Predmet izuma je naprava in informacijski sistem za samodejno interpretacijo rezultatov predtransfuzijskih preiskav, ki zagotavlja izmenjavo strokovnih podatkov pri delu specialistov transfuzijske medicine in pripadajoča naprava. Informacijski sistem po izumu omogoča na podlagi analize slik gelskih kartic in na podlagi tipa preiskave določitev in predlaga specialistu stopnje jakosti aglutinacije posameznih kolon in interpretacijo le-teh v dokončno interpretacijo preiskave. Poleg tega se sistem pri interpretacij preiskav nauči iz predhodnih odločitev specialistov, zabeleženih v sistemu za telekonzultacije v transfuzijski medicini. Pri postopku interpretacije posnema delo specialista, ki dela v dveh korakih in sicer tako, da v prvem koraku oceni stopnjo jakosti aglutinacije v vsaki od šestih kolon gelske kartice, v drugem pa na podlagi kombinacije jakosti stopenj aglutinacije v šestih kolonah gelske kartice določi dokončno interpretacijo preiskave.The subject of the invention is a device and an information system for the automatic interpretation of the results of pre-transfusion examinations, which ensures the exchange of expert data in the work of specialists of transfusion medicine and the associated device. The information system according to the invention enables determination and determination of the degree of agglutination of individual columns and interpretation of these into a definitive interpretation of the investigation, based on the analysis of gel card images and the type of investigation. In addition, the system learns from the prior decisions of specialists recorded in the transfusion teleconsultation system in interpreting investigations. In the interpretation process, it mimics the work of a specialist who works in two steps, by first assessing the degree of agglutination in each of the six columns of the gel card and, in the second, by determining the final interpretation of the investigation in the six columns of the gel card .
Tehnični problem, ki ga predložena naprava uspešno rešuje je realizacija telekonzultacijskega sistema, ki omogoča medsebojno komunikacijo medicinskega osebja, ki izvaja dela na področju transfuzijske medicine in je namenjen izmenjavi mnenj (konzultacij) pri postavljanju diagnoz, predvsem v mejnih primerih z zahtevo po prenosu podatkov med dežurnim zdravnikom in konzultatnom. Naprava mora omogočiti delovanje sistema, ki omogoča izmenjavo vprašanj, odgovorov, izmenjavo strokovnih podatkov v sporočilnem načinu, v nujnih primerih pa tudi telekonzultacijo v realnem času. Vse akcije v sistemu se morajo beležiti. Pri telekonzultaciji v realnem času naj se poleg prenosa naštetih tipov podatkov vzpostavi še videokonferenčna povezava. Sistem naj omogoča pozivanje uporabnika. Ena temeljnih zahtev je tudi uporabniku prijazen in intuitiven uporabniški vmesnik. Sistem naj omogoča tudi izdelavo papirnih kopij dokumentov o telekonzultaciji. Poleg tega naj sistem in pripadajoča naprava po izumu predstavlja vir učnih in testnih podatkov za nadaljni razvoj sistema za samodejno interpretacijo rezultatov predtransfuzijskih preiskav. Konzultacije, ki se izvajajo v nejasnih, in z vidika interpretacije, težavnih primerih, rešuje specialist osrednjega laboratorija. Rešitve primerov in njihovi vhodni podatki naj se shranjujejo v is sistemu, tako da bo možen dostop do vira, z vidika strojnega učenja, kakovostnih podatkov za gradnjo učne množice z enega mesta. Ta vir se z uporabo sistema po izumu nenehno dopolnjuje, kar omogoča, da lahko gradimo vedno boljšo in popolnejšo učno množico, ki je osnova za gradnjo učinkovitih modelov interpretacije rezultatov.The technical problem that the device successfully solves is the realization of a teleconsultation system that allows communication between medical personnel performing transfusion medicine work and intended to exchange opinions (consultations) in diagnosing, especially in borderline cases, with the requirement to transfer data between on-call doctors and consultant. The device must be capable of operating a system that enables the exchange of questions, answers, the exchange of expert data in messaging mode, and in urgent cases, real-time teleconsultation. All actions on the system must be logged. In real-time teleconsultation, video conferencing should be established in addition to transmitting the above types of data. The system should allow the user to be called. One of the basic requirements is a user-friendly and intuitive user interface. The system should also allow paper copies of teleconsultation documents to be made. In addition, the system and associated device according to the invention should be a source of learning and test data for the further development of a system for the automatic interpretation of the results of pre-transfusion examinations. Consultations that are conducted in unclear and, in terms of interpretation, difficult cases, are resolved by a specialist of the central laboratory. Case solutions and their inputs should be stored in the is system so that access to the resource can be accessed from a machine learning perspective, quality data to build a learning crowd from one place. This resource is constantly being supplemented by the use of the system of the invention, which allows us to build an ever better and more complete learning set, which is the basis for building effective models for the interpretation of results.
Storitve transfuzijske medicine se opravljajo v oddelkih za transfuzijo krvi, kjer se izda lahko tudi nekaj sto enot krvi na dan. Za vsako izdano enoto krvi se izvedejo predtransfuzijska testiranja. Preiskave se izvajajo z gelsko metodo, katere rezultate lahko tudi foto dokumentiramo. Za • · dejavnost transfuzijske službe je zato potrebnih nekaj nenehno dežurnih zdravnikov specialistov transfuzijske medicine. Če pri izvajanju predtransfuzijskih testiranj pride do nejasnosti, je uporaba telefonske konzultacije trenutno edina opcija za posvet s specialistom transfuzijske medicine.Transfusion medicine services are provided in blood transfusion units where several hundred units of blood per day can also be dispensed. Pre-transfusion tests are performed for each blood unit issued. Investigations are carried out using the gel method, the results of which can also be photo-documented. Therefore, • the activity of the transfusion service requires some constantly on-call physicians from transfusion specialists. If ambiguity is encountered in pre-transfusion testing, the use of telephone consultation is currently the only option to consult a transfusion specialist.
Zaradi pomanjkanja kadrov in različnega števila obdelanih primerov med posameznimi ustanovami niha tudi kakovost opravljenih storitev. V mejnih primerih se zdravniki, manj izkušeni na področju transfuzijske medicine o primerih posvetujejo z izkušenejšimi na tem področju z uporabo telefonske konzultacije. Nastaja potreba po sistemu, ki bi razbremenil potrebe po velikem številu specialistov transfuzijske medicine in poenotil kakovost storitev transfuzijske medicine v vseh ustanovah. Ta sistem naj omogoča povezavo dežurnih zdravnikov in specialistov transfuzijske medicine v vseh transfuzijskih ustanovah. Sistem naj omogoči izmenjavo podatkov, potrebnih za postavljanje diagnoz. Podatki, potrebni za postavljanje diagnoze, so pacientovi medicinski podatki, podatki, pridobljeni iz predhodnih obravnav, in rezultati preiskav.Due to the lack of staff and the different number of cases processed between institutions, the quality of services provided also fluctuates. In borderline cases, physicians less experienced in the field of transfusion medicine consult with those experienced in the field through telephone consultation. There is a need for a system that would relieve the need for a large number of transfusion medicine specialists and unify the quality of transfusion medicine services in all institutions. This system should allow the connection between on-call doctors and transfusion medicine specialists in all transfusion establishments. The system should be able to share the information needed to diagnose it. The information needed to make the diagnosis is the patient's medical information, data obtained from previous treatments and the results of the examinations.
Trenutna na trgu dostopna oprema DiaMed-ID Maestro, ki jo proizvaja podjetje DiaMed omogoča delno samodejno odčitavanje in interpretacijo predtransfuzijskih preiskav. Oprema je sposobna odčitati očitne rezultate, pri neočitnih pa je potrebno posredovanje specialistov transfuzijske medicine. Oprema, ki omogoča omenjeno funkcionalnost, je precej draga in si jo lahko privošči le osrednji transfuzijski laboratorij, ki dnevno obdela a aThe currently available DiaMed-ID Maestro equipment manufactured by DiaMed enables partial automatic reading and interpretation of pre-transfusion examinations. The equipment is capable of reading the obvious results, and the non-obvious ones require the intervention of transfusion specialists. The equipment that provides the aforementioned functionality is quite expensive and can only be afforded by a central transfusion laboratory that processes a
veliko primerov predtransfuzijskih preiskav z gelsko metodo. Ostali laboratoriji pa postopke predtransfuzijskih preiskav še vedno izvajajo ročno. Omenjeno napravo za samodejno interpretacijo rezultatov je potrebno ob postavitvi v laboratorij najprej kalibrirati in nastaviti delovne parametre, nakar je podlagi nastavljenih parametrov kalibracije sama sposobna določati posamezne stopnje jakosti aglutinacije eritrocitov v posameznih kolonah. Za določanje stopnje jakosti aglutinacije je področje vsake kolone na gelskih karticah razdeljeno na pet oken. Zgornje okno je za pozitivne rezultate, spodnje za negativne, vmesna za vmesne.many examples of gel pre-transfusion examinations. Other laboratories, however, still carry out pre-transfusion procedures manually. The device for the automatic interpretation of the results must first be calibrated and set operating parameters when placed in the laboratory, and then, on the basis of the calibration parameters set, it will itself be able to determine the individual levels of erythrocyte agglutination in individual columns. To determine the degree of agglutination strength, the area of each column on gel cards is divided into five windows. The upper window is for positive results, the lower window for negative results is intermediate for intermediate ones.
Algoritem ugotavlja prisotnost aglutinatov v teh oknih in na podlagi prisotnosti aglutinatov določi stopnjo jakosti aglutinacije. Pri postopku kalibracije naprave je potrebno definirati položaje in velikost treh področij kolon gelskih kartic. Ko so v obravnavani gelski kartici določene vse kolone, interpretira naprava glede na tip preiskave kombinacijo kolon iz is pravilnostne tabele posamezne preiskave v rezultat preiskave.The algorithm detects the presence of agglutinates in these windows and determines the degree of agglutination strength based on the presence of agglutinates. The position and size of the three areas of the gel card columns must be defined in the calibration process of the device. When all the columns under consideration are identified in the gel card, the device interprets, by type of investigation, the combination of columns from and from the regularity table of each investigation into the result of the investigation.
Naprava in informacijski sistem za samodejno interpretacijo rezultatov predtransfuzijskih testiranj po izumu omogoča z uporabo telekonzultacije v transfuzijski medicini prenos vseh podatkov, potrebnih za izvajanje transfuzijskih storitev, pri čemer sistem omogoča prenos in shranjevanje laboratorijskih rezultatov in se v primeru zahteve po takojšnji interakciji vzpostavi videokonferenčna povezava med konzultantom in konzultirajočim uporabnikom sistema. Pripadajoča naprava za izvedbo opisanega sistema je vključena v obstoječi sistem za telekonzultacije in • · · nudi podporo medicinskemu strokovnemu osebju pri interpretaciji preiskav. Na podlagi primerov določenih nterpretacij predtransfuzijskih preiskav, ki so določene s strani specialistov transfuzijske medicine z uporabo sistema za telekonzultacije v transfuzijski medicini, sama naprava adaptivno izboljšuje in popravlja model za samodejno interpretacijo rezultatov predtransfuzijskih preiskav, izpeljanih z gelsko metodo. Sistem pri svojem delovanju posnema postopek, ki ga za interpretacijo izvedejo specialisti transfuzijske medicine.The device and information system for the automatic interpretation of the results of pre-transfusion testing according to the invention enables the use of teleconsultation in transfusion medicine to transfer all the data necessary for the performance of transfusion services, the system allowing the transfer and storage of laboratory results and, in the case of a request for immediate interaction, a video conferencing consultants and consulting users of the system. The associated device for carrying out the described system is integrated into the existing teleconsultation system and • · provides support to medical professionals in interpreting the examinations. Based on the examples of certain interpretations of pre-transfusion examinations determined by transfusion specialists using a transfusion teleconsultation system, the device itself adaptively refines and corrects the model for the automatic interpretation of the results of gel pre-transfusion examinations. The system emulates in its operation a procedure performed by transfusion medicine specialists for interpretation.
Napravo za samodejno interpretacijo rezultatov predtransfuzijskih preiskav po izumu sestavljajo preko omrežja povezani posamezni moduli, ki omogočajo zajem slik gelskih kartic s čitalcem za fotografski zajem, uporabo podatkovnih baz z modulom za dostop do njih, nadzorom sistema videokonferenčno povezavo avtomatsko predlaganje diagnoz.The device for the automatic interpretation of the results of pre-transfusion examinations according to the invention consists of network-connected individual modules that enable the capture of gel card images with a photographic reader, the use of databases with a module for access to them, the control of the video conferencing system, the automatic suggestion of diagnoses.
Izum bomo podrobneje obrazložil na osnovi izvedbenega primera in is slik, ki kažejo:The invention will be explained in more detail on the basis of an embodiment and pictures showing:
slika 1 modularna zasnova naprave za izvedbo informacijskega sistema po izumu;Figure 1 is a modular design of an apparatus for implementing an information system according to the invention;
slika 2 čitalec za fotografski zajem slik gelskih kartic;figure 2 reader for photographic capture of gel card images;
slika 3 postavitev svetlobnih teles, snemalne naprave in gelske kartice v čitalcu za fotografski zajem slik gelskih kartic; slika 4 fotografija gelske kartice z vzorci krvi;Figure 3: arrangement of light bodies, recording equipment and gel cards in a reader for photographic capture of gel card images; figure 4 photograph of a gel card with blood samples;
slika 5 LED matrika.figure 5 LED arrays.
Arhitekturno je naprava in informacijski sistem za samodejno interpretacijo rezultatov predtransfuzijskih testiranj po izumu razdeljen v več medsebojno povezanih modulov, pri čemer so osnovni moduli sistema, prikazani na sliki 1: modul 1 za zajem slik gelskih kartic, modul 2 za varnost in avtentikacijo, modul 3 uporabniškega vmesnika, podatkovni bazi 4,5 z vmesnikom za dostop, modul 6 za nadzor sistema, modul 7 za videokonferenco in modul 8 za avtomatsko predlaganje diagnoz.Architecturally, the device and information system for the automatic interpretation of the results of pre-transfusion testing according to the invention are divided into several interconnected modules, the basic modules of the system shown in Figure 1: module 1 for gel card image capture, module 2 for security and authentication, module 3 user interface, database 4.5 with access interface, module 6 for system control, module 7 for video conferencing, and module 8 for automatic diagnosis of diagnoses.
Ker so za uspešno diagnosticiranje potrebne kakovostne barvne io fotografije gelskih kartic 13, je za zajem slik gelskih kartic 13 izdelan namenski čitalec za fotografski zajem slik gelskih kartic 13 in ustrezna programska oprema, zajeta v modulu 1 za zajem slik gelskih kartic 13. Da so rezultati posameznih fotografiranj med seboj primerljivi, mora biti postopek fotografiranja gelskih kartic normaliziran in ponovljiv. Fotografije morajo biti brez odbleskov, geometrijskih in barvnih popačenj. Fotografirane kartice morajo biti enakomerno osvetljene, goriščna razdalja fotografiranja mora biti vedno enaka, za poenostavitev nadaljnje obdelave pa mora biti vedno enak tudi položaj gelske kartice pri fotografiranju.Because good quality gel color photographs of gel cards 13 are required for successful diagnosis, a dedicated photo gel capture card reader 13 and corresponding software included in module 1 for gel card image capture 13 are produced to capture gel card images 13. of individual photographs being comparable, the procedure for photographing gel cards should be normalized and reproducible. Photos should be free of reflections, geometries and color distortions. Photographed cards should be illuminated uniformly, the focal length of the photograph should always be the same, and the position of the gel card when photographing should always be the same to facilitate further processing.
Na sliki 2 je prikazan čitalec za fotografski zajem slik gelskih kartic 13.Figure 2 shows a reader for photographic capture of gel card images 13.
Za samo fotografiranje je v napravi uporabljena komercialna snemalna naprava 9, ki omogoča izdelavo barvnih digitalnih fotografij, čitalec pa krmili mikrokrmilnik družine AVR. čitalec za fotografski zajem slik gelskih kartic 13 je na osebni računalnik priključena prek vmesnika USB. RezultatThe camera itself uses a commercial recording device 9 to produce color digital still images, and the reader controls the microcontroller of the AVR family. the gel card reader 13 is connected to a PC via USB. The result
zajema slik gelskih kartic 13 so barvne digitalne fotografije v velikosti 2048 x 1536 slikovnih elementov. Po ustrezni digitalni obdelavi so zajete fotografije dovolj kakovostne za postavljanje diagnoz.Gel Cards Images 13 is a 2048 x 1536 color digital still image. After proper digital processing, the captured photographs are of sufficient quality to diagnose.
Čitalec za fotografski zajem slik gelskih kartic 13 je sestavljen iz ohišja, mehanskega vodila, ki služi za vpenjanje fotografirane gelske kartice 13, senzorja prisotnosti gelske kartice 13, dveh svetlobnih teles 10,11, ki gelsko kartico 13 osvetlita s sprednje strani na način, da se na gladki površini gelske kartice 13 v objektiv snemalne naprave 9 ne odbijejo odbleski svetlobnih teles 10,11, svetlobnega telesa 12, ki gelsko kartico 13 io osvetli od zadaj s prosojno svetlobo in snemalne naprave 9 za zajem slike gelske kartice 13. Identifikacijska svetlobna telesa uporabnika čitalca obveščajo o delovanju čitalca, elektronika, ki zaznava stanje vstavljenosti gelske kartice 13 pa podatke posreduje računalniku, na katerega je modul 1 priključen, računalnik pa tudi nadzira identifikacijska svetlobna telesa.The photographic image reader of the gel cards 13 consists of a housing, a mechanical guide used to clamp the photographed gel card 13, a sensor for the presence of the gel card 13, two light bodies 10,11 which illuminate the gel card 13 from the front in such a way that on the smooth surface of the gel card 13, the reflections of the light bodies 10,11, the light body 12 which illuminates the gel card 13 io from behind with translucent light and the recording device 9 for capturing the image of the gel card 13 are not reflected in the lens of the recording device 9. the reader is informed of the operation of the reader, and electronics detecting the state of insertion of the gel card 13 transmit the data to the computer to which module 1 is connected, and the computer also controls the identification light bodies.
Na ta način je dosežen ponovljiv zajem slik gelskih kartic 13, ki je nujno potreben za nemoteno delo specialistov transfuzijske medicine kot tudi za delovanje algoritma samodejne interpretacije rezultatov predtransfuzijskih preiskav na gelskih karticah. Na sliki 3 je predstavljena postavitev svetlobnih teles 10,11,12, snemalne naprave 9, in gelske kartice 13 v čitalcu za fotografski zajem slik gelskih kartic 13. Na levi strani slike je zadnje svetlobno telo 12: matrika LED z dvema difuzorjema, sledi gelska kartica 13, dve sprednji svetlobni telesi 10,11 z difuzorjem, na desni strani pa je snemalna naprava 9. Sprednji svetlobni telesi 10,11 morata biti dovolj odmaknjeni od optične osi objektiva, da se neposredni odboji svetlobnih teles 10,11 od gladkih površin gelske kartice 13 ne odbijejo v objektiv snemalne naprave 9. Na sliki so narisani koti najneugodnejših odbojev s črtkano črto. Vidimo, da je postavitev gelske kartice 13, sprednjih svetlobnih teles 10,11 in snemalne naprave 9 taka, da se odboji ne odbijejo v objektiv snemalne naprave 9.In this way, the reproducible capture of gel card images 13 is achieved, which is essential for the smooth operation of transfusion specialists as well as for the operation of the algorithm for the automatic interpretation of the results of pre-transfusion examinations on gel cards. Figure 3 shows the layout of the light bodies 10,11,12, the recording device 9, and the gel card 13 in the photographic image reader of the gel cards 13. On the left side of the image is a rear light body 12: an LED matrix with two diffusers, followed by a gel card 13, two front light bodies 10,11 with diffuser and on the right side a recording device 9. The front light bodies 10,11 must be sufficiently spaced from the optical axis of the lens to allow the direct reflections of the light bodies 10.11 from the smooth surfaces of the gel cards 13 do not reflect into the lens of the recording device 9. The figure shows the angles of the worst reflections with the dashed line. It is seen that the placement of the gel card 13, the headlamps 10.11, and the recording device 9 is such that the reflections do not reflect into the lens of the recording device 9.
Da smo v čitalcu za fotografski zajem slik gelskih kartic 13 dosegli enakomerno osvetlitev, je bilo potrebno izbrati pravo porazdelitev svetilnosti prednjih svetlobnih teles 10,11. Če bi bilo namreč v čitalcu io dovolj prostora bi enakomerno osvetlitev dosegli z neskončno dolgimi svetili, za kar pa v čitalcu ni prostora. Za to smo izračunali optimalno porazdelitev led prednjih svetil na sledeči način: sprednji svetili sta dokaj ozki in dolgi, zato smo problem izračuna sprednjega vpliva svetlobnih teles 10,11 na gelsko kartico 13 poenostavili tako, da smo zanemarili eno is dimenzijo svetila in privzeli, da sta sprednji svetili linijsko svetilo. Privzeli smo tudi, da je uporabljen difuzor - pleksi steklo idealen difuzor in lahko vsako točko difuzorja obravnavamo kot Huygensov vir svetlobe. Jakost tega vira smo določili iz sevalnega diagrama LED, ki je svetila na difuzor. Na ta način smo izračunali prispevek ene LED na osvetljeni objekt.In order to obtain uniform illumination in the photographic capture of gel card images 13, it was necessary to select the correct luminous distribution of the headlamps 10.11. Namely, if there were enough space in the reader, even illumination would be achieved with infinitely long lights, which is not enough space in the reader. For this, we calculated the optimum distribution of the headlamps led as follows: the front lamps are rather narrow and long, so we simplified the problem of calculating the front impact of the luminaries 10,11 on the gel card 13 by neglecting one and the dimension of the lamp and assuming that the front lights are on line lamp. We have also accepted that the diffuser - plexiglass used is an ideal diffuser and we can treat each diffuser point as a Huygens light source. The strength of this source was determined from the radiation diagram of the LED illuminated by the diffuser. In this way, we calculated the contribution of one LED to the illuminated object.
Svetilno telo je izdelano iz kombinacije pleksi stekla in belih LED. Izračunali smo funkcijo svetlosti, ki jo povzroči le ena LED. Skupno svetlost pa smo določili tako, da smo izračunane funkcije svetlosti sešteli, ker se pleksi steklo za svetlobo obnaša LED linearno - to pomeni, da lahko kombiniran učinek več hkratnih LED ocenimo tako, da seštejemo prispevke posameznih. V nadaljevanju postopka smo izbrali število uporabljenih LED 8 in izbrali kriterijsko funkcijo enakomerne osvetlitve gelske kartice 13: čimmanjši kvadrat površine pod prvim odvodom funkcije osvetljenosti na področju gelske kartice 13. V nadaljevanju smo s postopkom optimizacije izračunali optimalno porazdelitev LED na danem svetilu. Izvedba optimizacije je temeljila na gradientnem postopku 1. reda, pri čemer smo optimizacijo pri pogoju izvedli s pomočjo Lagrangeovih multiplikatorjev. Rezultat porazdelitve LED je predstavljen na sliki 5.The luminaire is made of a combination of plexiglass and white LEDs. We calculated the brightness function caused by only one LED. However, total luminance was determined by summing the calculated luminance functions because the plexiglass light behaves LED linearly - that is, the combined effect of several simultaneous LEDs can be estimated by summing the contributions of each. In the continuation of the procedure, we selected the number of LED 8 used and selected the criterion function of uniform illumination of the gel card 13: the minimum square of the surface under the first drainage of the illumination function in the area of the gel card 13. In the following, the optimal distribution of the LED in the given light was calculated by the optimization procedure. The optimization was based on a 1st order gradient procedure, with the condition optimization performed using Lagrange multipliers. The result of the LED distribution is presented in Figure 5.
io Za komunikacijo modula 1 z napravo po izumu skrbi v Javi napisan aplikacija. Aplikacija skrbi za uporabniku prijazen vmesnik, za nadzor naprave, za zajem in obdelavo zajete slike in za komunikacijo ter pošiljanje zajete slike strežniku sistema.io An application written in Java is responsible for communicating module 1 with the device according to the invention. The application takes care of the user-friendly interface, the device control, the capture and processing of the captured image, and the communication and transmission of the captured image to the system server.
Modul 2 za avtentikacijo in varnost omogoča izvedbo varovanja osebnih is in medicinskih podatkov, ki tvorijo informacijski sistem po izumu, kjer je zelo pomembno zagotavljanje dovolj visoke stopnje varovanja podatkov in avtentikacije uporabnikov. Za izvedbo sistema je uporabljeno nezaščiteno javno paketno komutirano omrežje omrežje v katerem se komunikacija izvaja po protokolu IP (Internet Protocol). Večji del komunikacije se izvajaModule 2 for authentication and security enables the implementation of the protection of personal data and medical data that make up the information system of the invention, where it is very important to ensure a sufficiently high level of data protection and user authentication. An unsecured public packet-switched network is used to implement the system, the network in which communication is performed over IP (Internet Protocol). Most of the communication is done
2o po aplikacijskem protokolu HTTP (Hypertext Protocol) z izmenjavo POST sporočil. POST sporočila vsebujejo serializirane podatkovne vsebnike, v katerih se nahajajo podatki, ki se izmenjujejo med posameznimi moduli sistema. Uporabljeno omrežje IP in protokol HTTP v osnovi ne dajeta2o using HTTP (Hypertext Protocol) application with POST messaging. POST messages contain serialized data containers that contain data that is exchanged between individual system modules. The IP network used and the HTTP protocol are basically not giving
nobene zaščite prenašanih podatkov. Če bi uporabili le ta dva protokola, bi lahko do podatkov, ki se prenašajo po omrežju, dostopale tudi nepooblaščene osebe. Zato moramo zagotoviti ustrezno varovanje prenosa podatkov. Poleg tega je treba dostop do sistema zagotoviti samo pooblaščenim uporabnikom. Prav tako je treba zagotoviti, da uporabniki zanesljivo komunicirajo s sistemom in ne z nekom, ki se izdaja za sistem. Za zagotavljanje varnosti v sistemu je uporabljena tehnologija VPN (Virtual Private Netvvork), ki omogoča varno komunikacijo med posameznimi moduli sistema preko javnega paketno komutiranega podatkovnega omrežja. Omogoča enkripcijo podatkov, avtentikacijo komunicirajočih in zagotavljanje integritete podatkov. Enkripcija ali kodiranje podatkov nepoklicanim onemogoči branje podatkov tako, da podatke po določenem algoritmu pretvori v navidezno nesmiseln niz znakov. Druga stran uporabi zrcalni algoritem in iz navidezno nesmiselnega niza znakov izračuna is poslane podatke. Avtentikacija komunicirajočih zagotavlja drugim intentitetam identifikacijo entitet, s katerimi komunicirajo. Zagotavljanje integritete podatkov je zagotovilo, da so preneseni podatki nespremenjeni.no protection for transmitted data. If only these two protocols were used, the data transmitted over the network could also be accessed by unauthorized persons. We must therefore ensure that data transmission is properly protected. In addition, only authorized users should have access to the system. It must also be ensured that users are reliably communicating with the system and not with someone issuing to the system. Virtual Private Netvork (VPN) technology is used to secure the system, enabling secure communication between individual system modules over a public packet switched data network. It enables data encryption, authentication of communicators and assurance of data integrity. Encrypting or encoding data makes it impossible for the uninvited to read the data by converting the data into a seemingly meaningless character string after a certain algorithm. The other site uses a mirror algorithm to calculate and send data from a seemingly pointless character set. The authentication of communicators provides other intentions with the identification of the entities with which they communicate. Ensuring data integrity ensures that the transferred data is unchanged.
Modul 3 uporabniškega vmesnika mora omogočati preprosto in intuitivno uporabo sistema, mora biti preprost za namestitev na terminale in mora biti neodvisen od platforme. Vmesnik naj omogoča, da ga lahko preprosto spreminjamo brez posegov v samo logiko sistema. Za podporo teh zahtev smo za izvedbo uporabniškega vmesnika uporabili standardno, od platforme neodvisno in zelo razširjeno tehnologijo - Java.Module 3 of the user interface must allow for simple and intuitive use of the system, be easy to install at terminals and be platform independent. The interface should be easy to modify without interfering with the logic of the system. To support these requirements, we used standard platform-independent and widespread Java technology to implement the user interface.
Za razvoj aplikacije je bila izbrana relacijska podatkovna baza, ki razume ukaze SQL (Structured Query Language). SQL je najpogostejši standardizirani jezik za opisovanje poizvedb v podatkovnih bazah. Že od leta 1986 ga definira standard ANSI/ISO SQL. Ker je bila za razvoj in izvedbo aplikacije uporabljena tehnologija Java, je mogoče podatkovno bazo preprosto zamenjati, saj je podatkovna baza le eden od uporabljenih modulov z definiranimi vmesniki API. Tako se aplikaciji ni treba ukvarjati z različnimi tipi podatkovnih baz, dokler le te razumejo ukaze po standardu SQL. Pri zamenjavi podatkovne baze je treba v konfiguraciji aplikacije le io zamenjati pot do gonilnikov baze. Uporabljeni so bili krmilniki JDBC (Java Database Connectivity). Na začetku razvoja je bila kot podatkovna baza uporabljen Microsoftov produkt MS Access Database, v nadaljevanju pa je bil uporabljena podatkovna baza MySQL. MySQL je »open source« projekt podatkovne baze, ki je na voljo na MySQL spletni strani.A relational database that understands Structured Query Language (SQL) commands was selected to develop the application. SQL is the most common standardized language for describing database queries. It has been defined by ANSI / ISO SQL since 1986. Because Java technology was used to develop and execute the application, the database can be easily replaced, as the database is only one of the modules used with defined APIs. This way, the application does not have to deal with different types of databases as long as they understand the SQL command. When replacing a database, the path to the database drivers only needs to be changed in the application configuration. JDBC (Java Database Connectivity) controllers were used. At the beginning of the development, Microsoft's MS Access Database product was used as the database, followed by the MySQL database. MySQL is an open source database project that is available on the MySQL website.
Sistem prek ustreznih vmesnikov dostopa do dveh podatkovnih baz 4,5. Prva podatkovna baza 4 je sistemu lastna. V njej so avtorizacijski podatki uporabnikov, podatki, potrebni za samo delo sistema, podatki o postavljenih vprašanjih in odgovorih in podatki o imenih datotek, ki vsebujejo slike gelskih kartic. Posamezne slike gelskih kartic so shranjene vsaka v svoji datoteki z ustreznim imenom. Drugi vir podatkov pa je v podatkovni bazi 5 nameščen sistem DATEC, ki vsebuje osebne in medicinske podatke o pacientih in njihovih prejšnjih primerih. Vsi dogodki v sistemu se beležijo v sistemski bazi 4 podatkov. Zapisi so opremljeni s podatkom o času nastanka in o osebi, ki je dogodek povzročila.The system can access two databases through appropriate interfaces 4.5. The first database 4 is the system's own. It contains user authorization data, system-specific information, questions and answers, and file name information containing gel card images. Individual gel card images are stored each in its own file with a corresponding name. The second data source, in Database 5, is a DATEC system that contains personal and medical information about patients and their previous cases. All events in the system are recorded in the system database 4. The records shall contain information about the time of occurrence and the person who caused the event.
Zakonodaja predpisuje sledljivost postopka transfuzije in arhiviranje dokumentacije, kar je z opisano rešitvijo zagotovljeno. Za dodatno zadoščanje zakonskim zahtevam je v sitemu tudi tiskalnik, ki na papir tiska vse podatke o opravljenih postopkih.The legislation prescribes the traceability of the transfusion process and the filing of documentation, which is ensured by the solution described. To further satisfy the legal requirements, the system also includes a printer that prints on the paper all information about the operations performed.
Modul 6 za nadzor sistema skrbi za komunikacijo med posameznimi sklopi sistema. Realiziran je s tehnologijo JavaBeans. Nadzorni sistem beleži, kdo so trenutno prisotni uporabniki, razdeljuje naloge med uporabnike in jih o nalogah obvešča. Skrbi za avtentikacijo uporabnikov, io beleženje akcij, shranjevanje vprašanj, opremljenih z diagnostičnimi podatki, opremljanje vprašanj s podatki iz sistema DATEC, shranjevanje postavljenih diagnoz, tiskanje dokumentov in generiranje začasnih dokumentov HTML, ki vsebujejo parametre za videokonferenčni sistem in napravo za zajem slik gelskih kartic.The system control module 6 takes care of the communication between the different parts of the system. It is implemented with JavaBeans technology. The control system records who users are currently present, distributes tasks to users, and informs them about tasks. Provides user authentication, io logging of actions, storing questions with diagnostic information, equipping questions with DATEC data, storing diagnoses, printing documents and generating temporary HTML documents containing parameters for a video conferencing system and a gel card capture device .
Storitve v modulu 7 za videokonferenco opravlja v Javi napisan modul vključen v terminal. Za izvedbo nizkonivojskih funkcij telekonference skrbi nabor javanskih knjižnic JMF (Java Media Framevvork). Sistem ob zahtevi po telekonzultaciji z videokonferenco obema komunicirajočima terminaloma posreduje parametre, potrebne za vzpostavitev videokonferenčne povezave. Potrebna parametra sta: naslov IP in naslov vrat drugega terminala. Za potrebe prenosa videokonferenčnih podatkov (video, zvok) prek omrežja IP terminala vzpostavita neposredno povezavo. Za potrebe telekonzultacije z videokonferenco je treba terminale opremiti s kamero z mikrofonom in slušalkami. Na terminalu morajo biti nameščeni tudi ustrezni gonilniki.Services in Module 7 for video conferencing are performed in Java written module included in the terminal. The JMF (Java Media Framevvork) suite of java libraries is responsible for the implementation of low-level teleconferencing features. When requesting teleconsultation by videoconference, the system transmits to the two communicating terminals the parameters necessary to establish a videoconference. The required parameters are: IP address and port address of the second terminal. For the purpose of transmitting video conferencing data (video, sound) via an IP network, the terminals establish a direct connection. For the purposes of teleconsultation by videoconference, the terminals must be equipped with a camera with a microphone and headset. Appropriate drivers must also be installed at the terminal.
Modul 8 za avtomatsko predlaganje diagnoz se je na podlagi vhodnih podatkov in postavljenih diagnoz sposoben naučiti samostojnega predlaganja diagnoz. Modul 8 je pomembno podporno orodje za medicinsko strokovno osebje. Za doseganje omenjene funkcionalnosti je bilo treba podatke, ki jih sistem pridobi od strokovnjakov, kategorizirati. Modul 8 v napravi in informacijski sistem za samodejno interpretacijo rezultatov predtransfuzijskih testiranj po izumu konzultirajočemu io specialistu transfuzijske medicine pri odgovarjanju na vprašanja o diagnozi ponudi nabor diskretnih opcij, ki jih le-ta izbere. Sistem zajema dve skupini podatkov. Prva skupina so podatki o kategorizaciji posameznih epruvet v enega od šestih razredov. Druga skupina pa so na podlagi prve postavljene diagnoze. Obstaja končen diskreten nabor is diagnoz. Iz podatkov o kategorizaciji epruvet je zgrajen model za avtomatsko kategoriziranje epruvet na podlagi porazdelitve krvnih celic po volumnu posamezne epruvete. Iz nabora kategoriziranih epruvet in postavljene diagnoze pa je sestavljena pravilnostna tabela, ki preslikava med nabori kategoriziranih epruvet in diagnozami. Za učenje sistema je treba najprej zbrati dovolj velik nabor kategoriziranih fotografij gelskih kartic 13, opremljenih z ustrezno diagnozo, rezultati, ki jih daje modul za samostojno diagnosticiranje, pa služijo kot pomožno orodje konzultantu.Module 8 for automatic diagnosis of diagnoses is able to learn independent suggestion of diagnoses based on input data and diagnoses made. Module 8 is an important support tool for medical professionals. In order to achieve this functionality, the information that the system obtained from experts had to be categorized. Module 8 in the device and information system for the automatic interpretation of the results of pre-transfusion testing according to the invention provides a consultant and transfusion specialist in answering questions about the diagnosis, a set of discrete options that he chooses. The system comprises two sets of data. The first group is the data on the categorization of individual tubes into one of six classes. The second group is based on the first diagnosis. There is a finite discrete set of diagnoses. A model for the automatic categorization of test tubes based on the distribution of blood cells by volume of each tube is constructed from the categorization data of the test tubes. From the set of categorized test tubes and the diagnosis made there is a regularity table that maps between the sets of categorized test tubes and diagnoses. To learn the system, a sufficiently large set of categorized photographs of gel cards 13 equipped with an appropriate diagnosis must first be collected, and the results provided by the self-diagnosis module serve as an ancillary tool to the consultant.
Potek diagnosticiranja s predloženo naprava in informacijskim sistemom za samodejno interpretacijo rezultatov predtransfuzijskih testiranj po izumu poteka v naslednjem zaporedju.The diagnostic process with the submitted device and information system for the automatic interpretation of the results of pre-transfusion testing according to the invention is carried out in the following sequence.
Sklop predtransfuzijskih preiskav vsebuje naslednje laboratorijske 5 storitve: določitev krvne skupine ABO in RhD, indirektni Coombsov test, direktni Coombsov test in navzkrižni preiskus. Določanje končnega rezultata (v nadaljevanju diagnosticiranje) se izvaja z uporabo t.i. gelskih kartic. Gelske kartice so plastične kartice velike 7 x 5.3 cm, v katere je vdelanih šest epruvet s premerom 2mm. Slika 4 prikazuje primer gelske io kartice z vzorci krvi.The pre-transfusion test suite contains the following laboratory 5 services: ABO and RhD blood count, indirect Coombs test, direct Coombs test and cross-examination. The determination of the end result (hereinafter referred to as the diagnosis) is performed using t.i. gel cards. Gel Cards are plastic cards 7 x 5.3 cm large, with six 2mm diameter tubes. Figure 4 shows an example of a gel io card with blood samples.
Epruvete vsebujejo gel in različne reagente. Diagnosticiranje poteka tako, da se v epruveti zmeša vzorec krvi z reagentom. Po določenem časa med vzorcem in reagentom reakcija poteče ali pa ne poteče. Če je reakcija potekla, potem se celice krvi zlepijo v mrežo - aglutinat. Če reakcija ni potekla, potem celice ostanejo nepovezane. Za ugotovitev, ali je reakcija v posameznih epruvetah potekla in v kakšni meri je potekla, se gelske kartice z vzorci centrifugirajo. Specifična gostota gela v epruvetah je manjša od specifične gostote krvnih celic. Zato med centrifugiranjem proste celice potonejo skozi gel in se naberejo na dnu epruvet. Celice, ki so povsem povezane v aglutinat, pa zaradi velikosti aglutinata gela ne penetrirajo in ostanejo na vrhu gela v epruvetah. Celice, ki so se delno zlepile, pa se v glede na velikost strdkov porazdelijo po volumnu epruvet.The tubes contain gel and various reagents. Diagnosis is done by mixing the blood sample with the reagent in a test tube. After a certain period of time between the sample and the reagent, the reaction may or may not start. If the reaction has expired, then the blood cells clump into the mesh - the agglutinate. If the reaction has not expired, then the cells remain disconnected. Gel card samples were centrifuged to determine whether the reaction in the individual tubes had expired and to what extent it had expired. The specific gel density in the tubes is less than the specific density of blood cells. Therefore, during centrifugation, the free cells sink through the gel and accumulate at the bottom of the tubes. Cells that are completely bound to the agglutinate, however, do not penetrate due to the size of the agglutinate gel and remain on top of the gel in the tubes. However, the cells that have partially stuck together are distributed according to the size of the clots by the volume of the tubes.
Postavljanje diagnoze poteka takole: specialist transfuzijske medicine najprej oceni rezultate aglutinacije v vsaki mini epruvetki (koloni) z eno od šestih stopenj; te so: negativno, dvojna celična populacija (DCP), 1+, 2+,The diagnosis is as follows: a transfusion specialist first assesses the results of agglutination in each mini-tube (column) at one of six stages; these are: negative, double cell population (DCP), 1+, 2+,
3+ in 4+. Kategorizacija je izvedena na podlagi razporeditve celic v gelu.3+ and 4+. The categorization is based on the arrangement of cells in the gel.
Kombinacija vseh mogočih rezultatov v šestih kolonah se nato interpretira po pravilnostni tabeli v diagnozo.The combination of all possible results in the six columns is then interpreted according to the correctness table into the diagnosis.
Naprava in informacijski sistem za samodejno interpretacijo rezultatov predtransfuzijskih testiranj po izumu nato pri postopku interpretacije posnema delo specialista, ki dela v dveh korakih in sicer tako, da v prvem io koraku oceni stopnjo jakosti aglutinacije v vsaki od šestih kolon gelske kartice, v drugem pa na podlagi kombinacije jakosti stopenj aglutinacije v šestih kolonah gelske kartice določi dokončno interpretacijo preiskave. Na podlagi primerov določenih nterpretacij predtransfuzijskih preiskav, ki so določene s strani specialistov transfuzijske medicine z uporabo sistema za is telekonzultacije v transfuzijski medicini, sama naprava adaptivno izboljšuje in popravlja model za samodejno interpretacijo rezultatov predtransfuzijskih preiskav, izpeljanih z gelsko metodo. Naprava na ta način omogoči delovanje sistema, ki omogoča izmenjgvo vprašanj, odgovorov, izmenjavo strokovnih podatkov v sporočilnem načinu, v nujnih primerih pa tudi telekonzultacijo v realnem času. Vse akcije v sistemu se beležijo. Pri telekonzultaciji v realnem času pa se poleg prenosa naštetih tipov podatkov vzpostavi še videokonferenčna povezava.The device and information system for the automatic interpretation of the results of pre-transfusion tests according to the invention then imitate in the interpretation process the work of a specialist working in two steps, by assessing in the first io step the degree of agglutination strength in each of the six columns of the gel card and in the second by determine the definitive interpretation of the investigation based on the combination of the agglutination rates in the six columns of the gel card. Based on examples of certain interpretations of pre-transfusion examinations determined by transfusion medicine specialists using the IS teleconsultation system in transfusion medicine, the device itself adaptively refines and corrects the model for the automatic interpretation of the results of gel pre-transfusion examinations. In this way, the device enables the operation of the system, which enables the exchange of questions, answers, the exchange of expert data in a message mode, and in urgent cases also real-time teleconsultation. All actions in the system are logged. In real-time teleconsultation, in addition to transmitting the above types of data, a video conference connection is established.
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| PCT/SI2011/000047WO2012030305A2 (en) | 2010-09-02 | 2011-08-31 | Device and it system for remote and automatic pre-transfusion test interpretation |
| Application Number | Priority Date | Filing Date | Title |
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| SI201000267ASI23471A (en) | 2010-09-02 | 2010-09-02 | Device and information system for automatic interpretation of resultspre-transfusion investigations |
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| SI201000267ASI23471A (en) | 2010-09-02 | 2010-09-02 | Device and information system for automatic interpretation of resultspre-transfusion investigations |
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