The present invention relates generally to computer software and more particularly to software tools for analyzing voluminous electronic medical records (EMRs) or electronic health records (EHRs) sourced from numerous sources across multiple geographic regions for intelligent medical processing in optimizing the treatment of patients and in generating computer-generated medical treatment plans.
Healthcare is undergoing a major transformation with technology as one of the underpinning forces. Electronic medical records have largely been segregated by different affiliated hospitals, clinics, and doctor's offices and clinics within a geographical territory and by partnership or national government regulations, not to mention the complexity in sharing patient information across geographical boundaries. In the software analytic context, these electronic medical data may be considered as unstructured data, as there are many disparate formats or and types of data that are not integrated and analyzed. The critical analysis of mass electronic medical records to determine patterns and statistical evidence associated with medical treatments and outcomes could have a huge positive impact on the treatment of patients.
Both the medical industry and patients would benefit greatly from the computerized analysis of medical records, which contain significant, real world data regarding diagnoses, treatments, and patient outcomes. Modern medical information, such as medical records, remain vastly segregated by institutions, affiliations, locations, geographies, and regions. Often, doctors will diagnose and treat a patient based on information provided by the patient and the doctor's own experience rather than on statistical evidence showing how similar patients were treated and the outcomes from such treatment. One reason for this is that doctors have relatively limited access to patient information beyond their practice and the published literature. The collective wisdom of doctors' diagnoses and recommended treatment plans on a nationwide, international, or worldwide basis has not been collected, analyzed, and used to provide an practical, evidenced based approach to treating patients.
Accordingly, it is desirable to have a system and method for computationally analyzing a mass amount of medical data from different sources across multiple geographic regions to improve the treatment of patients and develop recommended treatment plans for patients. This system and method could be used to analyze treatments and medical outcomes for patients with particular diseases, which would allow doctors to base their treatment decisions on computational and statistical evidence showing how similar patients were treated and the outcomes from such treatment.
Embodiments of the present disclosure are directed to computer-intensive probabilistic global medical data methods, systems, and computer program products for optimizing a patient treatment plan for a particular symptom, disease, or patient profile by analyzing, classifying, and matching and degrouping a mass amount of electronic medical records from a large array of medical sources in the same region or across different geographical regions. The global medical data analysis computer system comprises a medical main server that includes an intelligent medical engine for optimizing the treatment plan process. The global medical data analysis computer system is communicatively coupled to a central database, a confidential personal database, and further communicatively coupled through a network to one or more of the following: hospitals, academic medical centers, clinics, and other sources of medical data. The intelligent medical engine may receive voluminous medical records globally from different countries, regions, and continents. The electronic medical records, which are sourced from hospitals, academic medial centers, clinics, and other medical sources around the world, are fed into the intelligent medical engine for large-scale computational analysis and correlation with one or more of patients' medical records. The intelligent medical engine includes a store module, an analytical module, a classification component, a matching module, a learning module, an input data module, and a display module. The intelligent medical engine incorporates a learning module for interactively processing and learning of the patient's and other electronic medical records and the prescribed treatment plans over time for optimizing the recommended treatment protocol.
The intelligent medical engine is configured for degrouping (also referred to as “filtering”) of a patient's symptom, disease, or patient profile against a large amount of electronic medical records. Degrouping means finding meaningful subgroups (subsets) of a group of patients which share the same or similar values on one or more clinical parameters and who have the same or similar medical outcome to a given treatment. In one embodiment, the filtering process, or degrouping process, comprises multiple levels of filters as a mechanism to reduce the number of related electronic medical records into smaller subgroups whose members share at least some clinical parameters, diseases, and/or treatment outcomes. For example, the degrouping of the existing electronic medical records against a patient's electronic medical record (including symptoms or disease) can include a first level filter using one or more significant parameters associated with the patient's disease to produce one or more first subgroups of similarly matched electronic medical records. At the second level filter, as a method to further reduce the number in the one or more first subgroups, the degrouping method filters the one or more first subgroups against the patient's electronic medical records by using side disease, chronic disease, complication parameters to produce one or more second subgroups (which may be equal but typically less than the first subgroup) of similarly matched patient electronic records. At the third level filter, the degrouping method further filter the one or more second subgroups by using the third set of parameters to produce one or more third subgroups (which may be equal but typically less than the second subgroup). At the fourth level filter, the degrouping method could further scale down the number of electronic medical records in the one or more third subgroups by using the fourth set of parameters, such as lifestyle parameters, (e.g., eating habits, exercise routine, smoker, overweight, stress, etc.) to produce one or more fourth subgroups (which may be equal but typically less than the third subgroup) of similarly matched patient electronic records. Additional degrouping levels are possible to reduce the number of similar matching subgroups to produce a desirable number in the subgroup relative to the patient's particular disease or symptoms in order to create a computer-generated the treatment protocol based on the computational analysis if the medical data. In general, degrouping results in a smaller set of items than those before the degrouping operation as additional criteria are added which have to be met by the items in the degrouped subset.
Degrouping methods can be implemented with respect to significant and indirect variables (also referred to as “parameters”), variables over a period of time (on a two-dimensional graph), two or three-dimensional images (e.g., X-Ray, MRI, CT scan images), or any combination of the above. In one embodiment, a degrouping method filters other patients' objective medical data from a database with a particular patient's objective medical data by using significant variables at a first level degrouping and indirect variables at a second level degrouping. In another embodiment, another degrouping method compares how the significant parameters evolve over time associated with a patient's objective medical data with other patients' objective medical data on the same significant parameter over the same period of time. Any meaningful deviation from one of the significant parameters over a specified time period, between the patient's objective medical data and other objective medical data, may provide the basis for degrouping that particular subgroup from the patient's objective medical data. In a further embodiment, an alternate degrouping method filters subgroups by comparing the patient's objective medical data, which includes illustrating the significant parameters in three-dimensional organ images, with other patients' objective medical data, which includes illustrating the significant parameters in three-dimensional organ images.
The collection and analysis of mass amount of patients' objective medical data, wherein each of a patient's objective medical data can include a standardized electronic medical record without the patient's confidential information, such as a social security number. The use of objective medical data also alleviates some privacy concerns because a person's confidential information is not revealed. The standardization of objective medical data enables the intelligent medical engine to process, correlate, analyze, and match voluminous electronic medical data sourced from medical hospitals, academic medical centers, clinics, and other sources of medical data. The standardization of objective medical data refers to any structure for consistently classifying or categorizing clinical parameters in a manner allowing the objective medical data to be stored, organized, and searched in a database format. Transformation of objective medical data can occur at different junctures of the process including, for instance, when a patient's objective medical data and the associated code are transmitted from a hospital to the intelligent medical engine, during the modification of the patient's medical data in the degrouping process, etc.
Numerous real-world applications of the standardized objective medical data and degrouping method implemented on an intelligent medical engine are feasible. One application would involve a physician using the devices and method of the invention to develop a treatment plan based on the medical outcomes of other patients with the same disease and significant medical parameters. In another application, a general physician places a disease capsule at his or her office to conduct an annual or regular medical examination (or annual checkup) by having a patient lie down on a platform for moving into the disease capsule in order to perform various medical readings for subsequent use in comparing with the patient's medical data stored in the intelligent medical engine. In a second application, a wearable device is placed on a patient for monitoring and treating the patient. The wearable device has a synthetic vessel or a port that is connectable to the patient for monitoring the patient's condition, injecting medication into the patient, or extracting blood from the patient. For example, a medical device is implanted underneath the patient's skin, which has one end connected to a blood vessel and another end connected to a female connecter, where a female connecter has a surface enclosure (also referred to as a valve, which the female connector is closed when not in use) to place an external male connecter into the female connecter to extract blood. The surface enclosure ensures that the blood and other fluids are contained within the patient's body. A patient's condition is continuously monitored by the wearable device, which transmits the patient's medical conditions to the intelligent medical engine for alerting a doctor, hospital, or ambulance when necessary. Other embodiments of the wearable device include embedding one or more sensors on a garment or underwear for wireless communication with a wearable mobile device.
Broadly stated, a computer-implemented method for processing electronic medical records, comprises storing a plurality of objective medical data for a plurality of patients, each patient's objective medical data being structured into multiple elements for use in storing the objective medical data, each patient's objective medical data containing at least parameters of the patient, diseases of the patients, treatments that the patient underwent and outcomes of the treatments; degrouping the plurality of patients' objective medical data to classify the plurality of objective medical data into subgroups, the classifying step including at least one level of classifications based on each patient's parameters, disease, and treatment that each patient underwent for the disease, and the outcome of the treatment, iteratively repeating the process, once for each subgroup in each level, until a set of subgroups smaller than the previously generated subgroups are identified wherein the patients in the smaller subgroups have substantially similar clinically-relevant parameters and substantially similar outcomes; receiving a new patient's disease template with the new patient's objective medical data based on the patient's disease, the new patient's template including at least the clinically-relevant parameters of the new patient, and at least one disease of the new patient; and matching the new patient's parameters and disease to the corresponding parameters and disease of the degrouped subgroups to select the most similar ones and determine the likely outcomes of potential treatments for the new patient based on the outcomes of treatments for the patients in the subgroups.
The structures and methods of the present disclosure are disclosed in the detailed description below. This summary does not purport to define or limit the invention in any way. The invention is defined by the claims. These and other embodiments, features, aspects, and advantages of the invention will become better understood with regard to the following description, appended claims, and accompanying drawings.
The invention will be described with respect to specific embodiments thereof, and reference will be made to the drawings, in which:
A description of structural embodiments and methods of the present invention is provided with reference to
The following definitions apply to the elements and steps described herein. These terms may likewise be expanded upon.
Course of Treatment—refers to a prescribed regimen, therapy, or other treatment for a patient's medical condition. The course of treatment includes the treatment protocols and treatment plans for the patient.
Degroup—refers to the method of separating a group of patients (or the electronic medical records corresponding to patients) into subgroups based on finding patients with shared values of one or more parameters (e.g. age, gender, weight, cholesterol level, blood glucose level, white-cell count, etc.) and who have resulted in the same or similar response to at least one treatment (e.g. to a statin drug treatment, or to chemotherapy regimen targeted at reducing tumor diameter, etc.).
Diagnosis—refers to any medical classification of any medical condition, infectious disease, mental illness, or other condition or illness, including chronic illnesses. Examples of diagnoses include diabetes, cancer, heart disease, atherosclerosis, stroke, etc.
Significant parameters (also referred to as “direct parameters”)—refers to parameters of each disease according to World Health Organization (WHO) classification that are known in medical field as predicting, affecting, or resulting from the treatment, prognosis, and progression of the patient's medical condition or disease.
Indirect parameters (also referred to as non-significant parameters)—refers to parameters, other than the direct parameters, of each disease according to World Health Organization classification that are relevant to disease, prognosis, and treatment of the patient's medical condition or disease.
Objective Medical Data—refers to objective data regarding a patient's medical history and medical condition. Objective medical data includes, but is not limited to, a patient's symptom, disease (if applicable), patient's profile, medical history, medical equipment examination data, lab results, lifestyle habits, but excluding information that would reveal the identity of the patient, for example, the patient's legal name, social security number, fingerprints, etc. Objective medical data can be a material part of an emerging standard like Good Data Collection and Recording Practice (GDCRP).
Patient Disease Template—refers to a collection of the parameters relevant to disease, prognosis, and treatment of a patient's medical condition(s) or disease according to the International Classification of Diseases (ICD), www.who.int/classifications/icd/en, by World Health Organization.
Recommended Treatment Protocol(s)—refers to result of processes performed by software based on one or more sets of criteria in analyzing and choosing among different selected treatment protocols.
Second Level Parameters—refers to a second set of parameters used in the degrouping process. These parameters can include parameters relating to potential or actual complications associated with a disease, parameters relating to side or chronic diseases, parameters relating to other medical conditions or diseases of the patient, and parameters relating to cellular and genetic markers of a medical condition or disease (e.g., tumor markers, genetic markers, particular molecules expressed by particular cell lines, etc.).
Standardized Clinical Form—refers to a form used to collect objective medical data for an individual patient.
Standard Treatment Protocol—refers to a medical treatment course (e.g. therapies, medications, or other treatments) generally accepted in the medical profession for the treatment of a patient with a particular disease
Treatment Plan—refers to a set of one or more treatment protocols over a period of time.
The present disclosure provides methods for compiling and storing medical records and for utilizing the electronic medical records for identifying a course of treatment for a patient based on stored data for other patients as well as diagnosing, treating, and/or monitoring the patient's medical conditions and disease. In the invention, the electronic medical records can be accessed easily and instantly by health care providers globally. The electronic medical records enable health care providers to develop treatment plans for patients, reduce misdiagnosis, improve quality of service, improve medical outcomes of patients, and control medical costs.
The present disclosure involves methods of obtaining, assembling, utilizing, and storing medical records of patients that can be accessed by health care providers and patients globally with ease. The electronic medical records are sortable and searchable electronically and instantaneously. The compiled medical records enable health care providers to diagnose, treat, and/or monitor or track medical diseases or conditions of various patients. Moreover, the patients can access their information and monitor their conditions.
The present disclosure provides a method for diagnosing and identifying an appropriate course of treatment for a patient. The method includes obtaining and inputting information regarding a patient's existing symptoms into the computer system. In one embodiment, the disease and course of treatment are based on the patient's existing symptoms and conditions entered into the computer system and the patient's medical history already in the computer system and on stored data for other patients with similar medical history, symptoms, and diseases. The computer system outputs the disease and recommended course of treatment based on the entered information and the iterative process of comparing with stored objective medical data obtained for other patients. The computer system can generate output information that requires further analysis, request additional information and/or medical tests, as well as requiring inputting information by consulting other health care providers or specialists.
New medical procedures are often developed for treating patients that can at a minimum improve a patient's quality of life during the course of treatment, if not treat and cure the patient. However, new medical procedures are not acceptable unless there is data to support their effectiveness. Such data can be compiled and stored in the computer system and made accessible to all health care providers. The data would be considered supporting evidence of effectiveness of a new medical procedure for consideration by other health care providers for use in treating other patients.
The present disclosure provides a method of monitoring and/or tracking a patient's symptoms, diseases, and the progress with a course of treatment prescribed by the health care provider. When a patient begins a treatment plan, it is necessary to monitor the patient to assess the patient's response to the treatment plan. Sometimes it is necessary to monitor the patient to determine whether the patient is allergic to a therapeutic agent. Alternatively, when a disease cannot be made or a course of treatment cannot be identified without additional medical information from a patient, it is necessary to monitor and/or track a patient's symptoms or conditions, so that an appropriate disease can be made and/or a course of treatment can be identified. The patient's information can be entered and accessed instantaneously by the patient. As an example, a patient with cardiovascular disease can obtain his blood pressure daily and enter it into the computer system and a health care provider can easily access the blood pressure of the patient. Also, once a course of treatment has been identified, the health care provider can easily access the blood pressure of a patient during the entire course of treatment.
Often during the course of treatment, a patient may be treated by various health care providers. For example, a patient may be seen by a primary physician, a specialist, a specialist at a specialized hospital, and a physician for follow-up care or at a rehabilitation center. In one embodiment, the present disclosure provides a method of accessing the entire medical history of the patient by any health care provider or the patient directly and instantly.
During the course of treatment, the information collected relating to a patient's condition at each visit to a health care provider's office is entered into the computer system and stored. In another embodiment, the present disclosure provides a method of monitoring a patient's progress and quality of life through the course of treatment by any health care provider. The disclosed method maximizes the capture of data and reduces the loss of data during the course of treatment, which enables enhanced follow-up care and improves quality of life and medical outcomes for the patient.
The present disclosure provides methods of assessing the risk of a subject/patient in developing a disease or condition in the future or in having a disease or condition recur during or after treatment (with time). Information, such as family medical history and subject's medical history can be inputted into the computer system for estimating the subject's risk for developing a disease or condition in the future. Based on the assessment, the health care provider can recommend a specific therapeutic agent, a change in diet, weight loss, and exercise for preventing the development of the disease or condition. For example, an asymptomatic subject with a family history of heart disease, is characterized as follows: high blood pressure, a high total cholesterol level (over 370 mg/dl (milligrams per deciliter)), a high LDL level (above 100 mg/dl), and a high triglyceride level (above 100 mg/dl), and overweight. These factors are inputted into the computer system as parameters for iterative comparison with the stored data of similar patients. The computer system can estimate the risk of the asymptomatic subject in developing a heart disease in the future. The computer system compares the information of the asymptomatic subject with the medical information of other patients with similar factors and through the process of degrouping provides an estimate of risk of the subject in developing a heart disease. Based on the risk assessment, the health care provider can recommend taking Lipitor or other cholesterol lowering medication and changing lifestyle, such as exercising and reducing the amount of cholesterol consumed in the subject's diet.
The present disclosure also provides methods of assessing a patient's prognosis as the patient's medical data is inputted into the computer system while undergoing treatment. The patient's medical data is compared with information of other patients and through the process of degrouping provides the prognosis of the patient's disease or condition. Likewise, the present disclosure provides methods of assessing the recurrence of a patient's disease or condition during or subsequent to treatment. The patient is monitored, and the patient's medical information is inputted into the computer system regularly, compared with the medical information of other patients, and through the process of degrouping, an assessment of the recurrence of potential disease or condition is provided. As an example, a cancer patient in remission may be monitored by the methods provided herein and assessed for recurrence of cancer with time.
The methods provided herein can be dynamic in that the patient's medical data can be gathered and inputted into the computer system regularly for comparison with the medical information of other patients. Through the process of regular degrouping, the treatments for the patient can be modified to provide the optimal course of treatment.
The methods described herein can be used to diagnose, treat, identify a course of treatment for and/or monitor any medical disease or condition. Examples of such medical diseases or conditions include, but are not limited to, allergies, autoimmune diseases, bacterial diseases, viral diseases, endocrine diseases, cancer, cardiovascular diseases, pregnancy, psychological and mental disorders, and neurological diseases. Examples of specific diseases conditions include but are not limited to cholera, diphtheria, lyme disease, tetanus, tuberculosis, typhoid fever, hepatitis, measles, mumps, ebola, dengue fever, yellow fever, Addison's disease, hyperthyroidism, lupus, septic shock, hemodynamic shock, malaria, inflammatory bowel diseases (IBDs) such as Crohn's disease and ulcerative colitis, inflammatory bone diseases, mycobacterial infections, meningitis, fibrotic diseases, ischemic attack, transplant rejection, atherosclerosis, obesity, diseases involving angiogenesis phenomena, autoimmune diseases, osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, juvenile chronic arthritis, multiple sclerosis, HIV, non-insulin-dependent diabetes mellitus, allergic diseases, asthma, chronic obstructive pulmonary disease (COPD), stroke, ocular inflammation, inflammatory skin diseases, psoriasis, atopic dermatitis, psoriatic arthritis, bipolar disorder, schizophrenia, cold, and flu.
Examples of cancer include but are not limited to lung cancer, breast cancer, leukemia, prostate cancer, ovarian cancer, pancreatic cancer, liver cancer, skin cancer, and colon cancer.
Examples of neurological diseases include but are not limited to Alzheimer's disease, Parkinson's disease, Parkinsonian disorders, amyotrophic lateral sclerosis, autoimmune diseases of the nervous system, autonomic diseases of the nervous system, dorsal pain, cerebral edema, cerebrovascular disorders, dementia, nervous system nerve fiber demyelinating autoimmune diseases, diabetic neuropathies, encephalitis, encephalomyelitis, epilepsy, chronic fatigue syndrome, giant cell arteritis, Guillain-Barre syndrome, headaches, multiple sclerosis, neuralgia, peripheral nervous system diseases, polyneuropathies, polyradiculoneuropathy, radiculopathy, respiratory paralysis, spinal cord diseases, Tourette's syndrome, central nervous system vasculitis, and Huntington's disease.
The intelligent medical engine 14 receives voluminous sets of electronic medical records (each medical record includes a patient code and objective medical data) 50, 52, 54, 56 globally from different countries, regions, and continents. The sets of electronic medical records 50, 52, 54, 56 are sourced from hospitals 20, 22, one or more clinics 24, and other medical sources 26 around the world, which are fed into the intelligent medical engine 14 for large-scale analysis and correlation of patients' medical records. The intelligent medical engine 14 is configured to receive one or more electronic medical records, such as those that originated from the sets of electronic medical records 50, 52, 54, and/or 56. In one embodiment, each of the sets of electronic medical records 50, 52, 54, and 56 includes a code (also referred to as a “patient code”) and objective medical data. In one embodiment, objective medical data includes all of a patient's medical information with verification process and quality checking, such as a patient's symptom, disease (if applicable), patient's profile, medical history, medical equipment examination data, lab results, lifestyle habits, but excluding information that would reveal the identity of the patient, for example, the patient's legal name, social security number, fingerprints, etc. The intelligent medical engine 14 is configured to perform analytical processes on the received electronic medical records by comparing, based on a set of parameters, the electronic medical records with the data that has previously been stored in the central database 16. The outcome of the analysis can be stored in the central database 16 or sent back to a doctor, nurse, or medical personnel in the first hospital 20, the second hospital 22, the clinic 24, or the source 26.
At step 88, the intelligent medical engine 14 is configured to receive and extract a particular patient's object medical data (or the patient's standardized template information) received from a sender, such as the first hospital 20, the second hospital 22, the clinic 24, or the source 26. At step 103, the intelligent medical engine 14 is configured to match the received patient disease template at step 88 and the small group with similar objective medical data in step 102 provides several different protocols that are available for possible treatment of the patient. From the small group of similar medical objective data, the intelligent medical engine 14 is configured to extract one or more treatment protocols and results, illustrated in step 104 with a first protocol and results, step 106 with a second protocol and results, and step 108 with N protocol and results. At step 110, the intelligent medical engine 14 is configured to compute and determine the most efficient protocol in each group from the different treatment protocols and results in steps 104, 106 and 108.
In an alternative embodiment, the degouping process may be executed in parallel with a patient's disease template. The intelligent medical engine 14 is configured to receive and extract a particular patient's object medical data (or the patient's standardized template information) received from a sender, such as the first hospital 20, the second hospital 22, the clinic 24, or the source 26. The intelligent medical engine 14 is configured to retrieve and extract a mass amount of other patients' objective medical data stored in the central database 16. The intelligent medical engine 14 is configured to compare some initial key parameters, such as the disease of the patient, in the patient template and with the parameters of other patient's objective medical data to select a population of the objective medical data in the central database 16 that may be relevant to the received patient's objective medical data. The central database 16 stores a large volume of patients' objective medical data on a standardized format from patients globally. The intelligent medical engine 14 is configured to compare key parameters, such as main disease with an optional treatment protocol (if applicable), from the patient template with the parameters of the objective medical data from the central database 16 and to classify into subgroups. After a population of the objective medical data from the central database 16 has been identified, the analysis to match the patient template with the selected population of the objective medical data in order to degroup into subgroups is conducted through different levels, generally from more generic characteristics to detailed characteristics, such as comparisons starting with significant parameters, side diseases, chronic diseases, complication, indirect parameters, the patient's general condition and the lifestyle of a patient, and so on. At the first level comparison, the intelligent medical engine 14 is configured to compare a first set of significant parameters (also referred to as primary parameters) between the patient template and the subgroups to degroup into one or more first level subgroups. The significant parameters may relate to, for example, one or more main diseases, such as the different stages defined in a particular disease, from the objective medical data in the subgroups as classified. Degrouping is a process used to filter one or more first subgroup(s) and refine into another one or more second subgroup(s) based on a set of parameters. At the second level degrouping, the intelligent medical engine 14 is configured to compare a second set of parameters (also referred to as secondary parameters), such as second disease parameters (including side disease, chronic disease, and complication parameters), between the patient template and the first level subgroup(s) to degroup into one or more second level subgroups, which the one or more second level subgroups represent a reduction in the number of people from the one or more first level subgroups. At the third level degrouping, the intelligent medical engine 14 is configured to compare a third set of key parameters (also referred to as tertiary parameters), such as indirect parameters, between the patient template and the one or more second level subgroup(s) to degroup into one or more third level subgroups, which the one or more third level subgroups represent a reduction in the number of people from the one or more second level subgroups. Exemplary third-level parameters include a patient's general conditions, e.g., overweight, sleep deprivation, depression, family stress, work stress, etc. At the fourth level degrouping, the intelligent medical engine 14 is configured compare a fourth set of key parameters (also referred to as quaternary parameters), such as lifestyle parameters, between the patient template and the one or more third level subgroups to degroup into one or more fourth level subgroups, which the one or more fourth level subgroups represent a reduction in the number of people from the one or more third level subgroups. Examples of quaternary parameters relate to lifestyle habits and living conditions. These different levels of comparison are used as a filter to refine the matching characteristics of the current patient template with the existing objective medical data in the subgroups as necessary. Additional levels beyond the quaternary parameters are contemplated and within the spirit of the present disclosure. The intelligent medical engine 14 has determined, filtered, and identified a small number of objective medical data, or a small similar group from the central database 16, which has the closest matching characteristics to the parameters from the patient template. To phrase in another way, whereby the large amount of objective medical data in the central database 16 may be degrouped into a first array of groups, where the first array of groups may be further sub-degrouped into a second array of subgroups from the first array of groups, where the second array of subgroups may be further degroup into a third array of subgroups from the second array of subgroups, and so on until a small subgroup has been identified, which has the most similar characteristics to the patient template. The small group with similar objective medical data provides several different protocols that are available for possible treatment of the patient associated with the patient template. From the small group of similar medical objective data, the intelligent medical engine 14 is configured to extract one or more treatment protocols and results with a first protocol and results, step with a second protocol and results, and with N protocol and results. The intelligent medical engine 14 is configured to compute and determine the most efficient protocol in each group from the different treatment protocols and results.
Optionally, the scientific module 76 in the intelligent medical engine 14 is configured to investigate and generate new or synthetic protocols to enhance the overall treatment protocols available for matching at step 112. For example, a medical company could make clinical trials or conduct some research concerning a disease to discover a new scientific protocol that can be independent or dependent on the available protocols.
In one embodiment, degrouping is the process of finding subsets of a population who both have common value(s) on a observable or measurable parameter(s) (e.g. age, weight, white-blood-cell count, cholesterol, etc.) and a common medical outcome to, for instance, a treatment (e.g. a statin regimen, or a particular chemotherapy). One embodiment of the invention involved automated degrouping, which requires automatically identifying the parameters that separate the group into subgroups, wherein each subgroup reacts more homogeneously to at least one particular medical treatment.
In order to perform systematic degrouping in different areas of medicine, one powerful embodiment is to rely on information theory. Consider degrouping based on a single parameter. Let G be the original (typically large) group of patients. Let A be the desired medical outcome of a treatment or procedure (e.g. tumor diameter shrinkage as a result of chemotherapy, or lowered LDL blood cholesterol level as a result of statin drug dosage). Let p be the probability of the target outcome for a typical patient in group G. The Shannon Entropy of G is defined for a group of patients G and is computed from the following equation, wherein p(t(qi)=R) is the probability that a patient qi receiving treatment t will have outcome R, and H(G) is the entropy of the group of patients G:
Entropy is a measure of “disorder” or variability. The smaller the entropy the more homogenous the group. Since degrouping strives for subgroup homogeneity, the method degroups G based on the parameter that generates the most homogenous subgroups, i.e. the one that maximally reduces the entropy. For this purpose, we use conditional entropy, which is the entropy of the subgroup of G when a particular parameter x a has a value above (or below or equal to) a given threshold value.
H(G|x>thresh(x))
For instance, the above G could be all the patients over 60 years old, or all the diabetics whose average blood glucose level exceeds a medically-defined threshold x. Then, the next step is to find the parameter that maximally reduces the total entropy i.e. the sum of the entropies of the resulting subgroups, separated by virtue of the value of the selected parameter.
Mathematically, this separation process to automate the degrouping is called the information gain, which is defined as:
I(G,A)=H(G)−ArgminxεX[H(G|x>thresh(x)]
In other words the degrouping process seeks the parameter x which has the greatest information gain, i.e. the greatest reduction in entropy when used as the criterion to degroup. Since there are many potential parameters of patients, a large fraction of which are recorded in their electronic medical records, the degrouping process may each one automatically to determine which produces the maximal information gain with respect to the desired medical outcome, and therefore determine which parameter degroups the original group G into the most homogenous subgroups with respect again to the medical outcome in question.
An alternate embodiment is to define multiple levels of degrouping based on selected candidate parameters ahead of time, based on clinical knowledge. In this embodiment the information gain is calculated and optimized at each level, saving computation and speeding-up the response time because only a few parameters are considered per level, namely those predefined as belonging to each level, as illustrated, for example, in
A related and more comprehensive embodiment is based on an extension of the conditional Shannon entropy based on multiple patient parameters x1, . . . xk as follows:
H(G|x1>thresh(x1), . . . ,xk>thresh(xk)
And then the information gain becomes:
I(G,A)=H(G)−Argmaxx
This extended method is computationally more complicated because in order to find a group of attributes which together optimally degroup a group of patients G different combinations of attributes must be considered. One embodiment is to consider all possible combinations of parameters up to a target number N. Another embodiment is to rely on clinical knowledge to pre-select which combinations of parameters are sensible to consider, so as to reduce the computational burden and speed up response time.
In all cases degrouping can be cascaded, that is, a group G may be degrouped into subgroups G1, G2 and Gs and either of these subgroups may be further degrouped, e.g. subgroup G1 into subgroups G1,a G1,b and G1,c and G2,a G2,b, respectively. The degrouping process further continues (or repeated) until sufficiently homogenous subgroups are found with respect to the medical outcomes) from one or more treatments, as illustrated in
For example, to evaluate a patient's risk of atherosclerosis to determine treatment, a doctor would look at several blood factors (or parameters) to determine the patient's risk.
In one embodiment, the disease and course of treatment for a patient is obtained based on data in the system which is obtained from other patients with similar medical history, symptoms, and conditions and their success and/or failure with a specific course of treatment. Through the iterative process of comparison, classification, and degrouping of parameters inputted for the patient, the system provides a disease and course of treatment for the patient. As an example, patients diagnosed with cancer have several options for treatment, such as hormonal therapy, radiation therapy, biologically targeted therapy, chemotherapy, and surgery. However, depending on the patient's medical history, previous diagnostic test results, and the particular type of cancer, one or more of the options may not be appropriate. The methods disclosed herein enable a physician to access the information on other patients. Based on the medical information and the success rate of the course of treatments for other patients with similar medical history, symptoms, and conditions compiled in the system, a health care provider can recommend one or more suitable options for treatment to the cancer patient seeking treatment.
The iterative process used by the system involves several levels of degrouping for identifying a course of treatment including a treatment protocol or treatment plan for a patient diagnosed with a disease such as cancer. The factors and symptoms associated with a patient diagnosed with cancer are inputted as parameters into the system. Examples of the parameters associated with cancer used for the first level degrouping may include direct parameters such as: (1) the type of cancer cells; (2) the stage of the cancer; (3) the grade of the cancer, (4) and patient general condition, e.g. the Karnofsky Performance Scale Index, http://www.pennmedicine.org/homecare/hcp/elig_worksheets/Karnofsky-Performance-Status.pdf. Examples of the parameters used for the second level degrouping may include information of the cancer at the molecular level, such as the presence of specific tumor markers, and complications associated with cancer. Examples of the parameters used for the third level degrouping may include the patient's other medical conditions. Examples of the parameters used for the fourth level degrouping may include the patient's lifestyle and habits. The degrouping may be performed and stored in the computer system and may be updated periodically. The degrouping may be performed prior to or after inputting a new patient disease template into the computer system. The medical information is obtained as a patient disease template. A new patient template refers to a person who has not been processed before through the intelligent medical engine 14, or a person who has been processed before by the intelligence medical engine 14 but now has a new disease (or a new treatment plan, or a treatment protocol).
As an example, the first level parameters for breast cancer may include the tumor features such as the following: (1) invasive or in situ; (2) if invasive, whether the tumor has metastasized; (3) ductal or lobular; (4) stage (extent of tumor); and (5) grade (appearance of the cancer cells).
The exemplary second level parameters for breast cancer may include the presence of tumor markers, such as estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), cancer antigen 15-3 (CA 15-3), cancer antigen 27.29 (CA 27.29), and carcinoembryonic antigen (CEA), urokinase plasminogen activator (uPA), and plasminogen activator inhibitor (PAI-1). The presence of tumor markers provides information about the tumor at a molecular level and is often used for determining the course of treatment. For illustrative purposes, the presence of ER and PR indicates that the breast cancer cells need estrogen and progesterone for growth, and that hormone therapy (blocking these hormones) may be an effective treatment. The presence of the protein HER2 in a breast cancer patient indicates that anti-HER2 (Herceptin) treatments to block HER2 may be an effective treatment. The cancer antigens, CA 15-3, CA 27.29, and CEA, are found in patients with metastatic breast cancer. A higher than normal level of uPA and PAI-1 may indicate that the cancer is aggressive.
The exemplary third level parameters for breast cancer may include the patient's general conditions such as age, personal history of breast cancer (if recurrence) and ovarian cancer, family history of breast cancer, inherited risk and genetic risk (presence of mutations in breast cancer genes 1 or 2 (BRCA 1 or 2)), exposure to estrogen and progesterone, hormone replacement therapy after menopause, oral contraceptives, and race and ethnicity.
The exemplary fourth level parameters may include the lifestyle and habits of the patient such as weight, level of physical activity, alcohol consumption, and food consumption (fruits and vegetables vs. animal fats). At the end of the fourth level of degrouping, the computer system provides the medical objective data of a similar group of patients.
The medical information for the new patient are inputted into the computer system are compared with the objective medical data that have been classified into subgroups by degrouping to obtain a match for identifying a course of treatment including a treatment protocol or treatment plan. The computer system analyzes the data and provide the most effective or optimal course of treatment including a treatment protocol or treatment plan for the new patient.
Although reference is made to objective medical data and patient parameters, an alternate embodiment of the invention is based on augmenting the patient parameters with additional attributes, which are transformation and combinations of the observable patient parameters. For instance parameter values can be converted into percentiles of the total patient population or of the degrouped subgroup patient population. A variant is to renormalize attributes into the 0 to 1 scale over the patient population as a whole, or the degrouped subgroup patient population. The normalization computation for attribute a and parameter p, corresponding to the equation:
Additionally, attributes may include ratios of patient parameters or other functional combinations such as products, differences, averages, sums, and so on.
The benefit of the degrouping process for the patient is the use of the information, after the patient has found his or small subgroup. The matching with the degrouped subgroups provides the full information about all available treatment plans, with indication of the most efficient one. The matching output summarizes long-term and short-term results for each available treatment plan, including information about clinical condition dynamics at any period of time, information about the significant parameters average dynamics at any period of time, any particular parameters average dynamic at any period of time, mortality information in this group in any period of time. The possibility to investigate any of all full patients files from your group to see particular dynamic of any each patient parameters. The degrouping process provides statistical data to understand the risks in the short and long term period of time for any complications, side, chronic or main diseases, with statistical percentage of each in investigated by patient period. This degrouping information gives a patient the potential possibility to minimize or prevent possible complications and disease before it starts. The degrouping information also facilitates a patient to find the best doctor or the best hospital, in any area, which has the best results in your particular subgroups. All these incentives serve as strong motivation for the patients to buy subscription for use this analytic computer system.
During the next or second level degrouping 96, the intelligent medical engine 14 is configured to perform a second level of degrouping based on a second level parameters (including side disease, chronic (historical) disease, and/or complication parameters) 117 to degroup the first level subgroups G1, G2 . . . Gs to one or more second level subgroups 118 G1a, G1b, G2a, G2b . . . 118. The side disease, chronic disease and/or complication parameters 117 include chronic obstructive pulmonary disease (CDP1) and tuberculosis (CDP2) in this particular instance. The reduced one or more second level subgroups 118 with the specified second level parameters 117 are associated with a corresponding set of treatment protocols 110, such as for radiation therapy (protocol C) and targeted therapy (protocol D), excluding sleeve resection (protocol A) and chemotherapy (protocol B) from the first-level degrouping. These protocol would possibly optimize the desirable outcome of the patient's response to the treatment.
During the next or third level degrouping 98, the intelligent medical engine 14 is configured to conduct a third level degrouping based on a set of third level indirect (or non-significant) parameters to degroup from one or more second level subgroups to one or more third level subgroups 124. Indirect parameter includes the feeling of weakness (NSP1), Xerostomia (NSP3), and Sweating (NSP7). The reduced one or more third level subgroups with the specified indirect parameters 122 is associated with a corresponding set of treatment protocols 126.
During the next or fourth level degrouping 100, the intelligent medical engine 14 is configured to execute a fourth level degrouping by using a set of lifestyle parameters 130 and optionally, the corresponding treatment protocols 134, to degroup from one or more third level subgroups to one or more fourth level subgroups 132. The lifestyle parameters 130 includes, for example, smoking (LSP5), a firefighter occupation (LSP8), in this subgroup, chemotherapy (treatment protocol B) maximizes the desirable outcome of the procedure.
A doctor submits the patient's clinical parameters form to the intelligent medical engine 14 at the medical main server 12 for run a degrouping process. The intelligent medical engine 14 is configured to compare the patient's parameters against other patient's electronic medical records in the central database 16, and filters out irrelevant groups with less similar sets of parameter, resulting in reduced one or more subgroups 108 with common parameters.
If the degrouping process yields subgroups wherein the patients' response to a selected treatment are not statistically significantly different from each other, then in one embodiment these subgroups should be merged. Statistical significance can be measured in many ways; a standard way is to apply the well-known t-test, preferably two-sided (or two-tailed) t-test at a given significance level. In a specific embodiment this significant level would be p<0.05.
The degrouping process has been described as occurring over a potentially-large collection of objective medical data. However as that data changes over time, primarily through new objective medical records being added—whether pertaining to existing patients, new patients, or both, the degrouping process may need to be repeated periodically to refresh the subgroups, and possibly create new ones. In one embodiment additional degrouping is triggered when a plurality of objective medical data corresponding to new or existing patients is added to the storage of the system so as to create a significant change in the entropy of any subgroups. Changes can be clinically significant at different levels for different diseases, but in general a change is said change to be deemed significant if larger than three percent (3%) with respect to patient responses to treatment based on the new objective patient medical data.
As would be appreciated by physicians and others of skill in the art, the outcomes treatments may be characterized by a single token (e.g. “Ebola-free” or “remission”), by a number, (e.g. the resulting viral load after HIV treatment with protease inhibitors and other anti-viral drugs), or by a vector, representing different values at different points in time (e.g. the same viral load measured every few months, or the tumor diameter measured every few weeks after radiation treatment). This vector corresponds to the trajectory of a patient's disease as that patient undergoes treatment, as it measures the outcome of the treatment at multiple time points.
Given a hierarchical degrouping, whether via pre-determined degrouping levels, or via an automated degrouping cascade process, the disclosure provides for ways to use these degroupings to find previous patients with the same or similar parameters to those of a new patient for whom the clinician wishes to determine one or more effective treatment options. In general terms, given a new patient Q with a set of measured parameters {yi, y2, . . . , yk} and a disease for which the clinician wishes to determine one or more effective treatment options, the method of the disclosure compares the patient parameters with the those of each subgroup of patients, wherein those subgroups were established by any embodiment of the degrouping method discussed previously with respect to each candidate treatment. The comparison can take place at one-level of degrouping or at multiple levels of degrouping, including levels pre-established based on medical knowledge such as in
One embodiment of this general subgroup matching process is to find the minimal p-norm sum of the differences of parameters between patient and subgroup, as follows:
Where Q(yi) are the parameters of the new patient; gj are the subgroups of G, i.e. the results of degrouping group G; gj(xi) are the parameters of each subgroup, p is the norm. If p=1, the BestMatch formula sums the differences of parameters, if p=2, BestMatch sums the squared differences (yielding a least-squared criterion), and if p=0, the BestMatch merely counts the number of differences. The Argmin operator returns the subgroup gj with the smallest differences in parameters to those of the new patient, i.e. the most similar subgroup with respect to the parameters that matter in selecting a treatment option.
A further embodiment uses the BestMatch method at each level of degrouping to first find the best subgroups at the top level, then the next level, and so on until the lowest levels. The levels are defined via medical knowledge as exemplified in
The present disclosure provides a method of monitoring a new patient's disease and if necessary adjusts the course of treatment or treatment protocol based on the progression of the patient's conditions. The computer system has stored medical records for various patients with similar disease or condition who have undergone treatment. The stored medical records include information for the various patients over the course of treatment which can be used for comparison with the new patient's medical condition over time. As an example, localized breast cancer is treated by surgery followed by chemotherapy, radiation therapy, or hormone replacement therapy (for ER positive tumors) to prevent recurrence of the tumor. After surgery for breast cancer, a significant parameter to be monitored may be the recurrence of the tumor during and after the course of treatment. The present disclosure provides a method that enables inputting and comparing the breast cancer patient's medical conditions after surgery over time with the medical data of other patients with similar medical conditions for determining the possibility of recurrence and identifying the appropriate course of treatment to prevent the recurrence. The present method also enables identifying the appropriate course of treatment if the cancer recurs. The treatment plan for the new patient provided by the methods disclosed herein can be modified depending on the new patient's symptoms. The methods disclosed herein can be routinely adjusted to provide the optimal course of treatment for the new patient.
The implantable port and treatment device 202 allows easy accessibility to a patient's blood parameters, such as cytokine, other proteins, or other cells, which are capable of providing cell signaling to the implantable port and treatment device 202, which in turn communicate such information to the portable device 188 for 24/7 monitoring of the patient. With online monitoring from the transmitted data from the portable device 188, a physician or nurse can observe the patient's changing blood cell parameters over time. Cytokines are a broad and loose category of small proteins (˜5-20 kDa) that are important in cell signaling. Cytokines are released by cells and affect the behavior of other cells, and sometimes the releasing cell itself. Cytokines include chemokines, interferons, interleukins, lymphokines, tumour necrosis factor but generally not hormones or growth factors. Cytokines are produced by a broad range of cells, including immune cells like macrophages, B lymphocytes, T lymphocytes and mast cells, as well as endothelial cells, fibroblasts, and various stromal cells; a given cytokine may be produced by more than one type of cell. One key aspect of Cytokines is their dynamics, changes in relative concentration of different cytokines are indicative of disease progression or remission, including early indicators of organ or tissue transplant rejection (e.g. see Starzl et al., 2013).
Optionally, the diagnosis capsule machine 216 is equipped with a robotic arm/hand 219 for moving a medical device (such as ultrasound, x-ray, etc.) and moving the medical device on to the patient as the patient lies on the a flat surface of the diagnosis capsule machine 216. An integrated diagnosis capsule machine 216 which is capable of performing multiple medical functions that would typically require several medical equipment to perform each medical function separately.
At step 346, the electronic device on the electronic underwear, or the textile electrodes of garments, monitors a patient based on the real time medical data (e.g., temperature, blood pressure, pulse/heart rate, etc.) reading collected from the electronic device affixed to the electronic underwear, or the textile electrodes. At step 348, the electronic device on the electronic underwear, or the textile electrodes, transmits the real time medical data to a mobile device, such as a smartphone 150, via a wireless protocol, such as Bluetooth or a cellular data network. Optionally, at step 350, the data can be displayed or incorporated into an overview or a dashboard with a smartphone app for a patient to keep up with all the vitals and to change the settings.
At step 352, the smartphone 150 in turn transmits the real time medical data to the medical main server 12. At step 354, the intelligent medical engine 14 is configured to analyze the real time objective medical data of the patient 148 relative to the patient's 148 previously stored objective medical data in the central database 16 to determine if the comparison would invoke a medical alert to the patient's medical doctor and to the patient. If one of the parameters in the patient's 148 real time objective medical data exceeds a threshold of the patient's 148 previously stored objective medical data, then the intelligent medical engine 14 is configured to send a medical alert to a medical professional associated with patient 148 and to the patient's 148 portable medical monitoring device 150 to inform the patient 148 at step 360. At the same time in step 356, the intelligent medical engine 14 is configured to store the resulting real time objective medical data from the patient 148 in the central database 16 by adding the resulting objective medical data to the existing patient's 148 EMR System. Optionally, at step 358, the resulting data is sent to a patient's smartphone and is updated/refreshed to overview or a dashboard displayed by the app. At step 362, if none of the parameters in the patient's 148 real time objective medical data exceeds a threshold of the patient's 148 previously stored objective medical data, then the intelligent medical engine 14 is configured to store the patient's 148 real time objective medical data in the central database 16. Optionally at step 364, the resulting data is sent to a patient's smartphone and is updated/refreshed to overview or a dashboard displayed by the app. The patient 148 is used for illustrative purposes whereby a large volume of patients, including patients 154, 160, is communicatively coupled to the medical main server 12 through their respective portable medical monitoring device 150. A portable medical monitoring device 150 includes any type of portable devices, like smartphones, tablets, glasses/goggles, watches, wearable devices, etc.
In some embodiments, an electronic container, such as part of a wearable device, like a watch, provides medication to a patient at suitable times. For example, the drugs can be stored in the electronic container for daily use. When it is time to take medication, the electronic container would beep to alert the patient to take the drug retrieved from the electronic container.
In Section 2, the complications are described with the following: (1) the name of the parameter is specified under column “B”; (2) the description of the parameter is specified under column “D”; (3) the ICD code is specified under column “G”. The main (significant) parameters may define the stage, severity and the form of the disease. Parameters can include complaints, examination data, laboratory results, the data of instrumental tests, indications of other diseases.
In Section 3, indirect parameters 410 typically do not change with the course of the disease. The “main line” 412 contains: (1) the name of the parameter, under column “B”; (2) specification and general information about the parameter in the context of this disease, which has to be inscribed (use keyword) under column “D”; (3) the general methods for the determination of the parameter under column “E”; (4) an explanation of the general methods under column “F”; (5) further information concerning the parameter under column “G”. Each “main line” 412 explores an “additional line” 414 where the values, order or form subjective to the main line parameter have to be specified. Each value order or form includes: (1) description of the value under column “C”; (2) values, order or form of the parameter such as laboratory ranges, size, localization of the pathological focus, type of lesions, the severity of a symptom, its duration, which have to be specified in the field under column “E”; (3) the parameter value specification in the context of the described diseases and explanations for each of the values under column “D”; (4) the value specific methods for the determination of the parameter under column “F”; and (5) further information concerning the value under column “G”. In Section 2, the name of the parameter is specified under column “B”, the description of the parameter is specified under column “D” 3 and the ICD code is specified under column “H”.
“Clarification to Methods” of each symptoms, e.g. “Complaint” as clarification to methods to “questioning” as detection of symptom “thoracic pain”.
As an example, for lung cancer, the first level parameters, the direct parameters, may include, but are not limited to: (1) type (small cell vs. non-small cell); (2) stage (size of the tumor and whether it has spread); and (3) grade (appearance and behavior).
The exemplary second level parameters for lung cancer may include presence of mutations of oncogenes: (1) epidermal growth factor receptor (EGFR); (2) Kirsten rat sarcoma onocogene homolog (KRAS); and (3) anaplastic lymphoma kinase (ALK). The presence of these mutations is used to determine whether a patient would benefit from non-small cell lung cancer (NSCLC) targeted therapies. The second level parameters may also include markers of neuroendocrine differentiation, such as (1) creatine kinase-BB, (2) chromogranin, and (3) neuron specific enolase; and of small peptide hormones, such as (1) gastrin-releasing peptide, (2) calcitonin, and (3) serotonin. These markers demonstrate the neuroendocrine differentiation of small cell lung cancer. The second level parameters may also include complications associated with lung cancer.
The exemplary third level parameters for lung cancer may include the patient's general conditions such as age, personal history of lung cancer, family history of lung cancer, race and ethnicity.
The exemplary fourth level parameters may include the lifestyle and habits of the patient such as weight, level of physical activity, alcohol consumption, smoking habits, exposure to second-hand smoke, and food consumption (fruits and vegetables vs. animal fats).
As an example, the first level parameters, the direct parameters, for a heart disease may include, but are not limited to, (1) type of heart failure (systolic dysfunction or diastolic dysfunction); (2) stage of the heart disease based on classification of the symptoms; and (3) grade of the heart disease based on severity of the heart symptoms.
The exemplary second level parameters for a heart disease may include, but are not limited to, markers associated with heart diseases. Example of genes found to be associated with myocardial infarction, include PCSK9, SORT1, MIA3, WDR12, MRAS, PHACTR1, LPA, TCF21, MTHFDSL, ZC3HC1, CDKN2A, 2B, ABO, PDGF0, APOA5, MNF1ASM283, COL4A1, HHIPC1, SMAD3, ADAMTS7, RAS1, SMG6, SNF8, LDLR, SLC5A3, MRPS6, and KCNE2. These markers can be used for disease, prognosis, and treatment of heart disease, such as myocardial infarction. The second level parameters may also include complications associated with heart disease.
The exemplary third parameters for heart disease may include the patient's general conditions such as age, personal history of heart disease, family history of heart disease, diabetes, high blood pressure, dyslipidemia/hypercholesterolemia (abnormal levels of lipoproteins in the blood), and race and ethnicity.
The exemplary fourth level parameters may include the lifestyle and habits of the patient such as obesity, level of physical activity, smoking habits, alcohol consumption, food intake (trans fat), and stress level of job.
The computer system 448 may be coupled via the bus 452 to a display 460, such as a flat panel for displaying information to a user. An input device 462, including alphanumeric, pen or finger touchscreen input, and other keys, is coupled to the bus 452 for communicating information and command selections to the processor 450. Another type of user input device is cursor control 464, such as a mouse (either wired or wireless), a trackball, a laser remote mouse control, or cursor direction keys for communicating direction information and command selections to the processor 450 and for controlling cursor movement on the display 460. This input device typically has two degrees of freedom in two axes, a first axis (e.g., x) and a second axis (e.g., y), that allows the device to specify positions in a plane.
The processes and modules described with respect to
The computer system 448 may be used for performing various functions (e.g., computations, calculations, etc.) in accordance with the embodiments described herein. According to one embodiment, such use is provided by the computer system 448 in response to the processor 450 executing one or more sequences of one or more instructions contained in the main memory 454. Such instructions may be read into the main memory 454 from another computer-readable medium, such as a data storage device 458. Execution of the sequences of instructions contained in the main memory 454 causes the processor 450 to perform the process steps described herein. One or more processors in a multi-processing arrangement may also be employed to execute the sequences of instructions contained in the main memory 454. In alternative embodiments, hard-wired circuitry may be used in place of or in combination with software instructions to implement the disclosure. Thus, embodiments of the disclosure are not limited to any specific combination of hardware circuitry and software.
The term “computer-readable medium” as used herein refers to any medium that participates in providing instructions to the processor 450 for execution. Common forms of computer-readable media include, but are not limited to, non-volatile media, volatile media, transmission media, a floppy disk, a flexible disk, a hard disk, magnetic tape, any other magnetic medium, a CD-ROM, a DVD, a Blu-ray Disc, any other optical medium, punch cards, paper tape, any other physical medium with patterns of holes, a RAM, a PROM, an EPROM, a FLASH-EPROM, any other memory chip or cartridge, a carrier wave as described hereinafter, or any other medium from which a computer can read. Non-volatile media includes, for example, optical or magnetic disks, such as the data storage device 458. Volatile media includes dynamic memory, such as the main memory 454. Transmission media includes coaxial cables, copper wire, and fiber optics. Transmission media can also take the form of acoustic or light waves, such as those generated during radio wave and infrared data communications. Transmission media can also include wireless networks, such as WiFi and cellular networks.
Various forms of computer-readable media may be involved in carrying one or more sequences of one or more instructions to the processor 450 for execution. For example, the instructions may initially be carried on a magnetic disk of a remote computer. The remote computer can load the instructions into its dynamic memory and send the instructions over a communication link 466. The computer system 448 includes a communication interface 468 for receiving the data on the communication link 466. The bus 452 carries the data to the main memory 454, from which the processor 450 retrieves and executes the instructions. The instructions received by the main memory 454 may optionally be stored on the data storage device 458 either before or after execution by the processor 450.
The communication interface 468, which is coupled to the bus 452, provides a two-way data communication coupling to the communication link 466 that is connected to a network 18. For example, the communication interface 468 may be implemented in a variety of ways, including but not limited to communications interfaces for communicating over an integrated services digital network (ISDN), a local area network (LAN), a Wireless Local Area Network (WLAN), a Wide Area Network (WAN), Bluetooth, and a cellular data network (e.g. 3G, 4G, 5G, and beyond). In wireless links, the communication interface 468 sends and receives electrical, electromagnetic, or optical signals that carry data streams representing various types of information.
The medical main server 12 can be implemented as a networked computer system or a dedicated computer system operating in a client-server architecture or in a cloud-computing environment. In one embodiment, the cloud computer is a browser-based operating system communicating through an Internet-based computing network that involves the provision of dynamically scalable and often virtualized resources as a service over the Internet, such as iCloud® available from Apple Inc. of Cupertino, Calif., Amazon Web Services (IaaS) and Elastic Compute Cloud (EC2) available from Amazon.com, Inc. of Seattle, Wash., SaaS and PaaS available from Google Inc. of Mountain View, Calif., Microsoft Azure Service Platform (Paas) available from Microsoft Corporation of Redmond, Wash., Sun Open Cloud Platform available from Oracle Corporation of Redwood City, Calif., and other cloud computing service providers.
The web browser is a software application for retrieving, presenting, and traversing a Uniform Resource Identifier (URI) on the World Wide Web provided by the cloud computer or web servers. One common type of URI begins with Hypertext Transfer Protocol (HTTP) and identifies a resource to be retrieved over the HTTP. A web browser may include, but is not limited to, browsers running on personal computer operating systems and browsers running on mobile phone platforms. The first type of web browsers may include Microsoft's Internet Explorer, Apple's Safari, Google's Chrome, and Mozilla's Firefox. The second type of web browsers may include the iPhone OS, Google Android, Nokia S60, and Palm WebOS. Examples of a URI include a web page, an image, a video, or other type of content.
The network 18 can be implemented as a wireless network, a wired network protocol or any suitable communication protocols, such as 3G (3rd generation mobile telecommunications), 4G (fourth-generation of cellular wireless standards), long term evolution (LTE), 5G, a wide area network (WAN), Wi-Fi™ like wireless local area network (WLAN) 802.11n, or a local area network (LAN) connection (internetwork—connected to either WAN or LAN), Ethernet, Bluebooth™, high frequency systems (e.g., 900 MHz, 2.4 GHz, and 5.6 GHz communication systems), infrared, transmission control protocol/internet protocol (TCP/IP) (e.g., any of the protocols used in each of the TCP/IP layers), hypertext transfer protocol (HTTP), BitTorrent™, file transfer protocol (FTP), real time transport protocol (RTP), real time streaming protocol (RTSP), secure shell protocol (SSH), any other communications protocol and other types of networks like a satellite, a cable network, or an optical network set-top boxes (STBs). A SmartAuto includes an auto vehicle with a processor, a memory, a screen, with connection capabilities of Wireless Local Area Network (WLAN) and Wide Area Network (WAN), or an auto vehicle with a telecommunication slot connectable to a mobile device, such as an iPod, iPhone, or iPad. A SmartTV includes a television system having a telecommunication medium for transmitting and receiving moving video images (either monochromatic or color), still images and sound. The television system operates as a television, a computer, an entertainment center, and a storage device. The telecommunication medium of the television system includes a television set, television programming, television transmission, cable programming, cable transmission, satellite programming, satellite transmission, Internet programming, and Internet transmission.
Some portions of the above description describe the embodiments in terms of algorithmic descriptions and processes, e.g. as with the description within
As used herein any reference to “one embodiment” or “an embodiment” means that a particular element, feature, structure, or characteristic described in connection with the embodiment is included in at least one embodiment. The appearances of the phrase “in one embodiment” in various places in the specification are not necessarily all referring to the same embodiment.
Some embodiments may be described using the expression “coupled” and “connected” along with their derivatives. It should be understood that these terms are not intended as synonyms for each other. For example, some embodiments may be described using the term “connected” to indicate that two or more elements are in direct physical or electrical contact with each other. In another example, some embodiments may be described using the term “coupled” to indicate that two or more elements are in direct physical or electrical contact. The term “coupled,” however, may also mean that two or more elements are not in direct contact with each other, but yet still cooperate or interact with each other. The embodiments are not limited in this context.
As used herein, the terms “comprises,” “comprising,” “includes,” “including,” “has,” “having,” or any other variation thereof, are intended to cover a non-exclusive inclusion. For example, a process, method, article, or apparatus that comprises a list of elements is not necessarily limited to only those elements but may include other elements not expressly listed or inherent to such process, method, article, or apparatus. Further, unless expressly stated to the contrary, “or” refers to “an inclusive or” and “not to an exclusive or”. For example, a condition A or B is satisfied by any one of the following: A is true (or present) and B is false (or not present), A is false (or not present) and B is true (or present), and both A and B are true (or present).
The terms “a” or “an,” as used herein, are defined as one or more than one. The term “plurality,” as used herein, is defined as two or more than two. The term “another,” as used herein, is defined as at least a second or more.
The term “subject” as used herein can be used to refer to an asymptomatic or symptomatic patient. A patient may be asymptomatic or symptomatic for one or more diseases or conditions.
The disclosure can be implemented in numerous ways, including as a computational method of process, an apparatus, and a system. In this specification, these implementations, or any other form that the disclosure may take, may be referred to as techniques. In general, the order of the connections of disclosed apparatus may be altered within the scope of the disclosure.
The present disclosure has been described in particular detail with respect to one possible embodiment. Those skilled in the art will appreciate that the disclosure may be practiced in other embodiments. First, the particular naming of the components, capitalization of terms, the attributes, data structures, or any other programming or structural aspect is not mandatory or significant, and the mechanisms that implement the disclosure or its features may have different names, formats, or protocols. Further, the system may be implemented via a combination of hardware and software, as described, or entirely in hardware elements. In addition, the particular division of functionality between the various system components described herein is merely exemplary, and not mandatory; functions performed by a single system component may instead be performed by multiple components, and functions performed by multiple components may instead be performed by a single component.
An ordinary artisan should require no additional explanation in developing the methods and systems described herein but may find some possibly helpful guidance in the preparation of these methods and systems by examining standard reference works in the relevant art.
Embodiments may comprise a computer program that embodies the functions described and illustrated herein, wherein the computer program is implemented in a computer system that comprises instructions stored in a machine-readable medium and a processor that executes the instructions. However, it should be apparent that there could be many different ways of implementing embodiments in computer programming, and the embodiments should not be construed as limited to any one set of computer program instructions. Further, a skilled programmer would be able to write such a computer program to implement an embodiment of the disclosed embodiments based on the appended flow charts and associated description in the application text. Therefore, disclosure of a particular set of program code instructions is not considered necessary for an adequate understanding of how to make and use embodiments. Further, those skilled in the art will appreciate that one or more aspects of embodiments described herein may be performed by hardware, software, or a combination thereof, as may be embodied in one or more computing systems. Moreover, any reference to an act being performed by a computer should not be construed as being performed by a single computer as more than one computer may perform the act.
The example systems, methods, and acts described in the embodiments presented previously are illustrative, and, in alternative embodiments, certain acts can be performed in a different order, in parallel with one another, omitted entirely, and/or combined between different example embodiments, and/or certain additional acts can be performed, without departing from the scope and spirit of various embodiments. Accordingly, such alternative embodiments are included in the invention claimed herein.
Although specific embodiments have been described above in detail, the description is merely for purposes of illustration. It should be appreciated, therefore, that many aspects described above are not intended as required or essential elements unless explicitly stated otherwise. Modifications of, and equivalent components or acts corresponding to, the disclosed aspects of the example embodiments, in addition to those described above, can be made by a person of ordinary skill in the art, having the benefit of the present disclosure, without departing from the spirit and scope of embodiments defined in the following claims, the scope of which is to be accorded the broadest interpretation so as to encompass such modifications and equivalent structures.
The examples illustrate exemplary methods provided herein. These examples are not intended, nor are they to be construed, as limiting the scope of the disclosure. It will be clear that the methods can be practiced otherwise than as particularly described herein. Numerous modifications and variations are possible in view of the teachings herein and, therefore, are within the scope of the disclosure.
When a new cancer patient visits a health care provider, the new patient's medical history, lab work, and images from CT, X-ray, PET scan, and mammogram are gathered and inputted into the computer system. If further tests need to be performed such as lab work for tumor markers, they are performed and the results inputted into the computer system. Once all the information regarding the patient is entered into the computer system, the physician can use the process provided by the computer system disclosed herein to obtain a course of treatment for the patient. The computer-implemented method comprises degrouping a plurality of patients' objective medical data to classify the data into subgroups. The objective medical data includes patients' parameters. The computer system recommends an optimal course of treatment including a treatment protocol and treatment plan based on all the new patient's medical information.
For breast cancer, the first level parameters may include tumor features such as the following: (1) invasive or in situ; (2) if invasive, whether the tumor has metastasized; (3) ductal or lobular; (4) stage; and (5) grade.
The second level parameters may include the presence of tumor markers, such as estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), cancer antigen 15-3 (CA 15-3), cancer antigen 27.29 (CA 27.29), and carcinoembryonic antigen (CEA), urokinase plasminogen activator (uPA), and plasminogen activator inhibitor (PAI-1).
The third level parameters may include the patient's general conditions such as age, personal history of breast cancer (if recurrence) and ovarian cancer, family history of breast cancer, inherited risk and genetic risk (presence of mutations in breast cancer genes 1 or 2 (BRCA 1 or 2)), exposure to estrogen and progesterone, hormone replacement therapy after menopause, oral contraceptives, and race and ethnicity.
The fourth level parameters may include the lifestyle and habits of the patient such as weight, level of physical activity, alcohol consumption, and food consumption (fruits and vegetables vs. animal fats).
The conventional course of treatment for a breast cancer patient who tests positive for ER and PR is hormone therapy. Depending on all the parameters associated with the patient, the computer system can recommend a specific hormone therapy such as a specific aromatase inhibitor, a selective estrogen receptor modulator, or an estrogen receptor downregulator. However, also depending on the other parameters associated with the patient, the computer system can recommend a specific hormone therapy and an additional course of treatment for the patient. The computer system can recommend hormone therapy in addition to surgically removing the ovaries and fallopian tubes as a preventative measure.
A triple negative breast cancer patient (a patient whose breast cancer cells that do not express the genes for ER, PR, and HER2) would not benefit from hormone therapy. Depending on all the parameters associated with the patient, the computer system can recommend chemotherapy, radiation therapy, surgery, or a combination thereof based on the computational analysis of medical data in the system. For example, the computer system can recommend mastectomy over lumpectomy as a form of surgery. Alternatively, the computer system can recommend a specific dosage of chemotherapy.
For lung cancer, the first level parameters may include: (1) type; (2) stage; and (3) grade.
The second level parameters may include presence of mutations of oncogenes for determining whether a patient would benefit from NSCLC targeted therapies. Such oncogenes include (1) epidermal growth factor receptor (EGFR); (2) Kirsten rat sarcoma onocogene homolog (KRAS); and (3) anaplastic lymphoma kinase (ALK). The second level parameters may also include markers of neuroendocrine differentiation of small cell lung cancer, such as (1) creatine kinase-BB, (2) chromogranin, and (3) neuron specific enolase; and of small peptide hormones, such as (1) gastrin-releasing peptide, (2) calcitonin, and (3) serotonin.
The third level parameters may include the patient's general conditions such as age, personal history of lung cancer, family history of lung cancer, and race and ethnicity.
The fourth level parameters may include the lifestyle and habits of the patient such as weight, level of physical activity, alcohol consumption, smoking habits, exposure to second-hand smoke, and food consumption (fruits and vegetables vs. animal fats).
Lung cancer patients are usually treated by chemotherapy, surgery, radiation therapy, and/or targeted therapy. Depending on all the parameters associated with the patient, the computer system can recommend a combination of therapies as the course of treatment for the lung cancer patient based on the computational analysis of the medical data in the system. For example, chemotherapy may be recommended before or after surgery, and chemotherapy may be recommended in combination with radiation therapy. The computer system can also recommend a specific surgery such as lobectomy, segmentectomy, or pneumonectomy.
Depending on whether the patient has a mutation in an oncogene, the computer system can recommend targeted therapies that block the oncogene. For example, erlotinib and gefitinib are drugs that have been used to block EGFR. Gilotrif is a tyrosine kinase inhibitor that stops uncontrolled cell growth caused by a mutation in the EGFR gene. Crizotinib is used to treat advanced NSCLC that has a mutation in the ALK gene.
This application claims priority to U.S. Provisional Application Ser. No. 62/059,588 entitled “Method and System for Intelligence Mass Medical Analysis,” filed on 3 Oct. 2014, U.S. Provisional Application Ser. No. 61/977,512 entitled “Method and System for Intelligence Mass Medical Analysis,” filed on 9 Apr. 2014, U.S. Provisional Application Ser. No. 61/946,339 entitled “Method and System for Intelligence Mass Medical Analysis,” filed on 28 Feb. 2014, and U.S. Provisional Application Ser. No. 61/911,618 entitled “Method and System Intelligence For Mass Medical Analysis,” filed on 4 Dec. 2013, the disclosures of which are incorporated herein by reference in their entireties.
Number | Date | Country | |
---|---|---|---|
62059588 | Oct 2014 | US | |
61977512 | Apr 2014 | US | |
61946339 | Feb 2014 | US | |
61911618 | Dec 2013 | US |