Computer assisted method for the diagnosis and treatment of illness

• US 5,993,386 A
• Filed: 07/15/1997
• Issued: 11/30/1999
• Est. Priority Date: 07/15/1997
• Status: Expired due to Fees

• Current Assignee: Arthur Dale Ericsson
• Original Assignee: Arthur Dale Ericsson
• Inventors: Ericsson, Arthur Dale
• Primary Examiner(s): Swann, Toe R.
• Assistant Examiner(s): Smithers, Matthew
• Application Number:
  US08/893,026
• Time in Patent Office: 868 Days
• Field of Search: 705/3, 705/2, 600/300, 600/301, 600/513
• US Class Current: 600/300
• CPC Class Codes: A61B 5/00 Measuring for diagnostic purposes radiation diagnosis A61B6/00; diagnosis by ultrasonic, sonic or infrasonic waves A61B8/00; Identification of persons
• CPC Class Codes: A61B 5/411 Detecting or monitoring allergy or intolerance reactions to an allergenic agent or substance
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 15/00 ICT specially adapted for medical reports, e.g. generation or transmission thereof

Abstract

A computerized technique for performing a medical outcomes analysis is disclosed including methods for quantifying a patients state of health to facilitate an increased quality of patient care and improving diagnostic techniques.

Claims

1. A method for using a computer to monitor the diagnosis and treatment of illness, said method comprising

evaluating a patient;

determining a first state of health for the patient at a first time,

assigning a first numeric value to the first state of health for the patient and inputting such value to the computer,

estimating an expected second state of health for a patient at or near a second time, wherein the expected second state of health can be the same as or different from the first state of health,

assigning a numeric value to the expected second state of health and inputting such value to the computer,

determining an actual second state of health for the patient at or near the second time,

assigning a second numerical value to the actual second state of health for the patient and inputting such value to the computer,

establishing, by use of the computer, a numeric value representative of error between the

expected second state of health and the actual second state of health according to a predetermined relationship between the numeric value assigned to the expected second state of health and the numeric value assigned to the actual second state of health,

wherein the numeric values are selected from a range of numeric values which increase or decrease from a value corresponding to dead at one end of the range to normal at the other end of the range, and

wherein the numeric value representative of error quantifies an outcome useful for evaluating the diagnosis and treatment of the patient.

2. A method as in claim 1 wherein the numeric value for state of health increases or decreases from dead at one end of the range to normal at the other end of the range according to the criteria shown in the following Table:

space="preserve" listing-type="tabular"> TABLE __________________________________________________________________________STATES OF HEALTH State of Health Criteria __________________________________________________________________________dead Lifeless moribund support mandatory, progressing rapidly pre-moribund Very sick, active support necessary. Severe signs and/or symptoms of disease. Laboratory tests abnormal. Severely Disabled critically unstable, hospitalization indicated, laboratory abnormal. Death is not imminent. Disabled requiring of special care and assistance. Signs and symptoms severe, laboratory abnormal. moderately disabled clinical signs and symptoms of disease, requires assistance and frequent medical care, laboratory abnormal mildly disabled clinical signs and symptoms of disease, requiring of some assistance, able to care for needs, laboratory abnormal impaired clinical signs and symptoms of disease, cares for self needs, Unable to perform normal activity, laboratory abnormal mildly impaired some clinical signs and symptoms of disease, able to carry on normal activity with effort, laboratory may be abnormal pre-impaired minor clinical signs and symptoms of disease, able to carry on normal activity, laboratory may be abnormal abnormal appears normal, no complaints, no clinical evidence of disease, laboratory may be abnormal normal Normal, no complaints, no evidence of disease, clinical and laboratory normal. __________________________________________________________________________

3. A method as in claim 2 wherein the numeric values assigned to state of health incrementally increase from dead to normal.

4. A method as in claim 2 wherein the numeric values assigned to state of health incrementally decrease from dead to normal.

5. A method as in claim 2 wherein the numeric values assigned to state of health are assigned by a computer based on a user input.

6. A method as in claim 1 further comprising

formulating a diagnosis for the patient,

selecting an intervention plan for the patient which is appropriate for the diagnosis, and

executing the intervention plan prior to the second time.

7. A method as in claim 6 further comprising

estimating the expected second state of health based in part on a presumed correctness of the diagnosis.

8. A method as in claim 6 further comprising

estimating the expected second state of health based in part on a presumed effectiveness of the intervention plan.

9. A method as in claim 6 further comprising

estimating the expected second state of health based in part on a presumed correctness of the diagnosis and a presumed effectiveness of the intervention plan.

10. A method as in claim 1 further comprising

estimating an expected second state of health for a patient at or near a second time, wherein

the expected second state of health can be the same as or different from the first state of health.

11. A method as in claim 6 further comprising

inputting into a computer a code representative of the identity of the patient,

inputting into a computer a code representative of the diagnosis for the patient, and

inputting into a computer a code representative of the intervention plan for the patient.

12. A method as in claim 11 further comprising

inputting into a computer a code representative of the costs of formulating the diagnosis for the patient, and

inputting into a computer a code representative of the costs of executing the intervention plan.

13. A method as in claim 12 further comprising

inputting into a computer a code representative of the identity of a physician who has formulated the diagnosis, and

inputting into a computer a code representative of the identity of a physician who has formulated the intervention plan.

21. A method as in claim 6 further comprising

performing a diagnostic test on the patient,

obtaining a positive test result from the diagnostic test;

and

determining a probability that the formulated diagnosis for the patient is correct.

22. A method as in claim 21 wherein probability is estimated based on a Chi Square analysis.

23. A method as in claim 22 wherein the Chi Square analysis is performed by computer based on data obtained from a population of patients characterized by the same set of determinations of whether the onset of the disease indicator was acute, subacute or chronic, whether the disease indicator has followed an abated, progressive or static course, and whether the disease indicator is focalized, multifocal or diffuse.

24. A method as in claim 22 further comprising inputting into the computer codes representative of a specific diagnostic test, the results of the specific diagnostic test, positive or negative, for each patient, and code representative of a determination of whether the test results were true positive, false positive, false negative, or true negative.

25. A method as in claim 21 wherein the probability is determined according to the formula

26. A method as in claim 25 wherein D+ is estimated based on the incidence of the disease in question among a large population of patients having similar signs and symptoms.

27. A method as in claim 26 wherein D+ is estimated from a computerized database.

28. A method as in claim 21 further comprising

inputting into a computer a code representative of the identity of a physician who has formulated the diagnosis.

29. A method as in claim 24 further comprising inputting into the computer codes representative of the numerical value of the results of a specific diagnostic test, accumulating in the computer a database of numerical test results and their classification as true positive, false positive, false negative, and true negative;

calculating from the database the numerical results of a particular test which is required to provide a predetermined certainty of result for a patient having a selected set of characterizing data; and

characterizing the actual test results for a particular patient as positive or negative in comparison to the calculated number.

14. A method for using a computer to monitor the diagnosis and treatment of illness of a patient, wherein the patient displays a disease indicator, said method comprising

evaluating the patient,

determining whether the onset of the disease indicator was acute, subacute or chronic,

determining whether the disease indicator has followed an abated, progressive or static course,

determining by examination whether the disease indicator is focalized, multifocal or diffuse,

determining a first state of health for the patient at a first time

assigning a first numeric value to the first state of health for the patient and inputting such value to the computer,

estimating an expected second state of health for a patient at or near a second time, wherein the expected second state of health can be the same as or different from the first state of health,

assigning a numeric value to the expected second state of health and inputting such value to the computer,

determining an actual second state of health for the patient at or near the second time,

assigning a second numerical value to the actual second state of health for the patient and inputting such value to the computer,

establishing, by use of the computer, a numeric value representative of error between the expected second state of health and the actual second state of health according to a predetermined relationship between the numeric value assigned to the expected second state of health and the numeric value assigned to the actual second state of health,

wherein the numeric values are selected from a range of numeric values which increase or decrease from a value corresponding to dead at one end of the range to normal at the other end of the range, and

wherein the numeric value representative of error quantifies an outcome useful for evaluating the diagnosis and treatment of the patient.

15. A method as in claim 14 further comprising, assigning, for a patient which displays a disease indicator, at least one disease pathogenesis possibility based on the determinations of whether the onset of the disease indicator was acute, subacute or chronic, whether the disease indicator has followed an abated, progressive or static course, and whether the disease indicator is focalized, multifocal or diffuse, as given by the following Table:

space="preserve" listing-type="tabular"> TABLE ______________________________________ DISEASE PATHOGENESIS POSSIBILITIES ONSET COURSE EXAM PATHOGENESIS ______________________________________ Acute abated focalized infectious, traumatic, vascular Multifocal infectious Diffuse infectious Progressive focalized infectious, allergic, iatrogenic Multifocal infectious, allergic Diffuse infectious, external toxin, allergic Static focalized infectious Multifocal infectious Diffuse infectious Subacute abated focalized infectious, electrophysiological Multifocal infectious Diffuse infectious Progressive focalized infectious, allergic, autoimmune, neoplasm, iatrogenic, electrophysiological Multifocal infectious, allergic, autoimmune, neoplasm, idiopathic Diffuse infectious, external toxin, metabolic, allergic, idiopathic Static focalized infectious, electrophysiological Multifocal infectious Diffuse infectious Chronic abated focalized infectious, electrophysiological Multifocal infectious Diffuse infectious Progressive focalized infectious, degenerative, autoimmune, neoplasm, electrophysiological Muitifocal infectious, degenerative, autoimmune, neoplasm, idiopathic Diffuse infectious, hereditary/genetic, external toxin, metabolic, idiopathic Static focalized infectious, electrophysiological Multifocal infectious Diffuse infectious, hereditary/genetic. ______________________________________

16. A method as in claim 15 wherein the at least one disease pathogenesis possibility is assigned by a computer based on user input of codes representative of the onset of the disease indicator was acute, subacute or chronic, whether the disease indicator has followed an abated, progressive or static course, and whether the disease indicator is focalized, multifocal or diffuse.

17. A method as in claim 16 further comprising

inputting into a computer a code representative of the diagnosis for the patient,

associating such code representative of the diagnosis for the patient with a disease pathogenesis selected from the group consisting of hereditary/genetic, infectious, traumatic, toxic (external), metabolic (internal), vascular, degenerative, allergic, autoimmune, neoplasm, idiopathic, iatrogenic, and electrophysiological, by use of the computer,

assigning a disease pathogenesis to the diagnosis for the patient by use of the computer,

comparing the assigned disease pathogenesis with the at least one disease pathogenesis possibility, and

generating an output from the computer listing any disease pathogenesis possibility which is different from the assigned disease pathogenesis.

18. A method as in claim 16 further comprising

inputting into a computer a code representative of the diagnosis for the patient,

associating such code representative of the diagnosis for the patient with a disease pathogenesis selected from the group consisting of hereditary/genetic, infectious, traumatic, toxic (external), metabolic (internal), vascular, degenerative, allergic, autoimmune, neoplasm, idiopathic, iatrogenic, and electrophysiological, by use of the computer,

associating the disease pathogenesis with at least one outcome possibility given by the following Table:

space="preserve" listing-type="tabular"> TABLE ______________________________________ OUTCOME POSSIBILITIES BETTER UNCHANGED WORSE ______________________________________ hereditary/genetic infectious infectious Infectious traumatic Toxic (external) Toxic (external) Metabolic (internal) Metabolic (internal) Vascular Degenerative Allergic Autoimmune Neoplasm Idiopathic Iatrogenic Electrophysiological electrophysiological ______________________________________

and estimating the expected second state of health based in part on the at least one outcome possibility.

19. A method as in claim 18 further comprising

determining whether the actual second state of health is better, unchanged or worse than the first state of health,

associating the determination of whether the actual second state of health is better, unchanged or worse than the first state of health with a plurality of disease pathogenesis possibilities from the Table of Outcome Possibilities,

generating an output from the computer of disease pathogenesis possibilities from the Table of Outcome possibilities which are different from the disease pathogenesis of the diagnosis.

20. A method as in claim 19 further comprising

generating an output from the computer of disease pathogenesis possibilities generated from the Table of Outcome possibilities which are different from disease pathogenesis possibilities derived from the Table of Disease Pathogenesis Possibilities.