Automated diagnostic system and method including multiple diagnostic modes

• US 6,730,027 B2
• Filed: 02/24/2003
• Issued: 05/04/2004
• Est. Priority Date: 02/14/2000
• Status: Expired due to Term

• Current Assignee: Healthways SC, LLC (Warner Bros. Discovery, Inc.)
• Original Assignee: First Opinion Corporation (Tivity Health, Inc.)
• Inventors: Iliff, Edwin C.
• Primary Examiner(s): Hindenburg, Max F.
• Assistant Examiner(s): ASTORINO, MICHAEL C
• Application Number:
  US10/374,007
• Publication Number:
  US 20030158468A1
• Time in Patent Office: 435 Days
• Field of Search: 600/300-301, 128/904, 128/920-925, 705/2-4, 702/19, 706/924, 434/262-265, 434/236-238
• US Class Current: 600/300
• CPC Class Codes: A61B 5/0002 Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network A61B5/07 takes precedence; transmission systems for measured values G08C; transmission H04B; transmission of digital information H04L; wireless communication networks H04W
• CPC Class Codes: G16H 10/20 for electronic clinical trials or questionnaires
• 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
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 70/60 relating to pathologies
• CPC Class Codes: Y02A 90/10 Information and communication technologies [ICT] supporting adaptation to climate change, e.g. for weather forecasting or climate simulation
• CPC Class Codes: Y10S 128/904 Telephone telemetry
• CPC Class Codes: Y10S 128/92 Computer assisted medical diagnostics
• CPC Class Codes: Y10S 128/925 Neural network

Abstract

Structure-based processing includes a method of diagnosing diseases that works by arranging diseases, symptoms, and questions into a set of related disease, symptom, and question structures, such as objects or lists, in such a way that the structures can be processed to generate a dialogue with a patient. A structure-based processing system organizes medical knowledge into formal structures and then executes those structures on a structure engine to automatically select the next question. Patient responses to the questions lead to more questions and ultimately to a diagnosis. An object-oriented embodiment includes software objects utilized as active, intelligent agents where each object performs its own tasks and calls upon other objects to perform their tasks at the appropriate time to arrive at a diagnosis. Alternative symptoms, synergies, encoding of patient responses, multiple diagnostic modes, disease profiles or timelines, and the reuse of diagnostic objects enhance the processing of the system and method.

Claims

1. A system for automated medical diagnosis of a patient, the system comprising:

a first medical symptom element having an actual symptom weight for a first disease and an alternative symptom weight for a second disease;

a second medical symptom element having an actual symptom weight for the second disease; and

a function configured to apply the actual weight for the first medical symptom element to a first diagnostic score and the alternative weight to a second diagnostic score, wherein the first diagnostic score is associated with the first disease and the second diagnostic score is associated with the second disease, and

wherein the function continues diagnostic scoring by applying actual symptom weights for the second disease to the second diagnostic score.

2. The system defined in claim 1, wherein the first symptom element establishes the presence of a medical symptom.

3. The system defined in claim 1, wherein the first symptom element establishes the value of a medical symptom.

4. The system defined in claim 3, wherein the medical symptom includes a subjective symptom, a vital sign, a physical sign, a result of a lab test done by the patient, or a result of an imaging modality.

5. The system defined in claim 1, wherein the actual symptom weight for the second medical symptom element may be different than the alternative symptom weight for the first medical symptom element.

6. The system defined in claim 1, wherein the second medical symptom element is related to the first medical symptom element.

7. The system defined in claim 1, wherein the first symptom element is associated with one or more preferred questions and the second symptom element is associated with one or more alternative questions.

45. The system defined in claim 4, wherein the physical sign includes a result of performing a physical self examination.

8. A computerized system for diagnosis of a patient, the system comprising:

a list of diseases, each disease associated with a list of symptoms;

either the following two features;

a first function configured to automatically select a one of the symptoms to be a focus symptom based on a predetermined criteria; and

a second function configured to evaluate the focus symptom so as to establish the focus symptom, wherein the established symptom contributes a weight to diseases having the established symptom;

or the following two features;

a third function configured to automatically select a one of the symptoms to be a focus symptom from the list of symptoms associated with a selected one of the diseases; and

a fourth function configured to evaluate the focus symptom to establish the focus symptom, wherein the established symptom contributes a weight to at least the selected disease having the established symptom; and

a fifth function configured to selectively repeat b) and c) or d) and e) until accumulated weights for a disease reach or pass a threshold so as to declare a diagnosis.

9. The system defined in claim 8, wherein each symptom is associated with one or more questions, formulas, or logic structures.

10. The system defined in claim 8, wherein the predetermined criteria includes a prevalence of the symptoms in the diseases.

11. The system defined in claim 8, wherein one of the diseases is selected when a condition is satisfied, and wherein the selectively repeating continues with d) and e).

12. The system defined in claim 11, wherein the condition comprises a preselected percentage of a disease threshold.

13. The system defined in claim 11, wherein the condition comprises a diagnostic momentum of the accumulated weights for a disease.

14. The system defined in claim 11, wherein the condition comprises a particular response by the patient.

15. The system defined in claim 8, wherein each function is a software code portion.

16. The system defined in claim 8, wherein the second and fourth functions are the same.

17. A computerized system for diagnosing the medical problem of a patient, the system comprising:

a list of diseases, each disease being associated with a list of symptoms;

a first function, in a first mode, configured to select a subset of diseases having shared symptoms from the list of diseases;

a second function configured to evaluate at least one of the shared symptoms;

a third function configured to switch the first function from the first mode to a second mode based on the evaluation of the shared symptoms, wherein a particular disease is selected;

a fourth function configured to select, in the second mode, symptoms associated with the particular disease, wherein at least one of the selected symptoms of the particular disease is evaluated; and

a fifth function configured to diagnose the medical problem of a patient based on the evaluating of the shared symptoms and the selected symptoms.

18. The system defined in claim 17, wherein the switch occurs when a criteria is met based on the evaluation of the shared symptoms.

19. The system defined in claim 18, wherein the criteria is based on an external request by a user.

20. The system defined in claim 18, wherein the criteria is based on a diagnostic score from the evaluation of the shared symptoms.

21. The system defined in claim 18, wherein the criteria is based on a diagnostic momentum from the evaluation of the shared symptoms.

22. The system defined in claim 18, wherein the criteria is based on a probability of diagnosis.

23. A system for automated medical diagnosis of a patient, the system comprising:

means for providing a first medical symptom element, the first medical symptom element having an actual symptom weight for a first disease and an alternative symptom weight for a second disease;

means for providing a second medical symptom element, the second medical symptom element having an actual symptom weight for the second disease;

means for applying the actual weight for the first medical symptom element to a first diagnostic score and the alternative weight to a second diagnostic score, wherein the first diagnostic score is associated with the first disease and the second diagnostic score is associated with the second disease; and

means for continuing diagnostic scoring by applying actual symptom weights for the second disease to the second diagnostic score.

24. The system defined in claim 23, wherein the first symptom element establishes the presence of a medical symptom.

25. The system defined in claim 23, wherein the first symptom element establishes the value of a medical symptom.

26. The system defined in claim 23, wherein the actual symptom weight for the second medical symptom element may be different than the alternative symptom weight for the first medical symptom element.

27. The system defined in claim 23, wherein the second medical symptom element is related to the first medical symptom element.

28. The system defined in claim 23, wherein the first symptom element is associated with one or more preferred questions and the second symptom element is associated with one or more alternative questions.

29. A computerized system for diagnosis of a patient, the system comprising:

means for providing a list of diseases, each disease associated with a list of symptoms;

either the following two features;

means for automatically selecting a one of the symptoms to be a focus symptom based on a predetermined criteria; and

means for evaluating the focus symptom to establish the focus symptom, the established symptom contributing a weight to diseases having the established symptom;

or the following two features;

means for automatically selecting a one of the symptoms to be a focus symptom from the list of symptoms associated with a selected one of the diseases; and

means for evaluating the focus symptom to establish the focus symptom, the established symptom contributing a weight to at least the selected disease having the established symptom; and

means for selectively repeating b) and c) or d) and e) until accumulated weights for a disease reach or pass a threshold so as to declare a diagnosis.

30. The system defined in claim 29, wherein each symptom is associated with one or more questions, formulas, or logic structures.

31. The system defined in claim 29, wherein the predetermined criteria includes a prevalence of the symptoms in the diseases.

32. The system defined in claim 29, wherein one of the diseases is selected when a condition is satisfied, and wherein the selectively repeating continues with d) and e).

33. The system defined in claim 32, wherein the condition comprises a preselected percentage of a disease threshold.

34. The system defined in claim 32, wherein the condition comprises a diagnostic momentum of the accumulated weights for a disease.

35. The system defined in claim 32, wherein the condition comprises a particular response by the patient.

36. A computerized system for diagnosing a medical problem of a patient, the system comprising:

means for providing a list of diseases, each disease being associated with a list of symptoms;

means for selecting, in a first mode, a subset of diseases having shared symptoms from the list of diseases;

means for evaluating at least one of the shared symptoms;

means for switching from the first mode to a second mode based on the evaluating of the shared symptoms, wherein a particular disease is selected;

means for selecting, in the second mode, symptoms associated with the particular disease;

means for evaluating at least one of the selected symptoms of the particular disease; and

means for diagnosing the medical problem of a patient based on the evaluating of the shared symptoms and the selected symptoms.

37. The system defined in claim 36, wherein the switching from the first mode to the second mode occurs when a criteria is met based on the evaluating of the shared symptoms.

38. The system defined in claim 37, wherein the criteria is based on an external request by a user.

39. The system defined in claim 37, wherein the criteria is based on a diagnostic score from the evaluating of the shared symptoms.

40. The system defined in claim 37, wherein the criteria is based on a diagnostic momentum from the evaluating of the shared symptoms.

41. The system defined in claim 37, wherein the criteria is based on a probability of diagnosis.

42. The system defined in claim 36, wherein one of the symptoms includes a subjective symptom, a vital sign, a physical sign, a result of a lab test done by the patient, or a result of an imaging modality.

43. A system for automated patient diagnosis, the system comprising:

means for automatically asking a patient questions;

means for receiving answers from the patient;

means for using the answers to select a subset of possible diseases based on a chief complaint;

means for determining a first significant symptom of the patient; and

means for diagnosing a disease by asking questions associated with the symptoms of one of the selected diseases, wherein the selected disease includes the first significant symptom.

44. The system defined in claim 43, wherein the chief complaint is different from the first significant symptom.