Abstract:
In a health checkup supporting method for predicting a health checkup receiver&#39;s risk of suffering from a disease, steps are provided to input checkup receiver information indicating the possibilities of a disease being contracted by a checkup receiver and to obtain a risk value indicating a degree of the checkup receiver&#39;s possible incidence of the disease based on inputted checkup receiver information and a risk parameter obtained from the ratio of past disease patients.

Description:
BACKGROUND OF THE INVENTION 
     The present invention relates to a health checkup system which operates to diagnose the health status of a checkup receiver; and, more particularly, the invention relates to a technique which is applicable to a health checkup system to predict the risk of a checkup receiver suffering from a disease based on the combined results of a clinical examination, a question-and-answer examination and a genetic examination. 
     When a person wishes to know the status of his health or to predict how much risk he or she has of suffering a certain disease he or she may possibly be exposed to while leading a certain life-style, it is general to obtain a health checkup. 
     In a conventional health checkup, the health status of a health checkup receiver is examined through a clinical examination and a question-and-answer examination, and the health status of the health checkup receiver is diagnosed on the basis of the results of these examinations compared with the average results obtained from healthy persons. Receiving such a health checkup, a person can roughly know the possibility of developing a certain disease and utilize this result as a guidance to improve his daily life style. 
     In recent years, meanwhile, there has been increased use of a genetic examination for detecting gene mutation in a sample, such as blood. A medical examination of this kind is only applicable to diseases for which the genes which cause the disease have been determined. Despite this, the above-described examination is advantageous in that it makes a precritical diagnosis possible. Therefore, this examination is often conducted as a prenatal checkup to diagnose gene-caused diseases with the mutation of specific genes being known as their causes. 
     Incidentally, a system of predicting the life-time incidence of Alzheimer&#39;s disease, which is capable of accurately obtaining data constituting a basis for the judgment of an early examination and treatment of Alzheimer&#39;s disease, is disclosed in Japanese Patent Laid-Open No. Hei 10-261029. 
     The above-described conventional health checkup to diagnose the health status of a checkup receiver by comparing the results of a clinical examination and a question-and-answer examination with average values makes it hard to conduct a diagnosis incorporating personal differences. 
     The above genetic examination is conducted with the checkup receiver&#39;s personal genetic difference taken into account. However, it is difficult to perform a diagnosis using only a genetic examination, since it is not applicable to diseases for which the genes which cause the disease are not determined or diseases depending on various genes and environmental factors. 
     SUMMARY OF THE INVENTION 
     In view of the above, the present invention has as its object to resolve the above problems and to provide a technique to enhance the precision of calculation of a value of a health checkup receiver&#39;s risk to a disease. 
     According to the present invention, a check receiver&#39;s risk of suffering from a disease is predicted based on a combination of the results of a clinical examination, the results of a question-and-answer examination and the results of a genetic examination in a health checkup system for predicting a risk of incidence of a disease of a checkup receiver who has received a health checkup. 
     According to the present invention, the results of a clinical examination indicating the bio-information of a checkup receiver, the results of a question-and-answer examination indicating information including the habitual activities of the checkup receiver and the results of a genetic examination indicating the genetic characteristics of the checkup receiver as an individual are inputted as checkup receiver information showing the possibilities of affecting the incidence of a disease obtained with respect to the checkup receiver who has received a health checkup. 
     By comparing the inputted checkup receiver information with risk parameters obtained from a disease incidence ratio calculated for other persons in the past, a risk value of the possible incidence of a disease is found and diagnostic messages and remedial measures are indicated in correspondence with the obtained risk value. 
     According to the present invention, as described above, since the results of a genetic examination showing the genetic characteristics of a checkup receiver are used for a diagnosis in addition to the results of a clinical examination indicating the bio-information of the checkup receiver and the results of the question-and-answer examination including the checkup receiver&#39;s habitual activities, it is possible to diagnose the checkup receiver&#39;s liability to contact a life-dependent disease based on a certain life-style and genetic characteristics, thereby providing a diagnosis which matches the characteristics of a health checkup receiver. 
     Since environmental factors such as life habits and the results of a genetic examination are diagnosed together, it is possible to diagnose a disease which cannot be diagnosed only through an examination of genes which are known to cause a disease, thereby widening the range of diseases it can diagnose. 
     As described above, the health checkup system according to the present invention conducts a risk prediction of a disease of a checkup receiver based on the results of a genetic examination indicating the genetic characteristics of an individual together with the results of a clinical examination and a question-and-answer examination, so that the precision of the calculation of a risk value with respect to a health checkup receiver can be enhanced. 
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS 
     FIG. 1 is a diagram showing a schematic configuration of a health checkup system according to the present invention; 
     FIG. 2 is a flowchart indicting steps of risk predicting processing according to the present invention; 
     FIG. 3 is a table showing an example of checkup receiver information according to the present invention; 
     FIG. 4 is a diagram showing an example of a question-and-answer examination interview sheet according to the present invention; 
     FIG. 5 is a table showing an example of a clinical Examination result parameter table  107  according to the present invention; 
     FIG. 6 is a table showing an example of a question-and-answer examination result parameter table  108  according to the present invention; 
     FIG. 7 is a table showing an example of a genetic examination result parameter table  109  according to the present invention; 
     FIG. 8 is a table showing an example of a checkup receiver information database  207  according to the present invention; 
     FIG. 9 is a flowchart showing steps of risk parameter calculation processing according to the present invention; and 
     FIG. 10 is a flowchart showing steps of contributive ratio calculation processing according to the present invention. 
    
    
     DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS 
     Now, there will be explained a health checkup system embodying the present invention to predict a checkup receiver&#39;s risk of suffering from a disease. 
     FIG. 1 is a diagram showing a schematic configuration of a health checkup system according to the present invention. As shown in FIG. 1, a health checkup apparatus  100 , representing an embodiment according to the present invention, comprises CPU  101 , a memory  102 , a magnetic disk apparatus  103 , a keyboard  104 , a display  105 , a CD-ROM apparatus  106 , a clinical examination result parameter table  107 , a question-and-answer result parameter table  108  and a genetic examination result parameter table  109 . 
     CPU  101  is a control device to control the overall operation of the health check apparatus  100 . The memory  102  is a memory device which loads various programs to control the health checkup system  100 , as well as data. The magnetic disk apparatus  103  is a memory device to store the above processing programs and data. 
     The keyboard  104  is an input device to conduct input operations such as the designation of a disease with respect to which a risk value is to be calculated. The display  105  is an output device to display diagnostic messages, including the result of a risk value calculation, and remedial measures, among other things. 
     The CD-ROM apparatus  106  is a device to read a CD-ROM which stores the above-described processing programs and data. The clinical examination result parameter table  107  is a table storing risk parameters corresponding to the results of clinical examinations conducted in the past. 
     The question-and-answer examination result parameter table  108  is a table storing risk parameters corresponding to the results of question-and-answer examinations conducted in the past. The genetic examination result parameter table  109  is a table storing risk parameters corresponding to the results of genetic examinations conducted in the past. 
     The health checkup apparatus  100  has a checkup receiver information inputting and processing section  110 , a risk prediction processing section  111  and a recommended remedial measure presenting and processing section  112 . 
     The checkup receiver information inputting and processing section  110  is a processing section which operates to input checkup receiver information showing the disease-incidence risk of a checkup receiver who has received a health checkup. The risk prediction processing section  111  is a processing section which operates to calculate the risk value of the checkup receiver&#39;s risk of suffering from a disease based on the inputted checkup receiver information and risk parameters for the incidence of a disease obtained from health checkup receivers in the past. The recommended remedial measure presenting and processing section  112  is a processing section which operates to show a remedial measure to lower the above-described risk value if it is higher than a predetermined value. 
     A program to make the health checkup apparatus  100  function as the checkup receiver information inputting and processing section  110 , the risk prediction processing section  111  and the remedial measure presenting and processing section  112  is first recorded on a medium such as a CD-ROM, from which it is loaded into the memory for its execution. A medium recording the program may be anything other than CD-ROM. 
     A checkup receiver information storage apparatus  200  is composed of CPU  201 , a memory  202 , a magnetic disk apparatus  203 , a keyboard  204 , a display  205 , a CD-ROM apparatus  206  and a checkup receiver information database  207 . 
     CPU  201  is a control apparatus which operates to control the overall operation of the checkup receiver information storage apparatus  200 . The memory  202  is a memory apparatus to load various programs for controlling the operations of the checkup receiver information storage apparatus  200 , as well as data. 
     The magnetic disk apparatus  203  is a memory apparatus to store the above processing programs and data. The keyboard  204  is an input apparatus to instruct and execute the calculation of risk parameters and their contributive ratios. The display  205  is an output apparatus which displays the results of processing of risk parameters and their contributive ratios. 
     The CD-ROM apparatus  206  is a device to read a CD-ROM which stores the processing programs and data described above. The checkup receiver information database  207  is a database to store information obtained from a health checkup receiver at the time of the health checkup and patient information obtained from outpatients visiting a hospital after the incidence of a disease. 
     The checkup receiver information storage apparatus  200  has a checkup receiver information storage and processing section  210 , a risk parameter calculation processing section  211  and a contributive ratio calculation processing section  212 . 
     The checkup receiver information storage and processing apparatus  210  is a processing section which operates to store in the checkup receiver information database  207  the checkup receiver information obtained at the time of a health checkup and information obtained from outpatients visiting a hospital after the incidence of a disease. The risk parameter calculation processing section  211  is a processing section which operates to calculate the risk parameters. The contributive ratio calculation processing section  212  is a processing section which operates to calculate the contributive ratio of each risk parameter in order to work out the above risk value. 
     A program to make the checkup receiver information storage apparatus  200  function as the checkup receiver information storage and processing apparatus  210 , the risk parameter calculation processing section  211  and the contributive ratio calculation processing section  212  is first recorded on a medium such as a CD-ROM, from which it is loaded into the memory for its execution. The medium recording the program also may be a storage medium other than a CD-ROM. 
     As shown in FIG. 1, the health checkup apparatus  100  in this embodiment of the present invention is connected to the checkup receiver information storage apparatus  200  through a network  300 , so that a checkup receiver information inputted into the health checkup apparatus  100  is fed to the checkup receiver information storage apparatus  200  through the network  300 . In this embodiment of the present invention, only the single health checkup apparatus  100  is connected to the checkup receiver information storage apparatus  200 . However, the checkup receiver information storage system  200  may totally manage all checkup receiver information obtained from a plurality of health checkup apparatuses  100  connected to the checkup receiver information storage apparatus  200  through the network  300 . 
     FIG. 2 is a flowchart showing steps of risk prediction processing according to the present invention. In Step  1201 , the checkup receiver information inputting and processing section  110  of the health checkup apparatus  100  receives the results of a clinical examination, the results of a question-and-answer examination and the results of a genetic examination as checkup receiver information. 
     FIG. 3 is a table showing an example of a checkup receiver information according to the present invention. As shown in FIG. 3, checkup receiver information in this embodiment of the present invention includes a checkup receiver ID  301 , a data entry date  302 , the results of a clinical examination  303 , the results of a question-and-answer examination  304  and the results of a genetic examination  305 . 
     The checkup receiver ID  301  is an identification number to identify a specific checkup receiver. The data entry date  302  includes a year, a month and a date when the checkup receiver information was inputted. The results of a clinical examination  303  are data indicating the bio-information of the checkup receiver obtained through various examinations. 
     The results of a question-and-answer examination  304  are checkup receiver-related data including the daily habits and other aspects of the checkup receiver obtained through an entry of data on an interview sheet. The results of a genetic examination  305  include information indicating the genetic characteristics of a checkup receiver and show data indicating whether the genes of the checkup receiver has gene mutation associated with the incidence of any disease. 
     FIG. 3 shows an example of diabetes-related checkup receiver information. In the results of a clinical examination  303  according to the present invention, a fasting blood glucose value and values shown in a glucose tolerance test and glycuresis have numerical indications designating a specific range of values. For example, the fasting glucose value of the checkup receiver is in the range of a glucose value represented by numeral  1 . It should be noted that, when this value is larger, an actually measured value corresponding to it as shown in the results of the corresponding clinical examination  303  is larger. 
     A circle in the results of a question-and-answer examination  304  indicates that the checkup receiver answered “yes” to a question “Q 1 ,” etc. on an interview sheet and a blank box in the results of the question-and-answer examination  304  indicates a “no” answer. “NIDDM 1 ” in the results of a genetic examination  305  shows a gene associated with incidence of non-insulin dependent diabetes, with a circle indicating that the checkup receiver has its gene mutation and a blank indicating the absence of such gene mutation. 
     FIG. 4 is a diagram showing an example of a question-and-answer examination interview sheet according to the present invention. Shown in FIG. 4 is an interview sheet used for a diagnosis of diabetes. The daily-intake of calories and habitual activities, such as regular exercise, may be added. 
     Then, in Step  1202  shown in FIG. 2, the risk prediction processing section  111  accepts the designation of a disease subject to a risk prediction. In Step  1203 , risk parameters p 1  corresponding the results of a checkup receiver&#39;s clinical examination  303  are read from the clinical examination result parameter table  107 . 
     FIG. 5 shows an example of the clinical examination result parameter table  107  according to the present invention. As shown in FIG. 5, the clinical examination result parameter table  107  represents the probability of suffering from diabetes within a specific period as a risk parameter p 1  for checkup receivers associated with the clinical examination results. Out of checkup receivers with fasting blood glucose, a glucose tolerance test and glycuresis showing values “ 1 ”, “ 2 ” and “ 4 ” respectively, 31 percent are shown to suffer from diabetes within a specific period. A fasting blood glucose value and values indicated by fasting blood glucose, a glucose tolerance test and glycuresis as shown in the clinical test result parameter table  107  have numerical indications specifying a scope of specific values for each item as shown in FIG.  3 . 
     In Step  1204 , a risk parameter p 2  corresponding to the results of a question-and-answer examination  304  of a checkup receiver as shown in FIG. 3 is read from the question-and-answer examination result parameter table  108 . 
     FIG. 6 shows an example of the question-and-answer examination result parameter table  108 . The question-and-answer examination result parameter table  108  as shown in FIG. 6 represents the probability of suffering from diabetes within a specific period as a risk parameter p 2  for checkup receivers associated with the question-and-answer examination results. Like FIG. 3, incidentally, a circle to a question such as Q 1  in the interview sheet represents a “yes” answer to that question and a blank means “no.” 
     In Step  1205 , a risk parameter p 3  corresponding to the results of a genetic examination  305  of a checkup receiver as shown in FIG. 3 is read from the genetic examination result parameter table  109 . 
     FIG. 7 shows an example of the genetic examination result parameter table  109 . As shown in FIG. 7, the genetic examination result parameter table  109  represents the probability of suffering from diabetes within a specific period as a parameter p 3  for checkup receivers&#39; associated with the genetic examination results. Like FIG. 3, each entry for a diabetes-related gene, such as “NIDDM 1 ,” shows a gene associated with the incidence of non-insulin dependent diabetes mellitus (NIDDM), with a circle indicating that a checkup receiver has a gene mutation and a blank indicating that a checkup receiver has no gene mutation. 
     In Step  1206 , parameters each showing a contributive ratio to the risk value of each risk parameter a, b or c is read out and, in Step  1207 , a risk value P is calculated through the following formula. 
     
       
           P=a·p   1 + b·p   2 + c·p   3   (Equation 1) 
       
     
     The equation 1 shows an example of formulas used to calculate a risk value in Step  1207 . P is a risk value showing the probability of a checkup receiver suffering from a disease within a specific period; p 1  is a risk parameter showing the probability of disease incidence within a specific period calculated on the basis of results of the past clinical examinations; p 2  is a risk parameter showing the probability of disease incidence within a specific period calculated on the basis of results of the past question-and-answer examination; and p 3  is a risk parameter showing the probability of disease incidence within a specific period calculated on the basis of results of the past genetic examinations. 
     Meanwhile, a is the contributive ratio of the results of a clinical examination contributing to a general risk with respect to the specific disease, b is the contributive ratio of the results of a question-and-answer examination contributing to the general risk with respect to the specific disease and c is the contributive ratio of the results of a genetic examination contributing to the general risk with respect to the specific disease, their relationship being shown as a+b+c=1. 
     In Step  1208 , a diagnostic message corresponding to the risk value P calculated as described above is read out. In Step  1209 , it is verified whether or not the above calculated risk value P is higher than a predetermined level and, if it is, remedial measures are read out from the recommended remedial measure presenting processing section  112  in Step  1210 . 
     In Step  1211 , a diagnostic message corresponding to the risk value P calculated as described above is displayed and remedial measures are presented if they are read out in Step  1210 . 
     For example, when the calculated risk value P is low, a message like “Your probability of the incidence of diabetes is less than P%. You don&#39;t need to pay any special attention in your daily life.” is displayed. 
     When the calculated risk value P is high, a diagnostic message like “Your values of diabetes-related items subject to the clinical examination are high and, judged together with genetic factors, your probability of the incidence of diabetes is P%. You need to change your habitual activities and it is recommended that you receive a detailed health checkup every six months.” is displayed. As remedial measures the recommended remedial measure processing section  112 , after its processing, displays a daily total calorie intake, urging a calorie intake limitation and aerobics exercise to consume fat, in Step  1210 . 
     These diagnostic messages and remedial measures are set beforehand for applicable risk values P and values of items applicable to checkup receiver information. 
     As described above, in addition to the results of a clinical examination  303  indicating the bio-information of the checkup receiver and the results of a question-and-answer examination  304  including information showing the habitual activities, etc. of a checkup receiver, the embodiment of the present invention uses the results of a genetic examination  305  indicting the genetic characteristics of the checkup receiver for a diagnosis, so that it is possible to diagnose a checkup receiver&#39;s risk of contracting a life-dependent disease, etc. based on habitual activities and genetic characteristics, making such a diagnosis match the characteristics of the checkup receiver. 
     Since a diagnosis is conducted on the basis of environmental factors such as habitual activities and the results of a genetic examination combined in this embodiment of the present invention, it is possible to diagnose a disease which could not be diagnosed only through a genetic examination and to widen a scope of diagnosable diseases. 
     After the above diagnostic messages and recommended remedial measures are displayed, the risk predicting processing section  111  completes its processing by sending the inputted check receiver information to the checkup receiver information storage apparatus  200 . The checkup receiver information storage and processing section  210  of the checkup receiver information storage apparatus  200  stores in the checkup receiver information database  207  the checkup receiver information at the time of a health checkup or a patient&#39;s information at the time of disease incidence transmitted as explained above. 
     FIG. 8 is a table showing an example of the checkup receiver information database  207  according to the present invention. As shown in FIG. 8, the checkup receiver information database  207  according to the present invention includes a checkup receiver ID  801 , the date of a data entry  802 , the results of a clinical examination  803 , the results of a question-and-answer examination  804 , the results of a genetic examination  805  and a history of diseases  806 . 
     The checkup receiver ID  801  is an identification number to identify a checkup receiver. The date of a data entry  802  includes a year, a month and a date when the checkup receiver information was inputted. The results of a clinical examination  803  are data showing the bio-information of the checkup receiver obtained through various examinations. 
     The results of a question-and-answer examination  804  are the checkup receiver-related data, including information on the habitual activities, etc. of the checkup receiver obtained through an entry an interview sheet. The results of a genetic examination  805  including information indicating the genetic characteristics of the checkup receiver are data on the genes of the checkup receiver diseases-causing gene mutation. The history of diseases  806  lists up the names of diseases the checkup receiver has suffered from in the past. 
     As shown in FIG. 8, the checkup receiver information database  207  stores the history of diseases  806  of a checkup receiver together with the checkup receiver information as shown in FIG.  3 . The information accumulated in the checkup receiver information database  207  is used for the calculation of the above-described risk Parameters and their contributing ratios. 
     FIG. 9 is a flowchart showing steps of risk parameter calculation processing. The risk parameter calculation processing section  211  of the checkup receiver information storage apparatus  200  starts its operation when specific conditions are satisfied, such as when the checkup receiver information database  207  is renewed or a predetermined period elapses from the previous calculation processing. In Step  901 , it reads out from the checkup receiver information database  207  the checkup receiver information over a predetermined period. 
     In Step  902 , checkup receivers corresponding to each other in the clinical examination  803  out of the above read-out checkup receiver information are counted, with reference to the history of diseases  806  out of the checkup, receiver information the ratio of checkup receivers, suffering from a specific disease among the checkup receivers is calculated every disease, and a risk parameter p 1  for each disease is found. 
     In Step  903 , the risk parameter p 1  obtained as described above is sent to the health checkup apparatus  100 . The health checkup apparatus  100  stores the received risk parameter p 1  in the clinical examination result parameter table  107 . 
     In Step  904 , checkup receivers corresponding to each other in the question-and-answer examination  804  out of the above read-out checkup receiver information are counted, with reference to the history of diseases  806  out of the checkup receiver information the ratio of checkup receivers&#39; suffering from a specific disease among the checkup receivers is calculated for every disease, and a risk parameter p 2  for each disease is found. 
     In Step  905 , the risk parameter p 2  worked out as described above is sent to the health checkup apparatus  100 . The health checkup apparatus  100  stores the received risk parameter p 2  into the question-and-answer result parameter table  108 . 
     In Step  906 , checkup receivers corresponding to each other in the genetic examination results  805  out of the above read-out checkup receiver information are counted and, with reference to the history of diseases  806 , the ratio of checkup receiver&#39;s suffering from a specific disease among the checkup receivers is calculated for every disease and a risk parameter p 3  for each disease is found. 
     In step  907 , the risk parameter p 3  worked out as described above is sent to the health checkup apparatus  100 . The health checkup apparatus  100  stores the received risk parameter p 3  in the genetic examination result parameter table  109 . 
     FIG. 10 is a flowchart showing steps of the contributive ratio calculation processing according to the present invention. Like the risk parameter calculation processing section  211 , the contributive ratio calculation processing section  212  of the checkup receiver information storage apparatus  200  starts its operation when specific conditions are satisfied, such as when the checkup receiver information database  207  is renewed or a predetermined period elapses from the previous calculation processing. In Step  1001 , a disease to calculate its contributive ratio first is selected and set out of the history of disease  806  in the checkup receiver information database  207 . 
     The checkup receiver information of the checkup receiver&#39;s suffering from the designated disease is read out from the checkup receiver information database  207  in Step  1002 , relationships between the results of a clinical examination  803 , the results of a question-and-answer examination  804  and the results of a genetic examination  805  for the read-out checkup receiver information and, the designated disease are studied, and contributive ratios a, b and c weighted in accordance with the strength of their relationships are calculated. 
     With dispersions obtained for objective items of the results of a clinical examination  803 , the results of a question-and-answer examination  804  and the results of a genetic examination  805  for the read-out checkup receiver information, for example, a, b and c as contributive ratios in proportion to their reciprocals are calculated. In this embodiment of the present invention, a contributive ratio is calculated for each item of the results of a clinical examination  603 , the results of a question-and-answer examination  804  and the results of a genetic examination  805 . In a case where objective items for such contributive ratio calculation processing are diversified and a number of items not specifically relating to the incidence of the designated disease are included, a contributive ratio for each item is used to calculate the risk value P by utilizing a contributive ratio calculated for each objective item. 
     In Step  1004 , the contributive ratio obtained as described above is sent to the health checkup apparatus  100 . The health checkup apparatus  100  stores the received contributive ratio as the contributive ratios a, b and c to calculate the risk value P of the disease. 
     In Step  1005 , a disease is searched for in the history of disease  806  of the checkup receiver information database  207 . It is also checked to see whether there is a disease for which a contributive ratio has not been calculated and, if there is, the processing returns to Step  1002  with the name of that disease designated. When contributive ratios are calculated for all the diseases stored in the history of diseases  806  of the checkup receiver information database  207 , this processing is completed and finished. 
     As described above, this embodiment of the present invention sends checkup receiver information inputted from the health checkup apparatus  100  to the checkup receiver information storage apparatus  200  to calculate risk parameters and their contributive ratios at the checkup receiver information storage apparatus  200  and to feed them back to the health checkup apparatus  100 , so that it is possible to heighten the precise calculation of risk values as checkup receiver information is accumulated. 
     According to the health checkup system embodying the present invention as described above, the prediction of a check receiver&#39;s risk liability to a disease is conducted with the results of a genetic examination indicating the genetic characteristics of an individual added to the results of a clinical system and the results of a question-and-answer examination, making it possible to enhance the precision of the calculation of a checkup receiver&#39;s disease-incidence risk value. 
     According to the present invention, the health checkup system conducts a risk prediction of a disease of a checkup receiver based on the results of a genetic examination indicating the genetic characteristics of an individual together with the results of a clinical examination and a question-and-answer examination, so that the precision of the calculation of a risk value with respect to a health checkup receiver can be enhanced.