CN114334141A

Movatterモバイル変換

Info

Publication number: CN114334141A
Application number: CN202210224586.4A
Authority: CN
Inventors: 尹红霞; 胡艳军; 王振常; 任鹏玲; 杨正汉; 田心
Original assignee: Beijing Friendship Hospital
Current assignee: Beijing Friendship Hospital
Priority date: 2022-03-09
Filing date: 2022-03-09
Publication date: 2022-04-12

Abstract

The application provides an early warning method and device for cancer risks caused by X-ray examination, computer equipment and a storage medium, and solves the problem that in the prior art, effective assessment and early warning cannot be carried out on cumulative influence of X-ray examination on patients. The early warning method comprises the following steps: determining the type of the disease suffered by the patient based on the treatment reason of the patient, wherein the treatment reason refers to a diagnosis description filled in when a doctor applies for a preset X-ray examination; triggering a first-level early warning when the disease type belongs to a preset high-risk disease; determining the cumulative risk of cancer of the patient on the preset X-ray examination based on the case record of the past X-ray examination of the patient and the cumulative cancer risk assessment model; and triggering a secondary early warning when the accumulated cancer risk meets a preset condition.

Description

Translated fromChinese

行X射线检查所致患癌风险的预警方法和装置Method and device for early warning of cancer risk due to X-ray examination

技术领域technical field

本申请涉及X射线技术领域，具体涉及一种行X射线检查所致患癌风险的预警方法和装置、计算机设备，以及存储介质。The present application relates to the field of X-ray technology, and in particular to a method and device for early warning of cancer risk caused by X-ray examination, computer equipment, and storage medium.

背景技术Background technique

从1985年伦琴发现X射线是一种波长很短的电磁波，到其应用于医学领域，然后发现X射线会对人体造成损害，比如，X射线照射人体，可产生电离作用，使人体产生生物学方面的改变，即生物效应。在对X射线的应用和探索过程中，X射线既给人类做出了巨大贡献，也带来了一些担忧，甚至恐慌。From 1985, when Roentgen discovered that X-rays are electromagnetic waves with a very short wavelength, to their application in the medical field, they found that X-rays can cause damage to the human body. Aspects of change, that is, biological effects. In the process of application and exploration of X-rays, X-rays have not only made great contributions to human beings, but also brought some concerns and even panic.

国际辐射防护委员会（International Commission on RadiologicalProtection，ICRP）的成立以及近百年的努力，确保了X射线可以更有效更安全的造福人类，而没有因为担心其危害而放弃使用。其中，ICRP倡议的辐射防护体系，起到了重要作用。ICRP的建议书指出，电离辐射对人体产生的生物效应分为确定性效应和随机性效应，辐射防护的目的是防止确定性效应，并将随机性效应的概率限制在可接受的水平。ICRP的建议书引入职业暴露、公众暴露和医疗暴露的概念时，对职业暴露和公众暴露给出了剂量限制的建议，但是对于医疗暴露因其有明确理由，所以没有剂量限制的建议。The establishment of the International Commission on Radiological Protection (ICRP) and nearly a hundred years of efforts have ensured that X-rays can benefit mankind more effectively and safely, without giving up their use due to concerns about their harm. Among them, the radiation protection system proposed by ICRP has played an important role. The ICRP Recommendation points out that the biological effects of ionizing radiation on the human body are divided into deterministic effects and random effects. The purpose of radiation protection is to prevent deterministic effects and limit the probability of random effects to an acceptable level. When the ICRP Recommendation introduces the concepts of occupational exposure, public exposure and medical exposure, it gives advice on dose limitation for occupational exposure and public exposure, but for medical exposure, there is no recommendation for dose limitation because there are clear reasons for it.

现如今，X射线已广泛应用于医疗领域，其相关诊断性检查已成为医院的常规检查，这些常规检查包括患者因病接受X射线检查和无症状人群的健康体检。随着X射线在健康体检中的应用越来越多，X射线存在的风险也越来越受重视，关注人群从专业人士逐渐扩展到普通大众。大众人群开始关心自己能够承受多少照射剂量，照射后是否会对健康造成影响等。Today, X-rays have been widely used in the medical field, and their related diagnostic tests have become routine inspections in hospitals. These routine inspections include patients receiving X-rays due to illness and health checkups for asymptomatic people. With more and more applications of X-rays in health examinations, the risks of X-rays have been paid more and more attention, and the attention group has gradually expanded from professionals to the general public. The general public has begun to care about how much radiation dose they can bear and whether it will affect their health after exposure.

基于上述现状，本领域技术人员进行了大量研究。其中，Radimetrics的文献1（Bayer teams with Radimetrics for dose-management software[J]. Medical DeviceDaily, 2012）、王鑫宏的文献2（王鑫宏,章伟敏,孙建忠,等.住院患者年累积CT有效剂量的分析[J].中华放射学杂志,2014,(6):503-504. DOI:10.3760/cma.j.issn.1005-1201.2014.06.016）和文献3（王鑫宏, 章伟敏, 孙建忠, et al. 住院患者年累积CT有效剂量的分析[J]. 中华放射学杂志, 2014(6):503-504）等对CT照射剂量在软件方面进行了研究，建立了剂量数据库，用于监测患者受到的辐射剂量。然而，患者只知道受到的照射剂量，也无法衡量自己究竟处于什么样的风险等级之中。《放射诊断的医疗照射指导水平》指出了每次X射线照射的参考剂量，可以用来指导单次医疗照射是否处于正常水平。然而，X射线照射的剂量存在累积效应。国际原子能机构曾在其出版物中指出，一次X射线扫描的剂量范围为1-20msv，重复扫描累积的剂量在50-500msv范围内，超过1%的患者接受的剂量超过100msv。因此，在评估X射线照射带来的风险时，单纯考虑单次照射剂量还不足以对X射线的辐射风险进行准确估计。Based on the above status quo, those skilled in the art have conducted a lot of research. Among them, the literature 1 of Radimetrics (Bayer teams with Radimetrics for dose-management software [J]. Medical DeviceDaily, 2012), the literature 2 of Wang Xinhong (Wang Xinhong, Zhang Weimin, Sun Jianzhong, et al. Analysis of the annual cumulative CT effective dose of inpatients [J]. ]. Chinese Journal of Radiology, 2014, (6): 503-504. DOI: 10.3760/cma.j.issn.1005-1201.2014.06.016) and document 3 (Wang Xinhong, Zhang Weimin, Sun Jianzhong, et al. Analysis of CT effective dose [J]. Chinese Journal of Radiology, 2014(6): 503-504) and others conducted research on CT radiation dose in terms of software, and established a dose database to monitor the radiation dose received by patients. However, patients only know the dose of exposure they have received, and they have no way of measuring their level of risk. The "Guidance Level of Medical Exposure for Radiological Diagnosis" points out the reference dose of each X-ray exposure, which can be used to guide whether a single medical exposure is at a normal level. However, there is a cumulative effect of the dose of X-ray exposure. The International Atomic Energy Agency has stated in its publication that the dose range from one X-ray scan is 1-20msv, the cumulative dose from repeated scans is in the range of 50-500msv, and more than 1% of patients received doses exceeding 100msv. Therefore, when evaluating the risk of X-ray exposure, simply considering the single exposure dose is not enough to accurately estimate the radiation risk of X-ray.

为此，Sodickson的文献4（Sodickson,A,Baeyens,PF,Andriole,KP,PrevedeTo this end, Sodickson's document 4 (Sodickson, A, Baeyens, PF, Andriole, KP, Prevede

llo,LM,Nawfel,RD,Hanson,R,Khorasani,R.Recurrent CT, cumulativeradiation exposure, and associated radiation-induced cancer risks from CT ofadults.[J].Radiology,2009,251(1): 175-184.）回顾性研究了单中心22年CT检查数据，计算量CT累积效应的患癌风险情况。另有Rampinelli C的文献5（Rampinelli C , DeMarco P , Origgi D , et al. Exposure to low dose computed tomography for lungcancer screening and risk of cancer: secondary analysis of trial data andrisk-benefit analysis[J]. BMJ, 2017:j347.）追踪性调研了10年，研究CT累积效应，计算CT筛查诱发癌症的概率。然而他们的研究只针对CT检查，并未包含放射科涉及的其他X射线检查。llo,LM,Nawfel,RD,Hanson,R,Khorasani,R.Recurrent CT, cumulativeradiation exposure, and associated radiation-induced cancer risks from CT ofadults.[J].Radiology,2009,251(1): 175-184. ) retrospectively studied 22 years of CT data from a single center and calculated the cumulative effect of CT on cancer risk. In addition, Rampinelli C's document 5 (Rampinelli C, DeMarco P, Origgi D, et al. Exposure to low computed dose tomography for lungcancer screening and risk of cancer: secondary analysis of trial data and risk-benefit analysis [J]. BMJ, 2017 :j347.) A follow-up study was conducted for 10 years to study the cumulative effect of CT and to calculate the probability of CT screening-induced cancer. However, their study only focused on CT examinations and did not include other X-ray examinations involved in radiology.

与此同时，文献6（UNSCEAR 2012 REPORT; SOURCES, EFFECTS AND RISKS OFIONIZING RADIATION; Annex A: Attributing health effects to ionizing radiationexposure and inferring risks）中指出，受到X射线低剂量照射随曝光年龄和性别不同，受照者终身增加额外的癌症发病率和死亡率。At the same time, literature 6 (UNSCEAR 2012 REPORT; SOURCES, EFFECTS AND RISKS OFIONIZING RADIATION; Annex A: Attributing health effects to ionizing radiationexposure and inferring risks) pointed out that exposure to low-dose X-rays varies with exposure age and gender. increase additional cancer morbidity and mortality throughout life.

基于上述背景技术，为X射线电离辐射医疗防护提供一个参考标准，以对X射线检查对患者的影响进行有效评估和预警，是亟待解决的问题。Based on the above background technology, it is an urgent problem to provide a reference standard for X-ray ionizing radiation medical protection, so as to effectively evaluate and give early warning of the impact of X-ray examination on patients.

发明内容SUMMARY OF THE INVENTION

有鉴于此，本申请实施例提供了一种行X射线检查所致患癌风险的预警方法和装置、计算机设备，以及存储介质，以解决现有技术中无法对X射线检查的累积效应对患者造成的影响进行有效评估和预警的问题。In view of this, the embodiments of the present application provide an early warning method and device for cancer risk caused by X-ray examination, computer equipment, and storage medium, so as to solve the problem that the cumulative effect of X-ray examination in the prior art cannot be affected on patients. Effective assessment and early warning of impacts.

本申请第一方面提供了一种行X射线检查所致患癌风险的预警方法，包括：基于患者的就诊原因确定患者所患疾病类型，就诊原因是指医生申请预定X射线检查时填写的诊断描述；当疾病类型属于预设高风险疾病时，触发一级预警；基于患者的过往X射线检查的病例记录和累积患癌风险评估模型确定患者行预设X射线检查的累积患癌风险，累积患癌风险用癌症的累积发病率和/或累积死亡率表征，累积发病率是指患者行过往X射线检查和预设X射线检查之一的单次癌症发病率的加和，累积死亡率是指患者行过往X射线检查和预设X射线检查之一的单次癌症死亡率的加和；当累积患癌风险满足预设条件时，触发二级预警。A first aspect of the present application provides a method for early warning of cancer risk caused by X-ray examination, including: determining the type of disease the patient suffers from based on the patient's reason for visiting a doctor, where the reason for visiting a doctor refers to the diagnosis filled in by a doctor when applying for a scheduled X-ray examination Description; when the disease type is a preset high-risk disease, a first-level warning is triggered; based on the patient's past X-ray examination case records and the cumulative cancer risk assessment model, the cumulative cancer risk of the patient undergoing the preset X-ray examination is determined, and the cumulative cancer risk is determined. Cancer risk is characterized by the cumulative incidence and/or cumulative mortality of cancer. The cumulative incidence is the sum of the single cancer incidence for one of the patient's previous X-rays and one of the scheduled X-rays. The cumulative mortality is Refers to the sum of the single cancer mortality rate of a patient’s previous X-ray examination and one of the preset X-ray examinations; when the cumulative cancer risk meets the preset conditions, a secondary warning is triggered.

在一个实施例中，基于患者的就诊原因确定患者所患疾病类型包括：将就诊原因和疾病类型数据库进行文本匹配，以确定疾病类型。In one embodiment, determining the type of disease the patient suffers from based on the reason for the patient's visit includes: performing text matching between the reason for the visit and the disease type database to determine the disease type.

在一个实施例中，累积患癌风险评估模型包括单次患癌风险评估模块和累加模块；基于患者的过往X射线检查的病例记录和累积患癌风险评估模型确定患者行预设X射线检查后的累积患癌风险包括：单次患癌风险评估模块分别针对过往X射线检查和预设X射线检查，基于患者的性别、检查时的年龄和有效剂量确定单次X射线检查的癌症发病率和癌症死亡率；累加模块对全部X射线检查的癌症发病率进行加和，得到累积发病率，对全部X射线检查的癌症死亡率加和，得到累积死亡率。In one embodiment, the cumulative cancer risk assessment model includes a single cancer risk assessment module and an accumulation module; based on the case records of the patient's past X-ray examinations and the cumulative cancer risk assessment model, it is determined that the patient undergoes a preset X-ray examination after The cumulative cancer risk includes: the single cancer risk assessment module determines the cancer incidence and Cancer mortality rate; the accumulating module sums the cancer incidence rates of all X-ray examinations to obtain the cumulative incidence rate, and adds the cancer mortality rates of all X-ray examinations to obtain the cumulative mortality rate.

在一个实施例中，在单次患癌风险评估模块分别针对过往X射线检查和预设X射线检查，基于患者的性别、检查时的年龄和有效剂量确定单次X射线检查的癌症发病率和癌症死亡率之前，还包括：确定过往X射线检查和预设X射线检查各自对应的标准检查项目；确定标准检查项目对应的有效剂量。In one embodiment, in the single cancer risk assessment module, for the past X-ray examination and the preset X-ray examination, respectively, the cancer incidence rate and Before the cancer mortality rate, it also includes: determining the respective standard inspection items corresponding to the past X-ray inspection and the preset X-ray inspection; determining the effective dose corresponding to the standard inspection items.

在一个实施例中，当累积患癌风险满足预设条件时，触发二级预警包括：当累积发病率超过发病率阈值，累积死亡率超过死亡率阈值时，触发二级预警。In one embodiment, when the cumulative cancer risk meets a preset condition, triggering the secondary early warning includes: when the cumulative incidence exceeds the incidence threshold and the cumulative mortality exceeds the mortality threshold, triggering the secondary early warning.

在一个实施例中，还包括：获取第一数据样本，第一数据样本包括第一预设期间内行X射线检查的多名患者的历史病例记录；基于第一数据样本和累积患癌风险评估模型，确定多名患者各自的终身累积发病率；基于多名患者的终身累积发病率确定发病率等级；确定发病率等级中预设发病率级别对应的边界值为发病率阈值。In one embodiment, the method further includes: acquiring a first data sample, where the first data sample includes historical case records of a plurality of patients who underwent X-ray examination within a first preset period; and an assessment model based on the first data sample and a cumulative cancer risk , determine the respective lifetime cumulative morbidity rates of multiple patients; determine the morbidity level based on the lifetime cumulative morbidity rates of multiple patients; determine the morbidity rate threshold corresponding to the preset morbidity level in the morbidity level.

在一个实施例中，在获取第一数据样本之后，还包括：基于第一数据样本和累积患癌风险评估模型，确定多名患者各自的终身累积死亡率；基于多名患者的终身累积死亡率确定死亡率等级；确定死亡率等级中预设死亡率级别对应的边界值为死亡率阈值。In one embodiment, after acquiring the first data sample, the method further includes: based on the first data sample and the cumulative cancer risk assessment model, determining the respective lifetime cumulative mortality rates of the multiple patients; based on the lifetime cumulative mortality rates of the multiple patients Determine the mortality level; determine the mortality threshold corresponding to the preset mortality level in the mortality level.

在一个实施例中，还包括：获取第二数据样本，第二数据样本包括第二预设期间内行X射线相关检查的多名患者的历史病例记录；基于第二数据样本和终身患癌风险评估模型，确定多名患者各自的终身累积发病率；基于多名患者各自的终身累积发病率确定发病率高风险组和发病率常规组；采用统计学logistic回归分析，以是否属于发病率高风险组为因变量，以患者的生日、性别、照射次数和疾病类型为自变量，确定至少一个第一高风险疾病，以作为预设高风险疾病，生日以年为单位，照射次数是指不同类型的X射线检查之间经过有效剂量的修正后的次数之和。In one embodiment, the method further includes: acquiring a second data sample, where the second data sample includes historical case records of multiple patients who underwent X-ray related examinations within a second preset period; and based on the second data sample and lifetime cancer risk assessment Model to determine the respective lifetime cumulative incidence rates of multiple patients; based on the respective lifetime cumulative incidence rates of multiple patients to determine the high incidence risk group and the conventional incidence group; use statistical logistic regression analysis to determine whether they belong to the high incidence risk group As the dependent variable, the patient's birthday, gender, number of exposures, and disease type are used as independent variables to determine at least one first high-risk disease as a preset high-risk disease. The birthday is in years, and the number of exposures refers to different types of disease. The sum of the corrected times of effective dose between X-ray examinations.

在一个实施例中，在获取第二数据样本之后，还包括：基于第二数据样本和终身患癌风险评估模型，确定多名患者各自的终身累积死亡率；基于多名患者各自的终身累积死亡率确定死亡率高风险组和死亡率常规组；采用统计学logistic回归分析，以是否属于死亡率高风险组为因变量，以患者的生日、性别、照射次数和疾病类型为自变量，确定至少一个第二高风险疾病，第一高风险疾病和第二高风险疾病共同作为预设高风险疾病。In one embodiment, after acquiring the second data sample, the method further includes: determining, based on the second data sample and the lifetime cancer risk assessment model, the respective lifetime cumulative mortality rates of the multiple patients; based on the respective lifetime cumulative mortality rates of the multiple patients The high-risk mortality group and the routine mortality group were determined by statistical logistic regression analysis, with the high mortality risk group as the dependent variable and the patient's birthday, gender, number of exposures, and disease type as independent variables to determine at least A second-high-risk disease, the first-high-risk disease and the second-high-risk disease are collectively referred to as a predetermined high-risk disease.

在一个实施例中，预设高风险疾病包括先天畸形及染色体异常、泌尿生殖器官疾病、消化系统疾病、肿瘤、影响健康状况及使用医疗服务的因素、感染症及寄生虫疾病和内分泌营养及代谢疾病。In one embodiment, the predetermined high-risk diseases include congenital malformations and chromosomal abnormalities, genitourinary diseases, digestive system diseases, tumors, factors affecting health status and use of medical services, infectious diseases and parasitic diseases, and endocrine nutrition and metabolism disease.

本申请第二方面提供了一种行X射线检查所致患癌风险的预警装置，包括：第一确定模块，基于患者的就诊原因确定患者所患疾病类型，就诊原因是指医生申请预定X射线检查时填写的诊断描述；第一预警模块，当疾病类型属于预设高风险疾病时，触发一级预警；第二确定模块，基于患者的过往X射线检查的病例记录和累积患癌风险评估模型确定患者行预设X射线检查的累积患癌风险，累积患癌风险用癌症的累积发病率和/或累积死亡率表征，累积发病率是指患者行过往X射线检查和预设X射线检查之一的单次癌症发病率的加和，累积死亡率是指患者行过往X射线检查和预设X射线检查之一的单次癌症死亡率的加和；第二预警模块，当累积患癌风险满足预设条件时，触发二级预警。A second aspect of the present application provides an early warning device for cancer risk caused by X-ray examination, including: a first determination module, which determines the type of disease the patient suffers from based on the patient's reason for seeking a doctor, where the reason for seeking a doctor refers to a doctor's application for ordering X-rays The diagnosis description filled in during the examination; the first early warning module, when the disease type is a preset high-risk disease, triggers a first-level warning; the second determination module, based on the patient's past X-ray examination case records and cumulative cancer risk assessment model Determining the cumulative cancer risk of a patient undergoing a scheduled X-ray examination. The cumulative cancer risk is characterized by the cumulative incidence and/or cumulative mortality of cancer. The first is the sum of the single cancer incidence rate, and the cumulative mortality rate refers to the sum of the single cancer mortality rate of the patient's previous X-ray examination and one of the preset X-ray examinations; the second early warning module, when the cumulative cancer risk When the preset conditions are met, a secondary warning is triggered.

本申请第三方面提供了一种计算机设备，包括存储器、处理器以及存储在存储器上被处理器执行的计算机程序，处理器执行计算机程序时实现上述任一实施例提供的行X射线检查所致患癌风险的预警方法的步骤。A third aspect of the present application provides a computer device, including a memory, a processor, and a computer program stored on the memory and executed by the processor. When the processor executes the computer program, the X-ray inspection provided by any of the foregoing embodiments is performed Steps in an early warning approach to cancer risk.

本申请第四方面提供了一种计算机可读存储介质，其上存储有计算机程序，其特征在于，计算机程序被处理器执行时实现上述任一实施例提供的行X射线检查所致患癌风险的预警方法的步骤。A fourth aspect of the present application provides a computer-readable storage medium on which a computer program is stored, characterized in that, when the computer program is executed by a processor, the risk of cancer caused by X-ray examination provided in any of the foregoing embodiments is realized The steps of the early warning method.

根据本申请实施例提供的行X射线检查所致患癌风险的预警方法和装置、计算机设备，以及存储介质，包括两级预警。其中，一级预警用于判断患者所患疾病类型是否属于预设高风险疾病。该预设高风险疾病是指容易因行X射线检查导致患癌的疾病。一级预警可以起到提醒医生注意的作用。二级预警用于判断患者行预设X射线检查的累积患癌风险。该预设X射线检查是指医生打算让患者去做的X射线检查。累积患癌风险用癌症的累积发病率和/或死亡率表征。累积发病率是指该患者在本次检查之前所行X射线检查所致癌症发病率和行预设X射线检查所致癌症发病率的加和。累积死亡率是指该患者在本次检查之前所行X射线检查所致癌症死亡率和行预设X射线检查所致癌症死亡率的加和。二级预警可以辅助医生最终确定是否让患者做预设X射线检查，从而为X射线检查的合理性选择提供参考。例如，当触发二级预警时，表示该患者行预设X射线检查后的癌症发病率和癌症死亡率处于一个较高水平，这时医生需要考虑对于该患者的病情而言，是否有必要冒此风险来做预设X射线检查，或者是否有其它可替代检查方式。The method and device for early warning of cancer risk caused by X-ray examination, computer equipment, and storage medium provided according to the embodiments of the present application include two-level early warning. Among them, the first-level early warning is used to determine whether the disease type of the patient belongs to the preset high-risk disease. The predetermined high-risk disease refers to a disease that is likely to cause cancer due to X-ray examination. The first-level warning can play a role in reminding doctors to pay attention. The second-level early warning is used to determine the cumulative cancer risk of patients undergoing scheduled X-ray examinations. The scheduled X-ray examination refers to the X-ray examination that the doctor intends for the patient to do. Cumulative cancer risk is characterized by cumulative incidence and/or mortality of cancer. The cumulative incidence is the sum of the cancer incidence from the X-rays performed prior to the current examination and the cancer incidence from the scheduled X-rays for the patient. Cumulative mortality is the sum of cancer mortality from X-rays taken prior to the patient's examination and cancer mortality from scheduled X-rays. The second-level early warning can assist the doctor to finally determine whether to let the patient do the preset X-ray examination, thus providing a reference for the rational choice of the X-ray examination. For example, when the second-level warning is triggered, it means that the cancer incidence and cancer mortality rate of the patient after the scheduled X-ray examination are at a high level. At this time, the doctor needs to consider whether it is necessary to risk the patient's condition. this risk to do a scheduled X-ray examination, or if there are other alternatives.

附图说明Description of drawings

图1示出了两组数据中患者的生日分布情况。Figure 1 shows the distribution of birthdays of patients in the two sets of data.

图2示出了两组数据中患者的曝光年龄和检查次数的分布情况。Figure 2 shows the distribution of patients' exposure age and number of examinations in the two sets of data.

图3为本申请一实施例提供的累积患癌风险等级的确定方法的流程图。FIG. 3 is a flowchart of a method for determining a cumulative cancer risk level according to an embodiment of the present application.

图4为本申请一实施例提供的变换前的单次患癌风险评估模型。FIG. 4 is a single cancer risk assessment model before transformation provided by an embodiment of the present application.

图5为本申请一实施例提供的确定预设高风险疾病的过程示意图。FIG. 5 is a schematic diagram of a process for determining a preset high-risk disease according to an embodiment of the present application.

图6为本申请一实施例提供的行X射线检查所致患癌风险的预警方法的流程图。FIG. 6 is a flowchart of a method for early warning of cancer risk caused by X-ray examination according to an embodiment of the present application.

图7为本申请一实施例提供的行X射线检查所致患癌风险的预警装置的结构框图。FIG. 7 is a structural block diagram of an early warning device for cancer risk caused by X-ray examination according to an embodiment of the present application.

图8是本申请一实施例提供的电子设备的结构框图。FIG. 8 is a structural block diagram of an electronic device provided by an embodiment of the present application.

具体实施方式Detailed ways

下面将结合本申请实施例中的附图，对本申请实施例中的技术方案进行清楚、完整地描述，显然，所描述的实施例仅是本申请一部分实施例，而不是全部的实施例。基于本申请中的实施例，本领域普通技术人员在没有做出创造性劳动前提下所获得的所有其他实施例，都属于本申请保护的范围。The technical solutions in the embodiments of the present application will be clearly and completely described below with reference to the accompanying drawings in the embodiments of the present application. Obviously, the described embodiments are only a part of the embodiments of the present application, but not all of the embodiments. Based on the embodiments in the present application, all other embodiments obtained by those of ordinary skill in the art without creative efforts shall fall within the protection scope of the present application.

如背景技术所述，目前在医疗领域缺少X射线电离辐射医疗防护的参考标准，难以对X射线检查的累积效应对患者的影响进行有效评估和预警。为此，本申请实施例提供了一种行X射线检查所致患癌风险的预警方法和装置、计算机设备，以及存储介质。根据本申请实施例提供的预警方法，包括两级预警。其中，一级预警用于判断患者所患疾病类型是否属于预设高风险疾病。该预设高风险疾病是指容易因行X射线检查导致患癌的疾病。一级预警可以起到提醒医生注意的作用。二级预警用于判断患者行预设X射线检查的累积患癌风险。该预设X射线检查是指医生打算让患者去做的X射线检查。累积患癌风险用癌症的累积发病率和/或死亡率表征。累积发病率是指该患者在本次检查之前所行X射线检查所致癌症发病率和行预设X射线检查所致癌症发病率的加和。累积死亡率是指该患者在本次检查之前所行X射线检查所致癌症死亡率和行预设X射线检查所致癌症死亡率的加和。二级预警可以辅助医生最终确定是否让患者做预设X射线检查，从而为X射线检查的合理性选择提供参考。例如，当触发二级预警时，表示该患者行预设X射线检查后的癌症发病率和癌症死亡率处于一个较高水平，这时医生需要考虑对于该患者的病情而言，是否有必要冒此风险来做预设X射线检查，或者是否有其它可替代检查方式。As described in the background art, there is currently a lack of reference standards for medical protection against X-ray ionizing radiation in the medical field, and it is difficult to effectively evaluate and pre-warn the impact of the cumulative effect of X-ray examination on patients. To this end, the embodiments of the present application provide a method and device for early warning of cancer risk caused by X-ray examination, computer equipment, and storage medium. The early warning method provided according to the embodiment of the present application includes two-level early warning. Among them, the first-level early warning is used to determine whether the disease type of the patient belongs to the preset high-risk disease. The predetermined high-risk disease refers to a disease that is likely to cause cancer due to X-ray examination. The first-level warning can play a role in reminding doctors to pay attention. The second-level early warning is used to determine the cumulative cancer risk of patients undergoing scheduled X-ray examinations. The scheduled X-ray examination refers to the X-ray examination that the doctor intends for the patient to do. Cumulative cancer risk is characterized by cumulative incidence and/or mortality of cancer. The cumulative incidence is the sum of the cancer incidence from the X-rays performed prior to the current examination and the cancer incidence from the scheduled X-rays for the patient. Cumulative mortality is the sum of cancer mortality from X-rays taken prior to the patient's examination and cancer mortality from scheduled X-rays. The second-level early warning can assist the doctor to finally determine whether to let the patient do the preset X-ray examination, thus providing a reference for the rational choice of the X-ray examination. For example, when the second-level warning is triggered, it means that the cancer incidence and cancer mortality rate of the patient after the scheduled X-ray examination are at a high level. At this time, the doctor needs to consider whether it is necessary to risk the patient's condition. this risk to do a scheduled X-ray examination, or if there are other alternatives.

在执行上述行X射线检查所致患癌风险的预警方法之前，需要先确定预设高风险疾病和累积患癌风险等级。下面按照确定累积患癌风险等级、确定预设高风险疾病、行X射线检查所致患癌风险的预警方法的顺序进行具体描述。Before implementing the above-mentioned methods of early warning of cancer risk due to X-ray examination, pre-determined high-risk diseases and cumulative cancer risk levels need to be determined. The following will be described in detail in the order of determining the cumulative cancer risk level, determining the preset high-risk disease, and performing an early warning method for cancer risk caused by X-ray examination.

确定累积患癌风险等级Determining cumulative cancer risk levels

一、准备数据1. Prepare data

首先，选取北京市一大型综合医院的放射学信息系统（RadiologyInformationSystem,RIS）中2004年8月至2020年4月所有行X射线检查且年龄小于80岁的患者的病例记录。这里提到的X射线检查为诊断性X射线检查，包括平片摄影（Digital Radiography，DR）、计算机断层扫描（Computed Tomography，CT）、透视造影（Radio Fluoroscopy，RF）和数字减影（ Digital Subtraction Angiography，DSA）。收集并整理病例记录中患者编号、性别、曝光年龄（即接受X射线照射时的年龄）、检查项目、检查次数、就诊原因（即医生申请检查时填写的诊断描述）等信息。First, the case records of all patients under the age of 80 who underwent X-ray examinations from August 2004 to April 2020 in the Radiology Information System (RIS) of a large general hospital in Beijing were selected. The X-ray examinations mentioned here are diagnostic X-ray examinations, including plain film photography (Digital Radiography, DR), computed tomography (Computed Tomography, CT), fluoroscopy (Radio Fluoroscopy, RF) and digital subtraction (Digital Subtraction) Angiography, DSA). Collect and organize information such as patient number, gender, exposure age (that is, the age when receiving X-ray irradiation), examination items, number of examinations, and reasons for visiting a doctor (that is, the diagnosis description filled in by the doctor when applying for the examination) in the case records.

由于2015年4月之前的病例记录不包含就诊原因，因此将2004年8月至2020年4月的全部病例记录分为两组，第一组数据为2004年8月至2020年4月的病例记录，第二组数据为2015年4月至2020年4月的病例记录。Since the case records before April 2015 did not include the reasons for visiting a doctor, all the case records from August 2004 to April 2020 were divided into two groups. The first group of data was the cases from August 2004 to April 2020. The second set of data is the case records from April 2015 to April 2020.

其次，分别对第一组数据和第二组数据进行统计分析。其中，第一组数据纳入患者1,282,046人，男性占比48.4%，女性占比51.6%。第二组数据共纳入患者548,689人，男性占比53.5%，女性占比46.5%。两组数据中性别分布情况大致相同。Secondly, statistical analysis is performed on the first set of data and the second set of data respectively. Among them, the first group of data included 1,282,046 patients, of which 48.4% were male and 51.6% were female. A total of 548,689 patients were included in the second set of data, of which 53.5% were male and 46.5% were female. The gender distribution in the two data sets was roughly the same.

第一组数据被纳入患者涉及3,604,282次检查，包括CT检查1,163,054次，DR检查2,384,981次，RF检查50213次，DSA检查6,034次。CT检查和DR检查次数之和占总检查次数的98.4%。第二组数据被纳入患者涉及1,559,027次检查，包括CT检查647,893次，DR检查891,150次，RF检查13,954次，DSA检查6,030次。CT检查和DR检查次数之和占总检查次数的98.7%。两组数据中检查类型的分布情况大致相同。The first set of data included patients involved 3,604,282 exams, including 1,163,054 CT exams, 2,384,981 DR exams, 50,213 RF exams, and 6,034 DSA exams. The sum of CT examinations and DR examinations accounted for 98.4% of the total number of examinations. The second set of data included patients involved 1,559,027 exams, including 647,893 CT exams, 891,150 DR exams, 13,954 RF exams, and 6,030 DSA exams. The sum of CT examinations and DR examinations accounted for 98.7% of the total number of examinations. The distribution of examination types in the two sets of data was about the same.

图1示出了两组数据中患者的生日分布情况。如图1所示，非阴影矩形条表示第一组数据中患者生日和患者人数的对应关系，阴影矩形条表示第二组数据中患者生日和患者人数的对应关系。从图1可以看出，两组数据中患者生日的分布规律大致相同。Figure 1 shows the distribution of birthdays of patients in the two sets of data. As shown in Figure 1, the non-shaded rectangular bars represent the correspondence between the patient's birthday and the number of patients in the first set of data, and the shaded rectangular bar represents the correspondence between the patient's birthday and the number of patients in the second set of data. It can be seen from Figure 1 that the distribution of patient birthdays in the two groups of data is roughly the same.

图2示出了两组数据中患者的曝光年龄和检查次数的分布情况。这里将患者按照曝光年龄划分为童年（0-6岁）、少年（7-17岁）、青年（18-40岁）、中年（40-65岁）和老年（66-80岁）。如图2所示，在第一组数据中，如图中非阴影矩形框所示，童年时期行X射线检查的次数为93,910次，少年（7-17岁）时期行X射线检查的次数为84,425次，青年（18-40岁）时期行X射线检查的次数为796,500次，中年（40-65岁）时期行X射线检查的次数为1,781,166次，老年（66-80岁）时期行X射线检查的次数为848,298次。在第二组数据中，如图中阴影矩形框所示，童年（0-6岁）时期行X射线检查的次数为46,405次，少年（7-17岁）时期行X射线检查的次数为29,250次，青年（18-40岁）时期行X射线检查的次数为359,506次，中年（40-65岁）时期行X射线检查的次数为783,508次，老年（66-80岁）时期行X射线检查的次数为340,358次。可见，两组数据中患者的曝光年龄和检查次数的分布情况大致相同。Figure 2 shows the distribution of patients' exposure age and number of examinations in the two sets of data. Here, patients were divided into childhood (0-6 years old), adolescent (7-17 years old), youth (18-40 years old), middle-aged (40-65 years old) and elderly (66-80 years old) according to the exposure age. As shown in Figure 2, in the first set of data, as shown by the non-shaded rectangle in the figure, the number of X-ray examinations in childhood is 93,910, and the number of X-ray examinations in adolescents (7-17 years old) is 84,425 times, 796,500 X-ray examinations in youth (18-40 years), 1,781,166 X-ray examinations in middle age (40-65 years), and X-rays in old age (66-80 years) The number of radiographs was 848,298. In the second set of data, indicated by the shaded rectangle in the figure, there were 46,405 X-rays in childhood (ages 0-6) and 29,250 in adolescence (ages 7-17). 359,506 times of X-ray examinations in youth (18-40 years old), 783,508 times in middle-aged (40-65 years old) period, and X-ray examination in old age (66-80 years old) period The number of checks was 340,358. It can be seen that the distribution of patients' exposure age and number of examinations in the two groups of data is roughly the same.

对比上面四个方面的数据可知，两组数据的分布情况基本一致，表明两组数据均具有代表性，可用于统计学规律的研究。Comparing the data in the above four aspects, it can be seen that the distribution of the two groups of data is basically the same, indicating that the two groups of data are representative and can be used for the study of statistical laws.

二、确定累积患癌风险等级2. Determine the cumulative cancer risk level

图3为本申请一实施例提供的累积患癌风险等级的确定方法的流程图。累积患癌风险等级包括癌症的发病率等级和/或死亡率等级。如图3所示，该累积患癌风险等级的确定方法300包括：FIG. 3 is a flowchart of a method for determining a cumulative cancer risk level according to an embodiment of the present application. The cumulative cancer risk class includes the incidence class and/or the mortality class of the cancer. As shown in FIG. 3 , themethod 300 for determining the cumulative cancer risk level includes:

步骤S310，基于第一组数据和累积患癌风险评估模型，确定第一组数据中每位患者的终身累积发病率和终身累积死亡率。Step S310 , based on the first group of data and the cumulative cancer risk assessment model, determine the lifetime cumulative incidence rate and lifetime cumulative mortality rate of each patient in the first group of data.

步骤S320，基于第一组数据中全部患者的终身累积发病率确定发病率等级。发病率等级指示发病率级别和发病率的对应关系。Step S320: Determine the morbidity level based on the lifetime cumulative morbidity rates of all patients in the first set of data. The morbidity level indicates the correspondence between the morbidity level and the morbidity rate.

步骤S330，基于第一组数据中全部患者的终身累积死亡率确定死亡率等级。死亡率等级指示死亡率级别和死亡率的对应关系。Step S330, determining a mortality rate based on the lifetime cumulative mortality rate of all patients in the first set of data. The mortality class indicates the correspondence between the mortality class and the mortality rate.

步骤S330和步骤S320的执行顺序可互换。确定方法300可以仅包括步骤S320和步骤S330之一，相应地步骤S310可仅确定终身累积发病率和终身累积死亡率之一。The execution order of step S330 and step S320 can be interchanged. Thedetermination method 300 may only include one of steps S320 and S330, and correspondingly, step S310 may only determine one of the lifetime cumulative morbidity rate and the lifetime cumulative mortality rate.

在步骤S310中，累积患癌风险评估模型包括单次患癌风险评估模块和累加模块。其中，单次患癌风险评估模块的输入为患者性别、曝光年龄和有效剂量，输出为患者行本次X射线检查的癌症发病率和癌症死亡率。累加模块用于对同一患者行多次X射线检查的癌症发病率进行加和，得到累积发病率；对同一患者行多次X射线检查的癌症死亡率进行加和，得到累积死亡率。In step S310, the cumulative cancer risk assessment model includes a single cancer risk assessment module and an accumulation module. Among them, the input of the single cancer risk assessment module is the patient's gender, exposure age and effective dose, and the output is the cancer incidence and cancer mortality of the patient undergoing this X-ray examination. The accumulating module is used to add up the cancer incidence rates of the same patient who underwent multiple X-ray examinations to obtain the cumulative incidence rate; and sum up the cancer mortality rates of the same patient who underwent multiple X-ray examinations to obtain the cumulative mortality rate.

具体而言，单次患癌风险评估模块基于文献6的附录12D中给出的点数据来确定。文献6的附录12D给出了图4中所示的四组点数据。其中，第一组点数据示为上面的圆圈点，表示女性、预定曝光年龄的患者每接收100mSv医疗照射每100万人中产生额外的癌症患者的人数。第二组点数据示为上面的实心点，表示男性、预定曝光年龄的患者每接收100mSv医疗照射每100万人中产生额外的癌症患者的人数。第三组点数据示为下面的圆圈点，表示女性、预定曝光年龄的患者每接收100mSv医疗照射每100万人中产生额外的因癌症死亡的人数。第四组点数据示为下面的实心点，表示男性、预定曝光年龄的患者每接收100mSv医疗照射每100万人中产生额外的因癌症死亡的人数。Specifically, the single cancer risk assessment module was determined based on the point data given in Appendix 12D of Reference 6. Appendix 12D of Document 6 gives the four sets of point data shown in Figure 4. Among them, the first set of point data is shown as the upper circled point, representing the number of additional cancer patients per million people per 100 mSv medical exposure received by female, predetermined exposure age patients. The second set of point data, shown as the solid dots above, represents the number of additional cancer patients per million people per 100 mSv of medical exposure received by male, pre-exposure age patients. The third set of point data, shown as the circled dots below, represents the number of additional cancer deaths per million people per 100 mSv of medical exposure received by female, pre-exposure age patients. The fourth set of point data, shown as the solid points below, represents the number of additional cancer deaths per million people per 100 mSv of medical exposure received by male, pre-exposure age patients.

本实施例分别对四组点数据进行线性内插，以补全0-80岁的相关数据。然后将图4中的纵坐标数值换算为每接收1mSv医疗照射每个人的癌症发病率和癌症死亡率，即将每个横坐标点对应的纵坐标数值除以100mSv，再除以10万，得到单次患癌风险评估模块。该单次患癌风险评估模块指示性别-曝光年龄-接受1mSv的X射线照射-癌症发病率-癌症死亡率的对应关系。因此，将患者的性别、曝光年龄、预定X射线检查接受的有效剂量输入到单次患癌风险评估模块后，可以输出该患者行本次X射线检查的癌症发病率和癌症死亡率。In this embodiment, linear interpolation is performed on the four groups of point data to complete the relevant data of 0-80 years old. Then, the ordinate value in Figure 4 is converted into the cancer incidence and cancer mortality rate of each person receiving 1mSv of medical irradiation, that is, the ordinate value corresponding to each abscissa point is divided by 100mSv, and then divided by 100,000, to obtain a single Secondary Cancer Risk Assessment Module. The single cancer risk assessment module indicates a sex-exposure age-received 1 mSv of X-ray exposure-cancer incidence-cancer mortality. Therefore, after inputting the patient's gender, exposure age, and the effective dose received by the scheduled X-ray examination into the single cancer risk assessment module, the cancer incidence and cancer mortality rate of the patient undergoing this X-ray examination can be output.

这里提到的有效剂量是指标准化检查项目对应的照射剂量估值，标准化检查项目可以通过对病例记录中记载的检查项目进行标准化得到。The effective dose mentioned here refers to the estimated radiation dose corresponding to the standardized inspection items. The standardized inspection items can be obtained by standardizing the inspection items recorded in the case records.

参阅表1，上面提到的四大类X射线检查，即DR、CT、RF和DSA中的每一类，可以根据照射部位的不同划分为多个子类，即标准化检查项目。表1示出了标准化检查项目及其对应的单次X射线照射时人体全身接受的有效曝光剂量。需要说明的是，对于成年人和未成年人而言，同一标准化检查项目对应的单次X射线照射时人体全身接受的有效曝光剂量稍有不同，表1以成年人为例进行示意。Referring to Table 1, each of the four categories of X-ray inspections mentioned above, namely DR, CT, RF and DSA, can be divided into multiple sub-categories, namely standardized inspection items, according to different irradiation sites. Table 1 shows the standardized inspection items and their corresponding effective exposure doses received by the human body during a single X-ray irradiation. It should be noted that for adults and minors, the effective exposure doses received by the human body during a single X-ray irradiation corresponding to the same standardized inspection item are slightly different. Table 1 shows adults as an example.

表1标准化检查项目和有效剂量的对应关系表Table 1 Correspondence table of standardized inspection items and effective doses

以第一组数据中的一位女性患者为例，该患者35岁的时候做了一次胸部CT，55岁的时候做了一次乳腺摄影。经查阅表1可知，胸部CT对应的有效剂量为7mSv，乳腺摄影对应的有效剂量为0.51mSv。将上述数据输入累积癌症风险评估模型后，单次患癌风险评估模块根据女性、35岁、7mSv输出该患者行胸部CT检查的癌症发病率和癌症死亡率，根据女性、55岁、0.51mSv输出该患者行乳腺摄影检查的癌症发病率和癌症死亡率，累加模块将CT检查的癌症发病率和乳腺摄影检查的癌症发病率相加，得到累积发病率，将CT检查的癌症死亡率和乳腺摄影检查的癌症死亡率相加，得到累积死亡率。Take a female patient in the first set of data as an example. The patient had a chest CT at the age of 35 and a mammography at the age of 55. According to Table 1, the effective dose corresponding to chest CT is 7 mSv, and the effective dose corresponding to mammography is 0.51 mSv. After inputting the above data into the cumulative cancer risk assessment model, the single cancer risk assessment module outputs the cancer incidence and cancer mortality of the patient who underwent chest CT examination according to female, 35 years old, 7mSv, and outputs according to female, 55 years old, 0.51mSv The cancer incidence rate and cancer mortality rate of the patient who underwent mammography, the summation module adds the cancer incidence rate of CT examination and the cancer incidence rate of mammography examination to obtain the cumulative incidence rate, and the cancer mortality rate of CT examination and the mammography examination are combined to obtain the cumulative incidence rate. The cancer mortality rates examined were summed to obtain the cumulative mortality rate.

在步骤S320中，通过对第一组数据中患者的终身累积发病率进行统计，得到第一组数据中有95%的患者的终身累积发病率低于0.2%，有0.24%的患者的终身累积发病率超过1%，其中终身累积发病率的最大值为9.65%。针对第一组数据，确定小于或等于每一发病率阈值的患者人数在第一组数据中全部患者人数中的占比。如表2所示，选取的发病率阈值包括0.02‰、0.10‰、0.55‰、2.04‰、4.84‰，该多个发病率阈值对应的患者人数占比依次为25%、50%、75%、95%、99%。相应地，在本实施例中，确定癌症发病率等级标准为：[0，0.10‰)为第一级别，[0.02‰，0.10‰)为第二级别，[0.10‰，0.55‰)为第三级别，[0.55‰，2.04‰)为第四级别，[2.04‰，4.84‰)为第五级别，[4.84‰，1)为第六级别，级别越高表明累积发病率越高。In step S320, through statistics on the lifetime cumulative incidence rate of the patients in the first group of data, it is obtained that the lifetime cumulative incidence rate of 95% of the patients in the first group of data is lower than 0.2%, and the lifetime cumulative incidence rate of 0.24% of the patients is obtained. The incidence rate exceeds 1%, with a maximum lifetime cumulative incidence rate of 9.65%. For the first set of data, determine the proportion of the number of patients less than or equal to each morbidity threshold in the total number of patients in the first set of data. As shown in Table 2, the selected morbidity thresholds include 0.02‰, 0.10‰, 0.55‰, 2.04‰, 4.84‰, and the proportion of patients corresponding to the multiple morbidity thresholds is 25%, 50%, 75%, 95%, 99%. Correspondingly, in this embodiment, the criteria for determining the level of cancer incidence are: [0, 0.10‰) is the first level, [0.02‰, 0.10‰) is the second level, and [0.10‰, 0.55‰) is the third level level, [0.55‰, 2.04‰) is the fourth level, [2.04‰, 4.84‰) is the fifth level, [4.84‰, 1) is the sixth level, the higher the level, the higher the cumulative incidence.

表2 第一组数据中患者的终身累积发病率百分位数（‰）Table 2 Lifetime cumulative incidence percentiles (‰) of patients in the first group of data

在步骤S330中，如可参阅步骤S320中终身累积发病率的分析方法。如表3所示，选取的死亡率阈值包括0.01‰、0.06‰、0.34‰、1.28‰、3.04‰，该多个死亡率阈值对应的患者人数占比依次为25%、50%、75%、95%、99%。相应地，在本实施例中，确定癌症死亡率等级标准为：[0，0.01‰)为第一级别，[0.01‰，0.06‰)为第二级别，[0.06‰，0.34‰)为第三级别，[0.34‰，1.28‰)为第四级别，[1.28‰，3.04‰)为第五级别，[3.04‰，1)为第六级别，级别越高表明累积死亡率越高。In step S330, for example, refer to the analysis method of lifetime cumulative incidence rate in step S320. As shown in Table 3, the selected mortality thresholds include 0.01‰, 0.06‰, 0.34‰, 1.28‰, 3.04‰, and the proportion of the number of patients corresponding to the multiple mortality thresholds is 25%, 50%, 75%, 95%, 99%. Correspondingly, in this embodiment, the criteria for determining the level of cancer mortality are: [0, 0.01‰) is the first level, [0.01‰, 0.06‰) is the second level, and [0.06‰, 0.34‰) is the third level level, [0.34‰, 1.28‰) is the fourth level, [1.28‰, 3.04‰) is the fifth level, [3.04‰, 1) is the sixth level, the higher the level, the higher the cumulative mortality.

表3 第一组数据中患者的终身累积死亡率百分位数（‰）Table 3 Lifetime cumulative mortality percentiles (‰) of patients in the first group of data

检查时间check the time最小值minimum25%25%50%50%75%75%95%95%99%99%最大值maximum value2004-2020年2004-20200.0000770.0000770.010.010.060.060.340.341.281.283.083.0838.1538.15

确定预设高风险疾病Identify prespecified high-risk diseases

本实施例研究疾病类型对累积发病率和累积死亡率的影响。This example investigates the effect of disease type on cumulative morbidity and cumulative mortality.

图5为本申请一实施例提供的确定预设高风险疾病的过程示意图。如图5所示，确定预设高风险疾病的方法500包括：FIG. 5 is a schematic diagram of a process for determining a preset high-risk disease according to an embodiment of the present application. As shown in FIG. 5, amethod 500 of determining a predetermined high-risk disease includes:

步骤S510，基于第二组数据和累积患癌风险评估模型，确定第二组数据中每位患者的终身累积发病率和终身累积死亡率。Step S510, based on the second set of data and the cumulative cancer risk assessment model, determine the lifetime cumulative incidence rate and lifetime cumulative mortality rate of each patient in the second set of data.

步骤S520，基于第二组数据中全部患者的终身累积发病率确定发病率等级，基于第二组数据中全部患者的终身累积死亡率确定死亡率等级，如表4所示。Step S520: Determine the morbidity level based on the lifetime cumulative morbidity rates of all patients in the second set of data, and determine the mortality level based on the lifetime cumulative mortality rates of all patients in the second set of data, as shown in Table 4.

表4 第二组数据中患者的终身累积发病率和终身累积死亡率的百分位数（‰）Table 4 Percentiles (‰) of lifetime cumulative morbidity and lifetime cumulative mortality of patients in the second group of data

步骤S510和步骤S520的具体执行过程参照步骤S310-步骤S330，这里不予详述。For the specific execution process of step S510 and step S520, refer to step S310-step S330, which will not be described in detail here.

步骤S530，参阅表4，对于终身累积发病率，以95百分位数为界分为两组，即发病常规组和发病高风险组。采用统计学logistic回归分析，将是否属于发病高风险组定义为因变量，将生日、性别、照射次数以及疾病类型作为自变量，确定至少一个第一高风险疾病。In step S530, referring to Table 4, for the lifetime cumulative incidence rate, the patients are divided into two groups with the 95th percentile as the boundary, namely, the conventional incidence group and the incidence high risk group. Statistical logistic regression analysis was used to define whether the patients belonged to a high-risk group as the dependent variable, and birthday, gender, number of exposures, and disease types were used as independent variables to determine at least one first-high-risk disease.

步骤S540，参阅表4，对于终身累积死亡率，以95百分位数为界分为两组，即死亡常规组和死亡高风险组。采用统计学logistic回归分析，将是否属于死亡高风险组定义为因变量，将生日、性别、照射次数以及疾病类型作为自变量，确定至少一个第二高风险疾病，第一高风险疾病和第二高风险疾病共同作为预设高风险疾病。应当理解，也可以将第一高风险疾病和第二高风险疾病之一作为预设高风险疾病。Step S540, referring to Table 4, for the lifetime cumulative mortality rate, the patients are divided into two groups with the 95th percentile as the boundary, namely, the death routine group and the death high risk group. Statistical logistic regression analysis was used to define whether belonging to a high-risk group of death as the dependent variable, and birthday, gender, number of exposures, and disease type as independent variables to determine at least one second-high-risk disease, first-high-risk disease and second-high-risk disease High-risk diseases are collectively referred to as pre-specified high-risk diseases. It should be understood that one of the first high-risk disease and the second high-risk disease can also be used as the preset high-risk disease.

在步骤S530和步骤S540中，疾病类型可以根据患者的就诊原因确定。疾病类型是指国际疾病分类代码第十版（international Classification of diseases , the 10thversion, ICD-10）给出的疾病类型。In steps S530 and S540, the disease type may be determined according to the reason for the patient's visit. Disease type refers to the disease type given by the International Classification of Diseases, the 10th version, ICD-10.

生日以年为单位。照射次数是指不同类型的所述X射线检查之间经过有效剂量的修正后的次数之和。Birthdays are in years. The number of irradiations refers to the sum of the corrected times of the effective dose between different types of X-ray examinations.

由于不同的检查类型，同样照射一次其有效剂量可能差别巨大。为了将不同的检查类型放在同一水平上比较，需要对不同的检查类型的照射次数进行标准化。该标准化过程可以是，以DR为参照标准，定义其有效剂量对应一次照射，记为基础照射次数，其他检查类型的有效剂量与DR的有效剂量的比值作为校正系数，校正系数即为该检查类型的校正照射次数。例如，如表5所示，照射一次DR认为是1次X射线校正照射，照射一次CT认为是16.6次X射线校正照射。Due to different types of examinations, the effective dose of the same exposure may vary greatly. In order to compare different examination types on the same level, the number of exposures for different examination types needs to be normalized. The standardization process may be, taking DR as a reference standard, defining its effective dose corresponding to one irradiation, and recording it as the basic irradiation times, and the ratio of the effective dose of other inspection types to the effective dose of DR as the correction coefficient, and the correction coefficient is the inspection type. The number of corrected exposures. For example, as shown in Table 5, one DR irradiation is considered to be one X-ray correction irradiation, and one CT irradiation is considered to be 16.6 X-ray correction irradiations.

表5 第二组数据中各检查类型对应的校正照射次数Table 5 Correction irradiation times corresponding to each inspection type in the second set of data

在步骤S530中，使用前进法筛选自变量，经过多次筛选后得到结果如表6所示。从表6可以看出，所有自变量P值均小于0.001，有统计学意义。In step S530, the independent variables are screened by the forward method, and the results are obtained after multiple screenings, as shown in Table 6. It can be seen from Table 6 that the P values of all independent variables are less than 0.001, which is statistically significant.

表6 疾病类型对累积发病率的影响Table 6 Effect of disease type on cumulative incidence

在步骤S540中，使用前进法筛选自变量，经过多次筛选后得到结果如表7所示。从表7可以看出，所有自变量P值均小于0.001，有统计学意义。In step S540, the independent variables are screened by the forward method, and the results obtained after multiple screenings are shown in Table 7. It can be seen from Table 7 that the P values of all independent variables are less than 0.001, which is statistically significant.

表7 疾病类型对累积死亡率的影响Table 7 Effect of disease type on cumulative mortality

结合表6和表7可以看出，按照优势比由大到小的顺序对疾病类型进行排序，对累积发病率和累积死亡率的影响排名前七的疾病类型相同，均为：先天畸形及染色体异常、泌尿生殖器官疾病、消化系统疾病、肿瘤、影响健康状况及使用医疗服务的因素、感染症及寄生虫疾病和内分泌营养及代谢疾病。本实施例中，将该七种疾病类型作为预设高风险疾病类型。Combining Table 6 and Table 7, it can be seen that the disease types are sorted according to the odds ratio from large to small, and the top seven disease types with the same impact on cumulative morbidity and cumulative mortality are: congenital malformations and chromosomes. Abnormalities, urogenital diseases, digestive system diseases, tumors, factors affecting health status and use of medical services, infectious and parasitic diseases, and endocrine nutrition and metabolic diseases. In this embodiment, the seven disease types are used as preset high-risk disease types.

行X射线检查所致患癌风险的预警方法Early warning methods of cancer risk due to X-ray examination

图6为本申请一实施例提供的行X射线检查所致患癌风险的预警方法的流程图。如图6所示，预警方法600包括：FIG. 6 is a flowchart of a method for early warning of cancer risk caused by X-ray examination according to an embodiment of the present application. As shown in FIG. 6 , theearly warning method 600 includes:

步骤S610，基于患者的就诊原因确定患者所患疾病类型，就诊原因是指医生申请预定X射线检查时填写的诊断描述。In step S610, the type of disease the patient suffers from is determined based on the reason for the patient's visit, where the reason for the visit refers to the diagnosis description filled in by the doctor when applying for a scheduled X-ray examination.

具体而言，可以将医生输入到计算机中的就诊原因和疾病类型数据库进行文本匹配，以确定患者的疾病类型。在一个实施例中，疾病类型数据库包括ICD-10给出的疾病类型。在另一个实施例中，疾病类型数据库包括预设高风险疾病。Specifically, a database of reasons for visits and disease types entered by a doctor into a computer can be text-matched to determine a patient's disease type. In one embodiment, the disease type database includes disease types given by ICD-10. In another embodiment, the disease type database includes predefined high risk diseases.

步骤S620，当疾病类型属于预设高风险疾病时，触发一级预警。一级预警可以起到提醒医生注意的作用。Step S620, when the disease type belongs to a preset high-risk disease, a first-level early warning is triggered. The first-level warning can play a role in reminding doctors to pay attention.

预设高风险疾病包括先天畸形及染色体异常、泌尿生殖器官疾病、消化系统疾病、肿瘤、影响健康状况及使用医疗服务的因素、感染症及寄生虫疾病和内分泌营养及代谢疾病中的至少一项。Predetermined high-risk diseases include at least one of congenital malformations and chromosomal abnormalities, urogenital diseases, digestive system diseases, tumors, factors affecting health status and use of medical services, infectious diseases and parasitic diseases, and endocrine nutrition and metabolic diseases .

步骤S630，基于患者的过往X射线检查的病例记录和累积患癌风险评估模型确定患者行预设X射线检查的累积患癌风险。Step S630, determining the cumulative cancer risk of the patient undergoing the preset X-ray examination based on the patient's past X-ray examination case records and the cumulative cancer risk assessment model.

过往X射线检查是指患者在行预设X射线检查之前做过的X射线检查，可以是一次或多次。累积患癌风险用癌症的累积发病率和/或累积死亡率表征。Past X-rays refer to the X-rays that a patient has had before a scheduled X-ray, which can be one or more times. Cumulative cancer risk is characterized by cumulative incidence and/or cumulative mortality of cancer.

具体而言，累积患癌风险评估模型包括单次患癌风险评估模块和累加模块。单次患癌风险评估模块分别针对过往X射线检查和预设X射线检查，基于患者的性别、检查时的年龄和有效剂量确定单次X射线检查的癌症发病率和癌症死亡率。累加模块对全部X射线检查的癌症发病率进行加和，得到累积发病率，对全部X射线检查的癌症死亡率加和，得到累积死亡率。具体执行过程参见针对步骤S310中累积患癌风险评估模型的描述，这里不再详述。Specifically, the cumulative cancer risk assessment model includes a single cancer risk assessment module and an accumulation module. The single cancer risk assessment module determines the cancer incidence and cancer mortality of a single X-ray examination based on the patient's gender, age at the time of examination and effective dose for the previous X-ray examination and the preset X-ray examination respectively. The accumulating module adds up the cancer incidence rates of all X-ray examinations to obtain a cumulative incidence rate, and adds up the cancer mortality rates of all X-ray examinations to obtain a cumulative mortality rate. For the specific execution process, please refer to the description of the cumulative cancer risk assessment model in step S310, which will not be described in detail here.

在一个实施例中，在执行步骤S630之前，还包括：确定过往X射线检查和预设X射线检查各自对应的标准检查项目；确定标准检查项目对应的有效剂量，以作为单次患癌风险评估模块的输入之一。In one embodiment, before step S630 is performed, the method further includes: determining the standard inspection items corresponding to the past X-ray inspection and the preset X-ray inspection; determining the effective dose corresponding to the standard inspection items as a single cancer risk assessment One of the module's inputs.

步骤S640，当累积患癌风险满足预设条件时，触发二级预警。Step S640, when the accumulated cancer risk meets the preset condition, trigger a secondary early warning.

在一个实施例中，当累积发病率超过发病率阈值，累积死亡率超过死亡率阈值时，触发二级预警。发病率阈值可以是发病率等级中预设发病率级别对应的边界值。例如，如表2所示，发病率阈值为1.04‰。死亡率阈值可以是死亡率等级中预设死亡率级别对应的边界值。例如，如表3所示，死亡率阈值为1.28‰。In one embodiment, a secondary alert is triggered when the cumulative morbidity exceeds the morbidity threshold and the cumulative mortality exceeds the mortality threshold. The morbidity threshold may be a boundary value corresponding to a preset morbidity level in the morbidity level. For example, as shown in Table 2, the incidence threshold is 1.04‰. The mortality threshold may be a boundary value corresponding to a preset mortality level in the mortality level. For example, as shown in Table 3, the mortality threshold is 1.28‰.

根据本实施例提供的行X射线检查所致患癌风险的预警方法，包括两级预警。其中，一级预警用于判断患者所患疾病类型是否属于预设高风险疾病。该预设高风险疾病是指容易因行X射线检查导致患癌的疾病。一级预警可以起到提醒医生注意的作用。二级预警用于判断患者行预设X射线检查的累积患癌风险。该预设X射线检查是指医生打算让患者去做的X射线检查。累积患癌风险用癌症的累积发病率和/或死亡率表征。累积发病率是指该患者在本次检查之前所行X射线检查所致癌症发病率和行预设X射线检查所致癌症发病率的加和。累积死亡率是指该患者在本次检查之前所行X射线检查所致癌症死亡率和行预设X射线检查所致癌症死亡率的加和。二级预警可以辅助医生最终确定是否让患者做预设X射线检查，从而为X射线检查的合理性选择提供参考。例如，当触发二级预警时，表示该患者行预设X射线检查后的癌症发病率和癌症死亡率处于一个较高水平，这时医生需要考虑对于该患者的病情而言，是否有必要冒此风险来做预设X射线检查，或者是否有其它可替代检查方式。The method for early warning of cancer risk caused by X-ray examination provided according to this embodiment includes two levels of early warning. Among them, the first-level early warning is used to determine whether the disease type of the patient belongs to the preset high-risk disease. The predetermined high-risk disease refers to a disease that is likely to cause cancer due to X-ray examination. The first-level warning can play a role in reminding doctors to pay attention. The second-level early warning is used to determine the cumulative cancer risk of patients undergoing scheduled X-ray examinations. The scheduled X-ray examination refers to the X-ray examination that the doctor intends for the patient to do. Cumulative cancer risk is characterized by cumulative incidence and/or mortality of cancer. The cumulative incidence is the sum of the cancer incidence from the X-rays performed prior to the current examination and the cancer incidence from the scheduled X-rays for the patient. Cumulative mortality is the sum of the cancer mortality from X-rays performed prior to the patient's examination and the cancer mortality from scheduled X-rays. The second-level early warning can assist the doctor to finally determine whether to let the patient do the preset X-ray examination, thus providing a reference for the rational choice of the X-ray examination. For example, when a secondary warning is triggered, it means that the patient's cancer incidence and cancer mortality rate after the scheduled X-ray examination are at a high level. At this time, the doctor needs to consider whether it is necessary to risk the patient's condition. this risk to do a scheduled X-ray examination, or if there are other alternatives.

在一个实施例中，图6所示的预警方法600还包括确定发病率阈值的过程。具体包括：首先，获取第一数据样本，第一数据样本包括第一预设期间内行X射线检查的多名患者的历史病例记录。第一数据样本例如为“一、准备数据”中提到的第一组数据。其次，基于第一数据样本和累积患癌风险评估模型，确定多名患者各自的终身累积发病率；基于多名患者的终身累积发病率确定发病率等级。该过程可参阅图3所示的确定方法300实施例。接着，确定发病率等级中预设发病率级别对应的边界值为发病率阈值。例如，确定发病率阈值为2.04‰，如表2所示。In one embodiment, theearly warning method 600 shown in FIG. 6 further includes a process of determining a morbidity threshold. Specifically, the method includes: first, acquiring a first data sample, where the first data sample includes historical case records of a plurality of patients undergoing X-ray examination within a first preset period. The first data sample is, for example, the first group of data mentioned in "1. Preparing data". Secondly, based on the first data sample and the cumulative cancer risk assessment model, the respective lifetime cumulative incidence rates of the multiple patients are determined; the incidence rate grade is determined based on the lifetime cumulative incidence rates of the multiple patients. For this process, reference may be made to the embodiment of thedetermination method 300 shown in FIG. 3 . Next, the boundary value corresponding to the preset morbidity level in the morbidity level is determined as the morbidity threshold. For example, the morbidity threshold was determined to be 2.04‰, as shown in Table 2.

在一个实施例中，在获取第一数据样本之后，预警方法600还包括还包括确定死亡率阈值的过程。具体包括：首先，基于第一数据样本和累积患癌风险评估模型，确定多名患者各自的终身累积死亡率；基于多名患者的终身累积死亡率确定死亡率等级。该过程可参阅图3所示的确定方法300实施例。其次，确定死亡率等级中预设死亡率级别对应的边界值为死亡率阈值。例如，确定死亡率阈值为1.28‰，如表3所示。In one embodiment, after acquiring the first data sample, theearly warning method 600 further includes a process of determining a mortality threshold. Specifically, it includes: first, determining the respective lifetime cumulative mortality rates of multiple patients based on the first data sample and the cumulative cancer risk assessment model; determining the mortality rate based on the lifetime cumulative mortality rates of the multiple patients. For this process, reference may be made to the embodiment of thedetermination method 300 shown in FIG. 3 . Secondly, the boundary value corresponding to the preset mortality level in the mortality level is determined as the mortality threshold. For example, the mortality threshold was determined to be 1.28‰, as shown in Table 3.

在一个实施例中，预警方法600还包括确定预设高风险疾病的过程。具体包括：首先，获取第二数据样本，第二数据样本包括第二预设期间内行X射线相关检查的多名患者的历史病例记录。第二数据样本例如为“一、准备数据”中提到的第二组数据。其次，基于第二数据样本和终身患癌风险评估模型，确定多名患者各自的终身累积发病率。接着，基于多名患者各自的终身累积发病率确定发病率高风险组和发病率常规组；采用统计学logistic回归分析，以是否属于发病率高风险组为因变量，以患者的生日、性别、照射次数和疾病类型为自变量，确定至少一个第一高风险疾病，以作为预设高风险疾病。生日以年为单位，照射次数是指第二数据样本中同一年出生的患者各自的个人终身照射次数的加和，个人终身照射次数是指终身接受的有效剂量相对于预设曝光剂量的倍数。该步骤具体可参阅图5所示确定预设高风险疾病的方法500实施例。In one embodiment, theearly warning method 600 further includes a process of determining a predetermined high risk disease. Specifically, it includes: first, acquiring a second data sample, where the second data sample includes historical case records of a plurality of patients who underwent X-ray related examinations within a second preset period. The second data sample is, for example, the second group of data mentioned in "1. Preparing data". Second, based on the second data sample and the lifetime cancer risk assessment model, the respective lifetime cumulative incidence rates of multiple patients are determined. Then, based on the respective lifetime cumulative morbidity rates of multiple patients, the high-risk group and the routine group were determined; statistical logistic regression analysis was used, with whether they belonged to the high-risk group as the dependent variable, and the patient's birthday, gender, The number of exposures and the disease type are independent variables, and at least one first high-risk disease is determined as a preset high-risk disease. Birthdays are in years, exposure times refer to the sum of the individual lifetime exposure times of patients born in the same year in the second data sample, and individual lifetime exposure times refer to the multiples of the effective dose received throughout the life relative to the preset exposure dose. For details of this step, reference may be made to the embodiment of themethod 500 for determining a predetermined high-risk disease shown in FIG. 5 .

在一个实施例中，在获取第二数据样本之后，还包括：基于第二数据样本和终身患癌风险评估模型，确定多名患者各自的终身累积死亡率；基于多名患者各自的终身累积死亡率确定死亡率高风险组和死亡率常规组；采用统计学logistic回归分析，以是否属于死亡率高风险组为因变量，以患者的生日、性别、照射次数和疾病类型为自变量，确定至少一个第二高风险疾病，第一高风险疾病和第二高风险疾病共同作为预设高风险疾病。该步骤具体可参阅图5所示确定预设高风险疾病的方法500实施例。In one embodiment, after acquiring the second data sample, the method further includes: determining, based on the second data sample and the lifetime cancer risk assessment model, the respective lifetime cumulative mortality rates of the multiple patients; based on the respective lifetime cumulative mortality rates of the multiple patients The high-risk mortality group and the routine mortality group were determined by statistical logistic regression analysis, with the high mortality risk group as the dependent variable and the patient's birthday, gender, number of exposures, and disease type as independent variables to determine at least A second-high-risk disease, the first-high-risk disease and the second-high-risk disease are collectively referred to as a predetermined high-risk disease. For details of this step, reference may be made to the embodiment of themethod 500 for determining a predetermined high-risk disease shown in FIG. 5 .

行X射线检查所致患癌风险的预警装置Early warning device for cancer risk due to X-ray examination

图7为本申请一实施例提供的行X射线检查所致患癌风险的预警装置的结构框图。如图7所示，预警装置700包括：第一确定模块710、第一预警模块720、第二确定模块730和第二预警模块740。其中，第一确定模块710用于基于患者的就诊原因确定患者所患疾病类型，就诊原因是指医生申请预定X射线检查时填写的诊断描述。第一预警模块720用于当疾病类型属于预设高风险疾病时，触发一级预警。第二确定模块730用于基于患者的过往X射线检查的病例记录和累积患癌风险评估模型确定患者行预设X射线检查的累积患癌风险，累积患癌风险用癌症的累积发病率和/或累积死亡率表征，累积发病率是指患者行过往X射线检查和预设X射线检查之一的单次癌症发病率的加和，累积死亡率是指患者行过往X射线检查和预设X射线检查之一的单次癌症死亡率的加和。第二预警模块740用于当累积患癌风险满足预设条件时，触发二级预警。FIG. 7 is a structural block diagram of an early warning device for cancer risk caused by X-ray examination according to an embodiment of the present application. As shown in FIG. 7 , the early warning device 700 includes: a first determination module 710 , a first early warning module 720 , a second determination module 730 and a second early warning module 740 . The first determination module 710 is configured to determine the type of disease the patient suffers from based on the patient's reason for visiting a doctor, where the reason for visiting a doctor refers to a diagnosis description filled in by a doctor when applying for a scheduled X-ray examination. The first early warning module 720 is configured to trigger a first-level early warning when the disease type belongs to a preset high-risk disease. The second determination module 730 is configured to determine the cumulative cancer risk of the patient undergoing a preset X-ray examination based on the case records of the patient's past X-ray examinations and the cumulative cancer risk assessment model, the cumulative cancer risk using the cumulative incidence of cancer and/or the cumulative cancer risk. Or Cumulative Mortality Characterization, Cumulative Incidence is the sum of the single cancer incidence for one of the patient's previous X-rays and a scheduled X-ray, and Cumulative Mortality is the patient's previous X-rays and a scheduled X-ray The sum of single cancer mortality rates for one of the radiographs. The second early warning module 740 is configured to trigger a secondary early warning when the accumulated cancer risk meets a preset condition.

第一确定模块710具体用于将就诊原因和疾病类型数据库进行文本匹配，以确定疾病类型。The first determination module 710 is specifically configured to perform text matching between the cause of the visit and the disease type database to determine the disease type.

累积患癌风险评估模型包括单次患癌风险评估模块和累加模块。单次患癌风险评估模块用于分别针对过往X射线检查和预设X射线检查，基于患者的性别、检查时的年龄和有效剂量确定单次X射线检查的癌症发病率和癌症死亡率。累加模块用于对全部X射线检查的癌症发病率进行加和，得到累积发病率，对全部X射线检查的癌症死亡率加和，得到累积死亡率。The cumulative cancer risk assessment model includes a single cancer risk assessment module and an accumulation module. The single cancer risk assessment module is used to determine the cancer incidence and cancer mortality of a single X-ray examination based on the patient's gender, age at the time of examination, and effective dose, respectively, for past X-ray examinations and preset X-ray examinations. The accumulating module is used for summing the cancer incidence rates of all X-ray examinations to obtain a cumulative incidence rate, and summing the cancer mortality rates of all X-ray examinations to obtain a cumulative mortality rate.

在一个实施例中，第二确定模块730还用于确定过往X射线检查和预设X射线检查各自对应的标准检查项目；确定标准检查项目对应的有效剂量。In one embodiment, the second determination module 730 is further configured to determine the standard inspection items corresponding to the past X-ray inspection and the preset X-ray inspection; and determine the effective dose corresponding to the standard inspection items.

第二预警模块740具体用于当累积发病率超过发病率阈值，累积死亡率超过死亡率阈值时，触发二级预警。The second early warning module 740 is specifically configured to trigger a secondary early warning when the cumulative morbidity exceeds the morbidity threshold and the cumulative mortality exceeds the mortality threshold.

在一个实施例中，预警装置700还包括第三确定模块，用于获取第一数据样本，第一数据样本包括第一预设期间内行X射线检查的多名患者的历史病例记录；基于第一数据样本和累积患癌风险评估模型，确定多名患者各自的终身累积发病率；基于多名患者的终身累积发病率确定发病率等级；确定发病率等级中预设发病率级别对应的边界值为发病率阈值。In one embodiment, the early warning device 700 further includes a third determination module for acquiring a first data sample, where the first data sample includes historical case records of a plurality of patients who underwent X-ray examinations within a first preset period; based on the first The data samples and the cumulative cancer risk assessment model are used to determine the respective lifetime cumulative incidence rates of multiple patients; the incidence rate grades are determined based on the lifetime cumulative incidence rates of multiple patients; the boundary value corresponding to the preset incidence rate grades in the incidence rate grades is determined. Incidence threshold.

第三确定模块还用于在获取第一数据样本之后，基于第一数据样本和累积患癌风险评估模型，确定多名患者各自的终身累积死亡率；基于多名患者的终身累积死亡率确定死亡率等级；确定死亡率等级中预设死亡率级别对应的边界值为死亡率阈值。The third determining module is further configured to, after acquiring the first data sample, determine the respective lifetime cumulative mortality rates of the multiple patients based on the first data sample and the cumulative cancer risk assessment model; and determine death based on the lifetime cumulative mortality rates of the multiple patients rate level; determine the mortality rate threshold corresponding to the boundary value of the preset mortality level in the mortality rate level.

在一个实施例中，预警装置700还包括第四确定模块，用于获取第二数据样本，第二数据样本包括第二预设期间内行X射线相关检查的多名患者的历史病例记录；基于第二数据样本和终身患癌风险评估模型，确定多名患者各自的终身累积发病率；基于多名患者各自的终身累积发病率确定发病率高风险组和发病率常规组；采用统计学logistic回归分析，以是否属于发病率高风险组为因变量，以患者的生日、性别、照射次数和疾病类型为自变量，确定至少一个第一高风险疾病，以作为预设高风险疾病，生日以年为单位，照射次数是指不同类型的所述X射线检查之间经过有效剂量的修正后的次数之和。In one embodiment, the early warning device 700 further includes a fourth determination module for acquiring a second data sample, where the second data sample includes the historical case records of a plurality of patients who underwent X-ray related examinations within the second preset period; Second, data samples and lifetime cancer risk assessment models were used to determine the respective lifetime cumulative incidence rates of multiple patients; based on the respective lifetime cumulative incidence rates of multiple patients, the high-risk incidence group and the conventional incidence group were determined; statistical logistic regression analysis was used , with whether it belongs to a high-risk group as the dependent variable, and with the patient’s birthday, gender, number of exposures, and disease type as independent variables, to determine at least one first high-risk disease as a preset high-risk disease, with birthday as the year In unit, the number of irradiations refers to the sum of the corrected times of the effective dose between the different types of X-ray inspections.

第四确定模块还用于在获取第二数据样本之后，基于第二数据样本和终身患癌风险评估模型，确定多名患者各自的终身累积死亡率；基于多名患者各自的终身累积死亡率确定死亡率高风险组和死亡率常规组；采用统计学logistic回归分析，以是否属于死亡率高风险组为因变量，以患者的生日、性别、照射次数和疾病类型为自变量，确定至少一个第二高风险疾病，第一高风险疾病和第二高风险疾病共同作为预设高风险疾病。The fourth determining module is further configured to, after acquiring the second data sample, determine the respective lifetime cumulative mortality rates of the multiple patients based on the second data sample and the lifetime cancer risk assessment model; determine the respective lifetime cumulative mortality rates based on the multiple patients The high mortality risk group and the routine mortality group; statistical logistic regression analysis was used to determine whether at least one of the patients belonged to the high mortality risk group as the dependent variable and the patient's birthday, gender, number of exposures, and disease type as the independent variables. The second high-risk disease, the first high-risk disease and the second high-risk disease are collectively regarded as the preset high-risk disease.

本实施例提供的预警装置，与本申请实施例所提供的预警方法属于同一申请构思，可执行本申请任意实施例所提供的预警方法，具备执行预警方法相应的功能模块和有益效果。未在本实施例中详尽描述的技术细节，可参见本申请实施例提供的预警方法，此处不再加以赘述。The pre-warning device provided in this embodiment belongs to the same application concept as the pre-warning method provided by the embodiment of the present application, can execute the pre-warning method provided by any embodiment of the present application, and has corresponding functional modules and beneficial effects for executing the pre-warning method. For technical details that are not described in detail in this embodiment, reference may be made to the early warning method provided in this embodiment of the present application, which will not be repeated here.

电子设备Electronic equipment

图8是本申请一实施例提供的电子设备的结构框图。如图8所示，电子设备800包括一个或多个处理器810和存储器820。FIG. 8 is a structural block diagram of an electronic device provided by an embodiment of the present application. As shown in FIG. 8 , electronic device 800 includes one or more processors 810 and memory 820 .

处理器810可以是中央处理单元（CPU）或者具有数据处理能力和/或指令执行能力的其他形式的处理单元，并且可以控制电子设备800中的其他组件以执行期望的功能。Processor 810 may be a central processing unit (CPU) or other form of processing unit having data processing capabilities and/or instruction execution capabilities, and may control other components in electronic device 800 to perform desired functions.

存储器820可以包括一个或多个计算机程序产品，计算机程序产品可以包括各种形式的计算机可读存储介质，例如易失性存储器和/或非易失性存储器。易失性存储器例如可以包括随机存取存储器（RAM）和/或高速缓冲存储器（cache）等。非易失性存储器例如可以包括只读存储器（ROM）、硬盘、闪存等。在计算机可读存储介质上可以存储一个或多个计算机程序指令，处理器810可以运行所述程序指令，以实现上文所述的本申请的各个实施例的预警方法以及/或者其他期望的功能。Memory 820 may include one or more computer program products, which may include various forms of computer-readable storage media, such as volatile memory and/or non-volatile memory. Volatile memory may include, for example, random access memory (RAM) and/or cache memory (cache), among others. Non-volatile memory may include, for example, read only memory (ROM), hard disk, flash memory, and the like. One or more computer program instructions may be stored on the computer-readable storage medium, and the processor 810 may execute the program instructions to implement the early warning method and/or other desired functions of the various embodiments of the present application described above .

在一个示例中，电子设备800还可以包括：输入装置830和输出装置840，这些组件通过总线系统和/或其他形式的连接机构（未示出）互连。In one example, the electronic device 800 may also include an input device 830 and an output device 840 interconnected by a bus system and/or other form of connection mechanism (not shown).

输出装置840可以向外部输出各种信息，包括确定出的预警信息等。输出设备840可以包括例如显示器、扬声器、打印机、以及通信网络及其所连接的远程输出设备等等。The output device 840 can output various information to the outside, including the determined early warning information and the like. Output devices 840 may include, for example, displays, speakers, printers, and communication networks and their connected remote output devices, among others.

当然，为了简化，图8中仅示出了该电子设备800中与本申请有关的组件中的一些，省略了诸如总线、输入/输出接口等等的组件。除此之外，根据具体应用情况，电子设备800还可以包括任何其他适当的组件。Of course, for simplicity, only some of the components in the electronic device 800 related to the present application are shown in FIG. 8 , and components such as buses, input/output interfaces and the like are omitted. Besides, the electronic device 800 may also include any other suitable components according to the specific application.

计算机程序产品和计算机可读存储介质Computer program product and computer readable storage medium

除了上述方法和设备以外，本申请的实施例还可以是计算机程序产品，其包括计算机程序指令，计算机程序指令在被处理器运行时使得处理器执行本说明书上述“示例性方法”部分中描述的根据本申请各种实施例的预警方法中的步骤。In addition to the above-described methods and apparatus, embodiments of the present application may also be computer program products comprising computer program instructions that, when executed by a processor, cause the processor to perform the methods described in the "Exemplary Methods" section of this specification above. Steps in an early warning method according to various embodiments of the present application.

计算机程序产品可以以一种或多种程序设计语言的任意组合来编写用于执行本申请实施例操作的程序代码，程序设计语言包括面向对象的程序设计语言，诸如Java、C++等，还包括常规的过程式程序设计语言，诸如“C”语言或类似的程序设计语言。程序代码可以完全地在用户计算设备上执行、部分地在用户设备上执行、作为一个独立的软件包执行、部分在用户计算设备上部分在远程计算设备上执行、或者完全在远程计算设备或服务器上执行。The computer program product may be written in any combination of one or more programming languages to write program codes for performing the operations of the embodiments of the present application. The programming languages include object-oriented programming languages, such as Java, C++, etc., as well as conventional procedural programming language, such as "C" language or similar programming language. The program code may execute entirely on the user's computing device, partly on the user's device, as a stand-alone software package, partly on the user's computing device and partly on a remote computing device, or entirely on the remote computing device or server execute on.

此外，本申请的实施例还可以是计算机可读存储介质，其上存储有计算机程序指令，计算机程序指令在被处理器运行时使得处理器810执行本说明书上述“示例性方法”部分中描述的根据本申请各种实施例的预警方法中的步骤。In addition, embodiments of the present application may also be computer-readable storage media having computer program instructions stored thereon that, when executed by the processor, cause the processor 810 to perform the methods described in the above-mentioned "Exemplary Methods" section of this specification. Steps in an early warning method according to various embodiments of the present application.

所述计算机可读存储介质可以采用一个或多个可读介质的任意组合。可读介质可以是可读信号介质或者可读存储介质。可读存储介质例如可以包括但不限于电、磁、光、电磁、红外线、或半导体的系统、装置或器件，或者任意以上的组合。可读存储介质的更具体的例子（非穷举的列表）包括：具有一个或多个导线的电连接、便携式盘、硬盘、随机存取存储器（RAM）、只读存储器（ROM）、可擦式可编程只读存储器（EPROM或闪存）、光纤、便携式紧凑盘只读存储器(CD-ROM)、光存储器件、磁存储器件、或者上述的任意合适的组合。The computer-readable storage medium may employ any combination of one or more readable media. The readable medium may be a readable signal medium or a readable storage medium. The readable storage medium may include, for example, but not limited to, electrical, magnetic, optical, electromagnetic, infrared, or semiconductor systems, apparatuses or devices, or any combination of the above. More specific examples (non-exhaustive list) of readable storage media include: electrical connections with one or more wires, portable disks, hard disks, random access memory (RAM), read only memory (ROM), erasable programmable read only memory (EPROM or flash memory), optical fiber, portable compact disk read only memory (CD-ROM), optical storage devices, magnetic storage devices, or any suitable combination of the foregoing.

以上结合具体实施例描述了本申请的基本原理，但是，需要指出的是，在本申请中提及的优点、优势、效果等仅是示例而非限制，不能认为这些优点、优势、效果等是本申请的各个实施例必须具备的。另外，上述公开的具体细节仅是为了示例的作用和便于理解的作用，而非限制，上述细节并不限制本申请为必须采用上述具体的细节来实现。The basic principles of the present application have been described above in conjunction with specific embodiments. However, it should be pointed out that the advantages, advantages, effects, etc. mentioned in the present application are only examples rather than limitations, and these advantages, advantages, effects, etc., are not considered to be Required for each embodiment of this application. In addition, the specific details disclosed above are only for the purpose of example and easy understanding, rather than limiting, and the above-mentioned details do not limit the application to be implemented by using the above-mentioned specific details.

本申请中涉及的器件、装置、设备、系统的方框图仅作为例示性的例子并且不意图要求或暗示必须按照方框图示出的方式进行连接、布置、配置。如本领域技术人员将认识到的，可以按任意方式连接、布置、配置这些器件、装置、设备、系统。诸如“包括”、“包含”、“具有”等等的词语是开放性词汇，指“包括但不限于”，且可与其互换使用。这里所使用的词汇“或”和“和”指词汇“和/或”，且可与其互换使用，除非上下文明确指示不是如此。这里所使用的词汇“诸如”指词组“诸如但不限于”，且可与其互换使用。The block diagrams of devices, apparatus, apparatuses, and systems referred to in this application are merely illustrative examples and are not intended to require or imply that the connections, arrangements, or configurations must be in the manner shown in the block diagrams. As those skilled in the art will appreciate, these means, apparatuses, apparatuses, systems may be connected, arranged, configured in any manner. Words such as "including", "including", "having" and the like are open-ended words meaning "including but not limited to" and are used interchangeably therewith. As used herein, the words "or" and "and" refer to and are used interchangeably with the word "and/or" unless the context clearly dictates otherwise. As used herein, the word "such as" refers to and is used interchangeably with the phrase "such as but not limited to".

还需要指出的是，在本申请的装置、设备和方法中，各部件或各步骤是可以分解和/或重新组合的。这些分解和/或重新组合应视为本申请的等效方案。It should also be pointed out that in the apparatus, equipment and method of the present application, each component or each step can be decomposed and/or recombined. These disaggregations and/or recombinations should be considered as equivalents of the present application.

提供所公开的方面的以上描述以使本领域的任何技术人员能够做出或者使用本申请。对这些方面的各种修改对于本领域技术人员而言是非常显而易见的，并且在此定义的一般原理可以应用于其他方面而不脱离本申请的范围。因此，本申请不意图被限制到在此示出的方面，而是按照与在此公开的原理和新颖的特征一致的最宽范围。The above description of the disclosed aspects is provided to enable any person skilled in the art to make or use this application. Various modifications to these aspects will be readily apparent to those skilled in the art, and the generic principles defined herein may be applied to other aspects without departing from the scope of the application. Therefore, this application is not intended to be limited to the aspects shown herein but is to be accorded the widest scope consistent with the principles and novel features disclosed herein.

为了例示和描述的目的已经给出了以上描述。此外，此描述不意图将本申请的实施例限制到在此公开的形式。尽管以上已经讨论了多个示例方面和实施例，但是本领域技术人员将认识到其某些变型、修改、改变、添加和子组合。The foregoing description has been presented for the purposes of illustration and description. Furthermore, this description is not intended to limit the embodiments of the application to the forms disclosed herein. Although a number of example aspects and embodiments have been discussed above, those skilled in the art will recognize certain variations, modifications, changes, additions and sub-combinations thereof.