RU2487655C2 - Method of medical non-invasive diagnostics of patients and system of medical non-invasive diagnostics of patients - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to field of medical equipment, namely to means of non-invasive diagnostics. Method lies in measurement of patient's biophysical parameters in the point of diagnostics, their transmission into the unified system of information processing and accumulation, registration in it of results of patient's measurements with account of their identification data, analysis and formulation of diagnosis, its transformation into feedback signal, supplied to the point of diagnostics. In the point of diagnostics for each patient: fixed list of biophysical parameters are measured and informative vector of patient's parameters, resulting from current diagnostic examination is formed. Diagnostic examination is carried out periodically, the difference of informative vectors of patient's parameters resulting from current and previous diagnostic examinations being used to determine informative vector of deviation of parameters for determination of degree of patient's state change, in accordance with which, patient's identification data and informative vector, reflecting disease history and hereditary factors, diagnosis is formulated. In case if there is not enough information to formulate diagnosis, additional measurements of biophysical parameters, which are not includes into the fixed list, are carried out, additional informative vector of patient's parameters is formed and taken into account in diagnosis formulation. Registration of results of measurement of biophysical parameters is carried out in unified register for all patients, included into the system of medical provision. The system contains m points of diagnostics, where diagnostic equipment for non-invasive measurement is placed, channel for connection with unit of information processing and accumulation, unit of diagnostic assessment, unit of control, management and presentation of information, unit of automatic determination of treatment methods and means. All diagnostic equipment is connected to corresponding inlets of outlet adaptor in each point of diagnostics, its outlet being connected by means of duplex connection channel with inlet system adaptor, which is connected to first inlet of unit of diagnostic assessment and to first unit of information processing and accumulation with its first outlet, and to first inlet of unit of additional control of patients' state with its second outlet. Diagnostic equipment for additional measurement of biophysical parameters is connected to corresponding inlet of unit of additional control of patients' state via connection channel.

EFFECT: application of the invention makes it possible to increase objectivity of patients' diagnostics due to automation of decision-making processes.

7 cl, 10 dwg

Description

The proposed invention relates to the field of medical support of the population, in particular to the diagnosis and treatment of diseases, and can be used in the design of diagnostic, control and treatment systems based on local, regional or global medical monitoring.

There are a number of methods of medical diagnosis described in [1]. In known technical solutions, the patient’s biophysical parameters are measured at each diagnostic point, the results of biophysical measurements are recorded, the results of measurements of the patient’s biophysical medical parameters are analyzed, and the patient’s diagnosis is established on the basis of the analysis.

There is also known a method of medical diagnostics, according to the application US US 2009005654, based on the measurement of the biophysical parameters of the patient with their subsequent conversion into an electrical signal and transmission to the information processing center.

As a prototype for the inventive method and system for medical diagnosis of a patient, the “Non-invasive method for determining hemodynamic parameters in biological objects and a device for its implementation” were selected, protected by RF patent No. 2127999 [3].

This invention can be used, for example, to determine the minute volume of blood circulation, stroke volume of the heart, heart rate, etc. As the analyzed signal, reflecting the parameters of hemodynamics, choose a pulse pressure wave. A pulsogram is recorded, for example on an earlobe. A number of pulse wave parameters are analyzed taking into account the parameter of anthropometric data (for example, height, arm span). The minute volume of blood circulation and other hemodynamic parameters are calculated according to the proposed mathematical formulas. The method is carried out using a device containing nodes for measuring parameters associated with the movement of blood in biological objects, nodes for processing these parameters and a processor for determining hemodynamic parameters interconnected in the original block diagram. The invention allows you to quickly and non-invasively determine the parameters of hemodynamics, and also makes it possible to provide continuous continuous monitoring of the values of the studied parameters.

The invention consists in the following.

In the proposed method, as well as in the prototype:

- measure in the diagnostic point biophysical parameters of at least one patient,

- convert the measurement results into an electrical signal transmitted to a single system for processing and accumulating information,

- register in it the results of measurements of biophysical parameters of at least one patient, taking into account his identification data,

- analyze the measurement results, after which, based on the analysis,

- establish a diagnosis of at least one patient,

- convert it into an electrical feedback signal, which arrives at the diagnostic point.

Unlike the prototype in the proposed method, firstly, in the diagnostic point for each patient, a fixed list of biophysical parameters is measured and an informative vector of patient parameters is obtained as a result of the current diagnostic examination, diagnostic examinations of the patient are carried out periodically and according to the difference of informative vectors of patient parameters in the result of the current and previous diagnostic examinations determine the informative vector of deviation of parameters to determine the step Changes in the patient’s condition, according to which the patient’s identification data and an informative vector reflecting the history of the disease and hereditary factors, are diagnosed, and in case of insufficient information to unambiguously determine the diagnosis, additional measurements of biophysical parameters not included in the fixed list, form an additional informative vector of patient parameters and establish a diagnosis based on it, recording the results of changes rhenium biophysical parameters is carried out in a single register for all patients included in the system of medical provision.

Secondly, if a patient’s disease is detected in a unified system of processing and accumulating information according to the appropriate algorithms, a list of the necessary tools and treatment methods for the patient is determined in the form of an electronic document and transferred to the diagnostic point in the form of a prescription for organizing and conducting treatment and electronic prescriptions for the purchase dosage forms and preparations.

Thirdly, the patient’s diagnostic examinations are carried out periodically at the diagnostic point, and the examination frequency and the list of equipment necessary for monitoring are determined in accordance with the type of disease, the patient’s state of health, his age, and in the case of a negative result of the treatment methods used or the threat of harm the patient’s health, in a unified system of processing and accumulating information form a team to change the methods and forms of treatment in the form of an electronic protocol, which is marked which are “urgently” sent to the appropriate diagnostic point to make changes to the patient's treatment process.

Fourthly, the results of a periodic diagnostic examination are documented in a unified system of processing and accumulating information, taking into account the age, gender, diagnosis, time of recovery and the degree of negative impact on the main internal organs of the patient and on its basis determine the effectiveness of the use of medicines and medical forms for treating patients.

Fifth, the first diagnostic examination of the patient is carried out as soon as possible from the date of his birth, and the diagnosis is established taking into account the medical data of all direct relatives on the patient’s maternal and paternal lines, which are in a single system for processing and accumulating information.

Sixthly, in case a patient is diagnosed with a disease, in a unified system of processing and accumulating information, his informative vector of parameters is compared with the data of previously identified and treated diseases, taking into account the patient’s age, gender, and health status, and the closest case previously available is determined by comparison in practice, and previously tested methods and means of treatment and control are used to treat the patient.

The proposed system of medical diagnosis of patients, as well as the prototype, contains m diagnostic points, which contain diagnostic equipment for measuring the medical parameters of patients.

Unlike the prototype, in the proposed system of medical non-invasive diagnosis of patients at all diagnostic points, the diagnostic laboratory measuring equipment is standardized to measure a strictly fixed list of parameters and additional control equipment and an output adapter are added to each diagnostic point to convert the measurement results into a single form and transfer connect them to the communication channel, to the corresponding inputs of the output adapter at each diagnostic point All laboratory and measuring equipment has been added, in addition, an input adapter, an information processing and accumulation unit, a diagnostic evaluation unit, an automatic determination of treatment methods and means, an additional patient condition monitoring unit and an information monitoring, control and display unit, have been added to the system the adapter of each diagnostic point is connected by a duplex communication channel with the input adapter of the system, which is connected with the first output to the first input of the diagnostic evaluation unit and to the first at the input of the information processing and accumulation unit, the second output - to the first input of the additional patient condition monitoring unit, and the third output - to the fifth input of the information monitoring, control and display unit, to the second, third, fourth and fifth inputs of the information processing and accumulation unit, respectively connected the second input of the diagnostic evaluation unit, the first input of the unit for automatically determining methods and means of treatment, the third input of the control unit, information management and display, and the second input of the add-on unit body condition monitoring of patients, the third output of the diagnostic evaluation unit, the second output of the automatic determination of methods and means of treatment and the third output of the additional patient status monitoring unit are connected respectively to the first, second and fourth inputs of the control, management and information display unit, in addition, additional equipment monitoring of each diagnostic point via GSM and GPRS communication channels is connected to the corresponding input of the unit for additional monitoring of patients the fourth output of the control unit, information management and display is connected to the third input of the input adapter, and the fourth output of the diagnostic evaluation unit is connected to the third input of the automatic determination of treatment methods and means.

The task to be solved by the claimed method and system is to expand the scope, reduce subjectivity in the system of medical support of the population, increase its productivity and reduce material costs for the population.

The combination of general and private essential features of the inventions provides the opportunity to solve the problem and achieve the required technical result, namely: increasing the objectivity of medical diagnosis of patients by automating decision-making processes, significantly expanding the capabilities of the system by accumulating statistical data on the effectiveness of treatment, the use of treatment methods and means taking into account hereditary and environmental factors.

Indeed, subjectivity in medical diagnostics today is the main cause of medical errors, since the final decision on the patient’s condition is determined by the medical professional, and, therefore, the degree of error is determined by the training of personnel, their psychophysical state at the time of the decision and the quality of the measuring base. Therefore, in the proposed technical solutions, an increase in the objectivity of decision-making is ensured by excluding medical personnel at the decision-making stage. In addition, it is possible to attract highly qualified specialists to service all diagnostic points in time close to real. This significantly reduces costs at the stage of diagnosis and treatment of patients. Thanks to the system of automatic archiving and accumulation of data, the proposed method and system of medical diagnostics, as the data accumulate, attract the latest treatment methods and means and expand the number of patients, will constantly improve their capabilities in the diagnosis and treatment of patients.

As a result of the search, no information was found allowing us to conclude that the distinguishing features of the claimed technical solutions are known, therefore, the claimed technical solutions correspond to the novelty condition.

From the prior art it is not known the influence of the distinctive features of the claimed technical solutions on the achieved technical result, therefore, the claimed technical solutions meet the condition of an inventive step.

The invention is disclosed by drawings, where Fig.1-Fig.8 explain the basic principles embodied in the proposed method, Fig.9 shows a block diagram, and Fig.10 shows a structural diagram of the proposed system of medical non-invasive diagnostics.

Figure 1 shows the operator model intended for structural analysis of the proposed method of medical non-invasive diagnosis of patients.

Figure 2 shows a diagram of the formation of the information matrix when obtaining the optimal criterion for the maximum likelihood of a diagnosis.

Figure 3 shows an example of the structure of the measuring equipment located in the diagnostic point (PD) for conducting non-invasive multi-level diagnosis of patients.

Figure 4 shows the structural implementation of the algorithm for determining the diagnosis adopted in the proposed method.

Figure 5 shows a diagram of the use of diagnostic equipment in one PD, depending on the pathology detected during the diagnosis.

Figure 6 shows a diagram for determining diagnoses in the proposed method.

Figure 7 shows a system for specifying a list of informative parameters subject to mandatory control for some measuring instruments placed in the PD. On figa - for a non-invasive blood analyzer AMP, on figb - for an electrocardiograph (ECG) type "Heard Vue", on figv - for a spirometer (CPM) type "MAC-1", and Fig.7g - for Oscillometer (OTsM) type "EPDV".

On Fig shows time diagrams of conducting diagnostics in the interactive mode for some types of pathologies.

Figure 9 shows the structural diagram of the proposed system of medical non-invasive diagnosis of patients, the structural diagram of which is shown in figure 10.

If we look at the process of medical diagnostics from the point of view of obtaining initial information about the patient’s state of health, its processing, analysis, determination of treatment methods on this basis and their direct application in the process of medical care, we will easily identify those zones in the information process, which are subject to the impact of the subject, that is, are areas of possible errors. The probability of an erroneous decision in the vast majority of cases depends, firstly, on the laboratory diagnostic base, and secondly, on the preparation of the responsibility and experience of medical personnel involved in the diagnosis and treatment of the patient. In addition, the causes of the error may be, thirdly, a large posterior (post-diagnostic) uncertainty and, fourthly, insufficient technical equipment of the diagnostic point during the examination.

In the proposed method, the diagnostic process is a multi-level spatially separated structure of the collection, processing and accumulation of information with interactive type feedback. For the analysis of processes and the synthesis of such a system, the most convenient vector-operator description of events and processes taking place in it in accordance with Fig. 1.

.In such a system, the number of PD m determines the number of rows of the output information matrix M _nm , and the number of columns n of this matrix is the dimension of the informative vector $$\overrightarrow{I}$$

.

The convenience of such a model consists in logical simplicity and in the ability to switch to a formal operator language for its description.

, размерность n которого определяется списком медицинских параметров (СМП), заданных для данной системы МНД. В этом случае система может описываться как пассивная с некоторой передаточной функцией $$F(t,\overrightarrow{r})$$

, где t - время, a $$\overrightarrow{r}$$

- векторный пространственный параметр, характеризующий ПД.By the i-th diagnostic item (PD) of the system (indicated in FIG. 1, as d _i ) we mean the diagnostic item of any type (stationary or mobile) included in the system of medical non-invasive diagnostics (MND). At the same time, we assume that the input unit vector receives the reference unit vector $${\overrightarrow{I}}_0$$

whose dimension n is determined by the list of medical parameters (SMP) specified for this MND system. In this case, the system can be described as passive with some transfer function $$F(t,\overrightarrow{r})$$

where t is time, a $$\overrightarrow{r}$$

- vector spatial parameter characterizing the PD.

. Наибольшую ценность для i-той (где $$i=\overline{\mathrm{1,}m}$$

) ПД имеет информативный вектор $${\overrightarrow{I}}_{i,j}$$

, который содержит всю информацию о состоянии здоровья j-того пациента, и, может быть записан в видеThe operator describing the diagnostic process of the patient is indicated in Fig. 1 as P _i (block 1i) and in our formal scheme performs a modulating function on a unit vector $${\overrightarrow{I}}_0$$

. The greatest value for the i-th (where $$i=\overline{\mathrm{one,}m}$$

) PD has an informative vector $${\overrightarrow{I}}_{i,j}$$

, which contains all the information about the state of health of the j-th patient, and, can be written as

$${\overrightarrow{I}}_{i,j}=(t,\overrightarrow{r},j)=P_i(I_0,t,\overrightarrow{r},j).(2)$$

. Из логики медицинской диагностики следует, что преобразующий оператор P_i является линейным, а сам процесс диагностики носит дискретный характер как в пространстве, так и во времени. В этом смысле система является асинхронной, что существенно упрощает процесс ее организации.From the description of the informative vector in the form (2) it immediately follows that its dimension is uniquely determined by the dimension of the unit vector $${\overrightarrow{I}}_0$$

. It follows from the logic of medical diagnostics that the transforming operator P _i is linear, and the diagnostic process itself is discrete in both space and time. In this sense, the system is asynchronous, which greatly simplifies the process of its organization.

The transforming operator G _i (block 2i) is determined by the information exchange protocol established in the medical monitoring system, and is essentially an output adapter for the i-th PD, according to which, the output signal of the PD can be written as

$$s_i({\overrightarrow{\lambda }}_{i,j},t,\overrightarrow{r})=G_i\left[I_{i,j}(t,\overrightarrow{r},j)\right]=G_i\left[P_{i,j}(I_0,t,\overrightarrow{r},j,i)\right](3)$$

where the i-th output informative vector for the j-th patient can be defined as

$${\overrightarrow{\lambda }}_{i,j}=\left\{{\lambda }_{\mathrm{one,}j},{\lambda }_{2j},{\lambda }_{3j}\mathrm{....}{\lambda }_{m,j}\right\}.(\mathrm{four})$$

от i-того ПД передается по каналам связи и поступает в систему обработки и накопления информации в виде информационной матрицы $$M_{mn}(t,\overrightarrow{r})$$

видаInformative package $$s_i({\overrightarrow{\lambda }}_{i,j},t,\overrightarrow{r})$$

from the i-th PD is transmitted via communication channels and enters the information processing and accumulation system in the form of an information matrix $$M_{mn}(t,\overrightarrow{r})$$

kind of

$$M_{mn}(t,\overrightarrow{r})={\displaystyle \sum _{i=\mathrm{one}}^m{s}_i({\overrightarrow{\lambda }}_{i,j},t,\overrightarrow{r})={\displaystyle \sum _{i=\mathrm{one}}^m{G}_k\left[{\overrightarrow{I}}_{ks}(t,\overrightarrow{r},j)\right]}}={\displaystyle \sum _{i=\mathrm{one}}^m{G}_k\left[P_{ks}({\overrightarrow{I}}_0,t,\overrightarrow{r},j)\right]},(5)$$

имеет m×n элементов и содержит всю информацию о пространственно-временном состоянии системы МНД на каждый конкретный момент времени.Matrix $$M_{mn}(t,\overrightarrow{r})$$

has m × n elements and contains all the information about the spatio-temporal state of the MND system at each particular moment in time.

A special place in the system is occupied by a unified system of processing and accumulation of information, which includes operator units 4-7. Archive 4 stores and accumulates all information on the results of diagnostics of all patients included in the system for monitoring and treatment, preserving the entire history of each patient, his place of residence, work, age, number of the last examination, as well as all the necessary information about the next of kin, determining possible hereditary pathologies or abnormalities, the results of prognostic diagnostics, DNA features, etc.

, вектор методов лечения $$\overrightarrow{L}$$

и векторный список $$\overrightarrow{S}$$

- необходимых средств и медикаментов для лечения пациентов в случаях выявления заболеваний. При этом используется «предыдущий опыт» или эталонная диагностическая матрица E_mn, которая хранится в электронном архиве 4 системы медицинского мониторинга. В общем случае вектор диагнозов может быть записан в видеSequential processing of the information matrix through the operators T, C and A (blocks 5, 6 and 7) allows you to sequentially determine the vector of diagnoses $$\overrightarrow{D}$$

treatment methods vector $$\overrightarrow{L}$$

and vector list $$\overrightarrow{S}$$

- the necessary funds and medicines for the treatment of patients in cases of detection of diseases. In this case, “previous experience" or the reference diagnostic matrix E _{mn is used} , which is stored in the electronic archive 4 of the medical monitoring system. In the general case, the vector of diagnoses can be written as

$$\overrightarrow{D}(t,\overrightarrow{r})=T\left\{E_{mn},M_{mn}(t,\overrightarrow{r})\right\}=T\left\{E_{mn},{\displaystyle \sum _{i=\mathrm{one}}^m{s}_i}({\overrightarrow{u}}_{i,j},t,\overrightarrow{r})\right\}.(6)$$

методов лечения используется весь априорный опыт лечения заболеваний, определенный вектором $$\overrightarrow{D}$$

, для чего вновь задействуется блок обработки и накопления информации 4 (база данных) в виде априорного вектора $${\overrightarrow{L}}_0$$

системы МНД, а информативный вектор $$\overrightarrow{L}$$

записывается в видеIn turn, when defining a vector $$\overrightarrow{L}$$

all a priori experience in the treatment of diseases defined by the vector is used $$\overrightarrow{D}$$

, for which the information processing and storage unit 4 (database) is again used in the form of an a priori vector $${\overrightarrow{L}}_0$$

MND systems, and an informative vector $$\overrightarrow{L}$$

written as

$$\overrightarrow{L}(t,\overrightarrow{r})=C\left[{\overrightarrow{L}}_0,\overrightarrow{D}(t,\overrightarrow{r})\right]=C\left[{\overrightarrow{L}}_0,T\left\{E_{mn},M_{mn}(t,\overrightarrow{r})\right\}\right].(7)$$

при операторной обработке наиболее полно использует данные БОНИ $${\overrightarrow{S}}_0$$

и записывается в видеFinally an informative vector list $$\overrightarrow{S}$$

during operator processing, it most fully uses BONI data $${\overrightarrow{S}}_0$$

and is written as

$$\overrightarrow{S}(t,\overrightarrow{r})=A\left\{{\overrightarrow{S}}_0,\overrightarrow{D}(t,\overrightarrow{r}),\overrightarrow{L}(t,\overrightarrow{r})\right\}=A\left\{L_{mn},C\left[{\overrightarrow{L}}_0,\overrightarrow{D}(t,\overrightarrow{r})\right]\right\}.(8)$$

All newly obtained information during processing is also recorded and stored in an electronic archive with the aim of increasing the diagnostic and therapeutic “intelligence” of the medical monitoring system and is used hereinafter as a priori information. This property of the MND system makes it possible to attribute it to the class of self-developing systems, which at a certain stage of intellectual development will make it possible to organize the process of diagnosis, control and treatment of a number of diseases without the participation of highly qualified medical personnel, based on only a priori information and diagnostic results. In this case, the empirical part of BONI, which focuses on the analysis of successful treatment of various diseases, is of the greatest importance. A special role in this is played by criteria for assessing the success of the use of the treatment base, which are probabilistic in nature and should reflect only objective factors in the treatment process and be unequivocally confirmed empirically. Criteria for assessing the success of the use of the treatment base are also important for the system for checking the effectiveness of drugs and methodological apparatus, since they will uniquely determine the comparative degree of their effectiveness, practical importance and safety.

, $$\overrightarrow{L}(t,\overrightarrow{r})$$

и $$\overrightarrow{S}(t,\overrightarrow{r})$$

протекает во времени, близком к реальному. Если для однозначного определения одного или нескольких информационных векторов информации по результатам диагностических измерений первого уровня недостаточно, то формируется запрос на дополнительную информацию, которая должна быть получена в ПД методами диагностики второго и, при необходимости, последующих уровней, обеспечивающими требуемую для принятия решения точность и информативность. Данное свойство и характеризует систему МНД как интерактивную.The entire described procedure for the formation of informative vectors $$\overrightarrow{D}(t,\overrightarrow{r})$$

, $$\overrightarrow{L}(t,\overrightarrow{r})$$

and $$\overrightarrow{S}(t,\overrightarrow{r})$$

flows in time close to real. If there is not enough information for the unambiguous determination of one or several information vectors of information from the results of diagnostic measurements of the first level, then a request is generated for additional information that should be obtained in the diagnostic methods of the second and, if necessary, subsequent levels, providing the accuracy and information required for making a decision . This property characterizes the MND system as interactive.

. Суть этого подхода состоит в том, что составляющие информативного вектора, измеряемого в процессе диагностики, коррелированны между собой в той или иной степени. Для увеличения достоверности установления диагноза необходимо ввести критерий получения оптимальной оценки, учитывая случайный характер получаемых в результате измерения параметров. Эта метода детально изучена и описана в монографии [2] и положена в основу установления диагноза пациента, оптимального в смысле критерия максимального правдоподобия, а также использована в качестве алгоритма принятия решения при определении векторного диагноза $$\overrightarrow{D}(t,\overrightarrow{r})$$

.Figure 2 shows a diagram of the formation of a statistical information matrix for the input vector $$\overrightarrow{\lambda }$$

. The essence of this approach is that the components of the informative vector measured in the process of diagnosis are correlated to one degree or another. To increase the reliability of establishing a diagnosis, it is necessary to introduce a criterion for obtaining the optimal score, taking into account the random nature of the parameters obtained as a result of the measurement. This method has been studied in detail and described in the monograph [2] and is the basis for establishing the patient’s diagnosis, which is optimal in the sense of the maximum likelihood criterion, and is also used as a decision algorithm in determining the vector diagnosis $$\overrightarrow{D}(t,\overrightarrow{r})$$

.

One of the possible examples of equipping PD with laboratory measuring equipment (LIO) for carrying out measurements of the biomedical parameters of a patient in a non-invasive manner is shown in FIG. 3. LIO 20 includes an AMP non-invasive blood analyzer 8, an electrocardiograph 9 (ECG), a spirometer 10 (SPM), a mammograph 11 (MMF), an oscilloscope 12 (OCM), a radiometer 13 (RDM) and an IR camera 14 (IKK) , video camera 15, means 16 of additional control (SDK), block 17 control and management, as well as methodological apparatus 18 non-invasive diagnostics. In addition, each PD is equipped with an output 19 PD adapter, which converts the output signals of all devices used in diagnostics to a single format. Each of the measuring devices 8-14, as well as the additional monitoring means 16, has a fixed number of monitored parameters that allow you to determine possible pathologies during the diagnosis of the patient or to obtain additional information about the diagnostic point itself and the controlled patients using SDK 16. When conducting diagnostic measurements the first level, to reduce the amount of information transmitted through communication channels, only part of the diagnostic equipment is used, which allows to identify the main The patient’s pathologies, for example, AMP 8 and ECG 9. If a pathology is identified at the stage of information processing of the first level, but additional information is required to specify it, then the system generates a request to the PD for conducting diagnostic measurements of the second level, where the list of diagnostic the equipment on which the diagnosis should be carried out, for example, a mammograph 11 or radiometer 13. At the diagnostic point, the patient is examined on this diagnostic equipment, and the obtained measurement results of the second levels are transferred to the system for further processing together with the results of measurements of the first level. If the information obtained at the first and second levels of diagnostics is not enough, then the system generates a third request, etc.

, необходимо включить в него все контролируемые параметры, измеряемые всеми приборами, входящими в состав ЛИО для каждого ПД.Naturally, asking an informative vector $$\overrightarrow{\lambda }$$

, it is necessary to include in it all the controlled parameters measured by all the instruments that make up the LIO for each PD.

. Рассмотрим пошагово процедуру медицинской неинвазивной диагностики, реализуемую в предлагаемом способе в соответствии со схемой, показанной на фиг.4.We will assume that an informative vector, including a list of parameters subject to mandatory diagnostic control at each medical examination, is given and laboratory-measuring equipment sufficient for its determination (Fig. 3) is defined and exists at each diagnostic point. Denote the informative vector obtained for the j-th patient undergoing the k-th examination in the i-th PD as $${\overrightarrow{\lambda }}_{ijk}$$

. Consider a step-by-step procedure for medical non-invasive diagnostics, implemented in the proposed method in accordance with the scheme shown in figure 4.

являются результатом k-того (от начала контроля, в идеале от рождения, k≥1) диагностического обследования в i-том ПД (i=1, …m; см. фиг.1), j-того пациента, $$j=\overline{\mathrm{1,}M}$$

, M - число пациентов, контролируемых в данном ПД.Individual components of an informative vector $${\overrightarrow{\lambda }}_{ijk}$$

are the result of the k-th (from the start of control, ideally from birth, k≥1) diagnostic examination in the i-th PD (i = 1, ... m; see figure 1), of the j-th patient, $$j=\overline{\mathrm{one,}M}$$

, M is the number of patients controlled in this PD.

, путем обмера пациента в ПД посредством ЛИО, состоящего из n приборов, посредством методического аппарата 19 и передачи этого вектора в единую систему обработки и накопления информации. И, во-вторых, установление диагноза пациента по вектору $${\overrightarrow{\lambda }}_{ijk}$$

в единой системе обработки и накопления информации, которая осуществляет анализ информативного вектора $${\overrightarrow{\lambda }}_{ijk}$$

c учетом всей имеющейся архивной информации на момент проведения диагностики. Функционально единая система обработки и накопления информации включает для обеспечения непосредственно процесса диагностики два взаимосвязанных блока. Это блок 5 обработки и анализа информации, который системно реализует алгоритмы определения диагноза, а также архив 4, который накапливает и систематизирует всю ранее полученную и вновь получаемую информацию.In accordance with the diagram shown in figure 4, the process of non-invasive diagnosis of the patient is divided into two interconnected components. This is, firstly, the formation of an informative vector sufficient for decision making $${\overrightarrow{\lambda }}_{ijk}$$

, by measuring the patient in the PD by means of a LIO consisting of n devices, by means of the methodological apparatus 19 and transferring this vector to a single information processing and accumulation system. And secondly, the diagnosis of a patient by vector $${\overrightarrow{\lambda }}_{ijk}$$

in a single system for processing and accumulating information that analyzes an informative vector $${\overrightarrow{\lambda }}_{ijk}$$

taking into account all available archival information at the time of the diagnosis. A functionally unified system for processing and accumulating information includes two interconnected units for providing the diagnostic process directly. This is a block 5 for processing and analyzing information that systematically implements the algorithms for determining the diagnosis, as well as archive 4, which accumulates and systematizes all previously received and newly received information.

, достаточный для последующего принятия решения о состоянии здоровья пациента. При этом для проведения измерений нет необходимости привлекать медицинский персонал, который должен проводить обработку полученной информации и принять решение относительно диагноза пациента. Дальнейшая обработка получаемой при лабораторном обследовании информации, ее всесторонний анализ с учетом архивных данных осуществляется в автоматическом режиме в единой системе обработки и накопления информации (ЕСОНИ).In accordance with the described model (figure 4) of non-invasive diagnostics, a laboratory examination of a patient involves only conducting instrumentation measurements on the LIO complex, which allow to form an informative vector $${\overrightarrow{\lambda }}_{ijk}$$

sufficient for subsequent decision on the patient’s health status. At the same time, there is no need to involve medical personnel for the measurements, who must process the information received and decide on the patient’s diagnosis. Further processing of the information obtained during the laboratory examination, its comprehensive analysis, taking into account archival data, is carried out automatically in a single information processing and accumulation system (ESONI).

In the case under consideration, the informative vector from the i-th PD at the input of the ESONI can be written as

$${\overrightarrow{\lambda }}_{ijk}={\left\{{\mathrm{<figure-callout\; id="0"\; label="\lambda \; i"\; filenames="00000058.png"\; state="\{\{state\}\}">\lambda \; </figure-callout>}}_i,{\lambda }_{i\mathrm{,one}},{\lambda }_{i\mathrm{,\; 2}},\mathrm{....}{\lambda }_{i,h},...{\lambda }_{i,n}\right\}}_{k,j},(9)$$

, $$i=\overline{\mathrm{1,}m}$$

. Локальные параметры λ_i,h являются составными, поскольку они все входят в состав информативного вектора $${\overrightarrow{\lambda }}_{ijk}$$

. Параметр λ_i,0 является личностным идентификатором пациента и включает индивидуальные данные, такие как дата рождения, место жительства и т.п.where λ _{i, h} is the component of the informative vector, which represents all the values of the diagnostic parameters for the h-th measuring instrument LIO, $$h=\overline{\mathrm{one,}n}$$

, $$i=\overline{\mathrm{one,}m}$$

. The local parameters λ _{i, h} are composite, since they are all part of the informative vector $${\overrightarrow{\lambda }}_{ijk}$$

. The parameter λ _{i, 0} is the personal identifier of the patient and includes individual data, such as date of birth, place of residence, etc.

, из архива запрашиваются значения информативного вектора $${\overrightarrow{\lambda }}_{ijk-1}$$

для данного пациента, исторически самое близкое к $${\overrightarrow{\lambda }}_{ijk}$$

по времени, а также вектор $${\overrightarrow{\phi }}_{ijk-1}$$

, отражающий историю болезней и наследственные факторы пациента. Основанием для установки диагноза является разностный вектор состояния пациента, представляющий собой вектор разностиWhen assessing the patient's condition in ECONI, after obtaining the value of the informative vector $${\overrightarrow{\lambda }}_{ijk}$$

, the values of the informative vector are requested from the archive $${\overrightarrow{\lambda }}_{ijk-\mathrm{one}}$$

for a given patient, historically closest to $${\overrightarrow{\lambda }}_{ijk}$$

by time as well as vector $${\overrightarrow{\phi }}_{ijk-\mathrm{one}}$$

, reflecting the history of diseases and hereditary factors of the patient. The basis for the diagnosis is a difference state vector of the patient, which is a difference vector

$${}_{\Delta }{\overrightarrow{\lambda }}_{ijk}={\overrightarrow{\lambda }}_{ijk}-{\overrightarrow{\lambda }}_{ijk-\mathrm{one}},(10)$$

и архивного вектора $${\overrightarrow{\phi }}_{ijk-1}$$

. В результате их оптимальной обработки в блоке 22 формируется оценка $${}_{\Delta }\overrightarrow{\lambda }{*}_{ijk}$$

, по которой из матрицы диагнозов выбирается наиболее соответствующий данному вектору. То есть, оптимальный алгоритм, принимаемый в системе, по входному вектору $${}_{\Delta }{\overrightarrow{\lambda }}_{ijk}$$

формирует оптимальную оценку состояния пациента $${}_{\Delta }\overrightarrow{\lambda }{*}_{ijk}$$

[2]. Этой оценке однозначно соответствует диагноз D_kij, присваиваемый j-тому пациенту.determining the degree of change in the patient's condition relative to the last medical examination. The implementation scheme of the optimal algorithm, the diagnosis is shown in Fig.5. In accordance with this scheme, the input of the evaluation unit 21 receives the initial data in the form of an informative difference vector $${}_{\Delta }{\overrightarrow{\lambda }}_{ijk}$$

and archival vector $${\overrightarrow{\phi }}_{ijk-\mathrm{one}}$$

. As a result of their optimal processing, an estimate is formed in block 22 $${}_{\Delta }\overrightarrow{\lambda }{*}_{ijk}$$

according to which from the matrix of diagnoses the one that is most suitable for a given vector is selected. That is, the optimal algorithm adopted in the system according to the input vector $${}_{\Delta }{\overrightarrow{\lambda }}_{ijk}$$

forms an optimal assessment of the patient's condition $${}_{\Delta }\overrightarrow{\lambda }{*}_{ijk}$$

[2]. This assessment clearly corresponds to the diagnosis D _kij assigned to the j-th patient.

Interval medical monitoring (or diagnosis) of the patient’s health status over a fixed time interval ΔТ ₀ prescribed by the proposed method is aimed at organizing the medical support process in such a way that in any practically known case the possibility of severe forms of diseases of the patient’s internal organs taking into account his health condition is excluded , hereditary factors, etc. Moreover, the frequency of medical control F ₀ = 1 / ΔТ ₀ is chosen so that even if the patient has a disease in a latent form (when the disease has no obvious pain expressions), the detection of the disease does not have a detrimental effect on the patient. In most cases, this time interval is from 1 to 6 months, depending on the results of the last diagnosis.

, а $${}_{\Delta }{\overrightarrow{\lambda }}_{ijk}={\overrightarrow{\lambda }}_{ijk}$$

, диагноз устанавливается путем интервальной фильтрации, задаваемой в алгоритме обработки параметров. В приложении 1 приведен протокол обследования пациента на неинвазивном анализаторе крови АМП. В колонке «Норма» указан допустимый интервал возможных значений для каждого контролируемого медицинского параметра. Выход параметра за норму свидетельствует о возможном медицинском нарушении или медицинской патологии. Степень влияния такого отклонения определяется его абсолютным значением отклонения от допустимого значения, с учетом корреляционных связей с другими зависимыми параметрами.In the case of the first measurement, when $${\overrightarrow{\lambda }}_{ijk-\mathrm{one}}=0$$

, but $${}_{\Delta }{\overrightarrow{\lambda }}_{ijk}={\overrightarrow{\lambda }}_{ijk}$$

, the diagnosis is established by interval filtering specified in the parameter processing algorithm. Appendix 1 shows the protocol for examining a patient using a non-invasive AMP blood analyzer. In the column “Norma” the permissible interval of possible values for each controlled medical parameter is indicated. The excess of the parameter for the norm indicates a possible medical violation or medical pathology. The degree of influence of such a deviation is determined by its absolute value of the deviation from the permissible value, taking into account the correlation with other dependent parameters.

Figure 6 shows a diagram of the involvement of measuring equipment located on the PD depending on the pathology detected in the patient during the diagnosis. When conducting the diagnosis of the first level, only a non-invasive blood analyzer AMP 8 is used. In the absence of any deviations (the diagnosis is "Healthy", see Fig.6), the pathology has a value of "0". All pathologies, for which the use of only AMP 8 is sufficient, have values from No. 1 to No. b. Starting from pathology No. (b + 1), the information received from AMP 8 is not enough to unambiguously determine the diagnosis and block 5 sends a request to BKU 17 in the form of an informative signal with the number of the identified pathology, which, in accordance with the table of FIG. 6, determines type of necessary equipment for additional diagnosis of the patient at the second level. At the diagnostic point, measurements are made of the second and subsequent (if necessary) levels, which are sent to a single system for processing and accumulating ECONI information.

Let us pay attention to the fact that the spatial separation between the PD and ESONI can be arbitrary and does not imply their placement in one place. This property is very important in the construction of branched networks of regional and global medical monitoring, when there can be any number of diagnostic points required for practical application. Moreover, only one ECONI unit can be used in the system, connected to all PD communication channels, as shown in FIGS. 3 and 4.

, оказывается недостаточно для установления диагноза при проведении k-того обследования j-того пациента или если на первом этапе диагностики выявлена какая-либо патология.Since we are considering an interactive monitoring system, in FIGS. 1, 3 and 4, all data channels intended for information exchange are designated as two-way. Situations of an interactive appeal of ESONI to one or another PD can occur in cases where information obtained on the basis of processing an informative vector $${}_{\Delta }{\overrightarrow{\lambda }}_{ijk}$$

, it turns out to be insufficient to establish a diagnosis during the k-th examination of the j-th patient or if any pathology is revealed at the first stage of diagnosis.

Fig.7 explains the system adopted in the proposed method, end-to-end encoding of informative parameters obtained from various measuring instruments. On figa shows the numbering of the parameters received from the AMP 8. In total, the device AMP monitors 110 parameters that relate to the control parameters and display the patient's condition. AMP 8 control parameters in a single system are located at positions No. 3, ... No. 112. At position No. 1, the patient’s personal number is always set in the system; at position No. 2, there is an information parameter that displays the general properties of the patient — his place of residence, work, age, etc.

Fig.7b displays the encoding order of information from the ECG 9. Since this device is connected to the patient’s diagnostics as an additional one, its informative vector contains 11 components, and No. 1, as in the previous case, is the patient’s personal number, and then ten informative parameters of the cardiogram .

Figv shows a coding scheme for additional information from the spirometer 10, which has 50 control parameters. Fig.7g explains the encoding of information from the oscilloscope 12.

The timing diagram of FIG. 8 shows three examples of diagnosing a patient for various pathologies. In Fig. 8a, the information package contains at its zero position the PD number assigned to it in a single system and the electronic coded word S _{AMP with} duration τ _AMP , which contains the values of all 110 parameters about the medical condition of the patient being examined received from the device AMP 8 (see Appendix one). After the diagnostic time T _{d has} elapsed, if necessary, an electronic request S _z is sent to the PD from ESONI for conducting second-level diagnostic measurements, indicating the number of the revealed pathology No. b, which, according to FIG. 6, requires the patient to receive ECG. After the time of additional measurements of the second level T _di expires, the ECONI receives an informative signal S _ecg , which supplements information about the patient’s medical condition and is taken into account when forming the final diagnosis in ECONI. Similar diagrams of information transfer are shown in Fig. 8b for a spirometer 10 and Fig. 8c for an oscilloscope.

If a patient is diagnosed with a disease during the next diagnosis, after determining the means and methods of treatment, in some cases when the patient’s health status is critical or the treatment methods used may have side effects, the proposed method prescribes the organization of additional patient monitoring during treatment. Additional control is organized in the PD to which the patient is attached, by reducing the time ΔT ₀ , depending on the type of disease and its form, from ten days to 24 hours (once a day). In cases where the disease is very dangerous (oncology, cardiology, diabetes, etc.), a number of basic parameters of the patient are monitored continuously. Continuous monitoring of the condition and location of the patient is organized in accordance with the scheme shown in Fig.9. To this end, the patient is equipped with an individual tracker 23 and associated sensors 24, placed on the body of the patient under control. An individual tracker 23 in automatic mode by means of navigation satellites 25 monitors the patient’s location and, together with the sensor data in real time, transmits all received information to ECONI via GSM and GPRS communication channels, as shown in Fig. 9. In this case, an operational control center for the condition of these patients, where the doctor on duty is located, can be created in ESONI. In the event of critical situations, the system immediately informs ESONI about this via communication channels, including SMS, which can be sent to emergency rooms on the phone. An example of the implementation of such information exchange is the Geoinformer system (see www.geoinformer.com). Additional control in the proposed method also includes spatial control of mobile PD included in the system. In addition to the functions of navigational control of medical transport, such a subsystem performs the functions of information support for PD during the transition from one settlement to another. Through it, information on all patients subject to medical examination in this locality, as well as all necessary contact information, is brought to the PD operator.

Thus, the proposed method allows to eliminate the main disadvantages of the prototype. Firstly, when conducting laboratory examinations of patients there is no need to use highly qualified, and, therefore, expensive medical personnel. A well-trained technician with a secondary technical education is able to carry out all measurements at the highest level, since his competence is only the proper maintenance of LIO diagnostic devices and the conduct of diagnostic measurements of medical parameters of patients on these devices. At the same time, the subjective factor in decision making is reduced as much as no decision is required from the staff. Secondly, the spatial separation of the processes for measuring the patient’s medical parameters and making a decision about his diagnosis in the proposed method, provided that LIO 20 is equipped with modern non-invasive high-performance equipment, can reduce the process of periodic diagnosis of one patient from several hours or even days to several minutes. This greatly simplifies and speeds up the diagnostic process and allows you to create a system of regional medical monitoring with mandatory monitoring of the medical condition of the population in the region. Thirdly, to obtain objective diagnoses, the patient does not need to directly contact expensive clinics with expensive specialists. Moreover, automation of treatment methods and the right choice of the time interval for compulsory examination of patients will allow to identify most diseases at an early stage and treat them without the involvement of medical personnel, which will significantly reduce the cost of medical care in general. Fourth, due to the accumulation of information about patients and their health in a single center for processing and accumulating information, a simple and easily implemented opportunity is created for a regional analysis of the medical condition of the population and the influence of external factors, such as ecology, drinking water, food, and others.

To implement the proposed method, you must perform the following operations:

- measure at each diagnostic point the biophysical parameters of the patient with non-invasive diagnostic tools,

- convert the measurement results at each diagnostic point into an electrical signal of a certain format,

- transmit this signal to a single system for processing and accumulating information,

- document the measurement results with fixed algorithms for processing electrical signals with reference to each patient at his place of residence, work, age, specialty, professional affiliation and gender, in a single register for all patients included in the medical support system,

- analyze the measurement results of the biophysical medical parameters of the patient,

- establish the diagnosis of the patient according to the results of the analysis,

- enter each received diagnosis into a single system for processing and accumulating information,

- convert the diagnosis into an electrical signal of a certain format,

- transmit this signal to each diagnostic point.

In addition, in the case when the information received from any diagnostic point is not enough to establish a diagnosis, the following operations are performed:

- generate an electrical request signal with a list of additional parameters to be measured in the corresponding diagnostic item,

- measure additional biophysical parameters of the patient,

- convert the results of additional measurements into an additional electrical signal of a certain format,

- transmit this signal to a single system for processing and accumulating information,

- document the results of additional measurements according to fixed algorithms for processing electrical signals, and the diagnosis is established taking into account the results of additional measurements.

Additionally, in case of detection of a patient's disease, the following operations are performed:

- determine in a single system for processing and accumulating information according to relevant algorithms a list of necessary tools and methods of treating a patient in the form of an electronic document,

- transmit all this information to the diagnostic point as a prescription for organizing and conducting treatment and electronic prescriptions for the purchase of dosage forms and drugs.

During treatment, also:

- periodically monitor the condition of the patient and the degree of influence of the treatment process on his vital organs, and:

- determine the frequency of periodic monitoring and the list of equipment necessary for monitoring in accordance with the type of disease, the state of the patient’s health, his age, and in the case of a negative result of the applied treatment methods or the threat of harm to the patient’s health, in a single system for processing and accumulating information

- form a team to change methods and forms of treatment in the form of an electronic protocol, which is marked "urgent"

- sent to the appropriate diagnostic point to make changes to the patient’s treatment process.

Besides:

- document all the results of periodic monitoring in a single system for processing and accumulating information, taking into account the age, gender, diagnosis, time of recovery and the degree of negative impact on the main internal organs of the patient and on its basis

- determine the effectiveness of the use of medicines and medical forms for the treatment of patients.

Besides:

фиксированной размерности с частотой проведения диагностических обмеров не менее F₀,- carry out the diagnosis of each patient for an informative vector $${\overrightarrow{\lambda }}_0$$

a fixed dimension with a frequency of diagnostic measurements of at least F ₀ ,

- establish a diagnosis in accordance with the formula

, $$\delta \overrightarrow{\lambda }={\overrightarrow{\lambda }}_{0n}-{\overrightarrow{\lambda }}_{0n-\mathrm{one}}$$

,

Where

- вектор отклонения медицинских параметров пациента от момента последнего обследования; $$\delta \overrightarrow{\lambda }$$

- the vector of deviation of the patient’s medical parameters from the time of the last examination;

- вектор медицинских параметров пациента, полученный в результате текущего диагностического обследования; $${\overrightarrow{\lambda }}_{0n}$$

- the vector of the patient’s medical parameters obtained as a result of the current diagnostic examination;

- вектор медицинских параметров пациента, полученный в результате предыдущего диагностического обследования. $${\overrightarrow{\lambda }}_{0n-\mathrm{one}}$$

is the vector of the patient’s medical parameters obtained as a result of a previous diagnostic examination.

Additionally:

- conduct the first diagnostic examination of each patient in the shortest possible time from the date of his birth,

- establish a diagnosis taking into account the medical data of all direct relatives on the maternal and paternal lines of the patient who are in a single system for processing and accumulating information.

In addition, if a patient develops a disease:

- compare in a single system for processing and accumulating information its vector of medical parameters with the data of previously identified and treated diseases, taking into account the age, gender, health status of the patient,

- establish by comparison the closest case previously available in practice,

- are applied, taking into account safety and effectiveness for treating a patient, previously tested methods and means of treatment and control.

Unlike the prototype, in the inventive method, the implementation of additional operations is aimed at ensuring the objectivity of the analysis obtained, reducing the cost of medical support and reducing the time for it, as well as identifying the ecological state in the region during the accumulation and processing of information.

The system of medical non-invasive diagnosis of patients is shown in Fig.10. It contains m diagnostic points connected via communication channels to the input adapter 28 of the ECONI 27 unified information processing and storage system. Each diagnostic point contains electrically connected laboratory and measuring equipment LIO 20 and output adapter 19, as well as equipment 26 for additional control. ECONI 27 contains an electrically coupled input adapter 28, an information processing and accumulation unit (BONI) 29, a diagnostic evaluation unit 30, an automatic determination unit for treatment methods and means 31, an additional patient condition monitoring unit 32, and information monitoring, control and display unit 33. The first output of the input adapter 28 is connected to the first input of the BONI 29, as well as to the first input of the diagnostic evaluation unit 30, the second output of which is connected to the second input of the BONI 29, and the third output is connected to the first input of the information monitoring, control and display unit 33. To the third, fourth and fifth inputs of BONI 29, respectively, the first output of the block 31 for automatically determining methods and means of treatment, the third output of the block 33 for monitoring, control and display of information, and the second output of the block 32 for additional monitoring of the patient's condition, the first and third inputs of which are connected respectively to the second output of the input adapter 28 and the fourth output of the information monitoring, control and display unit 33, which is connected to the second input of the automatic determination unit 31 by the second output I have methods and means of treatment.

The system operates as follows.

At the first level of diagnosis, the patient (not shown in FIG. 10) is examined in the PD using diagnostic equipment of the first level LIO 20, a possible variant of which is AMS 8, shown in FIG. 3. At the first examination in PD, the patient is assigned an individual number, which is assigned to him forever. This number serves as an individual identifier for the patient. Information from the output of the LIO 20 devices is fed to the input of the adapter 19, in which it is converted to a single standard and transmitted through the communication channel in ECONI 27, to the input adapter 28.

Further, in a standard form, the information is transmitted to the information processing and accumulation unit 29, where it is entered into the card file of the examined patient by his individual number. In addition, information from the first output of the input adapter 28 enters the diagnostic evaluation unit 30, where it is processed in accordance with the adopted optimal algorithms in order to establish the patient’s diagnosis. If there is enough information to make a decision about the patient’s diagnosis, block 30 establishes the diagnosis, enters it in BONI 29 and transmits it through adapter 28 to the PD for communication with the patient. If the information obtained during the first diagnostic level is not enough to establish a diagnosis, block 30 generates a request to the PD through the input adapter 28 and the communication channel for diagnostic measurements of the second and subsequent (if necessary) levels. Upon examination of the patient of the second level, additional information is transmitted through the adapter 28 to block 30 to determine the diagnosis of the patient. The diagnosis is established on the basis of diagnostic measurements of all completed levels. If, after receiving the results of the examination, there is enough information to determine the diagnosis, a signal is generated in block 30 that uniquely identifies the patient’s diagnosis, which is entered into the information processing and accumulation unit 29, the control and information display control unit 33, and also, through the adapter 28, are transmitted to communication channels PD. This information is entered into the information processing and accumulation unit 29. If the additional information received is not sufficient to uniquely determine the diagnosis in the diagnostic evaluation unit 30, the corresponding information is sent to the information monitoring, control and display unit 33. In the event of a diagnosis of the disease, the unit 30 of the diagnostic evaluation receives relevant information in unit 31, which, in accordance with the algorithms from the data from unit 29 for processing and storing information, determines an electronic list of means and methods of treatment, which is transmitted in the form of electronic instructions and recipes to unit 33 control, management and display of information. The following scenarios for the development of the diagnostic process and reaction to it are possible in the system:

1. The diagnostic information obtained at the first level of diagnosis is sufficient to establish a diagnosis, the patient is healthy, the diagnostic evaluation unit 30 transmits the relevant information to the PD, BONI 29 for registration and to the control, management and display information unit 33 for monitoring.

2. The information obtained at the first level of diagnosis is enough to establish a diagnosis, a disease has been identified that can be treated at home. The diagnostic evaluation unit 30 transmits the relevant information to BONI 29 for registration and to the unit 31 for automatically determining treatment methods and means for generating electronic lists and recipes, which, through the information monitoring, control and display unit 33, are transmitted through the input adapter via communication channels to the PD, where they are printed and transmitted to the patient in the form of prescriptions for the purchase of dosage forms and preparations and prescriptions for treatment.

3. The information obtained at the first level of diagnosis is not enough to establish a diagnosis, the diagnostic evaluation unit 30 transmits a corresponding request to the PD to conduct a second-level diagnosis at the patient. After receiving the results of a diagnostic examination of the second (and subsequent, if necessary) level:

3.1. The information received is sufficient to establish a diagnosis, a disease has been identified that can be treated at home. The diagnostic evaluation unit 30 transmits the relevant information to BONI 29 for registration and to the unit 31 for automatically determining treatment methods and means for generating electronic lists and recipes, which, through the information monitoring, control and display unit 33, are transmitted through the input adapter via communication channels to the PD, where they are printed and transmitted to the patient in the form of prescriptions for the purchase of dosage forms and preparations and prescriptions for treatment.

3.2. The information received is sufficient to establish a diagnosis, a disease has been identified that cannot be treated at home. The diagnostic evaluation unit 30 transmits the relevant information to BONI 29 for registration and to the information monitoring, control and display unit 33 for determining the place and forms of treatment of the patient. Block 33 generates the corresponding instructions and transmits them through the communication channels to the appropriate PD for execution.

3.3. The information received is insufficient to establish a diagnosis. The diagnostic evaluation unit 30 transmits the relevant information to BONI 29 for registration and to the information monitoring, control and display unit 33 to determine the location and forms of the additional examination of the patient. Block 33 generates the corresponding instructions and transmits them through the communication channels to the appropriate PD for execution.

3.4. The information received is sufficient to establish a diagnosis, a life-threatening disease has been identified that does not require immediate hospitalization or has a pronounced chronic form. The diagnostic evaluation unit 30 transmits the relevant information to BONI 29 for registration and to the appropriate PD for installing the necessary sensors in the patient, as well as supplying him with an individual tracker for organizing continuous medical monitoring. An individual tracker from additional equipment 26 transmits all the necessary information to block 32 for additional monitoring of the patient's condition. The information received is analyzed in real time and, in the event of anomalies that threaten the patient’s life, it sends an alarm message to the information monitoring, control and display unit 33 for immediate execution of the patient care instructions. In addition, block 32 automatically determines the location of the sick patient and generates an SMS message to the mobile phones of the patient and his immediate environment, indicating the necessary actions that must be performed before the arrival of medical care. To monitor the condition of especially sick patients, the system uses round-the-clock duty of a qualified specialist who makes the final decision regarding the patient's condition, forms and methods of providing him with medical care. In some cases, means of additional monitoring of the patient's condition can be used in the process of treating patients using new methods or new drugs, as well as in those cases when the drugs used for treatment have pronounced side effects that could lead to a serious impact on the patient's condition.

The entire exchange of information between all PDs and ESONI is organized via regular GSM, GPRS and SMS communication channels of the regional telecom operator 34. In this case, there is no need to synchronize the system, since all information is transferred to BONI in packets with an unambiguous binding of information in each package to the PD number, patient number, time and place of examination.

Typical blocks, devices, subsystems and algorithms that have wide practical application can be used as an elemental base for creating a system. Typical equipment for non-invasive control is used to equip PD. As adapters, typical programmable routers of information flows can be used, connected to the corresponding communication and data transmission channels. As BONI high-performance programmable servers can be used. Blocks 30, 31 and 32 can be built on high-performance processors. Block 33 is a classic operator’s workstation equipped with means for displaying information and controlling the entire system.

Literature

1. Dreval A.V. How to make an accurate diagnosis. M .: Eksmo, 2009, p. 181-210.

2. Scherbak V.I., Krivotsyuk V.I. Optical measuring processors and their metrological support. M.: Publishing House of Standards, 1992, p. 54-76.

3. Luzyanin AG, "Non-invasive method for determining hemodynamic parameters in biological objects and a device for its implementation", RF patent No. 2127999, 01.24.1997.

Claims (7)

1. The method of medical non-invasive diagnosis of patients, which consists in measuring at the diagnostic point of biophysical parameters of at least one patient, converting the measurement results into an electrical signal transmitted to a single system for processing and accumulating information, recording in it the results of measurements of biophysical parameters of at least one patient taking into account his identification data, analysis of the measurement results, after which, on the basis of the analysis, a diagnosis of at least one patient, they convert it into a feedback signal arriving at the diagnostic point, characterized in that in the diagnostic point for each patient a fixed list of biophysical parameters is measured and an informative vector of patient parameters is obtained, obtained as a result of the current diagnostic examination, the patient is examined periodically and the difference in the informative vectors of patient parameters as a result of the current and previous diagnostic examinations determine informati an explicit vector of deviation of parameters to determine the degree of change in the patient’s state, according to which the patient’s identification data and an informative vector reflecting the medical history and hereditary factors establish a diagnosis, and in case of insufficient information to uniquely determine the diagnosis, additional measurements of biophysical parameters are carried out in the diagnostic section , not included in the fixed list, form an additional informative vector of patient parameters and establish make a diagnosis taking it into account, registration of the results of measurements of biophysical parameters is carried out in a single register for all patients included in the medical support system. 2. The method according to claim 1, characterized in that in the case of revealing a patient’s disease in a single system for processing and accumulating information, a list of the necessary tools and treatment methods for the patient is determined in the form of an electronic document and transferred to the diagnostic point in the form of a prescription for organizing and conducting treatment and electronic prescriptions for the purchase of dosage forms and preparations. 3. The method according to claim 1, characterized in that the diagnostic examinations of the patient are carried out periodically at the diagnostic point, the frequency of the examination and the list of equipment necessary for monitoring the equipment are determined in accordance with the type of disease, the patient’s health status, his age, and in the case of a negative result the applied methods of treatment or the threat of harm to the patient’s health, in a single system for processing and accumulating information form a team to change the methods and forms of treatment in the form of electronic rotokola which is marked "urgent" is forwarded to the appropriate diagnosis point to changes in the patient's treatment process. 4. The method according to claim 3, characterized in that the results of the periodic diagnostic examination are documented in a single system for processing and accumulating information, taking into account the age, gender, diagnosis, time of recovery and the degree of negative impact on the main internal organs of the patient and on its basis determine the effectiveness of application medicines and medical forms for treating patients. 5. The method according to claim 1, characterized in that the first diagnostic examination of the patient is carried out as soon as possible from the date of his birth, and the diagnosis is established taking into account the medical data of all direct relatives on the patient’s maternal and paternal lines in the unified system for processing and accumulating information . 6. The method according to claim 1, characterized in that if a patient is diagnosed with a disease in a unified system of processing and accumulating information, his informative vector of parameters is compared with the data of previously detected and treated diseases, taking into account the patient’s age, gender, health status, and is established according to the results Comparison is the closest case, previously available in practice, and previously tested methods and means of treatment and control are used to treat the patient. 7. A system of medical non-invasive diagnosis of patients, containing m diagnostic points, which contains diagnostic equipment for non-invasive measurement of biophysical parameters of patients, a communication channel with a processing unit and information storage unit, a diagnostic evaluation unit, a control unit, information display and control, characterized in that all diagnostic equipment is connected to the corresponding inputs of the output adapter at each diagnostic point, and its output is connected by a duplex communication channel to the input a system apter, which is connected with the first input to the first input of the diagnostic evaluation unit and to the first input of the information processing and accumulation unit, the second output - to the first input of the additional patient condition monitoring unit, and the third output - to the fifth input of the information monitoring, control and display unit, to the second, third, fourth and fifth inputs of the information processing and accumulation unit, respectively, the second input of the diagnostic evaluation unit, the first input of the automatic method determination unit are connected means of treatment, the third input of the control unit, control and display of information and the second input of the unit for additional monitoring of the condition of patients, the third output of the unit for diagnostic evaluation, the second output of the unit for automatically determining methods and treatment and the third output of the unit for additional monitoring of the condition of patients are connected, respectively, to the first , the second and fourth inputs of the control unit, information management and display, diagnostic equipment for additional measurement of biophysical parameters h A communication channel is connected to the corresponding input of the unit for additional monitoring of the patient’s condition, the fifth output of the control unit, information management and display is connected to the third input of the input adapter, and the fourth output of the diagnostic evaluation unit is connected to the third input of the automatic determination of treatment methods and means.

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