory unit 32 may also be provided by communication. In this case, the control unit 31 acquires the various programs through the communication unit 33, and installs the acquired programs into the memory unit 32.
  • the communication unit 33 has a communication interface for connecting to the communication network NW.
  • the communication interface of the communication unit 33 is, for example, a communication interface conforming to communication standards such as WiFi (registered trademark), LAN, Bluetooth (registered trademark), ZigBee (registered trademark), 3G, 4G, 5G, and LTE.
  • the communication unit 33 transmits various information to be notified to the outside, and receives various information transmitted from the outside to its own device.
  • the operation unit 34 is equipped with input devices such as a keyboard and a mouse, and receives various types of operation information and setting information.
  • the operation unit 34 outputs the received operation information and setting information to the control unit 31.
  • the control unit 31 performs appropriate control based on the operation information input from the operation unit 34, and stores the setting information in the memory unit 32 as necessary.
  • the display unit 35 is equipped with a display device such as a liquid crystal display or an organic EL display, and displays information to be presented to medical personnel based on the control signal output from the control unit 31.
  • a display device such as a liquid crystal display or an organic EL display
  • the peritoneal management support system acquires patient information from the patient terminal 20 used by the patient.
  • the patient information is input by the patient himself/herself through a patient information input screen shown below.
  • FIG. 5 is a schematic diagram showing an example of a patient information input screen on the patient terminal 20.
  • the patient information input screen shown in FIG. 5 shows an example of a screen that is displayed on the display unit 25 when the server device 10 is accessed from the patient terminal 20 and a specified operation is performed.
  • This patient information input screen accepts information regarding edema, urine volume, and amount of water removed.
  • the state of edema is measured by the patient checking the indentation. Specifically, the area where bones such as the tibia are subcutaneously placed is pressed with the thumb or the second to fourth fingers, and the condition of the skin after the pressure is released is checked visually and palpably.
  • An edema level of "0" indicates a normal state with no indentation.
  • An edema level of "1+” indicates a slight indentation, but no visible distortion, and the indentation disappears quickly.
  • An edema level of "2+” indicates a somewhat deep indentation, but the indentation disappears within about 10 to 15 seconds.
  • An edema level of "3+” indicates a deep indentation that may last for one minute or more.
  • An edema level of "4+” indicates a very deep indentation that lasts for two to five minutes or more.
  • the state of edema is entered into three categories: "0 to 1+", “2+”, and "3+ to 4+”.
  • the edema condition may be entered into five categories ranging from “0" to "4+”.
  • Urine volume is measured by the patient themselves using a measuring cup or similar.
  • the daily urine volume (mL) is entered on the patient information input screen in Figure 5.
  • the amount of water removed is calculated as the amount of fluid injected - the amount of fluid drained.
  • the amount of fluid injected represents the amount of dialysis fluid injected into the patient's body, and is measured by weighing the bag containing the dialysis fluid before and after injection.
  • the amount of fluid drained represents the amount of dialysis fluid discharged from the patient's body, and is measured by weighing the bag that collects the drained fluid.
  • the daily amount of water removed (mL) is entered on the patient information input screen in Figure 5.
  • FIG. 5 an example of a patient information input screen that accepts information regarding edema, urine volume, and amount of water removed is shown, but it may also be possible to accept any one or any two of edema, urine volume, and amount of water removed.
  • dry mouth is subjectively rated by the patient on a numerical rating scale (NRS) of 0 to 10.
  • NRS numerical rating scale
  • dry mouth may be rated on a two-level scale: dry mouth/no dry mouth.
  • Body weight is measured by the patient using a weighing scale.
  • FIG. 6 is a schematic diagram showing an example of a patient information input screen on the doctor terminal 30.
  • the patient information input screen shown in Figure 6 shows an example of a screen that is displayed on the display unit 35 when the server device 10 is accessed from the doctor terminal 30 and a specified operation is performed.
  • This patient information input screen accepts information related to hANP, cardiothoracic ratio, bioimpedance, transperitoneal sodium removal, and urinary sodium excretion.
  • hANP is a human atrial natriuretic peptide, and its concentration is measured by a blood test.
  • the IRMA (immunoradiometric assay) method is used to measure the concentration.
  • the reference value for hANP is, for example, 43.0 pg/mL.
  • hAMP is secreted in response to stimulation of the atrium, so it shows abnormally high values in diseases or pathological conditions that cause increased atrial pressure or increased body fluid volume. In the example screen in Figure 6, the hAMP concentration is entered as a number (pg/mL).
  • the cardiothoracic ratio is an index that shows the ratio of the transverse diameter of the heart to the transverse diameter of the thorax, and is measured using a chest X-ray.
  • the appropriate ratio is 50% or less for men and 55% or less for women.
  • the cardiothoracic ratio increases.
  • the cardiothoracic ratio is entered as a number (%).
  • Bioimpedance is the resistance (impedance) of a living body, and is measured by a body composition analyzer.
  • Body composition analyzers use the bioelectrical impedance analysis (BIA) method, which takes advantage of the fact that almost no current flows through fat tissue, but that current flows easily through lean tissue, which contains water and electrolytes.
  • BIA bioelectrical impedance analysis
  • body composition analyzers can measure the indicator of excess/deficiency of body fluids (OH).
  • the standard value for OH is -1.1 to 1.1 L.
  • the indicator of excess/deficiency of body fluids is entered as a numerical value (L).
  • the transperitoneal sodium removal amount is measured, for example, by collecting the dialysis fluid (effluent) discharged from the patient's body during peritoneal dialysis and analyzing the components of the collected effluent.
  • the transperitoneal sodium removal amount is entered as a value (g) converted to salt.
  • the amount of urinary sodium removal is measured, for example, by collecting urine from the patient and analyzing the components of the collected urine.
  • the amount of urinary sodium removal is entered as a value (g) converted to salt.

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  • Engineering & Computer Science (AREA)
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  • General Health & Medical Sciences (AREA)
  • Medical Informatics (AREA)
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  • Urology & Nephrology (AREA)
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Abstract

L'invention concerne un programme d'ordinateur, un procédé de traitement d'informations et un dispositif de traitement d'informations.　La présente invention acquiert des informations sur un patient de dialyse péritonéale notamment au moins un œdème, une diurèse et/ou un volume d'ultrafiltration, introduit les informations acquises dans un modèle entraîné, qui est entraîné pour délivrer des informations relatives à une prescription de dialyse pour le patient de dialyse péritonéale lorsque les informations sur le patient de dialyse péritonéale sont introduites, exécute un calcul avec le modèle entraîné, génère une prescription de dialyse sur la base d'informations délivrées par le modèle entraîné, et délivre la prescription de dialyse générée.
PCT/JP2024/031187 2023-09-06 2024-08-30 Programme d'ordinateur, procédé de traitement d'informations et dispositif de traitement d'informations Pending WO2025053069A1 (fr)

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JP2023144749 2023-09-06
JP2023-144749 2023-09-06

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Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2018043003A (ja) * 2016-09-08 2018-03-22 株式会社アドバンス 透析個体差情報管理システム
WO2021155138A1 (fr) * 2020-01-30 2021-08-05 Fresenius Medical Care Holdings, Inc. Techniques de détermination de profils de patient de dialyse
US20220096724A1 (en) * 2020-09-30 2022-03-31 Uop Llc Process for removing ions from bodily fluids using small molecule metal chelators and metallate ion exchange compositions

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2018043003A (ja) * 2016-09-08 2018-03-22 株式会社アドバンス 透析個体差情報管理システム
WO2021155138A1 (fr) * 2020-01-30 2021-08-05 Fresenius Medical Care Holdings, Inc. Techniques de détermination de profils de patient de dialyse
US20220096724A1 (en) * 2020-09-30 2022-03-31 Uop Llc Process for removing ions from bodily fluids using small molecule metal chelators and metallate ion exchange compositions

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