Patent Publication Number: US-2007100658-A1

Title: Formation and expansion method for a medical case study collection

Description:
The present application hereby claims priority under 35 U.S.C. §119 on German patent application number DE 10202285.2 filed Jan. 22, 2002, the entire contents of which are hereby incorporated herein by reference.  
     FIELD OF THE INVENTION  
      The present invention generally relates to a formation and expansion method for a medical case study collection having a number of medical case studies.  
     BACKGROUND OF THE INVENTION  
      Case study collections are used in many fields of application, for example including the field of medicine. Case study collections such as these are generally maintained as local case study collections on the respective user computers. The case study collection is updated from a central point, for example by dispatching an updated version by post or via the Internet.  
      US 2002/0016539 A1 relates to an evaluation system for obtaining diagnostic information from signals and data from medical sensor systems. A method for classification of skin or mucous membrane changes which can be observed visually is known from DE 100 21 431 A1.  
     SUMMARY OF THE INVENTION  
      An object of an embodiment of the present invention is to make it possible to create a large case study collection and to provide this in a networked manner in a way which is as simple as possible.  
      The object may be achieved, for example, in that either at least one case study is transmitted to a central computer from a third computer and classification features relating to the case study and a cross-reference to the case study, at which the case study can be called up by a user computer, are determined by the central computer, or the classification features and the cross-reference are transmitted from the third computer to the central computer, and in that the classification features and the cross-reference are recorded by the central computer in a case study collection.  
      A case study collection concerns medical data relating to debilitations (illnesses and traumatic events). Data protection is critical for data such as this. Furthermore, case study collections such as these are used in particular for the training of doctors and for providing verification of medical diagnoses. Thus, not only data protection but, furthermore, also factual correctness of the case studies are of critical importance. Only authorized persons should therefore be able to transmit case studies and/or classification features and cross-references to the central computer. This is preferably ensured by the third computer transmitting an identification code to the central computer before or together with the transmission of the case study and/or the classification features and the cross reference. This is further ensured by the central computer not recording the classification features and the cross reference in the case study collection unless the transmitted identification code corresponds to an authorization code which is contained in an access authorization list.  
      If an account which is associated with the authorization code is credited with a credit on the basis of the expansion of the case study collection, users of the third computer have an incentive to make case studies available to the central computer.  
      The case study collection is accessed in a way which is generally known for data banks. Thus, first of all, the user computer transmits to the central computer a selection criterion for case studies. The central computer uses the case study collection to determine case studies which satisfy the selection criterion and cross-references for these case studies, at which the case studies can be called up. In the case of a cross-reference to a case study which is stored in the third computer, the central computer either calls up this case study from the third computer and transmits it to the user computer, or transmits to the user computer the cross reference to the case study, or transmits to the third computer a transmission command to transmit the case study to the user computer.  
      If the user computer transmits an identification code to the central computer before or together with the transmission of the selection criterion and the case studies which satisfy the selection criterion are not determined unless the transmitted identification code corresponds to an authorization code which is contained in an access authorization list, only authorized users can access the case studies in the case study collection, as well. Data protection is thus maintained.  
      If an account which is associated with the authorization code is debited with a debit on the basis of the transmission of the selection criterion, this makes it possible in a simple manner for the operator of the case study collection to amortize his costs for making the case study collection available.  
      The user computer and the third computer may in principle be computers that are different to one another. However, they may also be identical to one another.  
      If the case studies are made anonymous, this ensures even better data protection.  
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
      Further advantages and details will be found in the following description of an exemplary embodiment in conjunction with the drawings, in which, illustrated in outline form:  
       FIG. 1  shows a computer network with a number of computers,  
       FIG. 2  shows a basic flowchart for a central computer,  
       FIG. 3  shows a basic flowchart for a user computer,  
      FIGS.  4  to  9  show variants of  FIGS. 2 and 3 , and  
       FIG. 10  shows an illustration of a case study. 
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS  
      Three computers  1  to  3  are networked with one another via a computer network  4  in  FIG. 1 . The computer network  4  may in this case be a local area network or a global network, for example the Internet.  
      The computer  1  is a user computer and has a main unit  5 , at least one input device  6  and at least one output device  7 . It processes a computer program product  8 , which is stored in a part of its memory. During the processing of the computer program product  8  (or of the user program  8 ), the main unit  5  transmits outputs via the output device  7  to a user  9 , and receives inputs from this user  9  via the input device  6 . In addition, medical case studies  10  are stored in a further part of the memory of the user computer  1 .  
      The computer  2  is a central computer which also has a main unit  11 , an input device  12  and an output device  13 . It also processes a computer program product  14 , which is stored in a part of its memory. It communicates with an operator  15  of the central computer  2  via the input device  12  and the output device  13 .  
      During the processing of the computer program product  14  (or of the central computer program  14 ), the main unit  11  also accesses, inter alia, a buffer store  16 , an access authorization list  17  and a case study collection  18 . By way of example, case studies may be stored temporarily in the buffer store  16 . The access authorization list  17  contains two columns  17 ′,  17 ″. Authorization codes are stored in the first column  17 ′. Accounts which are associated with the authorization codes are maintained in the right-hand column  17 ″. The accounts make it possible to invoice those who use the case study collection  18 .  
      The case study collection  18  contains a number of columns  18 ′,  18 ″. The first column  18 ′ contains cross-references to case studies  10 ,  24 . The further columns  18 ″ contain classification features which are satisfied by the case studies  10 ,  24  to which the associated cross-references refer.  
      The computer  3  is a third computer and likewise has a main unit  19 , an input device  20  and an output device  21 . It processes a computer program product  22 , during the processing of which it communicates with an operator  23  of the third computer  3  via the input device  20  and the output device  21 . The main unit  19  can also access the case studies  24  which are stored in the third computer  3 .  
      The computers  1  to  3  communicate with one another via the computer network  4 . In this case, the central computer  2  processes the central computer program  14  as described in the following text in conjunction with  FIG. 2 .  
      As shown in  FIG. 2 , in a step  25 , the central computer  2  first of all receives an identification code from the user computer  1 . The identification code is thus transmitted to it. In a step  26 , the central computer  2  then checks whether the transmitted identification code corresponds to one of the authorization codes which are contained in the access authorization list  17 . The subsequent steps are not carried out unless this is the case. Otherwise, the processing of the central computer program  14  is ended.  
      During the further processing, a check is first of all carried out in a step  27  to determine whether the user  9  does or does not wish to interrogate the case study collection  18 . A jump is made either to a step  28  or to a step  37 , depending on the result in the response.  
      First of all, in step  28 , the account which is associated with the authorization code is debited with a first debit. This debit is independent of the complexity since it is made at the start of each new data bank session. The user computer  1  then transmits a selection criterion to the central computer  2  in a step  29 . The account is then once again debited with a second debit in a subsequent step  30 . The debiting of the second debit is dependent on the complexity, since the debit is made for each question (or for each transmission of a selection criterion).  
      In a subsequent step  31 , the central computer  2  determines which of the case studies  10 ,  24  in the case study collection  18  satisfy the transmitted selection criterion. Cross references to the respective case studies  10 ,  24  can then be determined in a step  32  by reading the first column  18 ′ of the lines of the case study collection  18  determined in this way. The central computer  2  transmits the determined cross-references to the user computer  1 , in a step  33 . The appropriate account can once again be debited with a third debit in a step  34 . This debit is also complexity-dependent, since it may be dependent on the number of determined case studies  10 ,  24  and/or on values associated with the case studies  10 ,  24 .  
      A check is then carried out in a step  35  to determine whether the search has now ended. If yes, the process continues with a step  36 , otherwise the process jumps back to step  29 . If step  36  is carried out, a check is carried out to determine whether the processing of the central computer program  14  should now be ended. If yes, the processing is ended, otherwise a jump is made back to step  27 .  
      If a jump is made from step  27  to step  37 , the case study collection  18  is intended to be formed with case studies  10 ,  24 , or expanded with new, additional case studies  10 ,  24 . In this situation, by way of example, the central computer  2  receives case studies  10 ,  24  from the third computer  3  or from the user computer  1 . In a step  38 , the transmitted case studies  10 ,  24  are verified. The verification process may be carried out, for example, by transmitting the case studies  10 ,  24  to the operator  15  of the central computer  2  who then either confirms them as being in order or else rejects them as not being in order. If necessary, the case studies  10 ,  24  may also be transmitted back to the transmitting computer  1  or  3 , with change requests added to them.  
      Classification features for the case studies  10 ,  24  and cross-references to the case studies  10 ,  24  are then determined in a step  39 . The process of determining the classification features and the cross-references may be automated or may be carried out interactively. Once the classification features and the cross-references have been determined, these are recorded in the case study collection  18 , in a step  40 . The cross references are thus entered in the first column  18 ′, and the classification features are entered in the corresponding lines in the further columns  18 ″. The account which is associated with the identification code is then credited with a credit.  
      A check is then carried out in a final step  42  to determine whether the transmission of case studies  10 ,  24  has ended. If yes, the process jumps to step  36 , otherwise it jumps back to step  37 .  
      Depending on the configuration of the central computer program  14 , the user computer  1  runs the user program  8 , as will be explained in more detail in the following text in conjunction with  FIG. 3 .  
      As shown in  FIG. 3 , the user computer  1  first of all transmits the identification code to the central computer  2  in a step  43 . A check is then carried out in a step  44  to determine whether the central computer  2  has accepted the transmitted identification code. Further steps  45  to  53  are not carried out unless this is the case, otherwise the processing of the user program  8  is ended.  
      During the further processing of the user program  8 , a check is first of all carried out in a step  45  to determine whether an interrogation is intended to be passed to the case study collection  18 . If yes, steps  46  to  50  are carried out, otherwise steps  52  and  53  are carried out.  
      In step  46 , the user computer  1  transfers a selection criterion to the central computer  2 . In step  47 , the user computer  1  then receives cross-references to case studies  10 ,  24  from the central computer  2 . In step  48 , the user computer  1  calls up the case studies  10 ,  24 . The case studies  10 ,  24  may in this case be stored on any of the computers, in particular in the user computer  1  itself, in the central computer  2  or in the third computer  3 . The case studies  10 ,  24  which are called up are then displayed to the user  9  via the output device  7 , for example, in step  49 .  
      A check is carried out in step  50  to determine whether the search of the case study collection  18  has ended. If yes, a check is carried out in step  51  to determine whether the processing of the user program  8  should be ended completely. A jump back to step  45  is made only if this is not the case.  
      If the process jumps from step  45  to step  52 , case studies  10  are intended to be recorded in the case study collection  18 , with the case study collection  18  being formed or expanded in this way. In this case, the case studies  10  are transmitted to the central computer  2  in step  52 . A check is then carried out in the next step  53  to determine whether the transmission of case studies  10  to the central computer  2  should be ended. Depending on the response, the process either jumps back to step  52  or jumps to step  51 .  
      The user computer  1  can thus not only check case studies  10  in the central computer  2  but can also transmit case studies  24  to the central computer  2 . It thus contains both functionalities.  
      The program  22  of the third computer  3  will not be described in detail in the following text. It either has the same structure as the user program  8 , or only that part which relates to the transmission of case studies  24  to the central computer  2 . In conjunction with  FIGS. 2 and 3 , the situation has been described in which the central computer  2  transmits to the user computer  1  cross-references to the case studies  10 ,  24 . However, alternative configurations are also possible, and these will be described in the following text in conjunction with  FIGS. 4 and 5 , as well as  6  and  7 .  
      As shown in  FIG. 4 , the central computer  2  carries out steps  54  and  55  instead of step  33 , in which the cross-references are transmitted to the user computer  1 . In step  54 , the central computer  2  itself calls up the case studies  10 ,  24  from the computers  1 ,  3  in which they are stored. In step  55 , the central computer  2  then transmits the case studies  10 ,  24  to the user computer  1 . According to  FIG. 5 , the user computer  1  carries out a step  56  instead of steps  47  and  48 , in a corresponding manner to this. The user computer  1  receives the transmitted case studies  10 ,  24  from the central computer  2  in step  56 .  
      According to  FIG. 6 , the central computer  2  transmits neither cross-references to case studies  10 ,  24  nor the case studies  10 ,  24  themselves to the user computer  1 . In this case, transmission commands are transmitted in a step  57  to the respective computers  1 ,  3  in which the case studies  10 ,  24  are stored, for example to the third computer  3 . These then themselves transmit the case studies  24  to the user computer  1 . In a corresponding manner to this, the user computer  1  receives the case studies  24  from the third computer  3 , or from third computers  3 , in a step  58 .  
      In conjunction with  FIGS. 2 and 3 , the above description has also covered how the case studies are themselves transmitted to the central computer  2 . An alternative is also possible in this case, and this will be described in the following text in conjunction with  FIGS. 8 and 9 .  
      According to  FIG. 8 , the central computer  2  carries out a step  59  instead of steps  37  to  39 . In step  59 , the central computer  2  receives from the user computer  1  or from the third computer  3  the classification features and the cross-references to the case studies  10 ,  24  which are to be added to the case study collection  18 . In a corresponding manner to this, the classification features and cross-references are determined by the user computer  1  (or possibly by the third computer  3 ) in a step  60 , and are transmitted to the central computer  2  in a step  61 . The steps  60  and  61  are carried out instead of the step  52 . In this case, of course, it is necessary to ensure in some suitable manner that the case studies  10 ,  24  to be recorded in the case study collection  18  are in order.  
      By way of example,  FIG. 10  shows the layout of the medical case studies  10 ,  24 . As shown in  FIG. 10 , the case studies  10 ,  24  have been made anonymous. The name of a patient is thus removed, blackened out or made illegible in some other way, for example by omitting the surname. This is indicated by a shaded block  62  in  FIG. 10 . As can also be seen in  FIG. 10 , the case study  10 ,  24  may contain details relating to the age or age group and sex of the patient. In any case, however, it contains details relating to the examination procedure used and to the debilitation symptoms found. Finally, the case study  10 ,  24  also contains a diagnosis and a preferred therapy. The case study  10 ,  24  may if required also contain a debilitation history (case history) as well as attached picture files  63 . The case studies  10 ,  24  can be classified on the basis of various medical distinguishing criteria (for example body region, age, sex, diagnosis, etc.), and may be provided with appropriate descriptors.  
      The invention being thus described, it will be obvious that the same may be varied in many ways. Such variations are not to be regarded as a departure from the spirit and scope of the invention, and all such modifications as would be obvious to one skilled in the art are intended to be included within the scope of the following claims.