WO2021044520A1 - Software, state-of-health determination device, and state-of-health determination method - Google Patents

Software, state-of-health determination device, and state-of-health determination method Download PDF

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Publication number
WO2021044520A1
WO2021044520A1 PCT/JP2019/034634 JP2019034634W WO2021044520A1 WO 2021044520 A1 WO2021044520 A1 WO 2021044520A1 JP 2019034634 W JP2019034634 W JP 2019034634W WO 2021044520 A1 WO2021044520 A1 WO 2021044520A1
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Prior art keywords
information
vital
value
condition
score
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PCT/JP2019/034634
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French (fr)
Japanese (ja)
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俊輔 前田
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前田商事株式会社
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Priority to JP2020513347A priority Critical patent/JP6719799B1/en
Priority to PCT/JP2019/034634 priority patent/WO2021044520A1/en
Publication of WO2021044520A1 publication Critical patent/WO2021044520A1/en

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    • GPHYSICS
    • G16INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16HHEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H10/00ICT specially adapted for the handling or processing of patient-related medical or healthcare data
    • G16H10/60ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records
    • GPHYSICS
    • G16INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16HHEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H50/00ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
    • G16H50/30ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for calculating health indices; for individual health risk assessment

Definitions

  • the present invention relates to software, a health condition determination device, and a health condition determination method. Specifically, it is possible to accurately capture individual fluctuations that differ from subject to subject by reflecting vital signs and daily physical condition that take into account individual differences of the subject, and there are few false positives in the subject. It relates to software, a health condition determination device, and a health condition determination method having excellent accuracy of abnormality determination.
  • Personalized medicine generally refers to tailor-made medicine, which means “providing medical care that suits each individual's individuality.”
  • biomarkers are indicators of the condition of a particular medical condition or organism, and a research group at the National Institutes of Health stated in 1998 that biomarkers were "ordinary biology.” It is defined as "a characteristic that is objectively measured and evaluated as an indicator of a pharmacological response to a physical process, pathological process, or therapeutic intervention.” In the past, biomarkers mainly meant physiological indicators such as blood pressure and heart rate.
  • EWS early warning score
  • EWS is an assessment of the subject's six major vital signs: respiratory rate (rpm), SpO2 (oxygen saturation) (%), body temperature (° C), blood pressure (mmHg), heart rate (bpm), and consciousness level.
  • AVPU response A: allart (normal)
  • V voice (responsive to voice)
  • P pain (responsive to pain)
  • U unresponsive (no response)
  • vital sign measurement results and evaluation results It is a method of calculating the score according to the above and determining the degree of illness based on the total score of the scores (see, for example, Non-Pain Document 1).
  • This EWS is based on the principle that clinical deterioration is seen through changes in multiple physiological measurements and large changes within a single variable.
  • a numerical value determined based on the results of the measured values of the group (plurality of subjects) is adopted.
  • the "normal range” and “abnormal range” set from the measured values of the vital signs of the group are adopted as the criteria.
  • the range set here may vary in consideration of the region, age, etc., but basically the reference range is determined based on the measured values of vital signs obtained from the majority of people. Has been done.
  • the setting of this criterion is the same for respiratory rate, oxygen saturation, blood pressure and heart rate.
  • scores may be assigned to other parameters such as urine output, oxygen administration flow rate, and pain score as parameters other than the six major vital signs.
  • the conventional mechanism of scoring based on the measured value of the vital sign of the subject and detecting the abnormality based on the information of the result causes the intra-individual variation of the subject. The detection is not taken into consideration.
  • the criteria set from the measured values of the vital signs of the group cannot correspond to the characteristics of each individual in the vital signs.
  • adolescents and the elderly have very different body temperatures in a calm state and daily fluctuations in body temperature.
  • the value of vital signs varies greatly depending on the target difference depending on the presence or absence of a pathological condition such as hypertension.
  • the "normal range” and “abnormal range” set from the measured values of vital signs of the population may not be appropriate criteria.
  • biomarkers suitable for purposes such as diagnosis, prognosis, pharmacodynamics, and monitoring will be indispensable.
  • the present inventor has been conducting research focusing on biomarkers for the purpose of "onset of illness in the elderly” and “diagnosis”.
  • the present inventor is not a biomarker that analyzes at the genetic level, which has been carried out in recent years, but the "vital signs" of body temperature, pulse, and blood pressure (pulse pressure), which are the most basic information on human life.
  • body temperature, pulse, and blood pressure (pulse pressure) in addition to the respiratory rate, are called “classical vital signs” in the medical field, and these four are positioned as basic and important vital signs.
  • the present inventor has found from previous studies that human classical vital signs basically follow a normal distribution when at least 30 measurement data are acquired for the same individual. ..
  • the normal distribution of classical vital signs includes the intra-individual variation peculiar to the person.
  • Patent Document 1 The technique described in Patent Document 1 can be utilized for early detection of a state in which an abnormality has occurred in physical condition by appropriately grasping the individual variation that differs for each subject.
  • the present inventors considered that there is room for improvement in further improving the accuracy of abnormality detection and reducing false positives.
  • the vital signs of the body temperature of the same individual are used for the mean value ⁇ and the standard deviation ⁇ in a predetermined period, and the vital signs are “within ⁇ ⁇ 2 ⁇ ”.
  • a score value of "0 points" was given as normal.
  • a score value of 1 or more was configured to be judged as "abnormal (caution or warning)".
  • the content of the criteria is set. Becomes stricter, and it becomes easier to judge that the value is abnormal.
  • the present invention was devised in view of the above points, and it is possible to accurately grasp the intra-individual variation that differs for each subject by reflecting the vital signs and daily physical conditions that take into consideration the individual differences of the subjects. It relates to software, a health condition determination device, and a health condition determination method, which are possible, have few false positives, and have excellent accuracy in detecting abnormalities in the subject.
  • the software of the present invention scores vital information, which is information on acquired vital signs, and determines the health condition of an individual based on the obtained score result information.
  • the information input means for receiving the input of the vital information including at least one measured value selected from the vital signs according to the normal distribution and the acquisition date and time while acquiring the information processing device from the same individual.
  • An information recording means for recording the input vital information and information on the acquisition date and time, a reference calculation means for calculating the average ⁇ and the standard deviation ⁇ of all or a part of the plurality of recorded vital information, and predetermined Based on the scoring conditions, the input predetermined vital information is scored to calculate the score result information which is the value of the score, and the predetermined scoring conditions are normal with at least the average ⁇ as the peak value.
  • the scoring condition comprises at least one measurement selected from a number, said mean ⁇ , said standard for at least one measurement selected from body temperature, blood pressure, pulse, pulse pressure and respiratory rate.
  • the lower limit value and the value of the formula (2) are set as the lower limit value and the value of the following formula (2) expressed using n and m, which are numbers larger than the deviation ⁇ and 0, and at least one of the lower limit value and the upper limit value is set.
  • the reference area condition including the reference area condition to be used as a reference is set by excluding the measurement value satisfying a predetermined vital exclusion condition from the measured values of vital signs, and the score determination means is set to the reference area condition. It is configured to make the next determination including the score result information scored based on the score.
  • ⁇ -n ⁇ ⁇ ⁇ ⁇ Equation (1) ⁇ + m ⁇ ⁇ ⁇ Equation (2)
  • the software is a program related to the operation of a computer.
  • a program is a program consisting of an ordered sequence of instructions suitable for processing by a computer.
  • the "vital information of 30 measurement data” is broadly the data of vital information measured every second, for example, every minute, every few minutes, every hour, 1 It includes data with different lengths of time, such as vital information data measured daily and monthly.
  • the "vital information of 30 measurement data” includes not only the data regularly acquired at regular intervals such as the above-mentioned every second or every minute, but also irregularly acquired data. Data is also included. For example, at least 30 pieces of data (for example, 1 second, 3 seconds, 6 seconds, 7 seconds, 9 seconds, etc.) acquired irregularly instead of being acquired at regular intervals in 1 minute (60 seconds). Acquisition) can be adopted.
  • At least 30 data irregularly acquired in 30 minutes, at least 30 data irregularly acquired in 1 hour, and at least 30 irregularly acquired in several hours shall be adopted as "vital information of 30 measurement data".
  • At least 30 pieces of data are randomly extracted from the accumulated vital information regardless of regular intervals or irregular intervals, and adopted as "vital information of 30 pieces of measurement data". be able to.
  • a normal distribution that reflects the intra-individual variation of the subject can be obtained by acquiring at least 30 measurement data regardless of the length of time or the regularity of the measurement interval.
  • the information input means accepts the input of vital information acquired from the same individual, and the information recording means records the input vital information, so that the vital information of the same individual can be accumulated.
  • the same individual as used herein refers to a determination target for determining whether or not the acquired vital sign value is an abnormal value.
  • the "individual” here is a single organism (human or animal).
  • the present invention includes a mode of recording the vital information of a single same individual and a mode of recording a plurality of vital information of the same individual for each same individual with a single software.
  • the same individual means, for example, the same person in the case of a human being.
  • the "vital information acquired from the same individual” here means that the individual can be distinguished at the stage of input by the information input means. For example, a mode in which one target person inputs his / her own vital information, a mode in which a specific personal input screen is displayed when handling information of a plurality of target persons, and a mode in which vital information is input, etc. It is conceivable to distinguish individuals by different forms for doing so.
  • the information input means receives the input of vital information including at least one measured value selected from the vital signs according to the normal distribution while being acquired from the same individual, and records the input vital information in the information recording means. By doing so, it is possible to accumulate information on the measured values of vital signs of the same individual.
  • the measured values of vital signs obtained from the same individual follow a normal distribution, and by accumulating the information of the measured values, it is possible to set a standard based on the normal distribution.
  • the information input means accepts the input of the vital information acquired from the same individual and the information of the acquisition date and time
  • the information recording means records the input vital information and the information of the acquisition date and time, thereby causing the vitals of the same individual.
  • the information will be accumulated together with the information on the date and time when the information was acquired. That is, it is possible to handle a plurality of vital information of the same individual in association with the information of the acquisition date and time. Further, when comparing different vital information, it is possible to confirm the displacement status and the displacement amount between the vital information to be compared.
  • the information of the acquisition date and time referred to here is the mode in which the input person inputs the information of the acquisition date and time when the vital information is input to the information input means, and the time when the vital information is input is automatically set to the information input means. Aspects to be input are included. Further, the information on the acquisition date and time includes the date and time when the vital sign was measured and the date and time when the vital sign was evaluated (for example, the consciousness level).
  • the reference calculation means calculates the average ⁇ of all or part of the recorded vital information, so that the information of the average value of the vital information reflecting the intra-individual variation of the same individual can be used. ..
  • the average ⁇ here means a value obtained by dividing the “total number of measured values of vital signs” by the “number of data of measured values of vital signs”.
  • the "average ⁇ of a plurality of recorded vital information" referred to here includes not only the one calculated from all the recorded vital information data but also the one calculated from a part of all the data. There is.
  • the vital information on which the average ⁇ is calculated is not only continuous data, for example, data measured continuously such as every second, every minute, every hour, and every day, but also intervals such as seconds, minutes, hours, and days. It may be calculated from the data extracted by opening.
  • the standard calculation means can use the standard deviation information of the vital information reflecting the intra-individual variation of the same individual by calculating the standard deviation ⁇ of all or a part of the recorded vital information.
  • the standard deviation ⁇ referred to here is the “root mean square of deviation” of vital information under predetermined conditions.
  • the "deviation” is a value obtained by subtracting "the average value of the measured values of the vital signs of the predetermined condition” from the "measured value of each vital sign" of the vital information of the predetermined condition.
  • the "standard deviation ⁇ of a plurality of recorded vital information" referred to here includes not only the one calculated from all the recorded vital information data but also the one calculated from a part of all the data. I'm out.
  • the vital information on which the standard deviation ⁇ is calculated is not only continuous data, for example, data measured continuously such as every second, every minute, every hour, and every day, but also intervals such as seconds, minutes, hours, and days. It may be calculated from the data extracted by opening.
  • the scoring processing means scores the input predetermined vital information based on the predetermined scoring condition, and calculates the score result information which is the value of the score, so that the input vital information can be obtained. , Can be converted into score result information (points) according to the content.
  • the average ⁇ According to the standard set based on the normal distribution with the peak value of, it is possible to obtain the score result information according to the content.
  • the standard set based on the normal distribution with the average ⁇ as the peak value at this time is a standard that reflects the intra-individual variation of the same individual, and the vital information of the same individual is reflected in the state that reflects the intra-individual variation. It becomes possible to score.
  • the "input predetermined vital information" referred to here means vital information to be scored.
  • the "predetermined scoring condition set based on the normal distribution with at least the average ⁇ as the peak value" referred to here is the input predetermined vital information, that is, the predetermined vital information to be scored. It includes both the one set by including and the one set from the past vital information before that without including the predetermined vital information to be scored. Further, the input predetermined vital information can be the most recently input vital information. Further, the input predetermined vital information can be one or more vital information of the previously input vital information.
  • the score determination means determines whether or not the score result information corresponding to a plurality of types of vital information is an abnormal value based on a predetermined score determination condition, so that the vital information acquired from the same individual. It is possible to determine whether or not the value of the score result information obtained from the contents of is an abnormal value.
  • the score determination means integrates the score result information corresponding to a plurality of types of vital information and determines whether or not the value is abnormal, so that only the score result information corresponding to a single vital information is abnormal. Compared with the mode of determining whether or not the value is correct, it is possible to more accurately determine the abnormality in the physical condition of the subject.
  • a predetermined scoring condition is set so as to be highly accurate (for example, at body temperature) for the single vital information that is the basis of the determination. If there is, if the range of the upper and lower limits for determining that the body temperature is normal (0 points) is set to be narrowed), the value of the score result information tends to be one or more points indicating abnormal vital signs. Then, the score determination means leads to determining that the score value is abnormal (the subject's physical condition is abnormal) with respect to the score result information of only a single vital information. In such an embodiment, the accuracy of the scoring condition is improved, so that the score value is abnormal in the score determination means even though the subject is not actually in a false positive state, that is, the subject's physical condition is not abnormal. It is easy to get an incorrect result.
  • the score determination means is an abnormal value by integrating the score result information corresponding to a plurality of types of vital information.
  • a configuration that determines whether or not it is used is adopted. That is, using the score result information corresponding to a plurality of types of vital information, a score determination condition for the total score result information is set, and whether or not the value is abnormal is determined. According to this, the influence of the content of a single vital information on the final result of the determination of anomalies is reduced, and it is possible to perform a complex and accurate determination of anomalies based on the contents of a plurality of vital information. It will be possible.
  • the alert notification means notifies the alert based on the judgment result of the score judgment means, so that the result of the score judgment means judging as an abnormal value can be notified by the alert.
  • the score determination means integrates the score result information corresponding to a plurality of types of vital information to determine whether or not the value is abnormal, and the alert notification means issues an alert based on the determination result of the score determination means.
  • the alert notification means can reduce the number of false positive alert notifications. As a result, it is possible to reduce the time and effort for the user to repeatedly check the result of the abnormality determination regarding the target person.
  • the vital information of at least 30 measurement data reflects the intra-individual variation peculiar to the individual, and the normal distribution is created from the vital information of at least 30 measurement data to obtain the vital information. It can be used as a biomarker to realize personalized medicine, and in particular, it will be possible to detect the deterioration of the condition of a subject in the chronic phase at an early stage. That is, vital information can be used as a "biomarker" that differs for each individual.
  • This biomarker is generally an indicator of a particular medical condition or condition of an organism, and is "objective as an indicator of a pharmacological response to normal biological, pathological, or therapeutic interventions. It is defined as a characteristic that is measured and evaluated in a physical manner. That is, the "biomarker that detects deterioration of the health condition” that is the subject of the present invention causes some abnormality in the subject's calm state and physical condition. It is an index peculiar to the subject that reflects various states of the subject, including the state of being in a state and the state of the stage before the abnormality occurs in the physical condition.
  • the way the vital signs change reflects the range of change that differs for each subject, and this is normally distributed.
  • This change in vital signs includes intra-individual fluctuations that differ from person to person, and by using and analyzing vital signs including intra-individual fluctuations as biomarkers, the subject's health management and diagnosis can be performed. It will be possible to realize personalized medicine.
  • the physical condition is remarkably abnormal, reflecting the individual characteristics. Early detection before it occurs is possible, which is very meaningful. Elderly people often have a slower progression of illness, and it is more difficult to detect changes in their physical condition or deterioration of their condition than general adults. It is possible to detect the deterioration of the condition at an early stage according to the characteristics of the subject.
  • the vital information of at least 30 measurement data reflects the intra-individual variation peculiar to the individual, and the normal distribution is created from the vital information of at least 30 measurement data, whereby the score determination means. This makes it possible to capture abnormal values of vital signs in the target individual.
  • the measurement data will be normally distributed reflecting the intra-individual variation for each subject. It was confirmed.
  • FIGS. 25 to 32 when the pulse is measured under each condition, if 30 measurement data are prepared, a normal distribution curve different for each subject can be obtained based on the measured data. It became. 25, 27, 29 and 31 are the results of the pulse obtained from the same subject (referred to here as Mr. A), and FIGS. 26, 28, 30 and 32 are different identical subjects. It is the result of the pulse obtained from the person (referred to as Mr. B here).
  • Mr. A the results of the pulse obtained from the same subject
  • FIGS. 26, 28, 30 and 32 are different identical subjects. It is the result of the pulse obtained from the person (referred to as Mr. B here).
  • FIGS. 25 to 32 30 measurement data are shown, and the circles on the curve correspond to one measurement data, but since there are a plurality of overlapping data centered on the average value, they are shown on the drawing. Then, the circles for 30 pieces do not appear.
  • FIGS. 25 and 26 are graphs based on the results of measuring the pulse every minute and acquiring the measurement data of 30 pulses.
  • the results showing the shape of the normal distribution with the mean value as the apex were obtained.
  • Mr. A and Mr. B have different average values at the vertices, and the values (minimum value and maximum value) located at both ends of the curve are also different. Therefore, it is clear that an individual normal distribution can be obtained. Regarding this point, the same tendency was confirmed in FIGS. 27 to 32.
  • FIGS. 27 and 28 are graphs based on the results of measuring the pulse every 7 minutes and acquiring the measurement data of 30 pulses. In this way, even when the measurement time interval was changed, the shape of the normal distribution with the average value of each subject as the apex was obtained.
  • FIGS. 29 and 30 are graphs based on the results of acquiring measurement data of 30 pulses at irregular times in a day.
  • FIG. 31 is a graph based on the result of acquiring measurement data of 30 pulses at irregular times in 30 hours
  • FIG. 32 is an irregular time in 30 days. It is a graph based on the result of acquiring the measurement data of 30 pulses. As shown here, even if the data is not regularly acquired at regular intervals, if 30 measurement data are acquired, the data will have the shape of a normal distribution with the average value of each subject as the apex. It was confirmed to take.
  • FIGS. 33 and 34 if 30 measurement data are prepared for body temperature, a normal distribution curve different for each subject can be obtained based on the measured data. .. 33 and 34 are graphs based on the results of measuring body temperature every 2 minutes and acquiring measurement data of 30 body temperatures. Further, in FIGS. 33 and 34, the subjects whose body temperature was measured are different. In this way, it was confirmed that even with body temperature, if 30 measurement data were acquired, the data would take the form of a normal distribution with the average value of each subject as the apex.
  • the present inventor can obtain a normal distribution reflecting the intra-individual variation of the subject by acquiring at least 30 measurement data for vital signs regardless of the length of time or the regularity of the measurement interval. We have found the possibility that it can be obtained and can be used as a biomarker, and have arrived at the present invention.
  • the physiological parameters (vital signs) of the target individual can be observed.
  • the values of vital signs that make up that one cycle can be confirmed.
  • the vital information of 30 pieces it is possible to sufficiently capture the abnormal value of the vital signs in the target individual, and the present invention pays attention to this point.
  • the vital information has at least one measured value selected from the vital signs of body temperature, blood pressure, pulse, pulse pressure and respiratory rate, so that the body temperature, blood pressure, pulse, pulse pressure and pulse pressure measured from the same individual are measured.
  • the respiratory rate it is possible to obtain score result information and combine a plurality of vital information to determine whether or not the value is abnormal.
  • a predetermined scoring condition is set based on a normal distribution with at least a mean ⁇ as the peak value, and the scoring condition is for at least one measured value selected from body temperature, blood pressure, pulse, pulse pressure and respiratory rate.
  • the lower limit is the value of the following equation (1) expressed using the average ⁇ , the standard deviation ⁇ , and n and m which are numbers larger than 0, and the upper limit is the value of the equation (2).
  • the average ⁇ Score result information is obtained using the reference range condition with the value separated by the value of n ⁇ in the negative direction as the lower limit value or the value separated by the value of m ⁇ from the average as the upper limit value as the standard of the scoring condition. It becomes possible.
  • the standard set based on the normal distribution with the average ⁇ as the peak value at this time is a standard that reflects the intra-individual variation of the same individual, and the vital information of the same individual is reflected in the form that reflects the intra-individual variation. It becomes possible to score.
  • the "criteria” referred to here is subject to scoring when the value of the following formula (1) is set as the lower limit value or the value of the formula (2) is set as the set value of the standard.
  • the numerical value exceeds the set value, it becomes 2 points, and when it is less than the set value, it becomes 1 point, and when the numerical value to be scored exceeds the set value, it becomes 2 points, and when it exceeds the set value, it becomes 1 point.
  • the values of n and m may be numbers larger than 0 as described above, and the values of n and m can be used for various conditions such as the strictness of the standard, the type of vital signs, and the medical history of the subject. It can be set as appropriate in consideration.
  • the lower limit value and the upper limit value since it is "at least one of the lower limit value and the upper limit value", it includes not only a mode in which only the lower limit value or only the upper limit value is set as a reference, but also a mode in which both the lower limit value and the upper limit value are adopted as a reference.
  • the values of the equations (1) and (2) here are numerical ranges set based on the normal distribution with the average ⁇ as the peak value. ⁇ -n ⁇ ⁇ ⁇ ⁇ Equation (1) ⁇ + m ⁇ ⁇ ⁇ Equation (2)
  • the reference range condition is set by excluding the measured values satisfying the predetermined vital exclusion condition from the measured values of vital signs, at least selected from body temperature, blood pressure, pulse, pulse pressure and respiratory rate.
  • scoring conditions can be set except for numerical values that are not desired to be included in the reference range that is the scoring condition. That is, for example, it is possible to improve the accuracy of detecting an abnormality in the determination of normality or abnormality in the vital information, exclude the value determined to be abnormal as the vital information, and set the scoring condition. Further, for example, it is possible to set scoring conditions for the measured values of vital signs by excluding the measured values that can be regarded as statistically outliers.
  • scoring conditions by excluding the measured values in a state in which the subject is clearly in an abnormal state (such as a state in which it is clear that the subject is ill).
  • scoring conditions by selecting a measured value that satisfies a certain condition with respect to a measured value obtained by measuring vital signs a plurality of times under a certain condition.
  • scoring conditions can be set by excluding measured values that do not satisfy the normality.
  • the scoring condition can be set by excluding the measured value that does not satisfy the measurement time condition. In this way, by excluding the measured values that satisfy the predetermined vital exclusion condition and setting the reference area condition (scoring condition), the accuracy of the abnormality judgment for the vital information, the statistical accuracy, etc. are guaranteed, and the score is obtained. It becomes possible to ring.
  • the score determination means includes the score result information scored based on the reference region condition, and makes the next determination to ensure the accuracy of the abnormality determination, the statistical accuracy, etc. of the vital information. Based on the result of scoring performed based on, the subject can be continuously judged. In addition, the subject can be continuously determined based on vital signs including intra-individual fluctuations.
  • vital information is obtained by observing at least one measured value selected from vital signs such as body temperature, blood pressure, pulse, pulse pressure, and respiratory rate, a measured value of oxygen saturation, and a consciousness level. If it has a level evaluation result, it is possible to combine these vital information, integrate the score result information corresponding to each vital information, and determine whether or not the score value is an abnormal value from the result. it can. That is, it is possible to determine an abnormality with respect to the score value in a complex manner from a plurality of vital information.
  • the scoring condition is within a predetermined numerical range set in advance for the measured value of oxygen saturation
  • the measured value of oxygen saturation acquired from the same individual is input as vital information.
  • score result information according to the content can be obtained based on a predetermined numerical range set in advance.
  • a numerical range set from the measured values of the vital signs of the group can be adopted.
  • the "predetermined numerical range” referred to here is a reference value, for example, when a constant value is set, the numerical value to be scored becomes 2 points when the numerical value is equal to or more than the constant value, and 1 point when the numerical value is less than the constant value. When the numerical value to be scored exceeds a certain value, 2 points are given, and when the numerical value to be scored exceeds a certain value, 1 point is given.
  • the scoring condition is a predetermined observation state indicating the degree of consciousness level with respect to the consciousness level evaluation result
  • the consciousness level evaluation result obtained from the same individual is the content of the predetermined observation state. It is possible to obtain score result information according to the content of the above.
  • the contents of the predetermined observation state include, for example, "presence / absence of abnormality" when the subject's consciousness is confirmed, and known consciousness evaluation methods (Japan comba scale, Glasgow comba scale, etc.). ) Includes information on the evaluation results divided into multiple stages.
  • the predetermined vital exclusion condition uses the value of the following equation (1) as the lower limit value and the value of the equation (2) as the upper limit value and the lower limit value and the upper limit value as a reference, the average ⁇ is negative.
  • the vital exclusion condition can be set based on the upper and lower limit range with the value separated by the value of 2 ⁇ in the direction as the lower limit value and the value separated by the value of 2 ⁇ from the average as the upper limit value.
  • the range of the upper and lower limits referred to here includes a range set by each combination of "above the lower limit value", “exceeds the lower limit value”, “below the upper limit value", and "less than the upper limit value".
  • the "range of ⁇ ⁇ 2 ⁇ ” regarding the measured values of vital signs includes the measured values of body temperature, blood pressure, pulse, pulse pressure and respiratory rate in the calculation basis of the reference range condition (scoring condition). It is within the standard range. For example, when “within ⁇ ⁇ 2 ⁇ " is set as the reference range, if the measured value of a certain vital sign is a value less than ⁇ -2 ⁇ or a value exceeding ⁇ + 2 ⁇ , the measured value scores the vital sign. It is excluded from the calculation basis of the reference range condition when ringing.
  • the probability of falling within the range of "within ⁇ ⁇ 2 ⁇ ” is about 95%. Therefore, if this range of "within ⁇ ⁇ 2 ⁇ ” is positioned as the "normal vital range (range of the subject's normal vitals)" that includes about 95% of the vital signs of the subject, it will be scored.
  • the reference range condition is always set from the measured values included in the subject's normal vital range. As a result, the reference area condition is such that the vital abnormality can be detected with high accuracy.
  • the range of the part that should be regarded as the "normal vital range” may be expanded. For example, when 37.5 ° C was recorded as a measured value of body temperature for 3 consecutive days, the value of 37.5 ° C deviated from “ ⁇ ⁇ 2 ⁇ " under the scoring conditions on the 1st and 2nd days, and 1 A score value of points or higher is calculated, but on the third day, the value of 37.5 ° C is included in the range of " ⁇ ⁇ 2 ⁇ " under the updated scoring conditions, and a score of 0 points is calculated. Can happen.
  • the range of " ⁇ ⁇ 2 ⁇ ", which is a scoring condition becomes wide, and it is not possible to detect an abnormality that is originally determined to be a vital abnormality and a score value of 1 point or more should be calculated. .. That is, the accuracy of detecting the abnormality of vitals is lowered, and accordingly, the determination of the score result information by the score determination means (determination of the presence or absence of the abnormality for the subject) is also affected. Therefore, by setting the "range of ⁇ ⁇ 2 ⁇ " related to the measured value of vital signs as the upper and lower limit range as a predetermined vital exclusion condition, the accuracy of detection of vital abnormality can be improved for the reference range condition for scoring. It will be possible to keep it high.
  • the predetermined vital exclusion condition corresponds to an outlier based on a predetermined test method
  • a value that is statistically significantly different from other measured values is regarded as an outlier.
  • This outlier can be excluded from the basis for calculating the reference range condition.
  • the criteria for scoring the measured values of body temperature, blood pressure, pulse, pulse pressure and respiratory rate are those that do not include outliers, in other words, those that are medically unacceptable are unlikely to be included in the calculation basis. be able to.
  • the predetermined test method includes, for example, the Smirnov-Grabs test.
  • the prescribed vital exclusion condition is whether or not the value is measured on the day when the prescription was made by the doctor, the period included in the prescription content, or the hospitalization period, the subject is diagnosed by the doctor. Therefore, the value of vital signs measured in a state determined to be ill or in a state requiring some treatment can be excluded from the calculation basis of the reference range condition. As a result, the vital information in the state where the subject is clearly in a state of physical condition is not reflected in the scoring standard, and the reference area condition is such that the vital abnormality can be detected with high accuracy.
  • the term "prescription by a doctor" as used herein includes treatments such as medication, infusion, injection, tube feeding, and follow-up at the time of care (not wishing for medical intervention).
  • the period included in the prescription content referred to here means, for example, a period from the start to the end of taking the drug.
  • the hospitalization period referred to here means the period during which the subject is hospitalized as a result of the diagnosis.
  • the predetermined vital exclusion condition is a lower limit with the value of the following equation (1) as the lower limit value and the value of the equation (2) as the upper limit value with respect to the measured value of the vital sign measured a plurality of times under the predetermined condition.
  • the measured value of the vital sign that is below the lower limit value or above the upper limit value is measured twice or more in succession based on the value and the upper limit value, and whether or not it is the second or subsequent measurement value.
  • the vital information is obtained by not completely excluding the values outside " ⁇ ⁇ 2 ⁇ " from the reference region condition and preventing two or more values from being included in the calculation basis of the reference region condition. It is possible to prevent the accuracy of detection of the reference range condition from being excessively lowered while including the value determined to be abnormal in the scoring criteria.
  • the predetermined condition referred to here is, for example, measured under substantially the same conditions, such as the measured values of a plurality of vital signs measured during 5 minutes before and after a certain reference time. It means the content that can be regarded as vital signs.
  • the predetermined vital exclusion condition is whether or not the measured value of the vital sign measured multiple times under the predetermined condition is a measured value other than the principal value selected under the predetermined principal value selection condition. It is possible to exclude measured values other than the principal value selected from a plurality of measured values from the calculation basis of the reference region condition.
  • the predetermined principal value selection condition is, for example, a condition in which one value is systematically selected from among the measured values of a plurality of vital signs artificially or by setting certain conditions. Then, values other than the selected principal value can be prevented from being reflected in the scoring criteria.
  • the artificial selection includes, for example, the act of selecting the other measured value from the two measured values, excluding the numerical value that can be recognized as the measured value due to an obvious input error.
  • a systematic selection for example, in the measurement of blood pressure, a mode in which a measured value included in a normal range is selected from a plurality of measured values can be considered.
  • the blood pressure is measured several times, and when the blood pressure is abnormal, the value in the normal range cannot be seen no matter how many times the blood pressure is measured.
  • the systematic selection can be considered as a mode in which a highly accurate measured value is selected from the range of the plot based on the Q-Q plot. This makes it easier to exclude clearly incorrect measurements from the scoring criteria. In addition, it becomes easier to reflect numerical values that can be said to be in the normal range and measured values whose normality is guaranteed in the scoring standard.
  • the predetermined vital exclusion condition is whether or not the measured value of vital signs whose normality is guaranteed based on the predetermined test method
  • the measured value whose normality is not guaranteed is used as the reference range condition. It can be excluded from the calculation basis.
  • the scoring standard can be set only by the measured value of vital signs whose normality is guaranteed, and it becomes easier to perform scoring that further reflects the intra-individual variation of the subject.
  • the predetermined test method is, for example, the Shapiro-Wilk test.
  • the predetermined vital exclusion condition is based on the information of the worker who measured the vital sign and the information on the normality of the measured value of the vital sign measured by the worker, the normality is not guaranteed.
  • the measured value of the vital sign measured by the worker can be excluded from the calculation basis of the reference range condition. According to this, it is possible to eliminate the result by the operator who may have a problem in the measurement method when measuring vital signs. That is, it is possible to reduce the human influence of the measuring operator's technique.
  • the predetermined vital exclusion condition is whether or not the measured value of the vital sign is a value measured by satisfying the predetermined time condition, the vital is not properly measured at the predetermined time. Sign measurements can be excluded from the basis for calculating reference zone conditions.
  • the handling of the score result information after the determination can be various. For example, even in a state indicating an abnormality, if the numerical value of the score result information is small, it is notified as "Caution”, and if the numerical value of the score result information is large, it is notified as "Warning". It is not necessary to handle the abnormality uniformly. As a result, when the judgment is made, it is possible to efficiently process the measures after the judgment such as whether or not the doctor needs to check immediately.
  • the information input means prompts the remeasurement of vital signs when the measured value satisfying the predetermined vital exclusion condition is input, it becomes easy to guarantee the accuracy of the vital measurement itself. That is, for example, when there is a problem in the work of measuring vitals and a measured value satisfying a predetermined vital exclusion condition is measured, an accurate measured value can be obtained by remeasurement, and the accuracy of vital measurement is guaranteed. can do.
  • the health condition determination device of the present invention scores vital information which is information on acquired vital signs, and based on the obtained score result information, individual health.
  • An information input that is a health condition determination device for determining a condition and accepts input of the vital information including at least one measured value selected from vital signs according to a normal distribution and acquisition date and time, which is acquired from the same individual.
  • the input predetermined vital information is scored based on the predetermined scoring condition to calculate the score result information which is the value of the score, and the predetermined scoring condition peaks at least the average ⁇ .
  • the scoring processing means set based on the normal distribution and the score result information corresponding to a plurality of types of the vital information are integrated, and whether or not the value is abnormal is determined based on a predetermined score determination condition. It is provided with a score determination means for determining, an alert notification means for notifying an alert based on the determination result of the score determination means, and a display means capable of displaying the determination result determined by the score determination means, for at least 30 pieces.
  • the vital information of the measurement data reflects the intra-individual variation peculiar to the individual, the normal distribution is created from the vital information of at least 30 measurement data, and the vital information is the vital sign.
  • the scoring condition comprises at least one measurement selected from body temperature, blood pressure, pulse, pulse pressure and respiratory rate, said scoring condition being at least one measurement selected from body temperature, blood pressure, pulse, pulse pressure and respiratory rate.
  • the value of the following equation (1) expressed using the average ⁇ , the standard deviation ⁇ , and n and m which are numbers larger than 0 is set as the lower limit value and the value of the equation (2) is set as the upper limit value.
  • a reference region condition based on at least one of a lower limit value and an upper limit value is included, and the reference region condition is set by excluding a measurement value satisfying a predetermined vital exclusion condition from the measured values of vital signs.
  • the score determination means is configured to perform the next determination including the score result information scored based on the reference region condition.
  • the health condition determination method of the present invention is a method executed by a computer, and the vital information which is the information regarding the acquired vital signs is scored, and the score result obtained.
  • Input based on an information recording process that accepts and records input, a standard calculation process that calculates the average ⁇ and standard deviation ⁇ of all or part of the recorded vital information, and predetermined scoring conditions.
  • the predetermined vital information is scored to calculate the score result information which is the value of the score, and the predetermined scoring condition is set based on a normal distribution having at least the average ⁇ as the peak value.
  • the processing step the score determination step of determining whether or not the value is abnormal based on a predetermined score determination condition by integrating the score result information corresponding to the plurality of types of the vital information, and the score determination step.
  • the vital information of at least 30 measurement data reflects the intra-individual variation peculiar to the individual, and the normal distribution is at least 30.
  • the vital information includes at least one measurement value selected from the vital signs body temperature, blood pressure, pulse, pulse pressure and respiratory rate, and the scoring condition is , The mean ⁇ , the standard deviation ⁇ , and n and m, which are numbers greater than 0, for at least one measurement selected from body temperature, blood pressure, pulse, pulse pressure and respiratory rate.
  • the value of the following equation (1) is the lower limit value and the value of the equation (2) is the upper limit value, and includes a reference region condition based on at least one of the lower limit value and the upper limit value, and the reference region condition is a vital sign.
  • the measured values the measured values satisfying the predetermined vital exclusion exclusion condition are excluded and set, and the score determination step performs the next determination including the score result information scored based on the reference region condition. It is configured as follows. ⁇ -n ⁇ ⁇ ⁇ ⁇ Equation (1) ⁇ + m ⁇ ⁇ ⁇ Equation (2)
  • the software of the present invention is software for determining the health condition of an individual based on vital information which is information on acquired vital signs, and is an information processing apparatus.
  • An information input means that accepts input of the vital information and acquisition date and time including at least one measured value selected from vital signs that are acquired from the same individual and follow a normal distribution, and the input vital information and acquisition date and time. It is selected from the information recording means for recording information, the reference calculation means for calculating the average ⁇ and the standard deviation ⁇ of all or a part of the plurality of recorded vital information, and the average ⁇ and the standard deviation ⁇ .
  • the predetermined numerical range Based on a predetermined numerical range set based on at least one, it is determined whether or not the input predetermined vital information is an abnormal value, and the predetermined numerical range has a peak value of at least the average ⁇ .
  • Judgment means set based on the normal distribution The vital information of the measurement data for at least 30 pieces reflects the intra-individual variation peculiar to the individual, and the normal distribution is the measurement data for at least 30 pieces.
  • the vital information includes at least one measurement value selected from the vital signs body temperature, blood pressure, pulse, pulse pressure and respiratory rate, and the predetermined numerical range includes body temperature, blood pressure.
  • the reference range condition is set by excluding the measured values satisfying a predetermined vital exclusion condition from the measured values of vital signs.
  • the software, the health condition determination device, and the health condition determination method according to the present invention can accurately capture individual fluctuations that differ from subject to subject, reflecting vital signs and daily physical conditions that take into account individual differences of the subject. It is possible, there are few false positives, and the accuracy of detecting abnormalities in the subject is excellent.
  • the pulse data is the data before excluding outliers based on the Smirnov-Grabs test, (a) is a QQ plot, and (b) is a distribution map.
  • the pulse data is the data after excluding outliers based on the Smirnov-Grabs test
  • (a) is a QQ plot
  • (b) is a distribution map. It is a distribution map of each data set when the number of data is increased for pulse data. It is a distribution map of each data set when the number of data is increased for pulse data.
  • (A) is a graph of a normal distribution curve created based on the vital information of a plurality of subjects
  • (b) is a graph of a normal distribution curve created based on the vital information of the same subject. is there.
  • FIG. 1 is a diagram showing a schematic configuration of a tablet terminal into which software to which the present invention is applied has been introduced.
  • the structure shown below is an example of the present invention, and the content of the present invention is not limited thereto.
  • the software to which the present invention is applied can be introduced into a general-purpose information processing device, and imparts each information processing function necessary for carrying out the present invention to the embedded information processing device.
  • the vital information of the target person is input, scoring is performed according to the content, and the obtained score result information (hereinafter referred to as "score value information") is an abnormal value. Whether or not it can be determined.
  • the information processing device includes a calculation unit such as a CPU, a storage unit such as a RAM or ROM, a display screen such as a liquid crystal screen, an input unit such as a keyboard, and a communication unit that controls communication with the Internet or the like. It is prepared.
  • a calculation unit such as a CPU
  • a storage unit such as a RAM or ROM
  • a display screen such as a liquid crystal screen
  • an input unit such as a keyboard
  • a communication unit that controls communication with the Internet or the like. It is prepared.
  • a general-purpose personal computer for example, a general-purpose personal computer, a tablet terminal, a smartphone, or the like.
  • various healthcare devices, medical systems and long-term care systems installed in hospitals, facilities, etc. are also targeted, and software to which the present invention is applied is incorporated and used in these. It may be.
  • the software to which the present invention is applied is downloaded and incorporated in the tablet terminal 3 as application software, and the tablet terminal having the vital information scoring function and the score value determination function is defined as the health condition determination device 1.
  • the user of the health condition determination device 1 that is, the person whose health condition is determined will be referred to as a "target person”.
  • the health condition determination device 1 (tablet terminal 3) includes a calculation unit 2.
  • the calculation unit 2 is a processing unit that executes each information processing function of the health condition determination device 1. That is, in the software to which the present invention is applied, the calculation unit 2 of the tablet terminal 3 functions as an information input means 23, an information recording means 24, a reference calculation means 5, a scoring processing means 100, a determination processing means 6, and the like.
  • each means information transmission / reception, information recording, scoring based on the contents of vital information, setting of scoring conditions (scoring reference information, reference area condition), determination of abnormality in score value information, score Setting of judgment criteria (score judgment conditions) for abnormalities related to values, notification of judgment results regarding score values, judgment of abnormalities in vital sign values, setting of judgment criteria for abnormalities related to vital sign values, judgment results regarding vital sign values Notification, creation and display of display information, etc.
  • the tablet terminal 3 can access an external server, terminal, etc. via the Internet, and can also send and receive information to and from an external server, terminal, and the like.
  • the information recording means 24, the reference calculation means 5, the scoring processing means 100, and the determination processing means 6 are the “information recording means”, the “reference calculation means”, the “scoring processing means”, and the “score determination means” of the claims of the present application, respectively. Is an example.
  • the tablet terminal 3 has an information recording unit 4, an information transmission / reception unit 3c, an input unit 3a, and a display unit 3b.
  • the information transmission / reception unit 3c is a part responsible for transmitting / receiving information between the calculation unit 2, the information recording unit 4, the input unit 3a, the display unit 3b, and the like. Also. Information may be transmitted and received between the tablet terminal 3 and the external terminal.
  • each information handled by the software to which the present invention is applied does not necessarily have to be recorded in the information recording unit 4 of the tablet terminal 3.
  • the information recording unit 4 of the tablet terminal 3 For example, even in a mode in which various information is transmitted to an external server or an external terminal via the information transmission / reception unit 3c of the tablet terminal 3 to be recorded, and necessary information is received from the external server or the like at the time of determination or the like. Good.
  • the tablet terminal 3 may display only the determination result information and the display information such as the heat type table, and record various information and perform the determination process on an external server or the like.
  • the software to which the present invention is applied may have a plurality of variations in the configuration on the system. Examples of some variations will be described below.
  • the schematic configuration of the tablet terminal 3 shown in FIG. 1 is such that the software to which the present invention is applied is introduced into the terminal, and the terminal itself inputs and records vital information, displays the score value, determines the score value, and determines the score value. It is possible to display the judgment result, set the scoring condition, set the judgment calculation standard of the score value, and notify the alert. That is, the function of the present invention can be executed by the device alone.
  • the schematic configuration shown in FIG. 1 shows the use of software to which the present invention is applied in a "stand-alone type" device that is not connected to an Internet environment.
  • the software of the present invention can be introduced into an information processing device that is not connected to the Internet environment, for example, various healthcare devices, or a medical system / long-term care system such as a hospital, and used as a dedicated device. Since the tablet terminal 3 is taken as an example of the information processing device here, it is possible to connect to the Internet environment. However, in the configuration shown in FIG. 1, the health condition can be determined only by the internal function of the tablet terminal 3. It can be performed.
  • FIG. 2 (Second system configuration)
  • a configuration in which the function of the software 1a to which the present invention is applied is provided to an external server can also be adopted.
  • the user terminal 50a and the external terminal 50b can access the information management server 32a via the Internet 30a.
  • the information management server 32a is, for example, an external server provided in a cloud format, and the function of software 1a to which the present invention is applied can be used on the information management server 32a.
  • the information management server 2a has an information recording unit 4a, an information transmission / reception unit 3c, and a calculation unit 2a. Further, the calculation unit 2a includes a reference calculation means 5a, an information recording means 24a, a scoring processing means 100a, and a determination processing means 6a.
  • the vital information is input via the user terminal 50a or the external terminal 50b, the information input from each terminal is transmitted to the information management server 32a, and the information management server 32a records the information and determines the score value. Be done.
  • the determination result of the score value and the recorded information are transmitted to the user terminal 50a and the external terminal 50b, and can be confirmed by each terminal. In this way, a system configuration that imparts the functions of software 1a on the external server can also be adopted.
  • FIG. 3 shows the configuration of the management terminal 70b including the module A having a plurality of software 32c, 32d, etc., in addition to the functions of the software 32b to which the present invention is applied, as the third system configuration.
  • the software 32b to which the present invention is applied constitutes one module A together with other software that causes the management terminal 70b to execute various functions different from the software 32b. That is, it is possible to incorporate the software 32b into the module A of the management terminal 70b into which a plurality of software 32c, 32d, etc. have been introduced in advance to make the software 32b function.
  • software to which the present invention is applied can be incorporated into a module provided in a management terminal of a medical system such as an electronic medical record.
  • vital information can be input to the management terminal 70b, scoring and score value determination can be performed, and the result information can be confirmed on the management terminal 70b.
  • the user terminal 60a or the external terminal 60b is connected to the management terminal 70b, vital information is input from the user terminal 60a or the external terminal 60b and transmitted to the management terminal 70b, and the management terminal 70b scores and scores. It is also possible to determine the value and receive and confirm the result information on the user terminal 60a or the external terminal 60b.
  • the software to which the present invention is applied may also adopt a configuration in which it functions as a part of a module composed of a plurality of software.
  • the information recording unit may be provided in the user terminal
  • the reference calculation means, the scoring processing means, and the determination processing means may be provided in the external server, and the location of the necessary functions may be divided into the terminal and the server. That is, if the vital information of the subject is recorded, the judgment criteria (scoring conditions, numerical range for vital judgment) reflecting the intra-individual variation are set, and the health condition can be judged, various configurations are adopted. sell.
  • the information recording unit 4 is composed of the personal information of the target person, the values of vital signs measured by various vital measuring instruments, and the evaluation result of the consciousness level obtained by observing the caregiver of the target person. It is a part that records the vital information together with the information of the measurement date and time or the acquisition date and time.
  • Various types of information recorded in the information recording unit 4 can be input and information can be modified via the input unit 3a, the information transmission / reception unit 3c, and the information input means 24 (not shown) of the tablet terminal 3. Further, the contents of various information recorded in the information recording unit 4 can be confirmed via the display unit 3b and the information transmission / reception unit 3c of the tablet terminal 3.
  • the information recording unit 4 includes personal information 7 of the subject, measurement values of vital signs measured by each vital measuring instrument, evaluation results of the consciousness level obtained from observation of the subject, and information on the measurement date and time or acquisition date and time. Vital information 8 including is recorded. Further, the personal information 7 and the vital information 8 are configured to be recordable in association with the identification information that can identify an individual target person. As a result, a plurality of target persons can be identified, and a plurality of target persons can use one health condition determination device 1.
  • Vital information 8 includes measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure and respiratory rate, which are vital signs.
  • the vital information 8 includes a measured value of oxygen saturation.
  • the vital information includes the above-mentioned evaluation result of the consciousness level.
  • the vital sign may also include a value of urine volume and the like.
  • the measurement date and time or acquisition date and time included in the vital information 8 is the date and time when the subject performed the vital measurement and the date and time when the consciousness level was confirmed.
  • the subject performed the vital measurement by himself / herself.
  • the time confirmed at that time and the time when the caregiver or the like observed the subject is input.
  • the vital information 8 includes vital information 8a that does not satisfy the condition of vital exclusion standard information 200, which will be described later, and vital information 8b that satisfies the condition of vital exclusion standard information 200.
  • the vital information 8a and the vital information 8b can be distinguished from each other and used for creating the scoring reference information 102.
  • the classification of the vital information 8a and the vital information 8b can be appropriately distinguished by selecting or combining a plurality of conditions included in the vital exclusion standard information 200.
  • the vital information 8a and the vital information 8b are classified only by a single vital exclusion condition. Further, it is also possible to combine two or more of the plurality of vital exclusion conditions and use the information satisfying all the conditions as the vital information 8b and the other information as the vital information 8a.
  • the reference region condition 220 ( ⁇ ⁇ n ⁇ ), which is one of the scoring standard information 102, is calculated from the vital information 8a.
  • the reference range condition 220 which is a reference when scoring the vital signs according to the normal distribution, such as body temperature, blood pressure, pulse, pulse pressure, and respiratory rate, does not satisfy the condition of the predetermined vital exclusion condition 200.
  • Vital information 8b that satisfies the condition of vital exclusion standard information 200 is excluded from the calculation basis.
  • the vital information 8 includes a value of vital signs, which is the basis for determining that the total score of the score value information 103 is an abnormal value based on the score determination standard information 18. .. That is, the vital information 8 includes not only the vital sign value when the score value information 103 is determined to be normal, but also the vital sign value when the score value information 103 is determined to be abnormal.
  • the vital information 8 includes the value of the vital sign that is the basis when the score value information 103 is determined to be abnormal and the value that the measured value of the vital sign is determined to be abnormal. As will be described later, it is sufficient that the vital information of at least 30 measurement data reflects the intra-individual variation peculiar to the individual.
  • the types of vital information 8 are not necessarily limited to body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure, respiratory rate, oxygen saturation measurement values, and consciousness level evaluation results, and other information. Scoring may be performed including vital signs, and the presence or absence of abnormality may be determined based on the total score of the score values. For example, urine output, body weight, pain (presence or absence or degree of pain), and other medical abnormalities can be included in vital information.
  • the above-mentioned vital signs are the most typical vital signs, and it is preferable to adopt them because it is easy to acquire vital information.
  • the measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure and respiratory rate of vital signs follow a normal distribution when obtained by the same subject, and have a normal distribution. It is particularly preferable to adopt it because the scoring conditions based on it can be set.
  • the vital measuring device for measuring the value of vital signs is not particularly limited, and can measure body temperature, pulse, systolic blood pressure, diastolic blood pressure, respiratory rate and oxygen saturation. Is enough.
  • vitals may be measured using a household vital measuring device.
  • the value of vital signs is measurable, it is not essential to use a vital measuring instrument. For example, it is possible to measure the pulse rate and the respiratory rate per minute while measuring the time with a clock, and use this as vital information.
  • the vital sign values are obtained by the same method.
  • the type of vital measuring instrument is changed frequently, and the measurement by the vital measuring device and the measurement without the vital measuring device are mixed, so that the vital sign measurement method is biased. .. Therefore, it is preferable to measure the vital sign value by the same method or the same vital measuring device as much as possible.
  • Vital information 8 (vital information 8a) is widely configured to be able to record vital information 8 every second. Further, the vital information 8 can be set to be recorded at different time intervals, for example, every minute or every hour.
  • the vital information 8 may adopt a configuration in which the measured values measured at irregular times are recorded instead of the measurements at regular intervals. Further, in the case of this irregular measurement, for example, at least 30 vital information 8s are acquired in 1 minute, and at least 30 vital information 8s are acquired in 30 minutes, and at least 30 vital information 8s are acquired in 1 hour. Acquire vital information 8; acquire at least 30 vital information 8 in a few hours. Acquire at least 30 vital information 8 in a day. Acquire at least 30 vital information 8 in a few days.
  • At least 30 vital information 8 in a week acquire at least 30 vital information 8 in a few weeks, acquire at least 30 vital information 8 in a month Etc., at least 30 vital information 8 (vital information 8a) may be recorded in a certain period of time.
  • the vital information 8 (vital information 8a) is obtained by randomly extracting at least 30 pieces of data from the accumulated vital information regardless of regular intervals or irregular intervals, and "30 pieces of data”. It can also be recorded as vital information 8 of the measurement data of.
  • the vital information 8 (vital information 8a) is configured to be able to record at least 30 measurement data regardless of the length of time and the presence or absence of regularity of measurement intervals.
  • the information recording unit 4 can record the guideline time information 9 which is the guideline time information for the target person to measure and acquire the vital information.
  • the guideline time information 9 records the guideline time for measuring and acquiring the vital information of the subject, such as 8:30 in the morning and 18:00 in the evening.
  • the reference time information 9 can be freely set and modified.
  • the information recording unit 4 records posture information 10 which is information on the correct posture when measuring the value of each vital sign.
  • the posture information 10 is, for example, as follows. (1) Body temperature For example, when measuring body temperature with a thermometer that measures body temperature under the armpit, “Is the measuring part of the thermometer located in the center of the armpit?", “Is the armpit and the thermometer in close contact?”, “Every time It is the information of the posture such as "Is it the same posture?" (2) Pulse For example, when measuring the pulse rate with an electronic pulse rate monitor or a finger on the wrist, “is it in a resting state?", “Is it in a relaxed and comfortable posture?" This is posture information such as "is it?" (3) Systolic blood pressure, diastolic blood pressure For example, when measuring by the oscillometric method that measures the vibration of blood vessels, “Is it in a resting state?" Information on postures such as "whether you are doing it” and “whether you are in the same posture every time”.
  • a certain number of data (at least 30) used in the calculation of the scoring conditions by the standard calculation means and the scoring processing means, the vital average value used for the calculation of the scoring conditions, and the calculation of the vital standard deviation.
  • the number of times vital information is recorded is not limited as long as the number of vital information is recorded. Further, it is not necessary that the vital information 8 is always recorded at regular intervals such as every second, every minute, every hour, and every day, and there may be times when the vital information 8 is not recorded.
  • the reference time information 9 it is not always necessary to record the reference time information 9 in the information recording unit 4. However, by recording the reference time information 9, it becomes easy to measure and acquire vital information in a time zone that seems appropriate. In addition, when the standard time is reached, the target person or the caregiver may be notified to that effect.
  • the posture information 10 does not necessarily have to be recorded in the information recording unit 4. However, by recording the posture information 10, it is possible to urge the target person to measure in an appropriate posture while displaying the posture information 10 at the time of measuring each vital sign.
  • the measurement method of each vital sign and the content of the posture information 10 are not limited to those described above, and the vital measurement method and the content of the posture information 10 suitable for this can be changed as appropriate.
  • the information recording unit 4 can record the temperature information 11 of the place where the vital information was measured and acquired.
  • the air temperature information 11 is recorded in association with the records at the time of measurement and acquisition of the vital information 8.
  • the air temperature information 11 for example, information that the subject confirms and inputs the air temperature at the measurement location is adopted.
  • the information recording unit 4 it is not always necessary for the information recording unit 4 to be able to record the temperature information 11 of the place where the vital information is measured and acquired. However, by recording the temperature information 11, it is possible to confirm whether or not the environment in which the vital information was measured and acquired was an appropriate place.
  • the information recording unit 4 records a reference area condition 220 and a scoring reference information 102, which are reference points when scoring each input vital information by the scoring processing means 100. .. Further, the information recording unit 4 records score value information 103, which is numerical information of the result of scoring based on the scoring reference information 102.
  • the total score of each score value information 103 scored from a plurality of vital signs obtained from the contents of the input vital information is obtained by the determination processing means 6 and its value (total).
  • the score determination reference information 18 that serves as a reference for determining whether or not the point) is an abnormal value is recorded.
  • the scoring standard information 102 and the score determination standard information 18, which will be described later, can be added or modified through the input unit 3a of the tablet terminal 3, the information transmission / reception unit 3c, and the information input means 24 of the calculation unit 2. .. Further, the contents of each scoring reference information 102 can be confirmed via the display unit 3b of the tablet terminal 3. The detailed contents of each standard in the scoring standard setting means 101 will be described later.
  • the determination processing means 6 determines that the total score of each score value information 103 scored from a plurality of vital signs is an abnormal value, which is the score determination result information. Twelve are recorded. The contents can be confirmed via the display unit 3b of the tablet terminal 3. Further, the score determination result information 12 can show the determination result not only by the display due to abnormality or normality but also by color coding according to the score.
  • the information recording unit 4 as the vital information 8, it is possible to record the vital information when the measurement and acquisition of the vital information are performed again and the remeasurement vital information 13 which is the information of the date at the time of measurement. It has become.
  • the remeasurement vital information 13 is the vital of the remeasurement performed to confirm the accuracy of the vital information when the input vital information satisfies the vital exclusion condition set as the vital exclusion standard information 200. Information.
  • the remeasurement vital information 13 is, for example, remeasurement performed to confirm the accuracy of the vital information when the determination processing means 6 determines that the score value obtained for the vital information is an abnormal value. Vital information may be included.
  • the vital information of the above is configured so that the colors of the characters indicating the vital information of the three patterns can be displayed differently.
  • the score determination result information 12 can be recorded in the information recording unit 4.
  • the information recording unit 4 it is not always necessary for the information recording unit 4 to be able to record the remeasurement vital information 13.
  • the information recording unit 4 has the remeasurement vitals because it leads to ensuring the accuracy of the vital information and it is possible to verify whether or not the vital measurement is accurate by using the remeasurement vital information 13. It is preferable that the information 13 can be recorded.
  • the reference calculation means 5 will be described.
  • the reference calculation means 5 is one of the functions executed by the software to which the present invention is applied to the calculation unit 2, and calculates the score value information 103 for the vital information (input vital information) recorded in the information recording unit 4.
  • the processing is performed to calculate the numerical range that becomes the scoring reference information 102, and to calculate the vital mean value and the vital standard deviation used for calculating the numerical range that becomes the scoring reference information 102.
  • the reference calculation means 5 sets the vital exclusion conditions for the measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure, and respiratory rate based on the vital exclusion conditions set as the vital exclusion reference information 200.
  • the vital information 8b that satisfies the vital information 8b and the vital information 8a that does not satisfy the vital exclusion condition are divided, and the numerical range (reference area condition 220) that becomes the scoring reference information 102 is calculated using the vital information 8a.
  • the reference range condition 220 serves as a reference for scoring the measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure, and respiratory rate.
  • FIG. 4 shows a function to be executed by the software to which the present invention is applied to the calculation unit 2.
  • the calculation unit 2 functions as the mean value calculation means 14, the standard deviation calculation means 15, the normal distribution calculation means 16, the scoring standard setting means 101, and the vital exclusion standard setting means 110 that constitute the reference calculation means 5.
  • the mean value calculating means 14 and the standard deviation calculating means 15 include vital information 8a (measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure and respiratory rate) recorded in the information recording unit 4. Based on the remeasured vital information 13a, from the recorded information under the vital exclusion condition set as the vital exclusion standard information 200, the "average value of the vital information after exclusion” and the “average value of the vital information under the same condition" in the statistical distribution. "Standard deviation of vital information after exclusion" is calculated respectively.
  • the "mean value of vital information after exclusion” is referred to as the “mean value of vital information” and "exclusion", except when referring to the name of the type of mean value or standard deviation for which special calculation is performed.
  • the later standard deviation of vital information shall be referred to as the "standard deviation of vital information”.
  • the vital exclusion conditions will be described later.
  • the remeasured vital information 13a is the remeasured vital information and the vital information that does not satisfy the set vital exclusion condition.
  • the mean value calculating means 14 and the standard deviation calculating means 15 include vital information 8 (measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure and respiratory rate) recorded in the information recording unit 4. Based on the remeasured vital information 13, the "average value of vital information" under the same conditions and the “standard deviation of vital information” in the statistical distribution of the vital information under the same conditions are obtained from the recorded information under the predetermined conditions. It is also possible to set each calculation.
  • the total score of the score value information 103 is an abnormal value based on the score determination reference information 18 with respect to the vital information 8a recorded in the information recording unit 4.
  • the vital information mean value and the vital information standard deviation may be calculated including the value of the vital sign which is the basis when the determination is made.
  • the "predetermined conditions" adopted when calculating the mean value calculation means 14 and the standard deviation calculation means 15 are usually 30 vital information 8a (body temperature, pulse, systolic blood pressure, diastole) starting from the time of determination. A method using (measured values of systolic blood pressure, pulse pressure and respiratory rate) is adopted. The vital information during this period is the vital information 8a and the remeasurement vital information 13a for the past 30 pieces including the measurement data at the time of determination.
  • the settings for the past 30 pieces are broadly the data of vital information measured every second, and in addition to this, every minute, every few minutes, every hour, every day. Data with different lengths of time, such as vital information data measured every month, can be adopted.
  • the data acquired irregularly may be extracted for the past 30 pieces. At this time, a method of simply extracting 30 pieces so as to go back in the order of acquisition may be used. Alternatively, a method may be used in which 30 pieces of data are extracted by setting some extraction conditions for the irregularly acquired data.
  • the extraction conditions include, for example, the condition that 30 pieces are extracted from within a predetermined 1-hour range, and the interval between the acquisition times of vital information satisfies certain conditions (the interval is at least 5 minutes or more, or the interval). Is within 1 hour, etc.) Conditions are also conceivable. Further, a method may be used in which 30 vital information 8a are randomly selected and extracted with respect to the vital information 8a measured regularly at regular intervals. The extraction conditions for the past 30 pieces can be appropriately set as needed. Regardless of how it is taken, if at least 30 vital information 8a can be extracted, a normal distribution that reflects intra-individual variation can be obtained and used for scoring reference information 102 (reference area condition 220). it can.
  • the vital information 8a is widely configured to be able to record the vital information 8a every second. Further, the vital information 8a can be set to be recorded at different time intervals such as every minute and every hour. Further, the vital information measured a plurality of times a day is irregularly configured to be recordable.
  • the calculation unit 2 functions as the mean value calculation means 14 and the standard deviation calculation means 15 to calculate the vital mean value and the vital standard deviation
  • the vital mean value and the vital standard deviation are calculated under appropriately set conditions. can do. For example, if the conditions for extracting the vital information for 30 pieces are set, the vital average value and the vital standard deviation can be calculated from the extracted vital information for 30 pieces.
  • the mean value calculation means 14 and the standard deviation calculation means 15 were recorded at the time of determining the score value information 103 or the vital sign value based on the input vital information of the target person, each time before the determination time.
  • the vital information 8a and the remeasured vital information 13a With reference to the vital information 8a and the remeasured vital information 13a, the vital information mean value and the vital information standard deviation at the time of the determination are calculated.
  • the criteria used by the determination processing means 6 (or the score processing means 100) are changed at each determination time point, and the total score of the score value information 103 based on the vital information of each vital sign is an abnormal value. It becomes easy to reflect the intra-individual variation of the vital information of the subject in the determination of whether or not the vital sign is present and whether or not the value of the vital sign is an abnormal value.
  • the number of vital information 8a used may be 30 or more, and a larger number such as 90 or more may be used.
  • the minimum number of data for capturing intra-individual variation is preferably 30 or more.
  • the calculation period is shown in FIG. 5, for example. It is possible to set the 90-day range to move one day at a time with the passage of time. That is, the 90-day period used for the calculation on a certain measurement date (determination date) is indicated by the range (reference numeral A) from 90 days before the measurement date to the measurement date including the measurement date. Further, the "predetermined condition" used for the calculation one day before the measurement date is indicated by the range (reference numeral B) from 91 days before the measurement date to the day one day before the measurement date.
  • the "predetermined condition" used for the calculation two days before the measurement date is indicated by the range (reference numeral C) from 92 days before the measurement date to the day two days before the measurement date.
  • the 90-day range of the "predetermined condition” can be set to move one day at a time with the passage of time (direction of the arrow of the symbol T). This point is the same when it is used as the number of data for 30 pieces with different lengths of time (for example, several minutes, several hours, in one day).
  • the "predetermined condition" adopted when calculating the mean value calculation means 14 and the standard deviation calculation means 15 is set so that 30 vital information including the time of determination is used.
  • the judgment time does not necessarily have to be the starting point.
  • the "predetermined condition" to be performed it is preferable that 30 vital information including the time of determination is used.
  • the "predetermined condition" adopted when calculating the mean value calculating means 14 and the standard deviation calculating means 15 does not necessarily have to be vital information measured on consecutive dates (number of pieces).
  • the number of days (number) of a predetermined condition is "30 days in total (30 days). (Individual) ”may be used.
  • vital information is recorded twice a day in the morning and afternoon continuously every day, and all the information is recorded by the mean value calculation means 14 and the standard deviation. It is used for the calculation of the calculation means 15.
  • the vital information does not necessarily have to be continuously acquired such as every second, every minute, every hour, and every day.
  • the date (timing) at which the vital information is acquired is discontinuous, and may be several days (several times). It may be a mode acquired once. Further, it may be a mode in which the vital information is partially extracted based on the set conditions in the presence of a continuous record of vital information.
  • the set conditions include, for example, extracting only vital information every Monday, extracting only vital information acquired in the morning, and extracting only a specified date.
  • the normal distribution calculation means 16 is a part that calculates a normal distribution from the average value and standard deviation of vital information under a predetermined condition. It is possible to calculate the normal distribution at each judgment time of the subject, and for the calculated normal distribution, a normal distribution curve that graphs the probability density function is created, and this normal distribution curve is displayed on the display unit 3b of the tablet terminal 3. It is configured to be.
  • the scoring standard setting means 101 is linked with the mean value calculation means 14 and the standard deviation calculation means 15, and the scoring processing means 100 performs scoring based on the vital mean value and the vital standard deviation calculated from each calculation unit.
  • the scoring reference information 102 and the reference area condition 220 to be used are created.
  • the created scoring reference information 102 and reference area condition 220 are recorded in the information recording unit 4.
  • the scoring standard setting means 101 interlocks with the mean value calculation means 14, the standard deviation calculation means 15, and the normal distribution calculation means 16, and the body temperature, pulse, systolic blood pressure, and diastole measured from the subject.
  • scoring reference information 102 and reference range condition 220 used for scoring are created based on the vital mean value and vital standard deviation calculated from each calculation means.
  • the scoring reference information 102 a standard in a certain numerical range set in advance is used in addition to the reference range condition 220 ( ⁇ ⁇ n ⁇ ) using the vital information mean value and the vital information standard deviation. May be good.
  • the scoring reference information 102 includes not only the calculation result of each calculation means, but also information in a certain preset numerical range used when scoring the measured value of oxygen saturation, and consciousness. It also contains information on the content of a given observational state that can distinguish the degree of level.
  • a predetermined numerical range can be input from the input unit 3a of the tablet terminal 3 and set as the scoring reference information 102. it can.
  • the set scoring reference information 102 is recorded in the information recording unit 4.
  • the content of a predetermined observation state capable of distinguishing the degree of the consciousness level can be input and set as the scoring reference information 102.
  • the set scoring reference information 102 is recorded in the information recording unit 4. The details of the calculation of the vital mean value, the vital standard deviation, the mode, and the scoring reference information 102, and the setting of the scoring reference information 102 composed of a plurality of items will be described later.
  • the scoring processing means 100 will be described.
  • the scoring processing means 100 is one of the functions executed by the software to which the present invention is applied to the calculation unit 2, and is an average value of the vital information 8a at the time of determination input via the input unit 3a of the tablet terminal 3.
  • the standard deviation calculation means 15 the scoring standard information 102 including the preset standard, and the reference area condition 220
  • the score value information 103 (score information) according to the content of the vital information, Performs processing to calculate the total score of each score value information of a plurality of vital signs.
  • the score value information 103 calculated by the scoring processing means 100 and the total score of each score value information are recorded in the information recording unit 4 as described above. At that time, the score value information 103 and the total score of each score value information are recorded in association with the identification information that can identify the individual and the information that is the calculation standard of the score value.
  • the scoring processing means 100 is configured to output the total score of the score value information 103 and each score value information in conjunction with the information recording unit 4 and the reference calculation means 5.
  • the contents of the score value information 103 and the total score of each score value information can be confirmed via the display unit 3b of the tablet terminal 3. Further, the score value information 103 and the total score of each score value information are sent to an external server or an external terminal via the information transmission / reception unit 3c of the tablet terminal 3 as well as the display unit 3b of the tablet terminal 3. Information 12 can also be transmitted and confirmed on these screens and the like.
  • the determination processing means 6 will be described.
  • the determination processing means 6 is one of the functions executed by the software to which the present invention is applied to the calculation unit 2, and the vital information at the time of determination input via the input unit 3a of the tablet terminal 3 is the scoring processing means 100.
  • the determination process is performed as to whether or not the total score of the score value information 103 is an abnormal value based on the score determination criterion information 18. ..
  • the score determination result information 12 which is the determination result determined by the determination processing means 6, is recorded in the information recording unit 4 as described above. Further, the content of the score determination result information 12 can be confirmed via the display unit 3b of the tablet terminal 3. Further, the score determination result information 12 transmits the score determination result information 12 not only to the display unit 3b of the tablet terminal 3 but also to an external server or an external terminal via the information transmission / reception unit 3c of the tablet terminal 3. You can also check on these screens.
  • the score determination result information 12 not only displays on the display unit 3b of the tablet terminal 3, but also indicates that the score determination result information 12 is issued via the alert notification means 120 (see FIG. 4). It can be configured to notify the target person with a notification sound or an e-mail message.
  • the alert notification means 120 notifies an alarm only when the result of "warning (for example, the total score of the score value information 103 is 2 points or more)" is obtained for the content of the score determination result information 12. Can be set. As a result, an alarm is notified to the outside only when the target person is determined to be abnormal based on the results of the score value information 103 of a plurality of vital signs, and the accuracy of abnormality detection is improved while being unsuccessful. It is possible to make it a mechanism that the alarm is not notified easily.
  • the setting for the alert notification means 120 to notify the alarm can be changed as appropriate.
  • the vital information is acquired by a wearable vital measuring device 21a, a thermometer 21b, or the like, and the measured values measured by these are combined with the measured time information on the tablet terminal. Input is performed via the screen displayed on the display unit 3b of 3. A touch panel type input unit 3a is displayed on the display unit 3b, and vital information is input here. If the tablet terminal 3 (first system configuration) into which the software to which the present invention is applied is installed, it is possible to record information, determine the health condition, and display the determination result by the terminal alone.
  • the vital information is transmitted from the smartphone terminal 22a and the personal computer terminal 22b (hereinafter, referred to as “PC terminal 22b)” to the information management server which is the external server described in the second system configuration described above. It is also possible to access 32a and input vital information from the smartphone terminal 22a or the PC terminal 22b. Based on the vital information transmitted from each terminal, the information management server 32a determines the health condition, and the result is The information is transmitted to each terminal, and the result information is displayed on the screen of each terminal.
  • the information management server 32a determines the health condition, and the result is The information is transmitted to each terminal, and the result information is displayed on the screen of each terminal.
  • FIGS. 8 and 9 are examples of input screens used when a hospital patient or a resident of a long-term care facility or the like is used as a health condition determination target.
  • FIG. 8 input items for one target person and a numeric keypad area displaying numbers are displayed.
  • the value of each vital sign can be input by operating the cursor on the touch panel or on the screen in the numeric keypad area.
  • the screen display of FIG. 8 items of meal, urination, defecation, observation / interview are provided, and in addition to the vital sign value, a plurality of items for confirming the health condition of the subject are provided. By recording a plurality of items for confirming these health conditions, it is possible to keep a record of the daily health condition of the subject.
  • the input information is recorded in the information recording unit 4 inside the apparatus or transmitted to the external information management server 32a (information recording unit of the server) by touching or clicking the transmission button.
  • the input screen shown in FIG. 9 is provided with input fields for measurement data of a plurality of vital signs and selection items for normal or abnormal physical condition judged by the subject himself / herself on the right side of the screen.
  • the subjective symptom, objective symptom, and fever type table can be selected so that further physical condition information can be input and the vital changes of the subject can be confirmed over time.
  • the names of a plurality of target persons are displayed, and by selecting the name field, the screens of the selected target persons can be displayed.
  • the time information at the time of inputting the vital sign value is input at the same time.
  • the input screen when using the software of the present invention is intended for hospital patients and residents of long-term care facilities, etc., and can be input and displayed together with related items. it can.
  • the display of the input screen is not limited to the content associated with the caregiver, etc.
  • application software for health management input and record of the value of each vital sign and management of information such as weight.
  • the screen configuration may be a combination of and. That is, it can be used by a healthy subject for daily health management.
  • the measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure, and respiratory rate are input vitals based on the vital exclusion conditions constituting the contents of the set vital exclusion standard information 200.
  • the measured values of the signs are classified into vital information 8a and vital information 8b.
  • This vital exclusion standard information 200 is composed of one type of vital exclusion condition or two or more types of vital exclusion condition.
  • the contents and combinations of vital exclusion conditions to be set can be appropriately set according to the purpose.
  • the entered vital sign value is excluded from the vital sign value that satisfies the set vital exclusion condition, and the vital information 8a is extracted.
  • the value of the excluded vital signs is the vital information 8b.
  • the vital information 8a and the vital information 8b are recorded in the information recording unit 4.
  • This vital information 8a is based on the set vital exclusion conditions such as information that is likely to be included in the normal range of the subject, information that does not include outliers statistically, and information whose normality is guaranteed.
  • the vital information is obtained by removing values that are considered abnormal as the values of vital signs.
  • the vital information 8a serves as a basis for calculating the reference region condition 220 ( ⁇ ⁇ n ⁇ ) for scoring the measured values of vital signs. Since the vital information 8a is a value obtained by removing a value that is considered to be abnormal as the value of vital signs, the reference range condition 220 ( ⁇ ⁇ n ⁇ ) is a value of the vital signs that can be regarded as a normal normal range in the subject. The range is narrowed down.
  • the reference area condition 220 is a condition in which the accuracy of abnormality detection is improved.
  • the high accuracy of abnormality detection means that when the measured value of vital signs is scored under the reference region condition 220, one point (single vital abnormality) or more is likely to be obtained as the score value information 103.
  • the scoring points and the determination of the presence or absence of an abnormality with respect to the total points of the score information 103 will be described later.
  • the measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure and respiratory rate are ⁇ -2 ⁇ or less or ⁇ + 2 ⁇ or more, the values satisfy the vital exclusion condition.
  • the measured value is excluded from the calculation basis of the reference region condition 220.
  • the vital average value " ⁇ " in “ ⁇ ⁇ 2 ⁇ ” under this condition and the value of the vital standard deviation " ⁇ ” itself are also the vital information already recorded when the measured value of vital signs is input. Is calculated from the measured values that satisfy the condition that they are included in the range of " ⁇ ⁇ 2 ⁇ ".
  • the measured values of vital signs that can be regarded as the normal normal range of the subject are aggregated, and the vital information 8a is extracted.
  • ⁇ -2 ⁇ or less or ⁇ + 2 ⁇ or more as a condition within the range of “ ⁇ ⁇ 2 ⁇ ” which is a vital exclusion condition.
  • the lower limit value may be "less than ⁇ -2 ⁇ ”
  • the upper limit value may be "a value exceeding ⁇ + 2 ⁇ ”.
  • the first body temperature of 35.6 ° C. was judged to be abnormal, but when the standard ( ⁇ ⁇ 2 ⁇ ) was set without excluding the value judged to be abnormal, the second time.
  • the body temperature of 35.6 ° C. is judged to be "normal” because the range of the standard has been expanded. That is, the range in which the value of vital signs is regarded as an abnormality has expanded, and the accuracy of detecting an abnormality has decreased.
  • the 74 values of blood pressure (bottom) are excluded as the basis for calculating the reference ( ⁇ ⁇ 2 ⁇ ) when it is judged to be abnormal the first time. It shows that the result of the second judgment is different.
  • the second judgment is made depending on whether or not to exclude it. It shows that the results are different.
  • the detection of vital sign anomaly is detected in the reference range condition 220 when scoring the measured value of vital signs.
  • the accuracy can be improved.
  • the Smirnov-Grabs test is a method for testing whether or not to exclude a set of measured values of vital signs that is considered to be abnormal as the value of vital signs. It is used in vital signs that follow a normal distribution.
  • the Smirnov-Grabs test proceeds as follows. (1) Obtain the mean value, variance, and maximum value (or minimum value) of the target data (set of measured values of vital signs). (2) Obtain the test statistic T. (3) Judge the significance. (4) If an outlier is used, the outlier is excluded, the test process is performed, and the process is repeated until no outlier is output.
  • the set of pulse measurement values has the QQ plot shown in FIG. 16 (a) and the distribution shown in FIG. 16 (b) before excluding the outliers.
  • the outliers are excluded, and as a result, the QQ plot shown in FIG. 17 (a) and the distribution shown in FIG. 17 (b) are obtained.
  • the vital information 8a can be made into information in which a medically unacceptable value is unlikely to be included in the calculation basis.
  • the date or period of medical intervention by this doctor corresponds to the date when the doctor diagnosed the subject and the prescription was made by the doctor, the period included in the prescription, and the length of hospital stay.
  • Prescriptions by doctors include treatments such as medication, infusion, injection, tube feeding, and follow-up during care (not wanting medical intervention).
  • the period included in the prescription content referred to here is, for example, the period from the start to the end of taking the drug.
  • the hospitalization period is the period from the day when the subject is admitted to a medical institution such as a hospital to the time when the subject is discharged as a result of a doctor's diagnosis.
  • care (not wishing for medical intervention) is when the subject is diagnosed with some kind of illness, but the subject's family does not wish to take treatment such as taking medication.
  • Information on the date or period of medical intervention by this doctor is recorded in the information recording unit 4 as personal information 7 of the subject. For example, when a medication is prescribed, information such as "temporary medication 10-day administration" and information on the corresponding period are recorded.
  • the value of vital signs measured on the day or period of medical intervention by this doctor is the vital sign when the subject is judged to be ill or needs some treatment. Therefore, by excluding the values of vital signs measured under such conditions as values that are considered to be abnormal, the measured values of vital signs that can be regarded as the normal normal range of the subject can be obtained from the vital information 8a. It can be an aggregated content.
  • the fixed condition means, for example, the content of measuring the blood pressure multiple times in 5 minutes, and means a condition that can be treated as a vital sign measured under the same condition.
  • this vital exclusion condition is a condition that is not set in duplicate with the vital exclusion condition described in [1] above due to its contents.
  • the vital measurement is performed a plurality of times, the measured value outside the range of " ⁇ ⁇ 2 ⁇ ” is measured twice or more, and the first measured value is included in the vital information 8a to obtain " ⁇ ⁇ 2 ⁇ ".
  • the reference zone condition 220 can be set without strictly excluding out-of-range measurements. Further, since the measured values outside the range of “ ⁇ ⁇ 2 ⁇ ” after the second time are excluded, it is possible to prevent the accuracy of detecting the abnormality under the reference region condition 220 from being excessively lowered.
  • a measured value of vital signs that can be determined to be "a value significantly deviated from the average value" by t-test is a value that is regarded as abnormal as a value of vital sign. It is the content to be excluded as. It is used in vital signs that follow a normal distribution.
  • Vital exclusion condition excluding other than the principal value Regarding the measured values of vital signs measured multiple times under certain conditions, the content is to exclude the measured values other than the principal value selected under the predetermined principal value selection condition.
  • the principal value means selecting one from a plurality of measured values.
  • a predetermined principal value selection condition there is a condition for artificially or systematically selecting one value by setting a certain condition.
  • the artificial selection includes, for example, the act of selecting one measured value from the measured values, excluding the numerical value that can be recognized as the measured value due to an obvious input error.
  • a mode in which a measured value included in the range of " ⁇ ⁇ 2 ⁇ " is selected from a plurality of measured values can be considered. Blood pressure is measured several times, and if there is an abnormality in blood pressure, no matter how many times it is measured, a value in the normal range cannot be seen. Therefore, if there is a measured value within the range of " ⁇ ⁇ 2 ⁇ ", it can be selected as the principal value.
  • the systematic selection may be, for example, a mode in which a highly accurate measured value is selected from the range of the plot based on the Q-Q plot for the measured value of vital signs.
  • the vital information 8a can be obtained by excluding the measured values of vital signs measured a plurality of times as the vital exclusion condition other than the measured values other than the principal value selected under the predetermined principal value selection condition. It can be highly reliable information.
  • a measured value of vital signs that can be determined to be a value whose normality is not guaranteed based on a predetermined test method is regarded as an abnormality as a value of vital signs.
  • the Shapiro-Wilk test can be adopted as a method for determining normality.
  • the Shapiro-Wilk test finds the p-value for a set of vital sign measurements, for example, when the significance level is set to 5%, "does not follow a normal distribution" when p ⁇ 0.05, p ⁇ If it is 0.05, it is a test method that determines that it follows a normal distribution.
  • the p-value is the probability of measuring evidence for rejecting the null hypothesis.
  • the measured values that are the "outliers" that are the basis of p ⁇ 0.05 are extracted. That is, this outlier is excluded as a measured value of vital signs whose normality is not guaranteed.
  • FIGS. 18 and 19 show distribution maps of the measured value data increased by 1 from 30 for each pulse and the p-value obtained for each data.
  • the number of data and the p-value in each figure are as follows.
  • the p value is 0.000000003445. That is, the value of 78 bpm is an “outlier” whose normality is not guaranteed. Then, in FIG. 19D, when the measured value of "78 bpm" is excluded and a new measured value of "50 bpm" is input, the p value is 0.08062, which is the data whose normality is guaranteed.
  • the measured values whose normality is not guaranteed can be excluded as outliers by using the p-value of the Shapiro-Wilk test.
  • the vital information 8a can be used as information whose normality is guaranteed by the Shapiro-Wilk test.
  • the Shapiro-Wilk test makes it possible to verify the accuracy of vital sign measurements.
  • data having poor accuracy is excluded, and a group is formed only by "quality data" whose quality is guaranteed.
  • the measured value of vital signs and the information of the measurer (for example, the subject's family, caregiver, etc.) who performed the measurement are input and recorded.
  • the measured value whose normality is not guaranteed by the measurement of a certain measurer is recorded and linked to the information of the measurer.
  • the measurer who measured the measured value whose normality is not guaranteed is recorded, the vital sign value measured by the measurer is excluded, and the vital information 8a is extracted.
  • the value of the result of the measurer is removed from the vital information 8a, and the value of the result of accurate measurement is collected. It will be easier to do.
  • the measured value may vary or be inaccurate depending on the measurement technique of the measurer. Therefore, by setting this exclusion condition, it becomes easy to ensure the accuracy of the measured value of vital signs caused by the skill of the worker.
  • the measured value measured by that measurer can be excluded.
  • the vital exclusion condition it is a condition whether or not the measured value of vital signs is a value measured by satisfying the predetermined time condition. This condition is set, for example, as to whether or not the measured value of vital signs is measured within one hour based on the set time.
  • the vital sign 8a is extracted by excluding the measured values of vital signs that were not properly measured at the determined time.
  • the vital information 8a can be made reliable information by excluding the measured value of the vital sign whose measurement is delayed.
  • the fixed condition means, for example, the content of measuring the blood pressure multiple times in 5 minutes, and means a condition that can be treated as a vital sign measured under the same condition.
  • the vital exclusion condition is different from the vital exclusion condition described in [1] above in that the exclusion method assumes a plurality of measurements.
  • the vital exclusion standard information 200 it is possible to set the vital exclusion standard information 200 by using a single condition or a combination of a plurality of conditions.
  • the vital information 8a from which the value considered to be abnormal as the value of vital signs has been removed is used for the calculation of the reference range condition 220 when scoring the measured value of vital signs.
  • the reference region condition 220 is set as “within ⁇ ⁇ n ⁇ ” based on, for example, vital average value information and vital standard deviation.
  • This reference area condition 220 is one of the scoring reference information 102.
  • the vital average value and the vital standard deviation are based on the vital information 8a and the remeasured vital information 13a recorded in the information recording unit 4, and the calculation unit 2 functions as the average value calculation means 14 and the standard deviation calculation means 15 of the reference calculation means 5. Is calculated. Further, based on the vital mean value and the vital standard deviation, scoring reference information 102 and reference range condition 220 for measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure, and respiratory rate are set.
  • the vital information 8a and the remeasured vital information 13a recorded in the information recording unit 4 are calculated as the vital average value and the like.
  • the standard deviation based on the distribution of the vital mean value and the vital information is calculated by the mean value calculating means 14 and the standard deviation calculating means 15 using the following equations (3) and (4).
  • (1 / N) ⁇ ⁇ Si ⁇ ⁇ ⁇ Equation (3)
  • ⁇ ((1 / N) ⁇ ⁇ (Si ⁇ ) 2 ) ⁇ ⁇ ⁇ Equation (4)
  • is the average value of vital information
  • Si is the measured value of each vital information
  • N is the number of data of all vital information
  • is the standard deviation.
  • ⁇ Si indicates the total of the measured values of all vital information.
  • the measured value of each vital information is a value of vital information acquired under a set predetermined condition as described above. As described above, the content of all vital information referred to here may be a part of the information recorded in the information recording unit 4.
  • the vital information here is measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure, and respiratory rate.
  • the above equations (3) and (4) are used from the data of the same target person recorded in the information recording unit 4 starting from the determination time point. Is used to calculate the vital mean value ⁇ and the vital standard deviation ⁇ . That is, the scoring reference information 102 and the reference area condition 220 are calculated including the value of the vital sign to be determined, which is measured at the time of determination.
  • the scoring standard setting means 101 uses the value represented by the following equation (1) or equation (2) as the reference region condition 220.
  • n and m are numbers larger than 0.
  • the scoring standard setting means 101 may use the value represented by the following formula (1) or formula (2) as the scoring standard information 102.
  • n and m are numbers larger than 0.
  • the values represented by the above equations (1) and (2) and the predetermined score value information 103 that is, the information of the points of 0 to 2 points are combined.
  • the combinations of the reference area condition 220, the scoring reference information 102, and the score value information 103 are as shown in Table 2 below.
  • ⁇ and ⁇ are values calculated from the measured values of each vital sign measured under predetermined conditions (for example, 30 vital information 8a).
  • the input vital sign measurement value may be a value of "more than ⁇ -2 ⁇ (or more) to less than ⁇ + 2 ⁇ (or less)" in the vital mean value and vital standard deviation calculated at the time of the determination. For example, a score of 0 points, a score of 1 point if the value is "more than ⁇ -3 ⁇ (greater than or equal to) to less than ⁇ -2 ⁇ (less than)” or "more than ⁇ + 2 ⁇ (greater than) to less than ⁇ + 3 ⁇ (less than or equal to)". If the value is " ⁇ -3 ⁇ or less (less than)" or " ⁇ + 3 ⁇ or more (super)", the score is 2 points.
  • the standard for each judgment time is set based on the vital average value and vital standard deviation calculated at the time of judgment.
  • the measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure, and respiratory rate are vital signs according to a normal distribution, and are reference region conditions calculated based on the above equation (1) or (2).
  • 220 is a standard that reflects the intra-individual variation of the target person and is a standard set based on the normal distribution of the target person. Therefore, it is an index that can accurately grasp the fluctuation of the physical condition of the subject.
  • the content of the score value information 103 shown in Table 2 is an example, and is not necessarily limited to the content of Table 2, and the settings of each range and the score value information 103 can be changed as appropriate.
  • the score value information 103 is set in the range of 0 points to 2 points, but it is not necessarily limited to this range. For example, it is possible to change the score value information to a setting of scoring in the range of 0 points, 1 point, 2 points, and 3 points. Furthermore, it is possible to adopt a numerical value larger than 3 points. Needless to say, when the score value information 103 is changed, the reference area condition 220 and the scoring reference information 102 can be appropriately set accordingly.
  • score value information 103 of 0 to 2 points is calculated based on the scoring reference information 102 shown in Table 2.
  • the content of the scoring reference information 102 for the oxygen saturation shown in Table 2 is not limited to this.
  • the numerical range for dividing the score value information of 0 to 2 points can be set as the scoring reference information 102 by appropriately changing the setting.
  • the caregiver or the like confirms the consciousness level of the target person, and applies the acquired result to the predetermined observation information set as the scoring reference information 102.
  • a known AVPU assessment can be used to confirm the level of consciousness.
  • the scoring standard information 102 for the consciousness level is set as shown in Table 2.
  • normal scores are set to 0 points
  • abnormal scores are set to 1 point
  • no response to pain is set to a score of 2 points.
  • the scoring processing means 100 calculates the score value information 103 based on the information input by the caregiver or the like.
  • the content of the scoring standard information 102 for the evaluation result of the consciousness level of the subject shown in Table 2 is not limited to this.
  • a consciousness level evaluation method other than the AVPU evaluation may be adopted.
  • the observation state for dividing the score value information of 0 to 3 points can be set as the scoring reference information 102 by appropriately changing the setting.
  • the vital signs of the subject are not necessarily have to be limited to these contents.
  • the vital signs of the subject do not necessarily have to be limited to these contents.
  • Score value information 103 of 0 points to 2 points is calculated for each type of vital signs, and the scoring processing means 100 calculates the "total point" of the score value information 103 from each score value information 103. That is, the score value information 103 of each vital sign from the systolic blood pressure to the consciousness level is added to calculate the total score.
  • the determination processing means 6 determines "normal or abnormal (caution, warning)" in the physical condition of the subject from the total score of the score value information 103 of each vital sign. The result of this determination will be obtained based on the contents shown in Table 3 (score determination standard information 18).
  • the determination processing means 6 determines that the total score of the score value information 103 is "normal” when 0 points are calculated. In addition, regarding the total score of the score value information 103, when 1 point was calculated, it was determined as “single vital abnormality", and when 2 points were calculated, "caution” and 3 points were calculated. In that case, it is judged as "warning”.
  • the physical condition of the subject in the present invention is determined to be "abnormal" when two points of "caution” or three points of "warning" are obtained. That is, in this configuration, the result of "abnormality" is determined in two stages of "caution” and "warning".
  • the total score of the score value information 103 calculated from the value of each vital sign and the score determination result information 12 such as attention to this value are recorded in the information recording unit 4 in association with the target person.
  • the determination processing means 6 determines "caution” or "warning” for the total score of the score value information 103 of each vital sign
  • the health state is determined via the alert notification means 120 and the information transmission / reception unit 3c.
  • the management device 1 emits a warning sound and sends an e-mail to the outside terminal or the like to the effect that a "warning" determination has been made.
  • the color for displaying the result information is set to be different according to the contents shown in the table.
  • abnormality it is not always necessary that the determination of the abnormality of the target person is made in two stages of "caution” or “warning”, and as a result of "abnormality", it may be summarized as one. However, since it is possible to confirm the abnormality in the physical condition of the subject by dividing the degree, it is preferable that the abnormality is judged in two stages of "caution” and "warning".
  • the numerical value determined by the determination processing means 6 to be abnormal (caution, warning) with respect to the score value information 103 is not limited to two or more points. For example, a determination of 3 points or more as an abnormality (caution, warning) may be adopted.
  • the important features are that it is not determined to be "abnormal" and that the alert notification means 120 does not notify the alarm.
  • This reference area condition 220 can be regarded as a range of vital signs that can be regarded as a normal normal area in the subject, but this range is excluded because the measured values satisfying the vital exclusion condition are excluded and the vital information 8a is extracted.
  • the range will be narrower than before.
  • the determination processing means 6 determines whether or not the total score of the score value information 103 of each vital sign is abnormal, and if the total score is not 2 points or more, the final target is No person is determined to be "abnormal (caution or warning)".
  • the alert notification means 120 does not issue an alarm. That is, it is possible to suppress the frequent sounding of alarms (detection of false positives).
  • the determination processing means 6 determines that the target person is abnormal, the determination is made from the results of a plurality of vital signs, so that it can be regarded as a highly reliable determination result.
  • the important features are that it is not determined to be "abnormal" and that the alert notification means 120 does not notify the alarm.
  • systolic blood pressure, diastolic blood pressure, pulse pressure, pulse, body temperature, oxygen saturation, and respiratory rate are used as scoring targets (markers).
  • Awareness level is mentioned, but this is just an example.
  • the threshold value for distinguishing the points in the scoring reference information 102 is only an example.
  • the threshold value for distinguishing the type of marker and the score can be set differently depending on the type of disease possessed by the subject and the nature of the subject. For example, a subject having heart failure and a subject having a urinary tract infection are set with different thresholds for distinguishing the type and score of markers.
  • a marker there are cases where only systolic blood pressure is adopted, or both systolic blood pressure and diastolic blood pressure are adopted.
  • a subject who is a healthy person and a subject who is an elderly person having a chronic disease are set with different threshold values for distinguishing the type and score of the marker.
  • the scoring standard information 102 also includes a mode of scoring as a marker, including a history of the subject, a family history of a morbid state in the subject's family and close relatives, a lifestyle, and the like. is there.
  • the history or A score is given to the family history marker, and points are added to the total score of the score value information 103.
  • a subject who has a lifestyle of smoking is given a score as a marker of the lifestyle and is added to the total score of the score value information 103. In this way, it is possible to adopt a configuration in which another item is provided as a marker and the total score is added.
  • FIGS. 20 (a) and 20 (b) are graphs of a normal distribution curve created based on body temperature information.
  • the horizontal axis is a random variable of body temperature
  • the vertical axis is a probability density.
  • (A) is created by a large number of subjects
  • (b) is created only by the same subject.
  • FIG. 20 (a) includes people with various normal temperatures and fluctuations in body temperature, and the average value ⁇ is 37.0 ° C., which is the average value of a large number of subjects, and the value of ⁇ + 2 ⁇ is 37.7.
  • the values of ° C and ⁇ -2 ⁇ are 36.0 ° C.
  • the body temperature at 37.0 ° C. is at the position of ⁇ . (Black circle in FIG. 20 (a)).
  • FIG. 20 (b) 37.
  • the body temperature at ° C. is at the upper limit of ⁇ + 2 ⁇ (black circle in FIG. 20B). That is, in the distribution shown in FIG. 20 (a) and the distribution shown in FIG. 20 (b), the same numerical value of ⁇ + 2 ⁇ on the distribution is a completely different value. Therefore, the scoring reference information 102 and the score value information 103 also change, and the determination result also differs.
  • the scoring reference information 102 and the score value information 103 based on the vital information of a large number of target persons are used to capture the "abnormal value". It can be said that it cannot be done.
  • Using the vital information of a large number of people as a standard is nothing but the conventional judgment based on "inter-individual variation", and in order to see the variation of vital information peculiar to the subject, "intra-individual variation” Indicates that is valid.
  • the subject who performs the average value and fluctuation of the body temperature shown in FIG. 20 (b) does not correspond to a special case.
  • other vital signs such as systolic blood pressure, diastolic blood pressure, pulse rate, and respiratory rate cause fluctuations peculiar to the subject, and these follow a normal distribution.
  • body temperature there are many elderly people whose body temperature changes in the temperature range shown in FIG. 20 (b), and when determining the health condition of such elderly people by vital signs, "individual” "Fluctuation" is effective.
  • FIG. 21 is shown as an example of the heat type table.
  • FIG. 21 shows vital information at the time of judgment regarding a certain target person, information on whether or not the value of the score value information based on the content of the vital information is an abnormal value (warning, caution, normal information), and the target person. Information on the presence or absence of abnormalities based on observations and interview results, and information on the total score of score value information are displayed.
  • heat type table shown in FIG. 21 information on the medical history, which is a risk factor for the health condition of the subject, and information on lifestyle-related habits are displayed.
  • detailed observation information of the subject and information on special notes are displayed on the heat type table.
  • the information displayed on the heat type table can be created based on the information input via the input unit 3a or the like.
  • a value of score value information based on the content of vital information is displayed in a heat type table which is one of the display information of the electronic medical record.
  • the image shown is shown.
  • the information based on the scoring result can be used for the risk evaluation of the subject together with the information of the electronic medical record in which the information of the inpatient is recorded.
  • FIG. 23 shows an image showing the value of the score value information based on the content of the vital information on the screen when the application software having the function of the software of the present invention is used on a smartphone terminal or the like. ..
  • the application software having the function of the software of the present invention is used on a smartphone terminal or the like.
  • information based on the scoring result can be used for health management on a smartphone and evaluation of a health condition in home medical care.
  • a QQ plot can be used as a method for confirming whether the measured vital information fits into the normal distribution.
  • the horizontal axis represents the value of the vital standard deviation
  • the vertical axis represents the value of the percentage point of the standard normal distribution corresponding to the cumulative probability of the standard deviation, and the vital standard deviation of the subject is plotted. If each plot is located on a straight line, it is possible to visually confirm that the acquired vital information is normally distributed.
  • FIG. 24 shows the flow of information processing from the input of vital information to the determination of abnormality and the display of result information.
  • the vital sign values of the subject measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure, oxygen saturation, and respiratory rate
  • the date and time information is input (S1).
  • the corresponding information of the observation information of the vital reference information 102 is selected or input from the evaluation result of the consciousness level of the subject.
  • the input information is recorded in the information recording unit 4 (DB) as vital information of the target person (S2).
  • the vital information 8 is separately recorded as the vital information 8a and the vital information 8b based on the vital exclusion standard information 200.
  • the calculation unit 2 functions as the reference calculation means 5 to calculate the reference area condition 220 and the scoring reference information 102. (S3).
  • the vital mean value and the vital standard deviation are calculated, and based on these values, the reference region condition 220 and the scoring reference information 102 under the set conditions are created.
  • the criteria for body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure and respiratory rate are calculated for each scoring.
  • the score value information 103 is calculated for each vital information by the scoring processing means 100 based on the reference area condition 220 and the scoring reference information 102 (S4).
  • the determination processing means 6 determines whether or not the total score of the score value information is an abnormal value based on the determination criteria (S5). If the result of the determination is not determined to be "abnormal value (caution or warning)", the determination result information is recorded in the information recording unit 4 (DB) (S9), and the determination result information is displayed in the display unit 3b. It is displayed (S11). In addition, the alert notification means 120 notifies the alarm.
  • the thermal type table (see FIG. 22) that graphs the changes in vital sign values over time and the probability density function of the normal distribution (graph of the normal distribution curve) are displayed. (S10), and these information can also be confirmed on the display unit 3b.
  • the score value information is judged to be "abnormal value (caution or warning)" as a result of the judgment based on the judgment criteria, for example, the display unit.
  • a display such as "Do you want to remeasure?" Or a warning of the posture when acquiring vitals is displayed, and the subject is confirmed whether or not there is remeasurement vital information (S7).
  • the judgment result information of the abnormal judgment is recorded in the information recording unit 4 (DB) (S9), and the judgment result information is recorded. It is displayed on the display unit 3b (S11). Further, a thermal type table (see FIG. 22) and a normal distribution establishment density function (normal distribution curve graph) are created as display information (S10), and these information can also be confirmed on the display unit 3b.
  • the information recording unit 4 records the value of the vital sign that is the determination result of the abnormal determination so as to be included in the vital information 8. As a result, both the vital information in which the score value information is determined to be a normal value and the vital information in which the score value information is determined to be an abnormal value are accumulated in the vital information 8.
  • the target person or caregiver selects "with remeasurement vital information"
  • the input of the remeasured vital sign value and the measurement date and time is prompted, and the information in which the input remeasurement vital information is input is the target. It is recorded in the information recording unit 4 (DB) as the remeasurement vital information of the person (S2).
  • the reference area condition 220 and the scoring reference information are calculated again (S3), and the abnormality determination of the score value information is performed again (S4). If it is not determined that the value is abnormal in the determination, the determination result information is recorded in the information recording unit 4 (DB) (S9). If it is determined that the value is abnormal, the process may proceed to the step of confirming the presence / absence of remeasurement vital information (S6), or since it is the second determination result, the determination result information is recorded as it is ( You may proceed to S9).
  • a series of information processing is completed when the target person confirms the judgment result information on the display unit 3b.
  • the software to which the present invention is applied determines the health condition from the vital information.
  • a health condition determination device to which the present invention is applied with a remote image diagnosis system.
  • a device such as a camera capable of acquiring image information to a health condition determination device and transmit the image information of the subject to the hospital side for remote diagnosis.
  • the doctor to make a diagnosis from a remote location while checking the abnormality of the subject's vital value etc. Become.
  • the health condition determination device to which the present invention is applied may have a plurality of variations of operational versions according to the level of the user.
  • the mode is linked with the electronic medical record as described above, it will be a diagnostic support tool at the time of diagnosis by a doctor in a hospital.
  • the information managed by the diagnostic apparatus contributes to raising the diagnostic level of the doctor because the information of the daily diagnosis in the hospital is accumulated.
  • ICT Information and Communication Technology
  • Japan's Ministry of Health, Labor and Welfare will realize a "comprehensive community care system” that comprehensively secures medical care, nursing care, prevention, housing, and living support in order to support the elderly in the super-aging society as a whole by 2025. It is said. However, most of the underlying medical information is shredded at each business site.
  • vital data is mentioned as follows. "The so-called secondary use, in which personal health, medical care, and long-term care information is anonymized and then analyzed and utilized as big data, is also considered as an important factor in considering the sustainability of PHR services. In particular, regarding vital data, various devices and services currently exist in the market, but when integrating with PHR and utilizing the data, the effect of health management will be effective. It is desirable to unify the API with the data granularity and the platform that collects PHR, with a view to secondary use for purposes such as analysis. "
  • the health condition determination device (or the present health condition determination method) to which the present invention is applied is linked to this PKR concept.
  • the major difference from existing technology is that when performing health management, "tailor-made diagnosis” tailored to each individual's characteristics rather than comparing with general data. This is the point of using so-called “individualized medicine”.
  • analysis of medical big data will open the way for preventive medicine, and "artificial intelligence" will be useful for its support.
  • the health condition determination device to which the present invention is applied will greatly contribute to the realization of the PHR concept.
  • this technology can verify vital accuracy by testing normality using statistics (Shapilow Wilk judgment, etc.). Therefore, when analyzing the accumulated vital data, it is possible to classify it into "targets measuring quality data” or “target facility groups measuring quality data” and “other groups”. It is possible to extract only the "quality data group” from all the accumulated vital data. Since this technology enables analysis from data whose accuracy is guaranteed, it can be used as a powerful index for artificial intelligence development for the first time, expanding the range of applications.
  • the health condition determination device of the present invention can also be used as an educational tool for medical professionals.
  • the pathological condition identification flowchart database in addition to the present invention, it is possible to create educational software that combines questions and answers based on this information. It is also possible to record and rank the scores of multiple healthcare professionals using educational software to create an evaluation table for doctors and nurses.
  • Reference tool for nurses when prescribing medicine It can also be used as a reference tool for nurses when prescribing medicine.
  • the information on the medication history of the subject is recorded in the personal information of the subject.
  • data on "what kind of medicine was prescribed at what kind of symptom" is accumulated, and the pharmacist can use it as reference information when taking the medicine.
  • it can be applied to take the drug without going through a pharmacist. The pharmacist can easily check the medication history.
  • the health condition determination device of the present invention records and utilizes information on regular health examinations at work or school. In this case, since the vital information acquisition period is vacant, cautions, warnings, and abnormality determinations are appropriately set. This will be useful for the health management of the subject. It is also a means of acquiring vast amounts of clinical data. Furthermore, by linking with information on health examinations conducted by public institutions, comprehensive health management of the subjects becomes possible.
  • the health condition determination device of the present invention can also be used for on-site health management in a remote place.
  • the health condition determination device of the present invention is installed in the country concerned on an overseas business trip, a ship in a pelagic fishery, an overseas dispatch destination of the Self-Defense Forces, and the like. This makes it possible to manage the health of the target person even in countries where the medical level is low or where there is no medical equipment.
  • a diagnosis by a doctor can be performed.
  • the health condition determination device of the present invention can contribute to preventive medical care in regional medical care by linking with information on the outbreak status of diseases by region. For example, by linking with information on influenza pandemic, it is possible to lead to preventive measures in areas where health condition determination devices are used. In addition, the information of the subjects in the endemic area can be utilized as clinical data.
  • the air environment detection mechanism can detect the concentration of formaldehyde or PM2.5, determine the degree of air pollution in the area from the concentration, and alert the device user. In addition, it can be used as an information acquisition tool for alerting local residents and improving the environment by linking with administrative services.
  • the health condition determination device of the present invention Based on the information recorded in the health condition determination device of the present invention, it can be considered to be used in a healthcare home where the room temperature and humidity can be adjusted by an air conditioner. It is possible to control the environment to a room temperature and humidity suitable for the subject who is judged to have an abnormal value of vital signs, and to control the temperature to an appropriate set temperature which makes it easy to maintain a healthy state.
  • the health condition determination device to which the present invention is applied may be linked with the long-term care recording software or the long-term care request software.
  • the health condition determination device to which the present invention is applied may be linked with the long-term care recording software or the long-term care request software.
  • the health condition determination device to which the present invention is applied can also be used for checking the health condition of the care staff on the care side. Health management is performed by measuring the vital information of the care staff and sending it to the health condition judgment device. This can lead to an improvement in the working environment at the nursing care site.
  • the person to be watched (for example) , Family, etc.) can be notified.
  • a motion sensor is installed in the house so that when a resident does not move in the toilet for a certain period of time, an alert is automatically sent to the security company and family members.
  • the vital information record of the person to be watched over may be simultaneously transmitted as data.
  • the health condition determination device to which the present invention is applied can also be used as a device that supports the diet and physical condition management of the user. For example, a configuration in which advice for weight loss is displayed based on vital information and information on calorie intake of a meal can be adopted. It is also possible to offer multiple weight loss programs in partnership with facilities such as training gyms.
  • a mechanism in which the health condition determination device of the present invention is linked with the wearable device is also conceivable.
  • small wearable devices that can be worn on the body have been developed. Using these devices, it is possible to acquire various vital information such as body temperature, pulse, systolic blood pressure, and diastolic blood pressure in real time.
  • the applicable range can be greatly expanded by combining with a wearable device as a means for acquiring vital information and a display means for displaying the determination result.
  • it can be used as a device for self-management that manages the physical condition by oneself.
  • the function of the health condition determination device of the present invention is provided as application software so that it can be used in a mobile terminal or a tablet terminal.
  • the functions of this device can be easily used, and the convenience can be improved.
  • it contributes to the improvement of the penetration rate of this device and can lead to the acquisition of a wider range of clinical data.
  • the health condition determination device of the present invention is used for animals. It can contribute to the health management of not only humans but also pets and zoo animals and the protection of wild animals. In addition, by accumulating clinical data and diagnostic information of animals, medically and academically useful information can be obtained.
  • a vital measuring instrument for example, a thermometer, a pulse rate monitor, a respiratory rate sensor, etc.
  • a vital measuring instrument for example, a thermometer, a pulse rate monitor, a respiratory rate sensor, etc.
  • a vital measuring instrument shall be installed in the driver's seat to call attention when the driver is suspected of being in poor physical condition.
  • it can be configured to check drunk driving in combination with an alcohol detector.
  • the software of the present invention can accurately capture the intra-individual variation that differs for each subject by reflecting the vital signs and daily physical conditions that take into consideration the individual differences of the subject. It contributes to the health management of the company and the provision of medical care that suits each individual's individuality.
  • the health condition determination device of the present invention can accurately capture individual fluctuations that differ from subject to subject by reflecting vital signs and daily physical condition in consideration of individual differences of the subject. It contributes to the health management of people and the provision of medical care that suits each individual's individuality.
  • the health condition determination method of the present invention can accurately capture individual fluctuations that differ from subject to subject by reflecting vital signs and daily physical condition in consideration of individual differences of the subject. It contributes to the health management of people and the provision of medical care that suits each individual's individuality.
  • Health condition judgment device 1a Software 2 Calculation unit 2a Calculation unit 3 Tablet terminal 3a (Tablet terminal) Input unit 3b (Tablet terminal) Display unit 3c (Tablet terminal) Information transmission / reception unit 4 Information recording unit 4a Information recording unit 5 Criteria calculation means 5a Criteria calculation means 6 Judgment processing means 6a Judgment processing means 7 Personal information 8 Vital information 9 Estimated time information 10 Attitude information 11 Temperature information 12 Judgment result information 13 Remeasurement vital information 14 Average value calculation means 15 Standard deviation calculation means 16 Normal distribution calculation means 18 Judgment standard information 21a Vital measuring instrument 21b Body thermometer 22a Smartphone terminal 22b Personal computer terminal (PC terminal) 23 Information input means 24 Information recording means 24a Information recording means 30a Internet 32a Information management server 32b Software 32c Software 32d Software 50a User terminal 50b External terminal 60a User terminal 60b External terminal 70b Management terminal 100 Scoring processing means 100a Scoring processing means 101 Scoring standard setting means 102 Scoring standard information

Abstract

[Problem] To provide software, a state-of-health determination device, and a state-of-health determination method that: reflect vital signs and day-to-day physical conditions, while taking into consideration individual subject differences; are capable of accurately capturing different internal fluctuations between each subject, with high precision; and are capable of excellent precision in determination of abnormalities in subjects, without false positives. [Solution] A state-of-health determination device 1, which is an example of a state-of-health determination device to which the present invention is applied, comprises an arithmetic calculation unit 2. The arithmetic calculation unit 2 is a processing unit which executes each information processing function of the state-of-health determination device 1. That is, the software to which the present invention is applied causes the arithmetic calculation unit 2 of a tablet terminal 3 to function as an information input means 23, an information recording means 24, a reference calculation means 5, a scoring processing means 100, and a determination processing means 6, etc. The processing functions of each of these means perform information transmission and reception, information recording, scoring on the basis of the details of the vital information, setting of scoring conditions (scoring reference information), determination of errors in score value information, setting of error determination references, notification of determination results, and creation and display of display information, etc.

Description

ソフトウェア、健康状態判定装置及び健康状態判定方法Software, health condition judgment device and health condition judgment method
 本発明はソフトウェア、健康状態判定装置及び健康状態判定方法に関する。詳しくは、対象者の個人差を考慮したバイタルサインや日々の体調を反映して、対象者ごとに異なる個体内変動を精度高く捉えることが可能であり、かつ、偽陽性が少なく、対象者における異常の判定の精度に優れたソフトウェア、健康状態判定装置及び健康状態判定方法に係るものである。 The present invention relates to software, a health condition determination device, and a health condition determination method. Specifically, it is possible to accurately capture individual fluctuations that differ from subject to subject by reflecting vital signs and daily physical condition that take into account individual differences of the subject, and there are few false positives in the subject. It relates to software, a health condition determination device, and a health condition determination method having excellent accuracy of abnormality determination.
 近年、医療分野において「個別化医療(personalized medicine)」の重要性が高まっている。個別化医療とは、一般的に、テーラーメード医療(tailor-made medicine)といわれる「一人ひとりの個性にかなった医療を行うこと」をさしている。 In recent years, the importance of "personalized medicine" has increased in the medical field. Personalized medicine generally refers to tailor-made medicine, which means "providing medical care that suits each individual's individuality."
 これまでの医療は、疾患を中心とした考え方に基づき行われるものであり、疾患の原因を探索したり、その治療法を開発したりすることが主な目的とされている。この一方で、疾患の状態は一人ひとりで千差万別であり、同じ病気であっても同じ治療法を適用することが必ずしも正しくないことは以前より知られてきている。 Medical treatment up to now has been performed based on the idea centered on the disease, and the main purpose is to search for the cause of the disease and to develop a treatment method for the disease. On the other hand, it has long been known that the state of the disease varies from person to person, and it is not always correct to apply the same treatment method even for the same disease.
 しかしながら、従来の医療において、治療効果の個人差は、治療とその効果を観察しなければ分からないものとされ、一人ひとりに最適な治療計画を行うことは難しい状況にある。 However, in conventional medical treatment, individual differences in therapeutic effects cannot be understood without observing the treatment and its effects, and it is difficult to make an optimal treatment plan for each individual.
 ここで、個別化医療の実現には、個人ごとに異なる「バイオマーカー」を捉えることが重要とされている。一般的には、バイオマーカーは、特定の病状や生命体の状態の指標であり、アメリカ国立衛生研究所(National Institutes of Health)の研究グループは、1998年に、バイオマーカーについて「通常の生物学的過程、病理学的過程、もしくは治療的介入に対する薬理学的応答の指標として、客観的に測定され評価される特性」と定義づけている。また、過去においては、バイオマーカーは主として、血圧や心拍数など生理学的指標のことを意味していた。 Here, in order to realize personalized medicine, it is important to grasp different "biomarkers" for each individual. In general, biomarkers are indicators of the condition of a particular medical condition or organism, and a research group at the National Institutes of Health stated in 1998 that biomarkers were "ordinary biology." It is defined as "a characteristic that is objectively measured and evaluated as an indicator of a pharmacological response to a physical process, pathological process, or therapeutic intervention." In the past, biomarkers mainly meant physiological indicators such as blood pressure and heart rate.
 また、医療分野において、対象者の病気の程度を迅速に評価する手法として、早期警戒スコア(Early warning score以下、「EWS」と称する)と呼ばれるスコアリング法が利用されている。 Also, in the medical field, a scoring method called an early warning score (hereinafter referred to as "EWS") is used as a method for quickly evaluating the degree of illness of a subject.
 EWSは、対象者の6つの主要なバイタルサインである呼吸数(rpm)、SpO2(酸素飽和度)(%)、体温(℃)、血圧(mmHg)、心拍数(bpm)、意識レベルの評価(AVPU応答、A:alart(正常)、V:voice(声に反応がある)、P:pain(痛みに反応がある)U:unresponsive(反応なし)に基づき、バイタルサインの測定結果や評価結果に応じたスコアを算出して、スコアの合計点数によって、病気の程度を判断する手法である(例えば、非特許文献1を参照)。 EWS is an assessment of the subject's six major vital signs: respiratory rate (rpm), SpO2 (oxygen saturation) (%), body temperature (° C), blood pressure (mmHg), heart rate (bpm), and consciousness level. (AVPU response, A: allart (normal), V: voice (responsive to voice), P: pain (responsive to pain) U: unresponsive (no response), vital sign measurement results and evaluation results It is a method of calculating the score according to the above and determining the degree of illness based on the total score of the scores (see, for example, Non-Pain Document 1).
 このEWSは、複数の生理学的測定値の変化及び単一変数内の大きな変化を介して臨床的劣化が見られるという原則に基づいている。また、各バイタルサインの測定値からスコアを算出する際には、集団(複数の対象者)の測定値の結果に基づいて決定された数値が採用されている。 This EWS is based on the principle that clinical deterioration is seen through changes in multiple physiological measurements and large changes within a single variable. In addition, when calculating the score from the measured values of each vital sign, a numerical value determined based on the results of the measured values of the group (plurality of subjects) is adopted.
 例えば、表1に示すように、体温であれば測定値の中心範囲として「36.0~37.9℃」が設定され、同範囲では0点のスコアとなる。また、その上下側の値については、「35.0~35.9℃」又は「38.0~38.9℃」であれば1点のスコア、「34.0~34.9℃」又は「38.9℃超える値」であれば2点のスコア、「34℃未満」であれば3点のスコアとなるように、体温の測定値とスコアリングの点数が設定されている。また、その他のバイタルサインについても表1に示すように設定されている。 For example, as shown in Table 1, if the body temperature is high, "36.0 to 37.9 ° C" is set as the central range of the measured values, and the score is 0 points in the same range. Regarding the values on the upper and lower sides, a score of 1 point is given for "35.0 to 35.9 ° C" or "38.0 to 38.9 ° C", and a score of 2 points is given for "34.0 to 34.9 ° C" or "value exceeding 38.9 ° C". The measured value of body temperature and the scoring score are set so that the score is 3 points if the score is "less than 34 ° C". In addition, other vital signs are also set as shown in Table 1.
Figure JPOXMLDOC01-appb-T000001
Figure JPOXMLDOC01-appb-T000001
 ここで表1に示す内容では、集団のバイタルサインの測定値から設定された「正常な範囲」、「異常な範囲」が基準として採用されている。ここで設定された範囲は、地域や年齢等を考慮して範囲を変動させることはあるが、基本的に大多数の人数から得られたバイタルサインの測定値に基づき、基準となる範囲が決められている。この基準の設定は、呼吸数、酸素飽和度、血圧及び心拍数においても同様である。 Here, in the contents shown in Table 1, the "normal range" and "abnormal range" set from the measured values of the vital signs of the group are adopted as the criteria. The range set here may vary in consideration of the region, age, etc., but basically the reference range is determined based on the measured values of vital signs obtained from the majority of people. Has been done. The setting of this criterion is the same for respiratory rate, oxygen saturation, blood pressure and heart rate.
 また、EWSでは、6つの主要なバイタルサイン以外のパラメータとして、尿出力、酸素投与流量、疼痛スコア等の、他のパラメータにスコアを割り当てることもある。 In EWS, scores may be assigned to other parameters such as urine output, oxygen administration flow rate, and pain score as parameters other than the six major vital signs.
国際公開第2019/098304号International Publication No. 2019/098304
 しかしながら、非特許文献1に記載のEWSをはじめ、対象者のバイタルサインの測定値に基づきスコアリングを行い、その結果の情報に基づき異常を検知する従来の仕組みは、対象者の個体内変動を考慮した検知とはなっていない。 However, the conventional mechanism of scoring based on the measured value of the vital sign of the subject and detecting the abnormality based on the information of the result, including the EWS described in Non-Patent Document 1, causes the intra-individual variation of the subject. The detection is not taken into consideration.
 非特許文献1では、上述したように、集団のバイタルサインの測定値から設定された「正常な範囲」、「異常な範囲」が基準となっている。そのため、対象者の個体内変動を考慮した検知とは言い難いものである。 In Non-Patent Document 1, as described above, the "normal range" and "abnormal range" set from the measured values of the vital signs of the population are the standards. Therefore, it is difficult to say that the detection takes into account the intra-individual variation of the subject.
 即ち、集団のバイタルサインの測定値から設定された基準では、バイタルサインにおける個人ごとの特性に対応することができない。例えば、青年と高齢者では、平穏な状態の体温や、1日の体温の変動が大きく異なっている。また、高血圧等の病態の有無によっても、対象差ごとにバイタルサインの値は大きく異なるものとなる。 That is, the criteria set from the measured values of the vital signs of the group cannot correspond to the characteristics of each individual in the vital signs. For example, adolescents and the elderly have very different body temperatures in a calm state and daily fluctuations in body temperature. In addition, the value of vital signs varies greatly depending on the target difference depending on the presence or absence of a pathological condition such as hypertension.
 つまり、対象者の年齢や病態の有無等を考慮した場合、集団のバイタルサインの測定値から設定された「正常な範囲」や「異常な範囲」は、適切な基準とならないことがある。 In other words, when considering the age of the subject and the presence or absence of pathological conditions, the "normal range" and "abnormal range" set from the measured values of vital signs of the population may not be appropriate criteria.
 今後、拡大が期待される個別化医療では、診断、予後、薬力学、モニタリングなどの目的にかなったバイオマーカーが欠かせないものとなる。本発明者は、これまでに、「高齢者の発病」、「診断」を目的とするバイオマーカーを中心に研究を進めてきた。 In personalized medicine, which is expected to expand in the future, biomarkers suitable for purposes such as diagnosis, prognosis, pharmacodynamics, and monitoring will be indispensable. The present inventor has been conducting research focusing on biomarkers for the purpose of "onset of illness in the elderly" and "diagnosis".
 その中で、本発明者は、近年実施されている遺伝子レベルでの解析を行うバイオマーカーではなく、人間の生命に関する最も基本的な情報である体温、脈拍、血圧(脈圧)の「バイタルサイン」をバイオマーカーとすることに可能性を見出した。この体温、脈拍、血圧(脈圧)は、呼吸数を加えて、医療分野において「古典的バイタルサイン」と称され、この4つが基本的かつ重要なバイタルサインとして位置付けられている。 Among them, the present inventor is not a biomarker that analyzes at the genetic level, which has been carried out in recent years, but the "vital signs" of body temperature, pulse, and blood pressure (pulse pressure), which are the most basic information on human life. We found the possibility of using "" as a biomarker. These body temperature, pulse, and blood pressure (pulse pressure), in addition to the respiratory rate, are called "classical vital signs" in the medical field, and these four are positioned as basic and important vital signs.
 この古典的バイタルサインをバイオマーカーにできる理由は、体温、血圧(脈圧)、脈拍、呼吸数の測定値に、一人ひとり異なる「個体内変動」があるためである。即ち、対象者によって、バイタルサインの変化の仕方が異なっており、この変化の仕方を適切に捉えて、解析することで、対象者の健康管理や診断等に寄与する技術が開発できると考えたのである。 The reason why this classical vital sign can be used as a biomarker is that there are individual "individual fluctuations" in the measured values of body temperature, blood pressure (pulse pressure), pulse, and respiratory rate. In other words, the way the vital signs change differs depending on the subject, and we thought that we could develop a technology that contributes to the health management and diagnosis of the subject by appropriately grasping and analyzing this change. It is.
 また、本発明者は、これまでの研究により、人間の古典的バイタルサインは、同一個体に関して、少なくとも30個分の測定データを取得すると、基本的にその測定値が正規分布に従うことを発見した。また、古典的バイタルサインの正規分布は、その人固有の個体内変動を含んで分布するものである。 In addition, the present inventor has found from previous studies that human classical vital signs basically follow a normal distribution when at least 30 measurement data are acquired for the same individual. .. In addition, the normal distribution of classical vital signs includes the intra-individual variation peculiar to the person.
 しかしながら、医療統計学において、バイタルサインに関する多くの人の標準偏差を見る「個体間変動」の論文や報告等は存在するが、バイタルサインについて、同一の対象者の「個体内変動」を扱ったものは皆無である。 However, in medical statistics, although there are treatises and reports on "individual variation" that look at the standard deviation of many people regarding vital signs, we dealt with "individual variation" of the same subject for vital signs. There is nothing.
 また、従来技術には、同一個体に対する古典的バイタルサインの測定値が正規分布に従うことを解析した結果や、これを異常判定に用いた技術は全く存在しなかった。当然に、上述した異常判定に用いるスコアリング手法の基準として、古典的バイタルサインの測定値が正規分布に従うことを利用する技術も皆無であった。 In addition, in the prior art, there was no result of analyzing that the measured values of classical vital signs for the same individual follow a normal distribution, and there was no technique using this for abnormality determination. As a matter of course, as a standard of the scoring method used for the above-mentioned abnormality determination, there is no technique that utilizes the fact that the measured values of classical vital signs follow a normal distribution.
 さらに、本発明者らは、これまでの開発により、バイタルサインの測定値が正規分布に従うことを用いて、各バイタルサインに対して、所定の基準を設けてスコアリングする手法により、個体における異常を検知する技術の開発を進めてきた(特許文献1参照)。 Furthermore, the present inventors have developed so far that the measured values of vital signs follow a normal distribution, and each vital sign is scored by setting a predetermined standard. We have been developing a technology for detecting vital signs (see Patent Document 1).
 ここで、特許文献1に記載の技術では、スコア判定手段またはバイタル判定手段が異常と判定した際に、その根拠となったバイタルサインの値、即ち、異常な値と判定されたバイタル情報も含めて、次回の個体の異常を判定するようにしていた。 Here, in the technique described in Patent Document 1, when the score determination means or the vital determination means determines that the value is abnormal, the value of the vital sign that is the basis for the determination, that is, the vital information determined to be the abnormal value is also included. Therefore, the next individual abnormality was determined.
 この特許文献1に記載の技術は、対象者の一人ひとりで異なる個体内変動を適切に捉え、体調に異常が生じた状態の早期発見に活用することが可能である。しかし、本発明者らは、異常の検知の精度をさらに高める点及び偽陽性を減らすことにつき、改良の余地があると考えた。 The technique described in Patent Document 1 can be utilized for early detection of a state in which an abnormality has occurred in physical condition by appropriately grasping the individual variation that differs for each subject. However, the present inventors considered that there is room for improvement in further improving the accuracy of abnormality detection and reducing false positives.
 特許文献1では、例えば、体温のスコア値の算出において、同一個体の体温のバイタルサインの値につき、所定の期間での平均値μ、標準偏差σを用いて、「μ±2σ以内」のバイタルサインの値は、正常として「0点」のスコア値を付与していた。また、スコア値が1点以上のものを「異常(注意または警告)」と判定するように構成されていた。 In Patent Document 1, for example, in the calculation of the body temperature score value, the vital signs of the body temperature of the same individual are used for the mean value μ and the standard deviation σ in a predetermined period, and the vital signs are “within μ ± 2σ”. As for the value of the sign, a score value of "0 points" was given as normal. In addition, a score value of 1 or more was configured to be judged as "abnormal (caution or warning)".
 このような設定において、例えば、同一個体について、37.5℃の体温が3日続けて記録された場合、1日目や2日目においては、37.5℃の測定値が「μ+2σ」を超えて、スコア値の結果が「異常」と判断されたとする。 In such a setting, for example, when the body temperature of 37.5 ° C is recorded for 3 consecutive days for the same individual, the measured value of 37.5 ° C exceeds "μ + 2σ" on the 1st and 2nd days, and the score It is assumed that the result of the value is judged to be "abnormal".
 しかし、3日目の判定においては、既に、2日間続けて37.5℃の体温が、同一個体のバイタルサインの値として記録され、「μ±2σ以内」の基準にも反映されることから、基準の範囲が広くなる。この結果、3日目の判定で、37.5℃の体温が「μ±2σ以内」に収まる可能性が高まり、スコア値が「0点」として「異常」と判定されにくくなることが考えられる。 However, in the judgment on the third day, the body temperature of 37.5 ° C is already recorded as the value of vital signs of the same individual for two consecutive days, and it is reflected in the standard of "within μ ± 2σ". The range of is widened. As a result, it is considered that the possibility that the body temperature of 37.5 ° C. is within "μ ± 2σ" is increased in the judgment on the third day, and the score value is set to "0 point", which makes it difficult to be judged as "abnormal".
 即ち、スコア判定手段またはバイタル判定手段が異常な値と判定したバイタルサインの値を、次回の判定の基準に反映することで、異常の検知の精度が下がることが予想される。 That is, it is expected that the accuracy of abnormality detection will be reduced by reflecting the value of vital signs determined by the score determination means or the vital determination means as an abnormal value in the criteria for the next determination.
 また、異常の検知の精度が下がることを考慮して、スコア判定手段またはバイタル判定手段が異常な値と判定したバイタルサインの値を、次回の判定の基準に含めない構成とすると、基準の内容が厳しくなり、異常な値であるとの判定が出やすくなる。 In addition, in consideration of the decrease in the accuracy of abnormality detection, if the vital sign value determined by the score determination means or the vital determination means as an abnormal value is not included in the criteria for the next determination, the content of the criteria is set. Becomes stricter, and it becomes easier to judge that the value is abnormal.
 この結果、実際には、その個体に異常が生じていないにも関わらず、バイタルサインの値から異常と判定される偽陽性が生じる確率が高まることになる。そのため、バイタルサインの値に対する異常の判定の精度を担保しながら、偽陽性の発生を抑止可能な技術とすることが重要であると考えられた。 As a result, the probability that a false positive that is determined to be abnormal from the vital sign value will increase even though the individual has not actually had an abnormality. Therefore, it was considered important to use a technique that can suppress the occurrence of false positives while ensuring the accuracy of determining abnormalities with respect to vital sign values.
 本発明は、以上の点に鑑みて創案されたものであり、対象者の個人差を考慮したバイタルサインや日々の体調を反映して、対象者ごとに異なる個体内変動を精度高く捉えることが可能であり、かつ、偽陽性が少なく、対象者における異常の検知の精度に優れたソフトウェア、健康状態判定装置及び健康状態判定方法に係るものである。 The present invention was devised in view of the above points, and it is possible to accurately grasp the intra-individual variation that differs for each subject by reflecting the vital signs and daily physical conditions that take into consideration the individual differences of the subjects. It relates to software, a health condition determination device, and a health condition determination method, which are possible, have few false positives, and have excellent accuracy in detecting abnormalities in the subject.
 上記の目的を達成するために、本発明のソフトウェアは、取得されたバイタルサインに関する情報であるバイタル情報をスコアリングして、得られたスコア結果情報に基づいて、個体の健康状態を判定するためのソフトウェアであって、情報処理機器を、同一個体から取得されると共に、正規分布に従うバイタルサインから選択される少なくとも1つの測定値を含む前記バイタル情報及び取得日時の入力を受け付ける情報入力手段と、入力された前記バイタル情報及び取得日時の情報を記録させる情報記録手段と、記録された複数の前記バイタル情報の全部又は一部の、平均μ及び標準偏差σを算出する基準算出手段と、所定のスコアリング条件を基準に、入力された所定のバイタル情報をスコアリングして、スコアの値であるスコア結果情報を算出すると共に、前記所定のスコアリング条件は少なくとも前記平均μをピーク値とした正規分布に基づき設定されるスコアリング処理手段と、複数の種類の前記バイタル情報に対応する前記スコア結果情報を総合して、所定のスコア判定条件を基準に、異常な値か否かを判定するスコア判定手段と、前記スコア判定手段の判定結果に基づき、アラートを通知するアラート通知手段と、を含む手段として機能させるためのソフトウェアであり、少なくとも30個分の測定データの前記バイタル情報には、個体に固有の個体内変動が反映され、前記正規分布は、少なくとも30個分の測定データの前記バイタル情報から作成され、前記バイタル情報は、前記バイタルサインである体温、血圧、脈拍、脈圧及び呼吸数から選択される少なくとも1つの測定値を含み、前記スコアリング条件は、体温、血圧、脈拍、脈圧及び呼吸数から選択される少なくとも1つの測定値に対しては、前記平均μ、前記標準偏差σ、0より大きい数であるn及びmを用いて表された下記の式(1)の値を下限値及び式(2)の値を上限値とし、下限値及び上限値の少なくとも一方を基準にする基準域条件を含み、前記基準域条件は、バイタルサインの測定値のうち、所定のバイタル除外条件を満たす測定値が除外されて設定され、前記スコア判定手段は、前記基準域条件に基づきスコアリングされた前記スコア結果情報を含めて、次回の判定を行うように構成されている。
 μ-nσ・・・式(1)
 μ+mσ・・・式(2)
 なお、本明細書において、ソフトウェアとは、コンピュータの動作に関するプログラムのことである。また、プログラムとは、コンピュータによる処理に適した命令の順番付けられた列からなるものをいう。
In order to achieve the above object, the software of the present invention scores vital information, which is information on acquired vital signs, and determines the health condition of an individual based on the obtained score result information. The information input means for receiving the input of the vital information including at least one measured value selected from the vital signs according to the normal distribution and the acquisition date and time while acquiring the information processing device from the same individual. An information recording means for recording the input vital information and information on the acquisition date and time, a reference calculation means for calculating the average μ and the standard deviation σ of all or a part of the plurality of recorded vital information, and predetermined Based on the scoring conditions, the input predetermined vital information is scored to calculate the score result information which is the value of the score, and the predetermined scoring conditions are normal with at least the average μ as the peak value. A score for determining whether or not the value is abnormal based on a predetermined score determination condition by integrating the scoring processing means set based on the distribution and the score result information corresponding to a plurality of types of the vital information. It is software for functioning as a means including a determination means and an alert notification means for notifying an alert based on the determination result of the score determination means, and the vital information of at least 30 measurement data includes an individual. The normal distribution is created from the vital information of at least 30 measurement data, and the vital information is the vital signs such as body temperature, blood pressure, pulse, pulse pressure and respiration. The scoring condition comprises at least one measurement selected from a number, said mean μ, said standard for at least one measurement selected from body temperature, blood pressure, pulse, pulse pressure and respiratory rate. The lower limit value and the value of the formula (2) are set as the lower limit value and the value of the following formula (2) expressed using n and m, which are numbers larger than the deviation σ and 0, and at least one of the lower limit value and the upper limit value is set. The reference area condition including the reference area condition to be used as a reference is set by excluding the measurement value satisfying a predetermined vital exclusion condition from the measured values of vital signs, and the score determination means is set to the reference area condition. It is configured to make the next determination including the score result information scored based on the score.
μ-nσ ・ ・ ・ Equation (1)
μ + mσ ・ ・ ・ Equation (2)
In the present specification, the software is a program related to the operation of a computer. A program is a program consisting of an ordered sequence of instructions suitable for processing by a computer.
 また、本発明において、「30個分の測定データのバイタル情報」とは、幅広くは1秒ごとに測定したバイタル情報のデータであり、例えば、1分ごと、数分ごと、1時間ごと、1日ごと、1か月ごとに測定したバイタル情報のデータのように、時間の長さが異なるものを含んでいる。また、「30個分の測定データのバイタル情報」には、上述した、1秒ごと又は1分ごと等のように、一定間隔で規則的に取得されたデータだけでなく、不規則に取得されたデータも含んでいる。例えば、1分間(60秒)中に、一定間隔で取得するのではなく、不規則に取得した少なくとも30個のデータ(例えば、1秒、3秒、6秒、7秒、9秒等のような取得)が採用できる。また、例えば、30分間の中で不規則に取得した少なくとも30個のデータ、1時間の中で不規則に取得した少なくとも30個のデータ、数時間の中で不規則に取得した少なくとも30個のデータ、1日の中で不規則に取得した少なくとも30個のデータ、数日間の中で不規則に取得した少なくとも30個のデータ、1週間の中で不規則に取得した少なくとも30個のデータ、数週間の中で不規則に取得した少なくとも30個のデータ、1か月の中で不規則に取得した少なくとも30個のデータ等が、「30個分の測定データのバイタル情報」として採用することができる。更に、一定間隔、又は、不規則な間隔に関わらず、蓄積したバイタル情報の中から、ランダムに少なくとも30個分のデータを抽出して、「30個分の測定データのバイタル情報」として採用することができる。後述するように、時間の長さや測定間隔の規則性の有無に関わらず、少なくとも30個分の測定データを取得すれば、対象者の個体内変動を反映した正規分布を得ることができる。 Further, in the present invention, the "vital information of 30 measurement data" is broadly the data of vital information measured every second, for example, every minute, every few minutes, every hour, 1 It includes data with different lengths of time, such as vital information data measured daily and monthly. In addition, the "vital information of 30 measurement data" includes not only the data regularly acquired at regular intervals such as the above-mentioned every second or every minute, but also irregularly acquired data. Data is also included. For example, at least 30 pieces of data (for example, 1 second, 3 seconds, 6 seconds, 7 seconds, 9 seconds, etc.) acquired irregularly instead of being acquired at regular intervals in 1 minute (60 seconds). Acquisition) can be adopted. Also, for example, at least 30 data irregularly acquired in 30 minutes, at least 30 data irregularly acquired in 1 hour, and at least 30 irregularly acquired in several hours. Data, at least 30 data acquired irregularly in a day, at least 30 data acquired irregularly in a few days, at least 30 data acquired irregularly in a week, At least 30 data irregularly acquired in a few weeks, at least 30 data irregularly acquired in a month, etc. shall be adopted as "vital information of 30 measurement data". Can be done. Furthermore, at least 30 pieces of data are randomly extracted from the accumulated vital information regardless of regular intervals or irregular intervals, and adopted as "vital information of 30 pieces of measurement data". be able to. As will be described later, a normal distribution that reflects the intra-individual variation of the subject can be obtained by acquiring at least 30 measurement data regardless of the length of time or the regularity of the measurement interval.
 ここで、情報入力手段が、同一個体から取得されたバイタル情報の入力を受け付け、情報記録手段に、入力されたバイタル情報を記録させることによって、同一個体のバイタル情報を蓄積することができる。なお、ここでいう同一個体とは、取得したバイタルサインの値が異常な値か否かを判定する判定対象を指すものである。 Here, the information input means accepts the input of vital information acquired from the same individual, and the information recording means records the input vital information, so that the vital information of the same individual can be accumulated. The same individual as used herein refers to a determination target for determining whether or not the acquired vital sign value is an abnormal value.
 また、ここでいう「個体」とは、単独の生物(ヒト又は動物)のことである。なお、本発明は、単一のソフトウェアで、単独の同一個体のバイタル情報を記録する態様と、複数の同一個体のバイタル情報を同一個体ごとに記録する態様を含んでいる。同一個体とは、例えばヒトであれば、同一人物のことをいう。 Also, the "individual" here is a single organism (human or animal). The present invention includes a mode of recording the vital information of a single same individual and a mode of recording a plurality of vital information of the same individual for each same individual with a single software. The same individual means, for example, the same person in the case of a human being.
 また、ここでいう「同一個体から取得されたバイタル情報」とは、情報入力手段での入力の段階で個体の区別が可能であることを意味している。例えば、1人の対象者が自分だけのバイタル情報を入力する態様や、複数の対象者の情報を取り扱う際に、特定の個人用の入力画面が表示されてバイタル情報を入力する態様等、入力するための形式を異ならせて、個体を区別することが考えられる。 Further, the "vital information acquired from the same individual" here means that the individual can be distinguished at the stage of input by the information input means. For example, a mode in which one target person inputs his / her own vital information, a mode in which a specific personal input screen is displayed when handling information of a plurality of target persons, and a mode in which vital information is input, etc. It is conceivable to distinguish individuals by different forms for doing so.
 また、情報入力手段が、同一個体から取得されると共に、正規分布に従うバイタルサインから選択される少なくとも1つの測定値を含むバイタル情報の入力を受け付け、情報記録手段に、入力されたバイタル情報を記録させることによって、同一個体のバイタルサインの測定値の情報を蓄積することができる。同一個体から取得したバイタルサインの測定値は正規分布に従うものであり、その測定値の情報を蓄積することで、正規分布に基づく基準を設定可能となる。 Further, the information input means receives the input of vital information including at least one measured value selected from the vital signs according to the normal distribution while being acquired from the same individual, and records the input vital information in the information recording means. By doing so, it is possible to accumulate information on the measured values of vital signs of the same individual. The measured values of vital signs obtained from the same individual follow a normal distribution, and by accumulating the information of the measured values, it is possible to set a standard based on the normal distribution.
 また、情報入力手段が、同一個体から取得されたバイタル情報及び取得日時の情報の入力を受け付け、情報記録手段に、入力されたバイタル情報及び取得日時の情報を記録させることによって、同一個体のバイタル情報が取得された日時の情報と共に蓄積されるものとなる。即ち、同一個体の複数のバイタル情報を取得日時の情報と紐付けて取扱うことが可能となる。また、異なるバイタル情報を比較する際に、比較するバイタル情報の間での変位の状況や、変位量を確認可能となる。なお、ここでいう取得日時の情報は、情報入力手段にバイタル情報を入力する際に、入力者が取得日時の情報を入力する態様や、バイタル情報を入力する際の時間が情報入力手段に自動的に入力される態様が含まれるものである。また、取得日時の情報とは、バイタルサインを測定した日時や、バイタルサインの評価(例えば、意識レベル)を行った日時を含むものである。 Further, the information input means accepts the input of the vital information acquired from the same individual and the information of the acquisition date and time, and the information recording means records the input vital information and the information of the acquisition date and time, thereby causing the vitals of the same individual. The information will be accumulated together with the information on the date and time when the information was acquired. That is, it is possible to handle a plurality of vital information of the same individual in association with the information of the acquisition date and time. Further, when comparing different vital information, it is possible to confirm the displacement status and the displacement amount between the vital information to be compared. In addition, the information of the acquisition date and time referred to here is the mode in which the input person inputs the information of the acquisition date and time when the vital information is input to the information input means, and the time when the vital information is input is automatically set to the information input means. Aspects to be input are included. Further, the information on the acquisition date and time includes the date and time when the vital sign was measured and the date and time when the vital sign was evaluated (for example, the consciousness level).
 また、基準算出手段が、記録された複数のバイタル情報の全部又は一部の平均μを算出することによって、同一個体の個体内変動が反映されたバイタル情報の平均値の情報を利用可能となる。なお、ここでいう平均μとは、「各バイタルサインの測定値の総和」から「バイタルの測定値のデータ数」を割った値を意味するものである。また、ここでいう「記録された複数のバイタル情報の平均μ」は、記録されたバイタル情報の全データから算出するものだけでなく、全データのうちの一部から算出されるものを含んでいる。更に、平均μの算出根拠となるバイタル情報は連続的なデータ、例えば、毎秒、毎分、毎時間、毎日等継続的に測定したデータだけでなく、秒、分、時間、日数等の間隔を開けて抽出したデータから算出されるものであってもよい。 In addition, the reference calculation means calculates the average μ of all or part of the recorded vital information, so that the information of the average value of the vital information reflecting the intra-individual variation of the same individual can be used. .. The average μ here means a value obtained by dividing the “total number of measured values of vital signs” by the “number of data of measured values of vital signs”. Further, the "average μ of a plurality of recorded vital information" referred to here includes not only the one calculated from all the recorded vital information data but also the one calculated from a part of all the data. There is. Furthermore, the vital information on which the average μ is calculated is not only continuous data, for example, data measured continuously such as every second, every minute, every hour, and every day, but also intervals such as seconds, minutes, hours, and days. It may be calculated from the data extracted by opening.
 また、基準算出手段が、記録された複数のバイタル情報の全部又は一部の標準偏差σを算出することによって、同一個体の個体内変動が反映されたバイタル情報の標準偏差の情報を利用可能となる。なお、ここでいう標準偏差σとは、所定の条件のバイタル情報の「偏差の二乗平均」である。更に言えば、「偏差」とは、所定の条件のバイタル情報の「各バイタルサインの測定値」から「所定の条件のバイタルサインの測定値の平均値」を引いた値である。また、ここでいう「記録された複数のバイタル情報の標準偏差σ」は、記録されたバイタル情報の全データから算出するものだけでなく、全データのうちの一部から算出されるものを含んでいる。更に、標準偏差σの算出根拠となるバイタル情報は連続的なデータ、例えば、毎秒、毎分、毎時間、毎日等継続的に測定したデータだけでなく、秒、分、時間、日数等の間隔を開けて抽出したデータから算出されるものであってもよい。 In addition, the standard calculation means can use the standard deviation information of the vital information reflecting the intra-individual variation of the same individual by calculating the standard deviation σ of all or a part of the recorded vital information. Become. The standard deviation σ referred to here is the “root mean square of deviation” of vital information under predetermined conditions. Furthermore, the "deviation" is a value obtained by subtracting "the average value of the measured values of the vital signs of the predetermined condition" from the "measured value of each vital sign" of the vital information of the predetermined condition. Further, the "standard deviation σ of a plurality of recorded vital information" referred to here includes not only the one calculated from all the recorded vital information data but also the one calculated from a part of all the data. I'm out. Furthermore, the vital information on which the standard deviation σ is calculated is not only continuous data, for example, data measured continuously such as every second, every minute, every hour, and every day, but also intervals such as seconds, minutes, hours, and days. It may be calculated from the data extracted by opening.
 また、スコアリング処理手段が、所定のスコアリング条件を基準に、入力された所定のバイタル情報をスコアリングして、スコアの値であるスコア結果情報を算出することによって、入力されたバイタル情報を、その内容に応じたスコア結果情報(点数)に変換することができる。 In addition, the scoring processing means scores the input predetermined vital information based on the predetermined scoring condition, and calculates the score result information which is the value of the score, so that the input vital information can be obtained. , Can be converted into score result information (points) according to the content.
 また、所定のスコアリング条件が、少なくとも平均μをピーク値とした正規分布に基づき設定されることによって、同一個体から取得されたバイタルサインの測定値がバイタル情報として入力された際に、平均μをピーク値とした正規分布に基づき設定した基準により、その内容に応じたスコア結果情報を得ることが可能となる。また、この際の平均μをピーク値とした正規分布に基づき設定した基準は、同一個体の個体内変動が反映された基準であり、個体内変動を反映した状態で、同一個体のバイタル情報を点数化することが可能となる。なお、ここでいう「入力された所定のバイタル情報」とは、スコアリングの対象となるバイタル情報を意味している。また、ここでいう「少なくとも平均μをピーク値とした正規分布に基づき設定される所定のスコアリング条件」は、入力された所定のバイタル情報、即ち、スコアリングの対象となる所定のバイタル情報を含んで設定されるものと、スコアリングの対象となる所定のバイタル情報を含まずに、それ以前の過去のバイタル情報から設定されたものの両方を含むものである。また、入力された所定のバイタル情報は、直近に入力されたバイタル情報であることができる。また、入力された所定のバイタル情報は、以前に入力されたバイタル情報のうちの一つまたは複数のバイタル情報であることができる。 In addition, by setting predetermined scoring conditions based on a normal distribution with at least the average μ as the peak value, when the measured values of vital signs obtained from the same individual are input as vital information, the average μ According to the standard set based on the normal distribution with the peak value of, it is possible to obtain the score result information according to the content. In addition, the standard set based on the normal distribution with the average μ as the peak value at this time is a standard that reflects the intra-individual variation of the same individual, and the vital information of the same individual is reflected in the state that reflects the intra-individual variation. It becomes possible to score. The "input predetermined vital information" referred to here means vital information to be scored. Further, the "predetermined scoring condition set based on the normal distribution with at least the average μ as the peak value" referred to here is the input predetermined vital information, that is, the predetermined vital information to be scored. It includes both the one set by including and the one set from the past vital information before that without including the predetermined vital information to be scored. Further, the input predetermined vital information can be the most recently input vital information. Further, the input predetermined vital information can be one or more vital information of the previously input vital information.
 また、スコア判定手段が、複数の種類のバイタル情報に対応するスコア結果情報を、所定のスコア判定条件を基準に、異常な値か否かを判定することによって、同一個体から取得されたバイタル情報の内容から得られたスコア結果情報の値について異常な値か否かを判定可能となる。 Further, the score determination means determines whether or not the score result information corresponding to a plurality of types of vital information is an abnormal value based on a predetermined score determination condition, so that the vital information acquired from the same individual. It is possible to determine whether or not the value of the score result information obtained from the contents of is an abnormal value.
 また、スコア判定手段が、複数の種類のバイタル情報に対応するスコア結果情報を総合して、異常な値か否かを判定することによって、単一のバイタル情報に対応するスコア結果情報のみで異常な値か否かを判定する態様に比べて、対象者の体調における異常の判定をより正確に行うことが可能となる。 In addition, the score determination means integrates the score result information corresponding to a plurality of types of vital information and determines whether or not the value is abnormal, so that only the score result information corresponding to a single vital information is abnormal. Compared with the mode of determining whether or not the value is correct, it is possible to more accurately determine the abnormality in the physical condition of the subject.
 ここで、単一のバイタル情報のみに基づき、異常を判定する態様において、判定の根拠となる単一のバイタル情報につき、所定のスコアリング条件を、精度が高くなるように設定(例えば、体温であれば、体温を正常(0点)と判定する上下限の範囲を狭くするように設定)すると、そのスコア結果情報の値は、バイタルサインの異常を示す1点以上の点数が出やすくなる。そして、スコア判定手段が、単一のバイタル情報のみのスコア結果情報に対して、スコア値が異常である(対象者の体調が異常である)と判断することに繋がる。このような態様では、スコアリング条件の精度が高くなった分、偽陽性、即ち、実際には、対象者の体調に異常をきたしていないのに、スコア判定手段が、スコア値が異常であると判定する、誤った結果が出やすくなってしまう。 Here, in the mode of determining an abnormality based only on a single vital information, a predetermined scoring condition is set so as to be highly accurate (for example, at body temperature) for the single vital information that is the basis of the determination. If there is, if the range of the upper and lower limits for determining that the body temperature is normal (0 points) is set to be narrowed), the value of the score result information tends to be one or more points indicating abnormal vital signs. Then, the score determination means leads to determining that the score value is abnormal (the subject's physical condition is abnormal) with respect to the score result information of only a single vital information. In such an embodiment, the accuracy of the scoring condition is improved, so that the score value is abnormal in the score determination means even though the subject is not actually in a false positive state, that is, the subject's physical condition is not abnormal. It is easy to get an incorrect result.
 そこで、本発明では、異常の有無の判定において、偽陽性が生じやすくなるリスクを減らすべく、スコア判定手段が、複数の種類のバイタル情報に対応するスコア結果情報を総合して、異常な値か否かを判定する構成を採用している。つまり、複数の種類のバイタル情報に対応するスコア結果情報を用いて、総合したスコア結果情報に対するスコア判定条件を設けて、異常な値か否かを判定している。これによれば、最終的な異常の判定の結果に、単一のバイタル情報の内容が及ぼす影響が小さくなり、複数のバイタル情報の内容に基づき、複合的かつ正確な異常の判定を行うことが可能となる。この結果、偽陽性の発生を抑止することができる。さらに、単一のバイタル情報の内容が及ぼす影響が小さくなることから、仮に、バイタルサインの測定行為(測定の仕方、測定者、測定時間等)に問題があり、異常な測定値が記録された際にも、スコア判定手段による異常の判定において、誤った結果が生じにくくなる。 Therefore, in the present invention, in order to reduce the risk that false positives are likely to occur in the determination of the presence or absence of an abnormality, the score determination means is an abnormal value by integrating the score result information corresponding to a plurality of types of vital information. A configuration that determines whether or not it is used is adopted. That is, using the score result information corresponding to a plurality of types of vital information, a score determination condition for the total score result information is set, and whether or not the value is abnormal is determined. According to this, the influence of the content of a single vital information on the final result of the determination of anomalies is reduced, and it is possible to perform a complex and accurate determination of anomalies based on the contents of a plurality of vital information. It will be possible. As a result, the occurrence of false positives can be suppressed. Furthermore, since the influence of the content of a single vital information is reduced, there is a problem in the measurement action of vital signs (measurement method, measurer, measurement time, etc.), and abnormal measured values are recorded. In this case, an erroneous result is less likely to occur in the determination of abnormality by the score determination means.
 また、アラート通知手段が、スコア判定手段の判定結果に基づき、アラートを通知することによって、スコア判定手段が異常な値と判定した結果を、アラートにより知らせることが可能となる。 Further, the alert notification means notifies the alert based on the judgment result of the score judgment means, so that the result of the score judgment means judging as an abnormal value can be notified by the alert.
 また、スコア判定手段が、複数の種類のバイタル情報に対応するスコア結果情報を総合して、異常な値か否かを判定し、アラート通知手段が、スコア判定手段の判定結果に基づき、アラートを通知することによって、アラート通知手段が、偽陽性によるアラート通知がなされる回数を抑えることができる。この結果、使用者が、対象者に関する異常判定の結果を、何度も確認する手間を減らすことができる。 In addition, the score determination means integrates the score result information corresponding to a plurality of types of vital information to determine whether or not the value is abnormal, and the alert notification means issues an alert based on the determination result of the score determination means. By notifying, the alert notification means can reduce the number of false positive alert notifications. As a result, it is possible to reduce the time and effort for the user to repeatedly check the result of the abnormality determination regarding the target person.
 また、少なくとも30個分の測定データのバイタル情報には、個体に固有の個体内変動が反映され、正規分布は、少なくとも30個分の測定データのバイタル情報から作成されることによって、バイタル情報をバイオマーカーとして活用して、個別化医療を実現でき、特に、慢性期にある対象者の状態悪化を早期に検知可能となる。即ち、個人ごとに異なる「バイオマーカー」として、バイタル情報を利用することができる。 In addition, the vital information of at least 30 measurement data reflects the intra-individual variation peculiar to the individual, and the normal distribution is created from the vital information of at least 30 measurement data to obtain the vital information. It can be used as a biomarker to realize personalized medicine, and in particular, it will be possible to detect the deterioration of the condition of a subject in the chronic phase at an early stage. That is, vital information can be used as a "biomarker" that differs for each individual.
 このバイオマーカーとは、一般的に、特定の病状や生命体の状態の指標であり、「通常の生物学的過程、病理学的過程、もしくは治療的介入に対する薬理学的応答の指標として、客観的に測定され評価される特性と定義されている。即ち、本発明で対象とする「健康状態の悪化を検知するバイオマーカー」は、対象者が平穏な状態、体調に何等かの異常を生じている状態、及び、体調に異常を生じる前の段階の状態を含む、対象者の種々の状態を反映した対象者に固有の指標である。 This biomarker is generally an indicator of a particular medical condition or condition of an organism, and is "objective as an indicator of a pharmacological response to normal biological, pathological, or therapeutic interventions. It is defined as a characteristic that is measured and evaluated in a physical manner. That is, the "biomarker that detects deterioration of the health condition" that is the subject of the present invention causes some abnormality in the subject's calm state and physical condition. It is an index peculiar to the subject that reflects various states of the subject, including the state of being in a state and the state of the stage before the abnormality occurs in the physical condition.
 また、バイタルサインの変化の仕方は、対象者ごとに異なる変化の幅を反映するものであり、これが正規分布するものとなっている。このバイタルサインの変化は、対象者の一人ひとりで異なる個体内変動を含むものであり、個体内変動を含むバイタルサインをバイオマーカーとして利用し、解析することで、対象者の健康管理や診断等を行い、個別化医療を実現することが可能となる。 In addition, the way the vital signs change reflects the range of change that differs for each subject, and this is normally distributed. This change in vital signs includes intra-individual fluctuations that differ from person to person, and by using and analyzing vital signs including intra-individual fluctuations as biomarkers, the subject's health management and diagnosis can be performed. It will be possible to realize personalized medicine.
 この点の効果については、とりわけ、病状は比較的安定しているが、治癒が困難な状態が続いている慢性期の高齢者において、その個人の特性を反映した上での体調に異常が著しく生じる前の早期発見が可能となり、非常に意義のあるものとなる。高齢者は病気の進行が遅い場合が多く、一般成人に比べて、体調の変化や状態の悪化が捉えにくくなるが、対象者の個体内変動を含むバイタルサインをバイオマーカーとして利用することで、対象者の特性に合わせた状態悪化を早期に検知することができる。 Regarding the effect of this point, especially in the elderly in the chronic phase where the condition is relatively stable but the condition remains difficult to cure, the physical condition is remarkably abnormal, reflecting the individual characteristics. Early detection before it occurs is possible, which is very meaningful. Elderly people often have a slower progression of illness, and it is more difficult to detect changes in their physical condition or deterioration of their condition than general adults. It is possible to detect the deterioration of the condition at an early stage according to the characteristics of the subject.
 また、少なくとも30個分の測定データのバイタル情報には、個体に固有の個体内変動が反映され、正規分布は、少なくとも30個分の測定データのバイタル情報から作成されることによって、スコア判定手段により、対象の個体におけるバイタルサインの異常な値を捉えることが充分に可能となる。 In addition, the vital information of at least 30 measurement data reflects the intra-individual variation peculiar to the individual, and the normal distribution is created from the vital information of at least 30 measurement data, whereby the score determination means. This makes it possible to capture abnormal values of vital signs in the target individual.
 ここで本発明において「30個分の測定データ」を採用する技術的な意義を説明する。より詳細には、時間の長さや測定間隔の規則性の有無に関わらず、バイタルサインについて、少なくとも30個分の測定データを取得すれば、対象者の個体内変動を反映した正規分布を得ることができる点について説明する。 Here, the technical significance of adopting "measurement data for 30 pieces" in the present invention will be described. More specifically, regardless of the length of time or the regularity of measurement intervals, if at least 30 measurement data of vital signs are acquired, a normal distribution reflecting the intra-individual variation of the subject can be obtained. Explain the points that can be done.
 本発明者は、これまでの検討により、同一個体から取得したバイタルデータについて、少なくとも30個分の測定データが取得できれば、その測定データが、対象者ごとの個体内変動を反映して正規分布することを確認した。 According to the studies so far, if at least 30 measurement data can be obtained for vital data obtained from the same individual, the measurement data will be normally distributed reflecting the intra-individual variation for each subject. It was confirmed.
 例えば、図25~図32に示すように、脈拍を各条件で測定した場合、30個分の測定データが揃えば、その測定したデータに基づき、対象者ごとに異なる正規分布曲線が得られる結果となった。図25、図27、図29及び図31は、同一対象者(ここではAさんと称する)から取得した脈拍の結果であり、図26、図28、図30及び図32は、別の同一対象者(ここではBさんと称する)から取得した脈拍の結果である。なお、図25~図32において、30個分の測定データを示し、曲線上の丸印は1つの測定データに対応しているが、平均値を中心に重なっているデータが複数存在するため、図面上では、30個分の丸印が表れていない。 For example, as shown in FIGS. 25 to 32, when the pulse is measured under each condition, if 30 measurement data are prepared, a normal distribution curve different for each subject can be obtained based on the measured data. It became. 25, 27, 29 and 31 are the results of the pulse obtained from the same subject (referred to here as Mr. A), and FIGS. 26, 28, 30 and 32 are different identical subjects. It is the result of the pulse obtained from the person (referred to as Mr. B here). In addition, in FIGS. 25 to 32, 30 measurement data are shown, and the circles on the curve correspond to one measurement data, but since there are a plurality of overlapping data centered on the average value, they are shown on the drawing. Then, the circles for 30 pieces do not appear.
 より詳細には、図25及び図26では、1分ごとに脈拍を測定して、30個分の脈拍の測定データを取得した結果に基づくグラフである。いずれも平均値を頂点とした正規分布の形を示す結果が得られた。また、AさんとBさんでは、頂点となる平均値が異なり、かつ、曲線の両端に位置する値(最小値及び最大値)も異なっている。従って、個体なりの正規分布が得られることが明らかである。なお、この点は、図27~図32において、同様の傾向が確認された。 More specifically, FIGS. 25 and 26 are graphs based on the results of measuring the pulse every minute and acquiring the measurement data of 30 pulses. In each case, the results showing the shape of the normal distribution with the mean value as the apex were obtained. In addition, Mr. A and Mr. B have different average values at the vertices, and the values (minimum value and maximum value) located at both ends of the curve are also different. Therefore, it is clear that an individual normal distribution can be obtained. Regarding this point, the same tendency was confirmed in FIGS. 27 to 32.
 また、図27及び図28は、7分ごとに脈拍を測定して、30個分の脈拍の測定データを取得した結果に基づくグラフである。このように、測定する時間間隔を変えた際にも、各対象者の平均値を頂点とした正規分布の形が得られた。 Further, FIGS. 27 and 28 are graphs based on the results of measuring the pulse every 7 minutes and acquiring the measurement data of 30 pulses. In this way, even when the measurement time interval was changed, the shape of the normal distribution with the average value of each subject as the apex was obtained.
 また、図29及び図30は、1日の中で、不規則な時間で、30個分の脈拍の測定データを取得した結果に基づくグラフである。更に、図31は、30時間の中で、不規則な時間で、30個分の脈拍の測定データを取得した結果に基づくグラフであり、図32は、30日の中で、不規則な時間で、30個分の脈拍の測定データを取得した結果に基づくグラフである。ここで示すように、一定間隔で規則的に取得されたデータでなくても、30個分の測定データを取得すれば、そのデータが、各対象者の平均値を頂点として正規分布の形を取ることが確認された。 In addition, FIGS. 29 and 30 are graphs based on the results of acquiring measurement data of 30 pulses at irregular times in a day. Further, FIG. 31 is a graph based on the result of acquiring measurement data of 30 pulses at irregular times in 30 hours, and FIG. 32 is an irregular time in 30 days. It is a graph based on the result of acquiring the measurement data of 30 pulses. As shown here, even if the data is not regularly acquired at regular intervals, if 30 measurement data are acquired, the data will have the shape of a normal distribution with the average value of each subject as the apex. It was confirmed to take.
 また、例えば、図33及び図34に示すように、体温についても、30個分の測定データが揃えば、その測定したデータに基づき、対象者ごとに異なる正規分布曲線が得られる結果となった。図33及び図34は、2分ごとに体温を測定して、30個分の体温の測定データを取得した結果に基づくグラフである。また、図33と図34では、体温を測定した対象者が異なっている。このように、体温でも、30個分の測定データを取得すれば、そのデータが、各対象者の平均値を頂点として正規分布の形を取ることが確認された。 Further, for example, as shown in FIGS. 33 and 34, if 30 measurement data are prepared for body temperature, a normal distribution curve different for each subject can be obtained based on the measured data. .. 33 and 34 are graphs based on the results of measuring body temperature every 2 minutes and acquiring measurement data of 30 body temperatures. Further, in FIGS. 33 and 34, the subjects whose body temperature was measured are different. In this way, it was confirmed that even with body temperature, if 30 measurement data were acquired, the data would take the form of a normal distribution with the average value of each subject as the apex.
 30個分の測定データから、個体なりの正規分布が得られる点は、脈拍と体温だけでなく、血圧(収縮期血圧及び拡張期血圧)、脈圧、呼吸数についても確認された。 From the measurement data for 30 pieces, it was confirmed that not only the pulse and body temperature but also the blood pressure (systolic blood pressure and diastolic blood pressure), pulse pressure, and respiratory rate can be obtained.
 従って、本発明者は、時間の長さや測定間隔の規則性の有無に関わらず、バイタルサインについて、少なくとも30個分の測定データを取得すれば、対象者の個体内変動を反映した正規分布を得ることができ、これをバイオマーカーとして利用しうる可能性を見出して、本発明に至った。 Therefore, the present inventor can obtain a normal distribution reflecting the intra-individual variation of the subject by acquiring at least 30 measurement data for vital signs regardless of the length of time or the regularity of the measurement interval. We have found the possibility that it can be obtained and can be used as a biomarker, and have arrived at the present invention.
 即ち、時間の長さや測定間隔の規則性の有無に関わらず、少なくとも30個分のバイタル情報を取得して、正規分布を得ることで、対象となる個体の生理学的パラメータ(バイタルサイン)を観察することができ、その一周期を構成するバイタルサインの値が確認可能となる。換言すれば、30個分のバイタル情報を利用すれば、対象の個体におけるバイタルサインの異常な値を捉えることが充分に可能になるということになり、本発明ではこの点に着目している。 That is, regardless of the length of time and the presence or absence of regularity of measurement intervals, by acquiring at least 30 vital information and obtaining a normal distribution, the physiological parameters (vital signs) of the target individual can be observed. The values of vital signs that make up that one cycle can be confirmed. In other words, by using the vital information of 30 pieces, it is possible to sufficiently capture the abnormal value of the vital signs in the target individual, and the present invention pays attention to this point.
 また、バイタル情報が、バイタルサインである体温、血圧、脈拍、脈圧及び呼吸数から選択される少なくとも1つの測定値を有することによって、同一個体から測定された体温、血圧、脈拍、脈圧及び呼吸数について、スコア結果情報を得て、複数のバイタル情報を総合して、異常な値か否かを判定することが可能となる。 In addition, the vital information has at least one measured value selected from the vital signs of body temperature, blood pressure, pulse, pulse pressure and respiratory rate, so that the body temperature, blood pressure, pulse, pulse pressure and pulse pressure measured from the same individual are measured. With respect to the respiratory rate, it is possible to obtain score result information and combine a plurality of vital information to determine whether or not the value is abnormal.
 また、所定のスコアリング条件が少なくとも平均μをピーク値とした正規分布に基づき設定され、スコアリング条件が、体温、血圧、脈拍、脈圧及び呼吸数から選択される少なくとも1つの測定値に対しては、平均μ、標準偏差σ、0より大きい数であるn及びmを用いて表された下記の式(1)の値を下限値及び式(2)の値を上限値とし、下限値及び上限値の少なくとも一方を基準にする基準域条件を含むことによって、同一個体から取得された体温、血圧、脈拍、脈圧及び呼吸数の測定値がバイタル情報として入力された際に、平均μから負の方向にnσの値分離れた数値を下限値、または、平均μからmσの値分離れた数値を上限値とした基準域条件を、スコアリング条件の基準として、スコア結果情報を得ることが可能となる。また、この際の平均μをピーク値とした正規分布に基づき設定した基準は、同一個体の個体内変動が反映された基準であり、個体内変動を反映した形で、同一個体のバイタル情報を点数化することが可能となる。なお、ここでいう「基準」は、下記の式(1)の値を下限値、または、式(2)の値を上限値を、基準の設定値とした際に、スコアリングの対象となる数値が、設定値以上で2点となり、設定値未満で1点となる態様と、スコアリングの対象となる数値が、設定値を超えると2点となり、設定値以下で1点となる態様の両方を含むものである。また、n及びmの値は上述したように0より大きい数であればよく、このn及びmの値は、基準の厳密さや、バイタルサインの種類、対象者の既往歴等の種々の条件を考慮して適宜設定することができるものである。また、「下限値及び上限値の少なくとも一方」であるので、下限値のみ又は上限値のみ基準として設定する態様だけでなく、下限値と上限値の両方を基準として採用する態様も含むものである。また、ここでの式(1)及び式(2)の値は、平均μをピーク値とした正規分布に基づき設定される数値範囲である。
 μ-nσ・・・式(1)
 μ+mσ・・・式(2)
In addition, a predetermined scoring condition is set based on a normal distribution with at least a mean μ as the peak value, and the scoring condition is for at least one measured value selected from body temperature, blood pressure, pulse, pulse pressure and respiratory rate. The lower limit is the value of the following equation (1) expressed using the average μ, the standard deviation σ, and n and m which are numbers larger than 0, and the upper limit is the value of the equation (2). And by including a reference range condition based on at least one of the upper limit values, when the measured values of body temperature, blood pressure, pulse, pulse pressure and respiratory rate obtained from the same individual are input as vital information, the average μ Score result information is obtained using the reference range condition with the value separated by the value of nσ in the negative direction as the lower limit value or the value separated by the value of mσ from the average as the upper limit value as the standard of the scoring condition. It becomes possible. In addition, the standard set based on the normal distribution with the average μ as the peak value at this time is a standard that reflects the intra-individual variation of the same individual, and the vital information of the same individual is reflected in the form that reflects the intra-individual variation. It becomes possible to score. The "criteria" referred to here is subject to scoring when the value of the following formula (1) is set as the lower limit value or the value of the formula (2) is set as the set value of the standard. When the numerical value exceeds the set value, it becomes 2 points, and when it is less than the set value, it becomes 1 point, and when the numerical value to be scored exceeds the set value, it becomes 2 points, and when it exceeds the set value, it becomes 1 point. It includes both. Further, the values of n and m may be numbers larger than 0 as described above, and the values of n and m can be used for various conditions such as the strictness of the standard, the type of vital signs, and the medical history of the subject. It can be set as appropriate in consideration. Further, since it is "at least one of the lower limit value and the upper limit value", it includes not only a mode in which only the lower limit value or only the upper limit value is set as a reference, but also a mode in which both the lower limit value and the upper limit value are adopted as a reference. Further, the values of the equations (1) and (2) here are numerical ranges set based on the normal distribution with the average μ as the peak value.
μ-nσ ・ ・ ・ Equation (1)
μ + mσ ・ ・ ・ Equation (2)
 また、基準域条件が、バイタルサインの測定値のうち、所定のバイタル除外条件を満たす測定値が除外されて設定されたことによって、体温、血圧、脈拍、脈圧及び呼吸数から選択される少なくとも1つの測定値について、スコアリング条件となる基準範囲の中に含めたくない数値を除いて、スコアリング条件を設定することができる。即ち、例えば、バイタル情報における正常または異常の判定で、異常の検知の精度を高めて、バイタル情報として異常と判定された値を除外して、スコアリング条件を設定可能となる。また、例えば、バイタルサインの測定値につき、統計的に見て外れ値とみなせる測定値を除外して、スコアリング条件を設定可能となる。さらに、対象者が明らかに異常な状態(病気になっていることが明らかな状態等)での測定値を除外して、スコアリング条件を設定可能となる。また、バイタルサインを、一定の条件下で複数回測定した測定値に対して、一定の条件を満たす測定値を選択して、スコアリング条件を設定可能となる。また、正規性を満たさない測定値を除外して、スコアリング条件を設定可能となる。さらに、測定時間の条件を満たさない測定値を除外して、スコアリング条件を設定可能となる。このように、所定のバイタル除外条件を満たす測定値を除外して基準域条件(スコアリング条件)を設定することで、バイタル情報に対する異常判定の精度、統計的な精度等を担保して、スコアリングすることが可能となる。 In addition, since the reference range condition is set by excluding the measured values satisfying the predetermined vital exclusion condition from the measured values of vital signs, at least selected from body temperature, blood pressure, pulse, pulse pressure and respiratory rate. For one measured value, scoring conditions can be set except for numerical values that are not desired to be included in the reference range that is the scoring condition. That is, for example, it is possible to improve the accuracy of detecting an abnormality in the determination of normality or abnormality in the vital information, exclude the value determined to be abnormal as the vital information, and set the scoring condition. Further, for example, it is possible to set scoring conditions for the measured values of vital signs by excluding the measured values that can be regarded as statistically outliers. Furthermore, it is possible to set scoring conditions by excluding the measured values in a state in which the subject is clearly in an abnormal state (such as a state in which it is clear that the subject is ill). In addition, it is possible to set scoring conditions by selecting a measured value that satisfies a certain condition with respect to a measured value obtained by measuring vital signs a plurality of times under a certain condition. In addition, scoring conditions can be set by excluding measured values that do not satisfy the normality. Further, the scoring condition can be set by excluding the measured value that does not satisfy the measurement time condition. In this way, by excluding the measured values that satisfy the predetermined vital exclusion condition and setting the reference area condition (scoring condition), the accuracy of the abnormality judgment for the vital information, the statistical accuracy, etc. are guaranteed, and the score is obtained. It becomes possible to ring.
 また、スコア判定手段が、基準域条件に基づきスコアリングされたスコア結果情報を含めて、次回の判定を行うことによって、バイタル情報に対する異常判定の精度、統計的な精度等を担保した基準域条件に基づき行うスコアリングの結果を元に、対象者の判定を継続的に行うことができる。また、個体内変動を含むバイタルサインを元に、対象者の判定を継続的に行うことができる。 In addition, the score determination means includes the score result information scored based on the reference region condition, and makes the next determination to ensure the accuracy of the abnormality determination, the statistical accuracy, etc. of the vital information. Based on the result of scoring performed based on, the subject can be continuously judged. In addition, the subject can be continuously determined based on vital signs including intra-individual fluctuations.
 また、バイタル情報が、バイタルサインである体温、血圧、脈拍、脈圧及び呼吸数から選択される少なくとも1つの測定値と、酸素飽和度の測定値と、意識レベルを観察して取得された意識レベル評価結果とを有する場合には、これらのバイタル情報を組み合わせて、各バイタル情報に対応するスコア結果情報を総合して、その結果から、スコア値が異常な値か否かを判定することができる。即ち、複数のバイタル情報から、複合的に、スコア値に対する異常を判定可能となる。 In addition, vital information is obtained by observing at least one measured value selected from vital signs such as body temperature, blood pressure, pulse, pulse pressure, and respiratory rate, a measured value of oxygen saturation, and a consciousness level. If it has a level evaluation result, it is possible to combine these vital information, integrate the score result information corresponding to each vital information, and determine whether or not the score value is an abnormal value from the result. it can. That is, it is possible to determine an abnormality with respect to the score value in a complex manner from a plurality of vital information.
 また、スコアリング条件が、酸素飽和度の測定値に対しては、予め設定した所定の数値範囲である場合には、同一個体から取得された酸素飽和度の測定値がバイタル情報として入力された際に、予め設定した所定の数値範囲を基準により、その内容に応じたスコア結果情報を得ることができる。なお、ここでいう「予め設定した所定の数値範囲」は、集団のバイタルサインの測定値から設定された数値範囲を採用することができる。また、ここでいう「所定の数値範囲」は、基準となる値、例えば、一定値を設定した際に、スコアリングの対象となる数値が一定値以上で2点となり、一定値未満で1点となる態様と、スコアリングの対象となる数値が一定値を超えると2点となり、一定値以下で1点となる態様の両方を含むものである。 Further, when the scoring condition is within a predetermined numerical range set in advance for the measured value of oxygen saturation, the measured value of oxygen saturation acquired from the same individual is input as vital information. At that time, score result information according to the content can be obtained based on a predetermined numerical range set in advance. As the "predetermined numerical range set in advance" here, a numerical range set from the measured values of the vital signs of the group can be adopted. Further, the "predetermined numerical range" referred to here is a reference value, for example, when a constant value is set, the numerical value to be scored becomes 2 points when the numerical value is equal to or more than the constant value, and 1 point when the numerical value is less than the constant value. When the numerical value to be scored exceeds a certain value, 2 points are given, and when the numerical value to be scored exceeds a certain value, 1 point is given.
 また、スコアリング条件が、意識レベル評価結果に対しては、意識レベルの程度を示す所定の観察状態である場合には、同一個体から取得された意識レベル評価結果を、所定の観察状態の内容に当て嵌め、その内容に応じたスコア結果情報を得ることが可能となる。なお、所定の観察状態の内容とは、例えば、対象者の意識を確認した際の「異常のあり・なし」や、既知の意識評価の手法(ジャパン・コーマ・スケールやグラスゴー・コーマ・スケール等)により複数の段階分けをした評価結果の情報が含まれる。 In addition, when the scoring condition is a predetermined observation state indicating the degree of consciousness level with respect to the consciousness level evaluation result, the consciousness level evaluation result obtained from the same individual is the content of the predetermined observation state. It is possible to obtain score result information according to the content of the above. The contents of the predetermined observation state include, for example, "presence / absence of abnormality" when the subject's consciousness is confirmed, and known consciousness evaluation methods (Japan comba scale, Glasgow comba scale, etc.). ) Includes information on the evaluation results divided into multiple stages.
 また、所定のバイタル除外条件が、下記の式(1)の値を下限値及び式(2)の値を上限値とし、下限値及び上限値を基準にする場合には、平均μから負の方向に2σの値分離れた数値を下限値、平均μから2σの値分離れた数値を上限値とした上下限の範囲を基準として、バイタル除外条件にすることができる。なお、ここでいう上下限の範囲には、「下限値以上」、「下限値を超える」、「上限値以下」、「上限値未満」のそれぞれの組み合わせで設定される範囲を含むものである。
 μ-2σ・・・式(1)
 μ+2σ・・・式(2)
 即ち、バイタルサインの測定値に関する「μ±2σの範囲」が、体温、血圧、脈拍、脈圧及び呼吸数における測定値を、基準域条件(スコアリング条件)の算出根拠に含めるか否かの基準の範囲となる。例えば、「μ±2σ以内」を基準範囲とした際、あるバイタルサインの測定値が、μ-2σ未満の値、または、μ+2σを超える値であれば、その測定値は、そのバイタルサインをスコアリングする時の基準域条件の算出根拠からは除外される。
Further, when the predetermined vital exclusion condition uses the value of the following equation (1) as the lower limit value and the value of the equation (2) as the upper limit value and the lower limit value and the upper limit value as a reference, the average μ is negative. The vital exclusion condition can be set based on the upper and lower limit range with the value separated by the value of 2σ in the direction as the lower limit value and the value separated by the value of 2σ from the average as the upper limit value. The range of the upper and lower limits referred to here includes a range set by each combination of "above the lower limit value", "exceeds the lower limit value", "below the upper limit value", and "less than the upper limit value".
μ-2σ ・ ・ ・ Equation (1)
μ + 2σ ・ ・ ・ Equation (2)
That is, whether or not the "range of μ ± 2σ" regarding the measured values of vital signs includes the measured values of body temperature, blood pressure, pulse, pulse pressure and respiratory rate in the calculation basis of the reference range condition (scoring condition). It is within the standard range. For example, when "within μ ± 2σ" is set as the reference range, if the measured value of a certain vital sign is a value less than μ-2σ or a value exceeding μ + 2σ, the measured value scores the vital sign. It is excluded from the calculation basis of the reference range condition when ringing.
 ここで、正規分布に従うバイタルサインにおいて、「μ±2σ以内」の範囲に収まる確率は約95%である。そのため、この「μ±2σ以内」の範囲を、対象者のバイタルサインの約95%が含まれる「正常なバイタルの範囲(対象者の通常のバイタルの範囲)」と位置付ければ、スコアリングする際の基準域条件が、常に、対象者の正常なバイタルの範囲に含まれる測定値から設定されるものとなる。これにより、基準域条件は、バイタルの異常を精度高く検知できる内容となる。 Here, in the vital signs that follow the normal distribution, the probability of falling within the range of "within μ ± 2σ" is about 95%. Therefore, if this range of "within μ ± 2σ" is positioned as the "normal vital range (range of the subject's normal vitals)" that includes about 95% of the vital signs of the subject, it will be scored. The reference range condition is always set from the measured values included in the subject's normal vital range. As a result, the reference area condition is such that the vital abnormality can be detected with high accuracy.
 もし、仮に、「μ±2σ」を外れた測定値が、基準域条件の算出根拠に含まれるようになると、「正常なバイタルの範囲」とみなすべき部分の範囲が広がるおそれがある。例えば、体温の測定値として、37.5℃が3日続けて記録された際に、1日目、2日目では、37.5℃の値が、スコアリング条件において「μ±2σ」を外れて、1点以上のスコア値が算出されるが、3日目では、37.5℃の値が、更新されたスコアリング条件において「μ±2σ」の範囲内に含まれる結果となり、0点のスコアが算出されることが起こりうる。 If the measured value outside "μ ± 2σ" is included in the calculation basis of the reference range condition, the range of the part that should be regarded as the "normal vital range" may be expanded. For example, when 37.5 ° C was recorded as a measured value of body temperature for 3 consecutive days, the value of 37.5 ° C deviated from "μ ± 2σ" under the scoring conditions on the 1st and 2nd days, and 1 A score value of points or higher is calculated, but on the third day, the value of 37.5 ° C is included in the range of "μ ± 2σ" under the updated scoring conditions, and a score of 0 points is calculated. Can happen.
 このようなケースでは、スコアリング条件となる「μ±2σ」の範囲が広くなり、本来、バイタルの異常と判定され、1点以上のスコア値が算出されるべきものが、異常として検知できなくなる。つまり、バイタルの異常の検知の精度が下がり、これに伴い、スコア判定手段によるスコア結果情報の判定(対象者に対する異常の有無の判定)にも影響を及ぼすことになる。したがって、所定のバイタル除外条件として、バイタルサインの測定値に関する「μ±2σの範囲」を上下限の範囲として設定することで、スコアリングを行う基準域条件について、バイタルの異常の検知の精度を高く維持することが可能となる。 In such a case, the range of "μ ± 2σ", which is a scoring condition, becomes wide, and it is not possible to detect an abnormality that is originally determined to be a vital abnormality and a score value of 1 point or more should be calculated. .. That is, the accuracy of detecting the abnormality of vitals is lowered, and accordingly, the determination of the score result information by the score determination means (determination of the presence or absence of the abnormality for the subject) is also affected. Therefore, by setting the "range of μ ± 2σ" related to the measured value of vital signs as the upper and lower limit range as a predetermined vital exclusion condition, the accuracy of detection of vital abnormality can be improved for the reference range condition for scoring. It will be possible to keep it high.
 また、所定のバイタル除外条件が、所定の検定法に基づく外れ値に該当するか否かである場合には、統計的に見て、他の測定値から大きく外れた値を、外れ値として、この外れ値を基準域条件の算出根拠から除外することができる。この結果、体温、血圧、脈拍、脈圧及び呼吸数における測定値をスコアリングする基準を、外れ値を含まない、換言すれば、医学的に取り得ない値が算出根拠に含まれにくい基準とすることができる。なお、所定の検定法とは、例えば、スミルノフ・グラブス検定が含まれるものである。 In addition, when the predetermined vital exclusion condition corresponds to an outlier based on a predetermined test method, a value that is statistically significantly different from other measured values is regarded as an outlier. This outlier can be excluded from the basis for calculating the reference range condition. As a result, the criteria for scoring the measured values of body temperature, blood pressure, pulse, pulse pressure and respiratory rate are those that do not include outliers, in other words, those that are medically unacceptable are unlikely to be included in the calculation basis. be able to. The predetermined test method includes, for example, the Smirnov-Grabs test.
 また、所定のバイタル除外条件が、医師による処方がなされた日、処方内容に含まれる期間、または、入院期間に測定された値であるか否かである場合には、対象者が医師による診断を受けて、病気と判断された状態、または、何等かの処置が必要な状態で測定されたバイタルサインの値を基準域条件の算出根拠から除外することができる。この結果、対象者が、明らかに体調に異常を生じている状態でのバイタル情報が、スコアリングする基準に反映されなくなり、基準域条件は、バイタルの異常を精度高く検知できる内容となる。
 なお、ここでいう、医師による処方とは、服薬、点滴、注射、経管栄養等の処置や、看取り(医療介入を望まない)の際の経過観察を含むものである。また、ここでいう、処方内容に含まれる期間とは、例えば、服薬の開始から終了までの期間を意味する。さらに、ここでいう入院期間とは、対象者が診断の結果、病院に入院している期間を意味する。
In addition, if the prescribed vital exclusion condition is whether or not the value is measured on the day when the prescription was made by the doctor, the period included in the prescription content, or the hospitalization period, the subject is diagnosed by the doctor. Therefore, the value of vital signs measured in a state determined to be ill or in a state requiring some treatment can be excluded from the calculation basis of the reference range condition. As a result, the vital information in the state where the subject is clearly in a state of physical condition is not reflected in the scoring standard, and the reference area condition is such that the vital abnormality can be detected with high accuracy.
The term "prescription by a doctor" as used herein includes treatments such as medication, infusion, injection, tube feeding, and follow-up at the time of care (not wishing for medical intervention). Further, the period included in the prescription content referred to here means, for example, a period from the start to the end of taking the drug. Further, the hospitalization period referred to here means the period during which the subject is hospitalized as a result of the diagnosis.
 また、所定のバイタル除外条件が、所定の条件で複数回測定したバイタルサインの測定値に対して、下記の式(1)の値を下限値及び式(2)の値を上限値とし、下限値及び上限値を基準にして、下限値以下または上限値以上となるバイタルサインの測定値が2回以上続けて測定された際に、2回目以降の測定値であるか否かである場合には、複数回測定したバイタルの中で「μ±2σ」を外れた値が2回以上続いた際に、1回目の測定値を基準域条件に反映させ、かつ、2回目以降の測定値は、基準域条件の算出根拠から除外することができる。
 μ-2σ・・・式(1)
 μ+2σ・・・式(2)
 即ち、「μ±2σ」を外れた値を、基準域条件から完全に除外せずに、かつ、2つ以上の値が基準域条件の算出根拠に含まれないようにすることで、バイタル情報の異常と判定される値もスコアリングの基準に入れながら、過度に、基準域条件の検知の精度が下がることを抑止することができる。なお、ここでいう所定の条件とは、例えば、ある基準となる時間に対して、その前後5分間の間に測定した複数のバイタルサインの測定値等、ほぼ同一の条件下での測定されたバイタルサインとみなしてよい内容を意味するものである。
Further, the predetermined vital exclusion condition is a lower limit with the value of the following equation (1) as the lower limit value and the value of the equation (2) as the upper limit value with respect to the measured value of the vital sign measured a plurality of times under the predetermined condition. When the measured value of the vital sign that is below the lower limit value or above the upper limit value is measured twice or more in succession based on the value and the upper limit value, and whether or not it is the second or subsequent measurement value. Is to reflect the first measurement value in the reference range condition when the value outside "μ ± 2σ" continues two or more times in the vitals measured multiple times, and the second and subsequent measurement values are , Can be excluded from the calculation basis of the reference area condition.
μ-2σ ・ ・ ・ Equation (1)
μ + 2σ ・ ・ ・ Equation (2)
That is, the vital information is obtained by not completely excluding the values outside "μ ± 2σ" from the reference region condition and preventing two or more values from being included in the calculation basis of the reference region condition. It is possible to prevent the accuracy of detection of the reference range condition from being excessively lowered while including the value determined to be abnormal in the scoring criteria. The predetermined condition referred to here is, for example, measured under substantially the same conditions, such as the measured values of a plurality of vital signs measured during 5 minutes before and after a certain reference time. It means the content that can be regarded as vital signs.
 また、所定のバイタル除外条件が、所定の条件で複数回測定したバイタルサインの測定値に対して、所定の主値選択条件で選択された主値以外の測定値であるか否かである場合には、複数の測定値の中から選ばれた主値以外の測定値を基準域条件の算出根拠から除外することができる。 Further, when the predetermined vital exclusion condition is whether or not the measured value of the vital sign measured multiple times under the predetermined condition is a measured value other than the principal value selected under the predetermined principal value selection condition. It is possible to exclude measured values other than the principal value selected from a plurality of measured values from the calculation basis of the reference region condition.
 ここで、所定の主値選択条件とは、例えば、複数のバイタルサインの測定値の中から、人為的、または、一定の条件を設けてシステム的に1つの値を選択する条件がある。そして、選択した主値以外の値を、スコアリングする基準に反映させなくすることができる。人為的な選択とは、例えば、2つの測定値の中から、明らかな入力ミスによる測定値とわかる数値を除いて、もう一方の測定値を選択するような行為が含まれる。また、システム的な選択とは、例えば、血圧の測定において、複数の測定値の中から、正常な範囲の中に含まれる測定値を選択するような態様が考えられる。血圧の測定では、数回測定を行い、血圧に異常がある場合には、何回測定しても、正常な範囲の値が見られないようになっているためである。さらに、システム的な選択とは、Q-Qプロットに基づき、プロットの範囲内から精度の高い測定値を選択するような態様が考えられる。これにより、スコアリングの基準から明らかに誤った測定値を除外しやすくなる。また、スコアリングの基準に、正常な範囲といえる数値や、正規性が担保された測定値を反映させやすくなる。 Here, the predetermined principal value selection condition is, for example, a condition in which one value is systematically selected from among the measured values of a plurality of vital signs artificially or by setting certain conditions. Then, values other than the selected principal value can be prevented from being reflected in the scoring criteria. The artificial selection includes, for example, the act of selecting the other measured value from the two measured values, excluding the numerical value that can be recognized as the measured value due to an obvious input error. Further, as a systematic selection, for example, in the measurement of blood pressure, a mode in which a measured value included in a normal range is selected from a plurality of measured values can be considered. This is because the blood pressure is measured several times, and when the blood pressure is abnormal, the value in the normal range cannot be seen no matter how many times the blood pressure is measured. Further, the systematic selection can be considered as a mode in which a highly accurate measured value is selected from the range of the plot based on the Q-Q plot. This makes it easier to exclude clearly incorrect measurements from the scoring criteria. In addition, it becomes easier to reflect numerical values that can be said to be in the normal range and measured values whose normality is guaranteed in the scoring standard.
 また、所定のバイタル除外条件が、所定の検定法に基づき、正規性が担保されたバイタルサインの測定値であるか否かである場合には、正規性が担保されない測定値を基準域条件の算出根拠から除外することができる。この結果、スコアリングの基準を、正規性が担保されたバイタルサインの測定値のみで設定可能となり、対象者の個体内変動をより一層反映したスコアリングを行いやすくなる。なお、所定の検定法とは、例えば、シャピロ-ウィルク検定である。このシャピロ-ウィルク検定で求めたp値から、測定値を外れ値とするかを判断して、外れ値である場合には、正規性が担保されない測定値として、基準域条件の算出根拠から除外することができる。 In addition, when the predetermined vital exclusion condition is whether or not the measured value of vital signs whose normality is guaranteed based on the predetermined test method, the measured value whose normality is not guaranteed is used as the reference range condition. It can be excluded from the calculation basis. As a result, the scoring standard can be set only by the measured value of vital signs whose normality is guaranteed, and it becomes easier to perform scoring that further reflects the intra-individual variation of the subject. The predetermined test method is, for example, the Shapiro-Wilk test. From the p-value obtained by this Shapiro-Wilk test, it is judged whether the measured value is an outlier, and if it is an outlier, it is excluded from the calculation basis of the reference range condition as a measured value whose normality is not guaranteed. can do.
 また、所定のバイタル除外条件が、バイタルサインの測定を行った作業者の情報と、作業者が測定したバイタルサインの測定値の正規性の情報を基準とする場合には、正規性が担保されないバイタルサインの測定値の測定に紐付けられた作業者につき、その作業者が測定したバイタルサインの測定値を、基準域条件の算出根拠から除外することができる。これによれば、バイタルサインを測定する際の測定の仕方に問題がある可能性がある作業者による結果を取り除くことができる。即ち、測定する作業者の技術による人為的な影響を減らすことが可能となる。 In addition, if the predetermined vital exclusion condition is based on the information of the worker who measured the vital sign and the information on the normality of the measured value of the vital sign measured by the worker, the normality is not guaranteed. For a worker associated with the measurement of the measured value of the vital sign, the measured value of the vital sign measured by the worker can be excluded from the calculation basis of the reference range condition. According to this, it is possible to eliminate the result by the operator who may have a problem in the measurement method when measuring vital signs. That is, it is possible to reduce the human influence of the measuring operator's technique.
 また、所定のバイタル除外条件が、バイタルサインの測定値が、所定の時間条件を満たして測定された値であるか否かである場合には、決められた時間に適切に測定されなかったバイタルサインの測定値を、基準域条件の算出根拠から除外することができる。 Further, when the predetermined vital exclusion condition is whether or not the measured value of the vital sign is a value measured by satisfying the predetermined time condition, the vital is not properly measured at the predetermined time. Sign measurements can be excluded from the basis for calculating reference zone conditions.
 また、スコア判定手段が、異常な値と判定する際に、異常を少なくとも2つの段階に分けて判定する場合には、スコア結果情報の判定後の取扱いを多様なものにできる。例えば、異常を示す状態であっても、スコア結果情報の数値が小さなものであれば「注意」として通知し、スコア結果情報の数値が大きなものについては「警告」として通知することで、全ての異常を画一的に処理しなくてよいものとなる。この結果、判定を行った際に、すぐに医師のチェックが必要か否かといった判定後の対処を効率よく処理できるものとなる。 Further, when the score determining means determines that the abnormal value is determined by dividing the abnormality into at least two stages, the handling of the score result information after the determination can be various. For example, even in a state indicating an abnormality, if the numerical value of the score result information is small, it is notified as "Caution", and if the numerical value of the score result information is large, it is notified as "Warning". It is not necessary to handle the abnormality uniformly. As a result, when the judgment is made, it is possible to efficiently process the measures after the judgment such as whether or not the doctor needs to check immediately.
 また、情報入力手段が、所定のバイタル除外条件を満たす測定値が入力された際に、バイタルサインの再測定を促す場合には、バイタルの測定自体の精度を担保しやすくなる。即ち、例えば、バイタルの測定の作業に問題があって、所定のバイタル除外条件を満たす測定値が測定された際に、再測定により、正確な測定値が得られ、バイタルの測定の精度を担保することができる。 Further, when the information input means prompts the remeasurement of vital signs when the measured value satisfying the predetermined vital exclusion condition is input, it becomes easy to guarantee the accuracy of the vital measurement itself. That is, for example, when there is a problem in the work of measuring vitals and a measured value satisfying a predetermined vital exclusion condition is measured, an accurate measured value can be obtained by remeasurement, and the accuracy of vital measurement is guaranteed. can do.
 また、上記の目的を達成するために、本発明の健康状態判定装置は、取得されたバイタルサインに関する情報であるバイタル情報をスコアリングして、得られたスコア結果情報に基づいて、個体の健康状態を判定するための健康状態判定装置であって、同一個体から取得されると共に、正規分布に従うバイタルサインから選択される少なくとも1つの測定値を含む前記バイタル情報及び取得日時の入力を受け付ける情報入力手段と、入力された前記バイタル情報及び取得日時の情報を記録させる情報記録手段と、記録された複数の前記バイタル情報の全部又は一部の、平均μ及び標準偏差σを算出する基準算出手段と、所定のスコアリング条件を基準に、入力された所定のバイタル情報をスコアリングして、スコアの値であるスコア結果情報を算出すると共に、前記所定のスコアリング条件は少なくとも前記平均μをピーク値とした正規分布に基づき設定されるスコアリング処理手段と、複数の種類の前記バイタル情報に対応する前記スコア結果情報を総合して、所定のスコア判定条件を基準に、異常な値か否かを判定するスコア判定手段と、前記スコア判定手段の判定結果に基づき、アラートを通知するアラート通知手段と、前記スコア判定手段が判定した判定結果を表示可能な表示手段とを備え、少なくとも30個分の測定データの前記バイタル情報には、個体に固有の個体内変動が反映され、前記正規分布は、少なくとも30個分の測定データの前記バイタル情報から作成され、前記バイタル情報は、前記バイタルサインである体温、血圧、脈拍、脈圧及び呼吸数から選択される少なくとも1つの測定値を含み、前記スコアリング条件は、体温、血圧、脈拍、脈圧及び呼吸数から選択される少なくとも1つの測定値に対しては、前記平均μ、前記標準偏差σ、0より大きい数であるn及びmを用いて表された下記の式(1)の値を下限値及び式(2)の値を上限値とし、下限値及び上限値の少なくとも一方を基準にする基準域条件を含み、前記基準域条件は、バイタルサインの測定値のうち、所定のバイタル除外条件を満たす測定値が除外されて設定され、前記スコア判定手段は、前記基準域条件に基づきスコアリングされた前記スコア結果情報を含めて、次回の判定を行うように構成されている。
 μ-nσ・・・式(1)
 μ+mσ・・・式(2)
Further, in order to achieve the above object, the health condition determination device of the present invention scores vital information which is information on acquired vital signs, and based on the obtained score result information, individual health. An information input that is a health condition determination device for determining a condition and accepts input of the vital information including at least one measured value selected from vital signs according to a normal distribution and acquisition date and time, which is acquired from the same individual. Means, an information recording means for recording the input vital information and acquisition date / time information, and a reference calculation means for calculating the average μ and the standard deviation σ of all or a part of the recorded vital information. , The input predetermined vital information is scored based on the predetermined scoring condition to calculate the score result information which is the value of the score, and the predetermined scoring condition peaks at least the average μ. The scoring processing means set based on the normal distribution and the score result information corresponding to a plurality of types of the vital information are integrated, and whether or not the value is abnormal is determined based on a predetermined score determination condition. It is provided with a score determination means for determining, an alert notification means for notifying an alert based on the determination result of the score determination means, and a display means capable of displaying the determination result determined by the score determination means, for at least 30 pieces. The vital information of the measurement data reflects the intra-individual variation peculiar to the individual, the normal distribution is created from the vital information of at least 30 measurement data, and the vital information is the vital sign. The scoring condition comprises at least one measurement selected from body temperature, blood pressure, pulse, pulse pressure and respiratory rate, said scoring condition being at least one measurement selected from body temperature, blood pressure, pulse, pulse pressure and respiratory rate. On the other hand, the value of the following equation (1) expressed using the average μ, the standard deviation σ, and n and m which are numbers larger than 0 is set as the lower limit value and the value of the equation (2) is set as the upper limit value. , A reference region condition based on at least one of a lower limit value and an upper limit value is included, and the reference region condition is set by excluding a measurement value satisfying a predetermined vital exclusion condition from the measured values of vital signs. The score determination means is configured to perform the next determination including the score result information scored based on the reference region condition.
μ-nσ ・ ・ ・ Equation (1)
μ + mσ ・ ・ ・ Equation (2)
 また、上記の目的を達成するために、本発明の健康状態判定方法は、コンピュータが実行する方法であり、取得されたバイタルサインに関する情報であるバイタル情報をスコアリングして、得られたスコア結果情報に基づいて、個体の健康状態を判定するための健康状態判定方法であって、同一個体から取得されると共に、正規分布に従うバイタルサインから選択される少なくとも1つの測定値を含む前記バイタル情報の入力を受け付けて記録する情報記録工程と、記録された複数の前記バイタル情報の全部又は一部の、平均μ及び標準偏差σを算出する基準算出工程と、所定のスコアリング条件を基準に、入力された所定のバイタル情報をスコアリングして、スコアの値であるスコア結果情報を算出すると共に、前記所定のスコアリング条件は少なくとも前記平均μをピーク値とした正規分布に基づき設定されるスコアリング処理工程と、複数の種類の前記バイタル情報に対応する前記スコア結果情報を総合して、所定のスコア判定条件を基準に、異常な値か否かを判定するスコア判定工程と、前記スコア判定工程の判定結果に基づき、アラートを通知するアラート通知工程とを備え、少なくとも30個分の測定データの前記バイタル情報には、個体に固有の個体内変動が反映され、前記正規分布は、少なくとも30個分の測定データの前記バイタル情報から作成され、前記バイタル情報は、前記バイタルサインである体温、血圧、脈拍、脈圧及び呼吸数から選択される少なくとも1つの測定値を含み、前記スコアリング条件は、体温、血圧、脈拍、脈圧及び呼吸数から選択される少なくとも1つの測定値に対しては、前記平均μ、前記標準偏差σ、0より大きい数であるn及びmを用いて表された下記の式(1)の値を下限値及び式(2)の値を上限値とし、下限値及び上限値の少なくとも一方を基準にする基準域条件を含み、前記基準域条件は、バイタルサインの測定値のうち、所定のバイタル除外条件を満たす測定値が除外されて設定され、前記スコア判定工程は、前記基準域条件に基づきスコアリングされた前記スコア結果情報を含めて、次回の判定を行うように構成されている。
 μ-nσ・・・式(1)
 μ+mσ・・・式(2)
Further, in order to achieve the above object, the health condition determination method of the present invention is a method executed by a computer, and the vital information which is the information regarding the acquired vital signs is scored, and the score result obtained. A method for determining the health condition of an individual based on the information, which is obtained from the same individual and contains at least one measured value selected from vital signs following a normal distribution. Input based on an information recording process that accepts and records input, a standard calculation process that calculates the average μ and standard deviation σ of all or part of the recorded vital information, and predetermined scoring conditions. The predetermined vital information is scored to calculate the score result information which is the value of the score, and the predetermined scoring condition is set based on a normal distribution having at least the average μ as the peak value. The processing step, the score determination step of determining whether or not the value is abnormal based on a predetermined score determination condition by integrating the score result information corresponding to the plurality of types of the vital information, and the score determination step. The vital information of at least 30 measurement data reflects the intra-individual variation peculiar to the individual, and the normal distribution is at least 30. Created from the vital information of the minute measurement data, the vital information includes at least one measurement value selected from the vital signs body temperature, blood pressure, pulse, pulse pressure and respiratory rate, and the scoring condition is , The mean μ, the standard deviation σ, and n and m, which are numbers greater than 0, for at least one measurement selected from body temperature, blood pressure, pulse, pulse pressure and respiratory rate. The value of the following equation (1) is the lower limit value and the value of the equation (2) is the upper limit value, and includes a reference region condition based on at least one of the lower limit value and the upper limit value, and the reference region condition is a vital sign. Among the measured values, the measured values satisfying the predetermined vital exclusion exclusion condition are excluded and set, and the score determination step performs the next determination including the score result information scored based on the reference region condition. It is configured as follows.
μ-nσ ・ ・ ・ Equation (1)
μ + mσ ・ ・ ・ Equation (2)
 また、上記の目的を達成するために、本発明のソフトウェアは、取得されたバイタルサインに関する情報であるバイタル情報に基づいて、個体の健康状態を判定するためのソフトウェアであって、情報処理機器を、同一個体から取得されると共に、正規分布に従うバイタルサインから選択される少なくとも1つの測定値を含む前記バイタル情報及び取得日時の入力を受け付ける情報入力手段と、入力された前記バイタル情報及び取得日時の情報を記録させる情報記録手段と、記録された複数の前記バイタル情報の全部又は一部の、平均μ及び標準偏差σを算出する基準算出手段と、前記平均μ及び前記標準偏差σから選択される少なくとも1つに基づいて設定された所定の数値範囲を基準にして、入力された所定のバイタル情報が異常な値か否かを判定すると共に、前記所定の数値範囲は少なくとも前記平均μをピーク値とした正規分布に基づき設定される判定手段と、
を含む手段として機能させるためのソフトウェアであり、少なくとも30個分の測定データの前記バイタル情報には、個体に固有の個体内変動が反映され、前記正規分布は、少なくとも30個分の測定データの前記バイタル情報から作成され、前記バイタル情報は、前記バイタルサインである体温、血圧、脈拍、脈圧及び呼吸数から選択される少なくとも1つの測定値を含み、前記所定の数値範囲は、体温、血圧、脈拍、脈圧及び呼吸数から選択される少なくとも1つの測定値に対しては、前記平均μ、前記標準偏差σ、0より大きい数であるn及びmを用いて表された下記の式(1)の値を下限値及び式(2)の値を上限値とし、下限値及び上限値の少なくとも一方を基準にする基準域条件を含み、
 前記基準域条件は、バイタルサインの測定値のうち、所定のバイタル除外条件を満たす測定値が除外されて設定される構成となっている。
 μ-nσ・・・式(1)
 μ+mσ・・・式(2)
Further, in order to achieve the above object, the software of the present invention is software for determining the health condition of an individual based on vital information which is information on acquired vital signs, and is an information processing apparatus. , An information input means that accepts input of the vital information and acquisition date and time including at least one measured value selected from vital signs that are acquired from the same individual and follow a normal distribution, and the input vital information and acquisition date and time. It is selected from the information recording means for recording information, the reference calculation means for calculating the average μ and the standard deviation σ of all or a part of the plurality of recorded vital information, and the average μ and the standard deviation σ. Based on a predetermined numerical range set based on at least one, it is determined whether or not the input predetermined vital information is an abnormal value, and the predetermined numerical range has a peak value of at least the average μ. Judgment means set based on the normal distribution
The vital information of the measurement data for at least 30 pieces reflects the intra-individual variation peculiar to the individual, and the normal distribution is the measurement data for at least 30 pieces. Created from the vital information, the vital information includes at least one measurement value selected from the vital signs body temperature, blood pressure, pulse, pulse pressure and respiratory rate, and the predetermined numerical range includes body temperature, blood pressure. For at least one measured value selected from pulse, pulse pressure and respiratory rate, the following equation expressed using the mean μ, the standard deviation σ, and n and m, which are numbers greater than 0, ( The value of 1) is the lower limit value and the value of the equation (2) is the upper limit value, and the reference range condition based on at least one of the lower limit value and the upper limit value is included.
The reference range condition is set by excluding the measured values satisfying a predetermined vital exclusion condition from the measured values of vital signs.
μ-nσ ・ ・ ・ Equation (1)
μ + mσ ・ ・ ・ Equation (2)
 本発明に係るソフトウェア、健康状態判定装置及び健康状態判定方法は、対象者の個人差を考慮したバイタルサインや日々の体調を反映して、対象者ごとに異なる個体内変動を精度高く捉えることが可能であり、かつ、偽陽性が少なく、対象者における異常の検知の精度に優れたものとなっている。 The software, the health condition determination device, and the health condition determination method according to the present invention can accurately capture individual fluctuations that differ from subject to subject, reflecting vital signs and daily physical conditions that take into account individual differences of the subject. It is possible, there are few false positives, and the accuracy of detecting abnormalities in the subject is excellent.
本発明を適用したソフトウェアを導入したタブレット端末の概略構成を示す図である(第1のシステム構成)。It is a figure which shows the schematic structure of the tablet terminal which introduced the software to which this invention is applied (the first system structure). 本発明を適用したソフトウェアを有する第2のシステム構成を示す概略図である。It is the schematic which shows the 2nd system configuration which has the software to which this invention is applied. 本発明を適用したソフトウェアを有する第3のシステム構成を示す概略図である。It is the schematic which shows the 3rd system configuration which has the software to which this invention is applied. 演算部、情報送受信部及び情報記録部の構成を示すブロック図である。It is a block diagram which shows the structure of the calculation unit, the information transmission / reception unit, and the information recording unit. バイタル平均値及びバイタル標準偏差の算出期間の設定の一例を示す概略図である。It is a schematic diagram which shows an example of setting of the calculation period of a vital average value and a vital standard deviation. バイタル情報の抽出の事例を示した概略図である。It is the schematic which showed the example of the extraction of vital information. (a)は、本発明を適用したソフトウェアを機能させる際に使用する装置の一例を示す概略図、(b)は、装置の他の例を示す概略図である。(A) is a schematic diagram showing an example of an apparatus used when operating software to which the present invention is applied, and (b) is a schematic diagram showing another example of the apparatus. バイタルサインの値の入力画面の一例を示す概略図である。It is the schematic which shows an example of the input screen of the value of vital signs. バイタルサインの値の入力画面の他の例を示す概略図である。It is the schematic which shows the other example of the input screen of the value of vital signs. 体温における異常の判断基準(μ±2σ)に異常と判断された値を含めるケースのグラフである。It is a graph of the case which includes the value judged to be abnormal in the criterion (μ ± 2σ) of the abnormality in body temperature. 体温における異常の判断基準(μ±2σ)に異常と判断された値を含めない(除外する)ケースのグラフである。It is a graph of the case which does not include (excludes) the value judged to be abnormal in the judgment criteria (μ ± 2σ) of the abnormality in body temperature. 血圧における異常の判断基準(μ±2σ)に異常と判断された値を含めるケースのグラフである。It is a graph of the case which includes the value judged to be abnormal in the criterion (μ ± 2σ) of the abnormality in blood pressure. 血圧における異常の判断基準(μ±2σ)に異常と判断された値を含めない(除外する)ケースのグラフである。It is a graph of the case where the value judged to be abnormal is not included (excluded) in the criterion (μ ± 2σ) for the abnormality in blood pressure. 脈拍における異常の判断基準(μ±2σ)に異常と判断された値を含めるケースのグラフである。It is a graph of the case which includes the value judged to be abnormal in the criterion (μ ± 2σ) of the abnormality in pulse. 脈拍における異常の判断基準(μ±2σ)に異常と判断された値を含めない(除外する)ケースのグラフである。It is a graph of the case where the value judged to be abnormal is not included (excluded) in the judgment criterion (μ ± 2σ) of the abnormality in the pulse. 脈拍のデータにつき、スミルノフ・グラブス検定に基づき外れ値を除外する前のデータであり、(a)はQ-Qプロット、(b)は分布図である。The pulse data is the data before excluding outliers based on the Smirnov-Grabs test, (a) is a QQ plot, and (b) is a distribution map. 脈拍のデータにつき、スミルノフ・グラブス検定に基づき外れ値を除外した後のデータであり、(a)はQ-Qプロット、(b)は分布図である。The pulse data is the data after excluding outliers based on the Smirnov-Grabs test, (a) is a QQ plot, and (b) is a distribution map. 脈拍のデータにつき、データ数を増やしていった際の各データ集合の分布図である。It is a distribution map of each data set when the number of data is increased for pulse data. 脈拍のデータにつき、データ数を増やしていった際の各データ集合の分布図である。It is a distribution map of each data set when the number of data is increased for pulse data. (a)は、複数の対象者のバイタル情報を元に作成された正規分布曲線のグラフであり、(b)は、同一の対象者のバイタル情報を元に作成された正規分布曲線のグラフである。(A) is a graph of a normal distribution curve created based on the vital information of a plurality of subjects, and (b) is a graph of a normal distribution curve created based on the vital information of the same subject. is there. 熱型表の例を示す概略図である。It is the schematic which shows the example of the heat type table. 電子カルテでスコアリングの結果を示した画像の例を示す概略図である。It is the schematic which shows the example of the image which showed the result of scoring by the electronic medical record. スマートフォン端末で利用するアプリケーションソフトウェアでスコアリングの結果を示した画像の例を示す概略図である。It is the schematic which shows the example of the image which showed the result of scoring by the application software used in the smartphone terminal. バイタル情報の入力からスコア値情報における異常の判定、結果の情報の表示までの情報処理の流れを示すフロー図である。It is a flow chart which shows the flow of information processing from the input of vital information to the determination of an abnormality in score value information, and the display of result information. 1分ごとに脈拍を測定して、30個分の脈拍の測定データを取得した結果に基づく正規分布曲線である。It is a normal distribution curve based on the result of measuring the pulse every 1 minute and acquiring the measurement data of 30 pulses. 1分ごとに脈拍を測定して、30個分の脈拍の測定データを取得した結果に基づく正規分布曲線である。It is a normal distribution curve based on the result of measuring the pulse every 1 minute and acquiring the measurement data of 30 pulses. 7分ごとに脈拍を測定して、30個分の脈拍の測定データを取得した結果に基づく正規分布曲線である。It is a normal distribution curve based on the result of measuring the pulse every 7 minutes and acquiring the measurement data of 30 pulses. 7分ごとに脈拍を測定して、30個分の脈拍の測定データを取得した結果に基づく正規分布曲線である。It is a normal distribution curve based on the result of measuring the pulse every 7 minutes and acquiring the measurement data of 30 pulses. 1日の中で、不規則な時間で、30個分の脈拍の測定データを取得した結果に基づく正規分布曲線である。It is a normal distribution curve based on the result of acquiring the measurement data of 30 pulses at irregular times in a day. 1日の中で、不規則な時間で、30個分の脈拍の測定データを取得した結果に基づく正規分布曲線である。It is a normal distribution curve based on the result of acquiring the measurement data of 30 pulses at irregular times in a day. 30時間の中で、不規則な時間で、30個分の脈拍の測定データを取得した結果に基づく正規分布曲線である。It is a normal distribution curve based on the result of acquiring the measurement data of 30 pulses at an irregular time in 30 hours. 30日の中で、不規則な時間で、30個分の脈拍の測定データを取得した結果に基づく正規分布曲線である。It is a normal distribution curve based on the result of acquiring the measurement data of 30 pulses at an irregular time in 30 days. 2分ごとに体温を測定して、30個分の体温の測定データを取得した結果に基づく正規分布曲線である。It is a normal distribution curve based on the result of measuring the body temperature every 2 minutes and acquiring the measurement data of the body temperature of 30 pieces. 2分ごとに体温を測定して、30個分の体温の測定データを取得した結果に基づく正規分布曲線である。It is a normal distribution curve based on the result of measuring the body temperature every 2 minutes and acquiring the measurement data of the body temperature of 30 pieces.
 以下、本発明の実施の形態について図面を参照しながら説明し、本発明の理解に供する。
 図1は、本発明を適用したソフトウェアを導入したタブレット端末の概略構成を示す図である。なお、以下に示す構造は本発明の一例であり、本発明の内容はこれに限定されるものではない。
Hereinafter, embodiments of the present invention will be described with reference to the drawings for the purpose of understanding the present invention.
FIG. 1 is a diagram showing a schematic configuration of a tablet terminal into which software to which the present invention is applied has been introduced. The structure shown below is an example of the present invention, and the content of the present invention is not limited thereto.
[1.全体の装置構成について]
 本発明を適用したソフトウェアは、汎用の情報処理機器に導入可能であり、組み込まれた情報処理機器に対して本発明の実施するために必要な各情報処理機能を付与する。この結果、タブレット端末3において、対象者のバイタル情報を入力して、その内容に応じたスコアリングを行い、得られたスコア結果情報(以下、「スコア値情報」と称する)が異常な値か否かの判定を行うことができる。
[1. About the overall device configuration]
The software to which the present invention is applied can be introduced into a general-purpose information processing device, and imparts each information processing function necessary for carrying out the present invention to the embedded information processing device. As a result, in the tablet terminal 3, the vital information of the target person is input, scoring is performed according to the content, and the obtained score result information (hereinafter referred to as "score value information") is an abnormal value. Whether or not it can be determined.
 なお、情報処理機器とは、CPUなどの演算部と、RAMやROMなどの記憶部と、液晶画面等の表示画面や、キーボード等の入力部、インターネット等との通信を制御する通信部等を備えたものである。例えば、汎用のパーソナルコンピュータやタブレット端末、スマートフォン等である。また、情報処理機器としては、例えば、各種のヘルスケア機器や、病院や施設等に設置された医療システムや介護システムも対象となり、本発明を適用したソフトウェアがこれらに組み込まれて使用されるものでもよい。 The information processing device includes a calculation unit such as a CPU, a storage unit such as a RAM or ROM, a display screen such as a liquid crystal screen, an input unit such as a keyboard, and a communication unit that controls communication with the Internet or the like. It is prepared. For example, a general-purpose personal computer, a tablet terminal, a smartphone, or the like. Further, as the information processing device, for example, various healthcare devices, medical systems and long-term care systems installed in hospitals, facilities, etc. are also targeted, and software to which the present invention is applied is incorporated and used in these. It may be.
 本発明を適用したソフトウェアは、アプリケーションソフトウェアとしてタブレット端末3にダウンロードされて組み込まれており、バイタル情報のスコアリング機能及びスコア値の判定機能を備えたタブレット端末を健康状態判定装置1とする。
 なお、以下では、健康状態判定装置1の使用者、即ち、健康状態が判定される人物を「対象者」と呼ぶものとする。
The software to which the present invention is applied is downloaded and incorporated in the tablet terminal 3 as application software, and the tablet terminal having the vital information scoring function and the score value determination function is defined as the health condition determination device 1.
In the following, the user of the health condition determination device 1, that is, the person whose health condition is determined will be referred to as a "target person".
 図1に示すように、健康状態判定装置1(タブレット端末3)は、演算部2を備えている。演算部2は、健康状態判定装置1の有する各情報処理機能を実行する処理部である。即ち、本発明を適用したソフトウェアでは、タブレット端末3の演算部2を情報入力手段23、情報記録手段24、基準算出手段5、スコアリング処理手段100、判定処理手段6等として機能させる。この各手段の処理機能により、情報の送受信、情報の記録、バイタル情報の内容に基づくスコアリング、スコアリング条件(スコアリング基準情報、基準域条件)の設定、スコア値情報における異常の判定、スコア値に関する異常の判定基準(スコア判定条件)の設定、スコア値に関する判定結果の通知、バイタルサインの値における異常の判定、バイタルサインの値に関する異常の判定基準の設定、バイタルサインの値に関する判定結果の通知、表示情報の作成や表示等を行う。なお、タブレット端末3は、インターネットを介して、外部のサーバ、端末等にアクセス可能であり、外部のサーバや端末等との間で情報の送受信を行うことも可能である。情報記録手段24、基準算出手段5、スコアリング処理手段100、判定処理手段6は、それぞれ本願請求項の「情報記録手段」、「基準算出手段」、「スコアリング処理手段」及び「スコア判定手段」の一例である。 As shown in FIG. 1, the health condition determination device 1 (tablet terminal 3) includes a calculation unit 2. The calculation unit 2 is a processing unit that executes each information processing function of the health condition determination device 1. That is, in the software to which the present invention is applied, the calculation unit 2 of the tablet terminal 3 functions as an information input means 23, an information recording means 24, a reference calculation means 5, a scoring processing means 100, a determination processing means 6, and the like. By the processing function of each means, information transmission / reception, information recording, scoring based on the contents of vital information, setting of scoring conditions (scoring reference information, reference area condition), determination of abnormality in score value information, score Setting of judgment criteria (score judgment conditions) for abnormalities related to values, notification of judgment results regarding score values, judgment of abnormalities in vital sign values, setting of judgment criteria for abnormalities related to vital sign values, judgment results regarding vital sign values Notification, creation and display of display information, etc. The tablet terminal 3 can access an external server, terminal, etc. via the Internet, and can also send and receive information to and from an external server, terminal, and the like. The information recording means 24, the reference calculation means 5, the scoring processing means 100, and the determination processing means 6 are the "information recording means", the "reference calculation means", the "scoring processing means", and the "score determination means" of the claims of the present application, respectively. Is an example.
 タブレット端末3は、情報記録部4と、情報送受信部3cと、入力部3aと、表示部3bを有している。 The tablet terminal 3 has an information recording unit 4, an information transmission / reception unit 3c, an input unit 3a, and a display unit 3b.
 情報送受信部3cは、演算部2、情報記録部4、入力部3a及び表示部3b等の間での情報の送受信を担う部分である。また。タブレット端末3と、外部端末との間で情報の送受信可能に構成されるものであってもよい。 The information transmission / reception unit 3c is a part responsible for transmitting / receiving information between the calculation unit 2, the information recording unit 4, the input unit 3a, the display unit 3b, and the like. Also. Information may be transmitted and received between the tablet terminal 3 and the external terminal.
 ここで、以下、本発明を適用したソフトウェアが取り扱う各情報が、必ずしも、タブレット端末3の情報記録部4に記録される必要はない。例えば、タブレット端末3の情報送受信部3cを介して、外部サーバや外部端末に各種情報を送信して記録させ、判定等の際に、外部サーバ等から必要な情報を受信する態様であってもよい。 Here, hereinafter, each information handled by the software to which the present invention is applied does not necessarily have to be recorded in the information recording unit 4 of the tablet terminal 3. For example, even in a mode in which various information is transmitted to an external server or an external terminal via the information transmission / reception unit 3c of the tablet terminal 3 to be recorded, and necessary information is received from the external server or the like at the time of determination or the like. Good.
 更に言えば、タブレット端末3に、健康状態判定装置1の主要な構成が全てダウンロードされる必要はない。例えば、タブレット端末3では、判定結果の情報や熱型表等の表示情報の表示のみを行い、各種情報の記録及び判定処理等は外部サーバ等で行う態様であってもよい。 Furthermore, it is not necessary to download all the main configurations of the health condition determination device 1 to the tablet terminal 3. For example, the tablet terminal 3 may display only the determination result information and the display information such as the heat type table, and record various information and perform the determination process on an external server or the like.
 本発明を適用したソフトウェアは、システム上の構成において、複数のバリエーションが存在しうる。以下、幾つかのバリエーションの事例を説明する。 The software to which the present invention is applied may have a plurality of variations in the configuration on the system. Examples of some variations will be described below.
(第1のシステム構成)
 図1に示したタブレット端末3の概略構成は、本発明を適用したソフトウェアを端末に導入して、端末単体で、バイタル情報の入力、記録、スコア値の表示、スコア値の判定、スコア値の判定結果の表示、スコアリング条件の設定、スコア値の判定算出基準の設定、アラートの通知が可能となっている。即ち、装置単体で本発明の機能を実行しうるものである。図1に示す概略構成は、インターネット環境と接続されていない「スタンドアローン形式」の装置における、本発明を適用したソフトウェアの利用を示している。インターネット環境と接続されない情報処理機器、例えば、各種のヘルスケア機器や、病院等の医療システム・介護システムに本発明のソフトウェアを導入して、専用機器として利用することができる。なお、ここではタブレット端末3を情報処理機器の一例として挙げたため、インターネット環境との接続が可能となるが、図1に示す構成であれば、タブレット端末3の内部機能のみで、健康状態の判定を行うことができる。
(First system configuration)
The schematic configuration of the tablet terminal 3 shown in FIG. 1 is such that the software to which the present invention is applied is introduced into the terminal, and the terminal itself inputs and records vital information, displays the score value, determines the score value, and determines the score value. It is possible to display the judgment result, set the scoring condition, set the judgment calculation standard of the score value, and notify the alert. That is, the function of the present invention can be executed by the device alone. The schematic configuration shown in FIG. 1 shows the use of software to which the present invention is applied in a "stand-alone type" device that is not connected to an Internet environment. The software of the present invention can be introduced into an information processing device that is not connected to the Internet environment, for example, various healthcare devices, or a medical system / long-term care system such as a hospital, and used as a dedicated device. Since the tablet terminal 3 is taken as an example of the information processing device here, it is possible to connect to the Internet environment. However, in the configuration shown in FIG. 1, the health condition can be determined only by the internal function of the tablet terminal 3. It can be performed.
(第2のシステム構成)
 図2では、第2のシステム構成として、本発明を適用したソフトウェア1aの機能を外部サーバに持たせた構成も採用しうる。ここでは、ユーザ端末50aや、外部端末50bが、インターネット30aを介して、情報管理サーバ32aにアクセス可能となっている。情報管理サーバ32aは、例えば、クラウド形式で提供される外部サーバであり、情報管理サーバ32a上で本発明を適用したソフトウェア1aの機能が利用しうる。
(Second system configuration)
In FIG. 2, as the second system configuration, a configuration in which the function of the software 1a to which the present invention is applied is provided to an external server can also be adopted. Here, the user terminal 50a and the external terminal 50b can access the information management server 32a via the Internet 30a. The information management server 32a is, for example, an external server provided in a cloud format, and the function of software 1a to which the present invention is applied can be used on the information management server 32a.
 情報管理サーバ2aは、情報記録部4a、情報送受信部3c、演算部2aを有している。また、演算部2aは、基準算出手段5a、情報記録手段24a、スコアリング処理手段100a、判定処理手段6aを有している。バイタル情報の入力は、ユーザ端末50aや、外部端末50bを介して行い、各端末から入力された情報が情報管理サーバ32aに送信され、情報管理サーバ32a側で情報の記録、スコア値の判定がなされる。スコア値の判定結果や、記録された情報は、ユーザ端末50aや、外部端末50bに送信され、各端末で確認することができる。このように、外部サーバ上にソフトウェア1aの機能を付与するシステム構成も採用しうる。 The information management server 2a has an information recording unit 4a, an information transmission / reception unit 3c, and a calculation unit 2a. Further, the calculation unit 2a includes a reference calculation means 5a, an information recording means 24a, a scoring processing means 100a, and a determination processing means 6a. The vital information is input via the user terminal 50a or the external terminal 50b, the information input from each terminal is transmitted to the information management server 32a, and the information management server 32a records the information and determines the score value. Be done. The determination result of the score value and the recorded information are transmitted to the user terminal 50a and the external terminal 50b, and can be confirmed by each terminal. In this way, a system configuration that imparts the functions of software 1a on the external server can also be adopted.
(第3のシステム構成)
 図3では、第3のシステム構成として、本発明を適用したソフトウェア32bの機能以外に、複数のソフトウェア32c、32d等を有するモジュールAを備える管理端末70bの構成を示している。本発明を適用したソフトウェア32bは、これとは異なる各種機能を管理端末70bに実行させる他のソフトウェアと共に、1つのモジュールAを構成している。即ち、予め複数のソフトウェア32c、32d等が導入された管理端末70bのモジュールAに、ソフトウェア32bを組み込んで機能させることが可能である。例えば、電子カルテ等の医療システムの管理端末が備えるモジュールに本発明を適用したソフトウェアを組み込むこともできる。
(Third system configuration)
FIG. 3 shows the configuration of the management terminal 70b including the module A having a plurality of software 32c, 32d, etc., in addition to the functions of the software 32b to which the present invention is applied, as the third system configuration. The software 32b to which the present invention is applied constitutes one module A together with other software that causes the management terminal 70b to execute various functions different from the software 32b. That is, it is possible to incorporate the software 32b into the module A of the management terminal 70b into which a plurality of software 32c, 32d, etc. have been introduced in advance to make the software 32b function. For example, software to which the present invention is applied can be incorporated into a module provided in a management terminal of a medical system such as an electronic medical record.
 このような第3のシステム構成では、管理端末70bにバイタル情報を入力して、スコアリング及びスコア値の判定を行い、結果の情報を管理端末70b上で確認することができる。また、ユーザ端末60aや、外部端末60bと、管理端末70bを接続させて、ユーザ端末60aや、外部端末60bからバイタル情報を入力して管理端末70bに送信し、管理端末70bでスコアリング及びスコア値の判定を行い、結果の情報をユーザ端末60aや、外部端末60bで受信して確認することもできる。このように、本発明を適用したソフトウェアは、複数のソフトウェアで構成されたモジュールの一部として機能させる構成も採用しうる。 In such a third system configuration, vital information can be input to the management terminal 70b, scoring and score value determination can be performed, and the result information can be confirmed on the management terminal 70b. Further, the user terminal 60a or the external terminal 60b is connected to the management terminal 70b, vital information is input from the user terminal 60a or the external terminal 60b and transmitted to the management terminal 70b, and the management terminal 70b scores and scores. It is also possible to determine the value and receive and confirm the result information on the user terminal 60a or the external terminal 60b. As described above, the software to which the present invention is applied may also adopt a configuration in which it functions as a part of a module composed of a plurality of software.
 以上のように、本発明を適用したソフトウェア(又は健康状態判定装置)のシステム上の構成は複数のバリエーションが存在する。なお、上記では、3つの例を中心に説明したが、本発明を適用したソフトウェア(又は健康状態判定装置)の構成はこれに限定されるものではない。例えば、情報記録部をユーザ端末に設けて、基準算出手段、スコアリング処理手段及び判定処理手段は外部サーバに持たせて、必要な機能の所在を端末とサーバに分ける構成であってもよい。即ち、対象者のバイタル情報が記録され、個体内変動を反映した判定基準(スコアリング条件、バイタル判定用数値範囲)が設定され、健康状態の判定が可能であれば、種々の構成が採用しうる。 As described above, there are a plurality of variations in the system configuration of the software (or health condition determination device) to which the present invention is applied. In the above description, three examples have been mainly described, but the configuration of the software (or health condition determination device) to which the present invention is applied is not limited to this. For example, the information recording unit may be provided in the user terminal, the reference calculation means, the scoring processing means, and the determination processing means may be provided in the external server, and the location of the necessary functions may be divided into the terminal and the server. That is, if the vital information of the subject is recorded, the judgment criteria (scoring conditions, numerical range for vital judgment) reflecting the intra-individual variation are set, and the health condition can be judged, various configurations are adopted. sell.
 図1に示したタブレット端末3の使用態様を用いて、以下、詳細な構成の説明を続ける。 Using the usage mode of the tablet terminal 3 shown in FIG. 1, a detailed description of the configuration will be continued below.
[2.情報記録部]
 図4に示すように、情報記録部4には、各種情報が記録されている。
 情報記録部4は、対象者の個人情報や、各種のバイタル計測器で測定されたバイタルサインの値、及び、対象者の介護者等が観察して得られた意識レベルの評価結果から構成されたバイタル情報を、測定日時又は取得日時の情報と共に記録する部分である。情報記録部4に記録された各種の情報はタブレット端末3が有する入力部3a、情報送受信部3c及び情報入力手段24(図示せず)を介して入力や情報の修正が可能となっている。また、情報記録部4に記録された各種の情報はタブレット端末3が有する表示部3b及び情報送受信部3cを介して、その内容を確認可能となっている。
[2. Information recording section]
As shown in FIG. 4, various information is recorded in the information recording unit 4.
The information recording unit 4 is composed of the personal information of the target person, the values of vital signs measured by various vital measuring instruments, and the evaluation result of the consciousness level obtained by observing the caregiver of the target person. It is a part that records the vital information together with the information of the measurement date and time or the acquisition date and time. Various types of information recorded in the information recording unit 4 can be input and information can be modified via the input unit 3a, the information transmission / reception unit 3c, and the information input means 24 (not shown) of the tablet terminal 3. Further, the contents of various information recorded in the information recording unit 4 can be confirmed via the display unit 3b and the information transmission / reception unit 3c of the tablet terminal 3.
 情報記録部4は、対象者の個人情報7、各バイタル計測器で計測したバイタルサインの測定値と、対象者に対する観察から得られた意識レベルの評価結果、及びその測定日時又は取得日時の情報を含むバイタル情報8が記録されている。また、個人情報7及びバイタル情報8は、個別の対象者を識別可能な識別情報と紐付けられて記録可能に構成されている。これにより、複数の対象者が識別可能となり、複数の対象者が1つの健康状態判定装置1を使用可能となっている。 The information recording unit 4 includes personal information 7 of the subject, measurement values of vital signs measured by each vital measuring instrument, evaluation results of the consciousness level obtained from observation of the subject, and information on the measurement date and time or acquisition date and time. Vital information 8 including is recorded. Further, the personal information 7 and the vital information 8 are configured to be recordable in association with the identification information that can identify an individual target person. As a result, a plurality of target persons can be identified, and a plurality of target persons can use one health condition determination device 1.
 バイタル情報8には、バイタルサインである体温、脈拍、収縮期血圧、拡張期血圧、脈圧及び呼吸数の測定値が含まれている。また、バイタル情報8には、酸素飽和度の測定値が含まれている。更に、バイタル情報には、上述した意識レベルの評価結果が含まれている。なお、バイタルサインとは、上述した各内容の他、尿量の値等を含んだものを指す場合もある。 Vital information 8 includes measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure and respiratory rate, which are vital signs. In addition, the vital information 8 includes a measured value of oxygen saturation. Further, the vital information includes the above-mentioned evaluation result of the consciousness level. In addition to the above-mentioned contents, the vital sign may also include a value of urine volume and the like.
 また、バイタル情報8に含まれる測定日時又は取得日時とは、対象者がバイタル計測を行った日時や、意識レベルの確認を行った日時であり、例えば、対象者が自身でバイタル計測を行った際に確認した時間や、介護者等が対象者を観察した時間を入力するものである。 The measurement date and time or acquisition date and time included in the vital information 8 is the date and time when the subject performed the vital measurement and the date and time when the consciousness level was confirmed. For example, the subject performed the vital measurement by himself / herself. The time confirmed at that time and the time when the caregiver or the like observed the subject is input.
 また、バイタル情報8は、後述するバイタル除外基準情報200の条件を満たさないバイタル情報8aと、バイタル除外基準情報200の条件を満たすバイタル情報8bとが含まれている。このバイタル情報8aと、バイタル情報8bとは、両者を区別してスコアリング基準情報102の作成に用いることができる。 Further, the vital information 8 includes vital information 8a that does not satisfy the condition of vital exclusion standard information 200, which will be described later, and vital information 8b that satisfies the condition of vital exclusion standard information 200. The vital information 8a and the vital information 8b can be distinguished from each other and used for creating the scoring reference information 102.
 また、バイタル情報8aと、バイタル情報8bとの分類は、バイタル除外基準情報200に含まれる複数の条件について、その選択または組み合わせによって、適宜区別することができる。 Further, the classification of the vital information 8a and the vital information 8b can be appropriately distinguished by selecting or combining a plurality of conditions included in the vital exclusion standard information 200.
 即ち、単一のバイタル除外条件だけで、バイタル情報8aと、バイタル情報8bに分類することもできる。また、複数のバイタル除外条件の中から、2つ以上を組み合わせて、各条件を全て満たす情報をバイタル情報8bとし、それ以外の情報をバイタル情報8aとすることも可能である。 That is, it is possible to classify the vital information 8a and the vital information 8b only by a single vital exclusion condition. Further, it is also possible to combine two or more of the plurality of vital exclusion conditions and use the information satisfying all the conditions as the vital information 8b and the other information as the vital information 8a.
 また、このようにバイタル除外基準情報200で分類されたバイタル情報のうち、バイタル情報8aから、スコアリング基準情報102の1つである基準域条件220(μ±nσ)が算出される。 Further, among the vital information classified by the vital exclusion standard information 200 in this way, the reference region condition 220 (μ ± nσ), which is one of the scoring standard information 102, is calculated from the vital information 8a.
 即ち、正規分布に従うバイタルサインである体温、血圧、脈拍、脈圧及び呼吸数についてスコアリングを行う際の基準となる基準域条件220は、所定のバイタル除外条件200の条件を満たさないバイタル情報8aのみから算出され、その算出根拠からは、バイタル除外基準情報200の条件を満たすバイタル情報8bが除外される。 That is, the reference range condition 220, which is a reference when scoring the vital signs according to the normal distribution, such as body temperature, blood pressure, pulse, pulse pressure, and respiratory rate, does not satisfy the condition of the predetermined vital exclusion condition 200. Vital information 8b that satisfies the condition of vital exclusion standard information 200 is excluded from the calculation basis.
 また、バイタル情報8には、スコア判定基準情報18に基づき、スコア値情報103の合計点につき、その値が、異常な値であると判定された根拠となった、バイタルサインの値が含まれる。即ち、バイタル情報8には、スコア値情報103が正常と判定された際のバイタルサインの値だけでなく、スコア値情報103が異常と判定された際のバイタルサインの値も含まれている。 Further, the vital information 8 includes a value of vital signs, which is the basis for determining that the total score of the score value information 103 is an abnormal value based on the score determination standard information 18. .. That is, the vital information 8 includes not only the vital sign value when the score value information 103 is determined to be normal, but also the vital sign value when the score value information 103 is determined to be abnormal.
 ここで、必ずしも、バイタル情報8に、スコア値情報103が異常と判定された際の根拠となったバイタルサインの値と、バイタルサインの測定値が異常と判定された値が含まれる必要はなく、後述するように、少なくとも30個分の測定データのバイタル情報として、個体に固有の個体内変動が反映されるものとなっていれば充分である。 Here, it is not always necessary that the vital information 8 includes the value of the vital sign that is the basis when the score value information 103 is determined to be abnormal and the value that the measured value of the vital sign is determined to be abnormal. As will be described later, it is sufficient that the vital information of at least 30 measurement data reflects the intra-individual variation peculiar to the individual.
 また、必ずしも、バイタル情報8の種類が体温、脈拍、収縮期血圧、拡張期血圧、脈圧、呼吸数、酸素飽和度の測定値及び意識レベルの評価結果に限定される必要はなく、その他のバイタルサインを含み、スコアリングを行って、スコア値の合計点により、異常の有無の判定を行ってもよい。例えば、尿量、体重、痛み(痛みの有無や程度)、その他の病状異常をバイタル情報に含めることができる。但し、上述したバイタルサインは、最も代表的なバイタルサインであり、バイタル情報の取得も簡易なため、採用されることが好ましい。更に、上記のうち、バイタルサインの体温、脈拍、収縮期血圧、拡張期血圧、脈圧及び呼吸数の測定値は、同一の対象者で取得した場合に、正規分布に従うものとなり、正規分布に基づくスコアリング条件が設定可能となるため、特に採用されることが好ましい。 In addition, the types of vital information 8 are not necessarily limited to body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure, respiratory rate, oxygen saturation measurement values, and consciousness level evaluation results, and other information. Scoring may be performed including vital signs, and the presence or absence of abnormality may be determined based on the total score of the score values. For example, urine output, body weight, pain (presence or absence or degree of pain), and other medical abnormalities can be included in vital information. However, the above-mentioned vital signs are the most typical vital signs, and it is preferable to adopt them because it is easy to acquire vital information. Furthermore, among the above, the measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure and respiratory rate of vital signs follow a normal distribution when obtained by the same subject, and have a normal distribution. It is particularly preferable to adopt it because the scoring conditions based on it can be set.
 また、バイタル情報のうち、バイタルサインの値を計測するバイタル測定器は、特に限定されるものではなく、体温、脈拍、収縮期血圧、拡張期血圧、呼吸数及び酸素飽和度が測定可能であれば充分である。例えば、家庭用のバイタル測定器を使用してバイタルが計測されるものでもよい。更に言えば、バイタルサインの値が測定可能であれば、バイタル測定器を使用することは必須ではない。例えば、時計で時間を測定しながら、1分間あたりの脈拍数や呼吸数を測定して、これをバイタル情報として利用することも可能である。但し、正規分布に従う体温、脈拍、収縮期血圧、拡張期血圧及び呼吸数の測定値の個体内変動を正確に捉える観点からは、バイタルサインの値は同一の手法で取得されることが好ましい。日々の測定において、バイタル測定器の種類を頻繁に変更したり、バイタル計測機による測定と、バイタル計測機を用いない測定が混在したりすることで、バイタルサインの測定方法によるバイアスがかかってしまう。そのため、なるべく、同一の手法又は同一のバイタル測定器でバイタルサインの値を測定することが好ましい。 Further, among the vital information, the vital measuring device for measuring the value of vital signs is not particularly limited, and can measure body temperature, pulse, systolic blood pressure, diastolic blood pressure, respiratory rate and oxygen saturation. Is enough. For example, vitals may be measured using a household vital measuring device. Furthermore, if the value of vital signs is measurable, it is not essential to use a vital measuring instrument. For example, it is possible to measure the pulse rate and the respiratory rate per minute while measuring the time with a clock, and use this as vital information. However, from the viewpoint of accurately capturing the intra-individual fluctuations of the measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure and respiratory rate according to the normal distribution, it is preferable that the vital sign values are obtained by the same method. In daily measurement, the type of vital measuring instrument is changed frequently, and the measurement by the vital measuring device and the measurement without the vital measuring device are mixed, so that the vital sign measurement method is biased. .. Therefore, it is preferable to measure the vital sign value by the same method or the same vital measuring device as much as possible.
 バイタル情報8(バイタル情報8a)は、幅広くは1秒ごとのバイタル情報8を記録可能に構成されている。また、バイタル情報8は、例えば、1分ごと、1時間ごと等、異なる時間間隔で記録するように設定することもできる。 Vital information 8 (vital information 8a) is widely configured to be able to record vital information 8 every second. Further, the vital information 8 can be set to be recorded at different time intervals, for example, every minute or every hour.
 また、バイタル情報8(バイタル情報8a)は、一定間隔ごとの測定ではなく、不規則な時間で測定した測定値を記録する構成も採用しうる。また、この不規則な測定の場合、例えば、1分間に少なくとも30個分のバイタル情報8を取得する、30分間に少なくとも30個分のバイタル情報8を取得する、1時間に少なくとも30個分のバイタル情報8を取得する、数時間に少なくとも30個分のバイタル情報8を取得する、1日に少なくとも30個分のバイタル情報8を取得する、数日中に少なくとも30個分のバイタル情報8を取得する、1週間に少なくとも30個分のバイタル情報8を取得する、数週間中に少なくとも30個分のバイタル情報8を取得する、1か月中に少なくとも30個分のバイタル情報8を取得する等、一定の期間で、少なくとも30個のバイタル情報8(バイタル情報8a)を記録する構成としてもよい。 Further, the vital information 8 (vital information 8a) may adopt a configuration in which the measured values measured at irregular times are recorded instead of the measurements at regular intervals. Further, in the case of this irregular measurement, for example, at least 30 vital information 8s are acquired in 1 minute, and at least 30 vital information 8s are acquired in 30 minutes, and at least 30 vital information 8s are acquired in 1 hour. Acquire vital information 8; acquire at least 30 vital information 8 in a few hours. Acquire at least 30 vital information 8 in a day. Acquire at least 30 vital information 8 in a few days. Acquire at least 30 vital information 8 in a week, acquire at least 30 vital information 8 in a few weeks, acquire at least 30 vital information 8 in a month Etc., at least 30 vital information 8 (vital information 8a) may be recorded in a certain period of time.
 更に、バイタル情報8(バイタル情報8a)は、一定間隔、又は、不規則な間隔に関わらず、蓄積したバイタル情報の中から、ランダムに少なくとも30個分のデータを抽出して、「30個分の測定データのバイタル情報8」として記録することもできる。 Further, the vital information 8 (vital information 8a) is obtained by randomly extracting at least 30 pieces of data from the accumulated vital information regardless of regular intervals or irregular intervals, and "30 pieces of data". It can also be recorded as vital information 8 of the measurement data of.
 このように、バイタル情報8(バイタル情報8a)は、時間の長さや測定間隔の規則性の有無に関わらず、少なくとも30個分の測定データを記録可能に構成されている。 As described above, the vital information 8 (vital information 8a) is configured to be able to record at least 30 measurement data regardless of the length of time and the presence or absence of regularity of measurement intervals.
 また、情報記録部4には、対象者がバイタル情報の測定及び取得を行う目安となる時刻の情報である目安時刻情報9が記録可能となっている。目安時刻情報9は、例えば、朝の8時30分、夕方の18時のように、対象者のバイタル情報の測定及び取得を行う目安の時刻が記録される。目安時刻情報9は、自由に設定及び修正することができる。 In addition, the information recording unit 4 can record the guideline time information 9 which is the guideline time information for the target person to measure and acquire the vital information. The guideline time information 9 records the guideline time for measuring and acquiring the vital information of the subject, such as 8:30 in the morning and 18:00 in the evening. The reference time information 9 can be freely set and modified.
 情報記録部4には、各バイタルサインの値を計測する際の正しい姿勢の情報である姿勢情報10が記録されている。姿勢情報10とは、例えば、以下のようなものである。
(1)体温
 例えば、体温を脇下で測定する体温計で体温を測定する場合、「体温計の測定部が脇の中心に位置しているか」、「脇と体温計が密着しているか」、「毎回同じ姿勢となっているか」等の姿勢の情報である。
(2)脈拍
 例えば、手首で電子脈拍計又は指を当てて脈拍数を測定する場合、「安静な状態であるか」、「リラックスした楽な姿勢であるか」、「毎回同じ姿勢となっているか」等の姿勢の情報である。
(3)収縮期血圧、拡張期血圧
 例えば、血管の振動で測るオシロメトリック法で測定する場合、「安静な状態であるか」、「腕帯を巻き付けた腕や手首が心臓の高さに位置しているか」、「毎回同じ姿勢となっているか」等の姿勢の情報である。
The information recording unit 4 records posture information 10 which is information on the correct posture when measuring the value of each vital sign. The posture information 10 is, for example, as follows.
(1) Body temperature For example, when measuring body temperature with a thermometer that measures body temperature under the armpit, "Is the measuring part of the thermometer located in the center of the armpit?", "Is the armpit and the thermometer in close contact?", "Every time It is the information of the posture such as "Is it the same posture?"
(2) Pulse For example, when measuring the pulse rate with an electronic pulse rate monitor or a finger on the wrist, "is it in a resting state?", "Is it in a relaxed and comfortable posture?" This is posture information such as "is it?"
(3) Systolic blood pressure, diastolic blood pressure For example, when measuring by the oscillometric method that measures the vibration of blood vessels, "Is it in a resting state?" Information on postures such as "whether you are doing it" and "whether you are in the same posture every time".
 後述するが、基準算出手段及びスコアリング処理手段によるスコアリング条件の算出や、このスコアリング条件の算出に利用するバイタル平均値、バイタル標準偏差の算出の処理において利用する一定のデータ数(少なくとも30個分)が記録されていれば、バイタル情報の記録回数は限定されるものではない。また、バイタル情報8が毎秒、毎分、毎時、毎日等、一定間隔で常に記録される必要はなく、バイタル情報8が記録されない時が存在してもよい。ここで、同一個体の個体内変動を適切に捉える観点から、幅広くは1秒ごとのバイタル情報を記録する態様がよく、1日に1回~24回のバイタル情報が記録される構成であってもよい。 As will be described later, a certain number of data (at least 30) used in the calculation of the scoring conditions by the standard calculation means and the scoring processing means, the vital average value used for the calculation of the scoring conditions, and the calculation of the vital standard deviation. The number of times vital information is recorded is not limited as long as the number of vital information is recorded. Further, it is not necessary that the vital information 8 is always recorded at regular intervals such as every second, every minute, every hour, and every day, and there may be times when the vital information 8 is not recorded. Here, from the viewpoint of appropriately grasping the intra-individual variation of the same individual, it is preferable to record the vital information every second in a wide range, and the vital information is recorded once to 24 times a day. May be good.
 また、必ずしも、情報記録部4に目安時刻情報9が記録される必要はない。但し、目安時刻情報9を記録することで、適切と思われる時間帯でバイタル情報を計測及び取得しやすいものとなる。また、目安時刻になった際に、対象者や介護者にその旨を通知する態様とすることもできる。 In addition, it is not always necessary to record the reference time information 9 in the information recording unit 4. However, by recording the reference time information 9, it becomes easy to measure and acquire vital information in a time zone that seems appropriate. In addition, when the standard time is reached, the target person or the caregiver may be notified to that effect.
 また、必ずしも、情報記録部4に姿勢情報10が記録される必要はない。但し、姿勢情報10を記録することで、各バイタルサインの測定の際に姿勢情報10を表示しながら、適切な姿勢での測定を対象者に促すことができる。 Also, the posture information 10 does not necessarily have to be recorded in the information recording unit 4. However, by recording the posture information 10, it is possible to urge the target person to measure in an appropriate posture while displaying the posture information 10 at the time of measuring each vital sign.
 また、各バイタルサインの測定方法や姿勢情報10の内容は上述したものに限定されるものではなく、バイタル測定方法や、これに適した姿勢情報10の内容は、適宜変更することができる。 Further, the measurement method of each vital sign and the content of the posture information 10 are not limited to those described above, and the vital measurement method and the content of the posture information 10 suitable for this can be changed as appropriate.
 情報記録部4には、バイタル情報の測定及び取得を行った場所の気温情報11が記録可能となっている。気温情報11は、バイタル情報8の測定時や取得時の記録と紐付けて記録される。気温情報11は、例えば、対象者が測定場所の気温を確認して入力する情報が採用される。 The information recording unit 4 can record the temperature information 11 of the place where the vital information was measured and acquired. The air temperature information 11 is recorded in association with the records at the time of measurement and acquisition of the vital information 8. As the air temperature information 11, for example, information that the subject confirms and inputs the air temperature at the measurement location is adopted.
 ここで、必ずしも、情報記録部4に、バイタル情報の測定及び取得を行った場所の気温情報11が記録可能とされる必要はない。但し、気温情報11を記録することで、バイタル情報の測定及び取得を行った環境が適切な場所であったか否かを確認することが可能となる。 Here, it is not always necessary for the information recording unit 4 to be able to record the temperature information 11 of the place where the vital information is measured and acquired. However, by recording the temperature information 11, it is possible to confirm whether or not the environment in which the vital information was measured and acquired was an appropriate place.
 図4に示すように、情報記録部4には、入力される各バイタル情報をスコアリング処理手段100でスコアリングする際の基準となる基準域条件220及びスコアリング基準情報102が記録されている。また、情報記録部4には、スコアリング基準情報102に基づきスコアリングされた結果の数値の情報であるスコア値情報103が記録されている。 As shown in FIG. 4, the information recording unit 4 records a reference area condition 220 and a scoring reference information 102, which are reference points when scoring each input vital information by the scoring processing means 100. .. Further, the information recording unit 4 records score value information 103, which is numerical information of the result of scoring based on the scoring reference information 102.
 また、情報記録部4には、入力されたバイタル情報の内容から得られた、複数のバイタルサインからスコアリングされた各スコア値情報103の合計点を、判定処理手段6で、その値(合計点)が異常な値か否かを判定する際の基準となるスコア判定基準情報18が記録されている。 Further, in the information recording unit 4, the total score of each score value information 103 scored from a plurality of vital signs obtained from the contents of the input vital information is obtained by the determination processing means 6 and its value (total). The score determination reference information 18 that serves as a reference for determining whether or not the point) is an abnormal value is recorded.
 後述するスコアリング基準情報102及びスコア判定基準情報18は、タブレット端末3の入力部3a、情報送受信部3c及び演算部2の情報入力手段24を介して情報の追加や修正が可能となっている。また、各スコアリング基準情報102はタブレット端末3の表示部3bを介して、その内容を確認可能となっている。なお、スコアリング基準設定手段101における各基準の詳細な内容は後述する。 The scoring standard information 102 and the score determination standard information 18, which will be described later, can be added or modified through the input unit 3a of the tablet terminal 3, the information transmission / reception unit 3c, and the information input means 24 of the calculation unit 2. .. Further, the contents of each scoring reference information 102 can be confirmed via the display unit 3b of the tablet terminal 3. The detailed contents of each standard in the scoring standard setting means 101 will be described later.
 情報記録部4には、判定処理手段6が、複数のバイタルサインからスコアリングされた各スコア値情報103の合計点について、異常な値か否かと判定した判定結果の情報であるスコア判定結果情報12が記録されている。タブレット端末3の表示部3bを介して、その内容を確認可能となっている。また、スコア判定結果情報12は、異常又は正常による表示だけでなく、点数に応じた色分けで判定結果を示すことができる。 In the information recording unit 4, the determination processing means 6 determines that the total score of each score value information 103 scored from a plurality of vital signs is an abnormal value, which is the score determination result information. Twelve are recorded. The contents can be confirmed via the display unit 3b of the tablet terminal 3. Further, the score determination result information 12 can show the determination result not only by the display due to abnormality or normality but also by color coding according to the score.
 また、情報記録部4では、バイタル情報8として、バイタル情報の測定及び取得に関して、再度の測定等を行った際のバイタル情報及び測定時の日付の情報である再測定バイタル情報13が記録可能となっている。 Further, in the information recording unit 4, as the vital information 8, it is possible to record the vital information when the measurement and acquisition of the vital information are performed again and the remeasurement vital information 13 which is the information of the date at the time of measurement. It has become.
 再測定バイタル情報13とは、入力されたバイタル情報が、バイタル除外基準情報200として設定された、バイタル除外条件を満たす際に、バイタル情報の正確性を確認するために行った再度の計測のバイタル情報である。 The remeasurement vital information 13 is the vital of the remeasurement performed to confirm the accuracy of the vital information when the input vital information satisfies the vital exclusion condition set as the vital exclusion standard information 200. Information.
 また、再測定バイタル情報13は、例えば、バイタル情報について得られたスコア値に関して、判定処理手段6が異常な値と判定した際に、バイタル情報の正確性を確認するために行った再度の計測のバイタル情報が含まれていてもよい。 Further, the remeasurement vital information 13 is, for example, remeasurement performed to confirm the accuracy of the vital information when the determination processing means 6 determines that the score value obtained for the vital information is an abnormal value. Vital information may be included.
 また、各バイタル情報をタブレット端末3の表示部3bに表示する際には、再測定をせずに記録された通常のバイタル情報と、再測定の対象となったバイタル情報と、再測定した後のバイタル情報について、3つのパターンのバイタル情報を示す文字の色を異ならせて表示可能に構成されている。 Further, when displaying each vital information on the display unit 3b of the tablet terminal 3, the normal vital information recorded without remeasurement, the vital information to be remeasured, and the vital information to be remeasured are measured again. The vital information of the above is configured so that the colors of the characters indicating the vital information of the three patterns can be displayed differently.
 ここで、必ずしも、情報記録部4に、スコア判定結果情報12が記録可能とされる必要はない。但し、過去のバイタル情報の判定結果を確認可能となり、また、判定精度を高めるための参考情報として利用できる点、医師の診断結果との照合や、医療システムとの連動にも利用しうる情報となる点から、情報記録部4に、スコア判定結果情報12が記録可能とされることが好ましい。 Here, it is not always necessary that the score determination result information 12 can be recorded in the information recording unit 4. However, it is possible to check the judgment result of past vital information, and it can be used as reference information to improve the judgment accuracy, and it can be used for collation with the diagnosis result of a doctor and for linking with a medical system. From this point of view, it is preferable that the score determination result information 12 can be recorded in the information recording unit 4.
 また、必ずしも、情報記録部4において、再測定バイタル情報13が記録可能とされる必要はない。但し、バイタル情報の正確性を担保することに繋がる点や、再測定バイタル情報13を用いて、バイタル測定が正確であったか否かを検証可能となる点から、情報記録部4において、再測定バイタル情報13が記録可能とされることが好ましい。 Further, it is not always necessary for the information recording unit 4 to be able to record the remeasurement vital information 13. However, the information recording unit 4 has the remeasurement vitals because it leads to ensuring the accuracy of the vital information and it is possible to verify whether or not the vital measurement is accurate by using the remeasurement vital information 13. It is preferable that the information 13 can be recorded.
[3.基準算出手段]
 基準算出手段5について説明する。基準算出手段5は、本発明を適用したソフトウェアが演算部2に実行させる機能の1つであり、情報記録部4に記録されるバイタル情報(入力されるバイタル情報)についてスコア値情報103を算出するためのスコアリング基準情報102となる数値範囲の算出や、このスコアリング基準情報102となる数値範囲の算出に利用するバイタル平均値、バイタル標準偏差の算出の処理を行う。
[3. Criteria calculation method]
The reference calculation means 5 will be described. The reference calculation means 5 is one of the functions executed by the software to which the present invention is applied to the calculation unit 2, and calculates the score value information 103 for the vital information (input vital information) recorded in the information recording unit 4. The processing is performed to calculate the numerical range that becomes the scoring reference information 102, and to calculate the vital mean value and the vital standard deviation used for calculating the numerical range that becomes the scoring reference information 102.
 また、基準算出手段5は、バイタル除外基準情報200として設定されたバイタル除外条件に基づき、体温、脈拍、収縮期血圧、拡張期血圧、脈圧、及び呼吸数の測定値について、バイタル除外条件を満たすバイタル情報8bと、バイタル除外条件を満たさないバイタル情報8aに分け、バイタル情報8aを用いて、スコアリング基準情報102となる数値範囲(基準域条件220)を算出する。 Further, the reference calculation means 5 sets the vital exclusion conditions for the measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure, and respiratory rate based on the vital exclusion conditions set as the vital exclusion reference information 200. The vital information 8b that satisfies the vital information 8b and the vital information 8a that does not satisfy the vital exclusion condition are divided, and the numerical range (reference area condition 220) that becomes the scoring reference information 102 is calculated using the vital information 8a.
 健康状態判定装置1においては、体温、脈拍、収縮期血圧、拡張期血圧、脈圧、及び呼吸数の測定値について、基準域条件220がスコアリングの際の基準となる。 In the health condition determination device 1, the reference range condition 220 serves as a reference for scoring the measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure, and respiratory rate.
 演算部2を基準算出手段5として機能させて算出又は記録された各種の情報は、タブレット端末3の入力部3a、情報送受信部3c及び演算部2の情報入力手段24を介して情報の追加や修正が可能となっている。また、演算部2を基準算出手段5として機能させて算出又は記録された各種の情報はタブレット端末3の表示部3bを介して、その内容を確認可能となっている。 Various information calculated or recorded by using the calculation unit 2 as the reference calculation means 5 can be added or added via the input unit 3a of the tablet terminal 3, the information transmission / reception unit 3c, and the information input means 24 of the calculation unit 2. It can be modified. Further, various information calculated or recorded by using the calculation unit 2 as the reference calculation means 5 can be confirmed via the display unit 3b of the tablet terminal 3.
 図4には本発明を適用したソフトウェアが演算部2に実行させる機能を記載している。演算部2は、基準算出手段5を構成する平均値算出手段14、標準偏差算出手段15、正規分布算出手段16、スコアリング基準設定手段101、バイタル除外基準設定手段110として機能する。 FIG. 4 shows a function to be executed by the software to which the present invention is applied to the calculation unit 2. The calculation unit 2 functions as the mean value calculation means 14, the standard deviation calculation means 15, the normal distribution calculation means 16, the scoring standard setting means 101, and the vital exclusion standard setting means 110 that constitute the reference calculation means 5.
 また、平均値算出手段14及び標準偏差算出手段15は、情報記録部4に記録されたバイタル情報8a(体温、脈拍、収縮期血圧、拡張期血圧、脈圧及び呼吸数の測定値)及びその再測定バイタル情報13aに基づき、バイタル除外基準情報200として設定されたバイタル除外条件下の記録情報から、「除外後のバイタル情報の平均値」と、同条件下のバイタル情報を統計した分布における「除外後のバイタル情報の標準偏差」を、それぞれ算出する。
 なお、以下では、特別な算出を行う種類の平均値や標準偏差の名称を指す場合以外には、「除外後のバイタル情報の平均値」を「バイタル情報平均値」と呼び、また、「除外後のバイタル情報の標準偏差」を「バイタル情報標準偏差」と呼ぶものとする。なお、バイタル除外条件については後述する。また、再測定バイタル情報13aとは、再測定したバイタル情報であり、かつ、設定したバイタル除外条件を満たさないバイタル情報である。
Further, the mean value calculating means 14 and the standard deviation calculating means 15 include vital information 8a (measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure and respiratory rate) recorded in the information recording unit 4. Based on the remeasured vital information 13a, from the recorded information under the vital exclusion condition set as the vital exclusion standard information 200, the "average value of the vital information after exclusion" and the "average value of the vital information under the same condition" in the statistical distribution. "Standard deviation of vital information after exclusion" is calculated respectively.
In the following, the "mean value of vital information after exclusion" is referred to as the "mean value of vital information" and "exclusion", except when referring to the name of the type of mean value or standard deviation for which special calculation is performed. The later standard deviation of vital information shall be referred to as the "standard deviation of vital information". The vital exclusion conditions will be described later. The remeasured vital information 13a is the remeasured vital information and the vital information that does not satisfy the set vital exclusion condition.
 また、平均値算出手段14及び標準偏差算出手段15は、情報記録部4に記録されたバイタル情報8(体温、脈拍、収縮期血圧、拡張期血圧、脈圧及び呼吸数の測定値)及びその再測定バイタル情報13に基づき、所定の条件下の記録情報から、同条件下の「バイタル情報の平均値」と、同条件下のバイタル情報を統計した分布における「バイタル情報の標準偏差」を、それぞれ算出する設定とすることも可能である。 Further, the mean value calculating means 14 and the standard deviation calculating means 15 include vital information 8 (measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure and respiratory rate) recorded in the information recording unit 4. Based on the remeasured vital information 13, the "average value of vital information" under the same conditions and the "standard deviation of vital information" in the statistical distribution of the vital information under the same conditions are obtained from the recorded information under the predetermined conditions. It is also possible to set each calculation.
 また、平均値算出手段14及び標準偏差算出手段15は、情報記録部4に記録されたバイタル情報8aについて、スコア値情報103の合計点が、スコア判定基準情報18に基づき、異常な値であると判定された際の根拠となるバイタルサインの値も含めて、バイタル情報平均値及びバイタル情報標準偏差の算出を行ってもよい。 Further, in the mean value calculating means 14 and the standard deviation calculating means 15, the total score of the score value information 103 is an abnormal value based on the score determination reference information 18 with respect to the vital information 8a recorded in the information recording unit 4. The vital information mean value and the vital information standard deviation may be calculated including the value of the vital sign which is the basis when the determination is made.
 平均値算出手段14及び標準偏差算出手段15の算出の際に採用される「所定の条件」は、通常、判定時点を起点に30個分のバイタル情報8a(体温、脈拍、収縮期血圧、拡張期血圧、脈圧及び呼吸数の測定値)を利用する方法が採用されている。この期間のバイタル情報とは、判定時点の測定データを含めて過去30個分のバイタル情報8a及び再測定バイタル情報13aである。 The "predetermined conditions" adopted when calculating the mean value calculation means 14 and the standard deviation calculation means 15 are usually 30 vital information 8a (body temperature, pulse, systolic blood pressure, diastole) starting from the time of determination. A method using (measured values of systolic blood pressure, pulse pressure and respiratory rate) is adopted. The vital information during this period is the vital information 8a and the remeasurement vital information 13a for the past 30 pieces including the measurement data at the time of determination.
 ここで、過去30個分の設定は、上述したように、幅広くは1秒ごとに測定したバイタル情報のデータであり、この他にも、1分ごと、数分ごと、1時間ごと、1日ごと、1か月ごとに測定したバイタル情報のデータのように、時間の長さが異なるものが採用しうる。また、不規則に取得されたデータを、過去30個分抽出するようにしてもよい。この際、単純に、取得された順番を遡るように30個分抽出する方法でもよい。また、不規則に取得されたデータに対して、何等かの抽出条件を設定して30個分抽出する方法でもよい。抽出条件は、例えば、所定の1時間の範囲内から30個分抽出するとの条件や、バイタル情報同士の取得時間の間隔が、一定の条件を満たす(間隔が最低5分以上ある、又は、間隔が1時間以内である等)条件も考えられる。更に、一定間隔で規則的に測定したバイタル情報8aに対して、ランダムに、30個分のバイタル情報8aを選択して抽出する方法であってもよい。過去30個分の抽出条件は、必要に応じて、適宜設定可能である。どのような取り方をしても、少なくとも30個分のバイタル情報8aが抽出できれば、個体内変動を反映した正規分布が得られ、スコアリング基準情報102(基準域条件220)に利用することができる。 Here, as described above, the settings for the past 30 pieces are broadly the data of vital information measured every second, and in addition to this, every minute, every few minutes, every hour, every day. Data with different lengths of time, such as vital information data measured every month, can be adopted. In addition, the data acquired irregularly may be extracted for the past 30 pieces. At this time, a method of simply extracting 30 pieces so as to go back in the order of acquisition may be used. Alternatively, a method may be used in which 30 pieces of data are extracted by setting some extraction conditions for the irregularly acquired data. The extraction conditions include, for example, the condition that 30 pieces are extracted from within a predetermined 1-hour range, and the interval between the acquisition times of vital information satisfies certain conditions (the interval is at least 5 minutes or more, or the interval). Is within 1 hour, etc.) Conditions are also conceivable. Further, a method may be used in which 30 vital information 8a are randomly selected and extracted with respect to the vital information 8a measured regularly at regular intervals. The extraction conditions for the past 30 pieces can be appropriately set as needed. Regardless of how it is taken, if at least 30 vital information 8a can be extracted, a normal distribution that reflects intra-individual variation can be obtained and used for scoring reference information 102 (reference area condition 220). it can.
 また、上述したように、バイタル情報8aとして、幅広くは1秒ごとのバイタル情報8aを記録可能に構成されている。また、バイタル情報8aは、例えば、1分ごと、1時間ごと等、異なる時間間隔で記録するように設定することもできる。更に、不規則に、1日に複数回測定したバイタル情報が記録可能に構成されている。演算部2が平均値算出手段14及び標準偏差算出手段15として機能して、バイタル平均値及びバイタル標準偏差を算出する際には、適宜、設定した条件で、バイタル平均値及びバイタル標準偏差を算出することができる。例えば、30個分のバイタル情報を抽出する条件が設定されていれば、抽出した30個分のバイタル情報から、バイタル平均値及びバイタル標準偏差を算出することができる。 Further, as described above, the vital information 8a is widely configured to be able to record the vital information 8a every second. Further, the vital information 8a can be set to be recorded at different time intervals such as every minute and every hour. Further, the vital information measured a plurality of times a day is irregularly configured to be recordable. When the calculation unit 2 functions as the mean value calculation means 14 and the standard deviation calculation means 15 to calculate the vital mean value and the vital standard deviation, the vital mean value and the vital standard deviation are calculated under appropriately set conditions. can do. For example, if the conditions for extracting the vital information for 30 pieces are set, the vital average value and the vital standard deviation can be calculated from the extracted vital information for 30 pieces.
 また、平均値算出手段14及び標準偏差算出手段15は、入力された対象者のバイタル情報に基づくスコア値情報103又はバイタルサインの値の判定時点において、都度、その判定時点より前に記録されたバイタル情報8a及び再測定バイタル情報13aを参照して、その判定時点のバイタル情報平均値及びバイタル情報標準偏差の算出を行う。これにより、判定処理手段6(又はスコア処理手段100)が利用する基準が、判定時点ごとに改められるものとなり、各バイタルサインのバイタル情報に基づくスコア値情報103の合計点が、異常な値であるか否かの判定、及び、バイタルサインの値が異常な値であるか否かの判定に、対象者のバイタル情報の個体内変動を反映しやすいものとなる。 Further, the mean value calculation means 14 and the standard deviation calculation means 15 were recorded at the time of determining the score value information 103 or the vital sign value based on the input vital information of the target person, each time before the determination time. With reference to the vital information 8a and the remeasured vital information 13a, the vital information mean value and the vital information standard deviation at the time of the determination are calculated. As a result, the criteria used by the determination processing means 6 (or the score processing means 100) are changed at each determination time point, and the total score of the score value information 103 based on the vital information of each vital sign is an abnormal value. It becomes easy to reflect the intra-individual variation of the vital information of the subject in the determination of whether or not the vital sign is present and whether or not the value of the vital sign is an abnormal value.
 また、バイタル情報8aを利用する個数が30個分以上の数であり、更に多い数、例えば、90個以上等、より多くの数のバイタル情報を利用する構成であってもよい。なお、個体内変動を捉えるための最低の個数として、30個分以上のデータ数となることが好ましい。 Further, the number of vital information 8a used may be 30 or more, and a larger number such as 90 or more may be used. The minimum number of data for capturing intra-individual variation is preferably 30 or more.
 この平均値算出手段14及び標準偏差算出手段15の算出の際に採用する「所定の条件」として、例えば、「90日間」を採用した場合には、この算出期間は、例えば、図5に示すような時間経過とともに90日間の範囲が1日ずつ移動する設定にすることができる。即ち、ある測定日(判定日)における算出に利用する90日の期間は、その測定日を含めて、測定日の90日前から測定日までの範囲(符号A)で示すものとなる。また、測定日の1日前において算出に利用された「所定の条件」は、測定日の91日前から測定日の1日前の日までの範囲(符号B)で示すものとなる。更に、測定日の2日前において算出に利用された「所定の条件」は、測定日の92日前から測定日の2日前の日までの範囲(符号C)で示すものとなる。このように、「所定の条件」の90日間の範囲は、時間の経過(符号Tの矢印の方向)と共に、1日ずつ移動する設定とすることができる。この点は、異なる時間の長さ(例えば、数分、数時間、1日の中)で、30個分のデータ数として利用する場合にも同様である。 When, for example, "90 days" is adopted as the "predetermined condition" adopted when calculating the average value calculating means 14 and the standard deviation calculating means 15, the calculation period is shown in FIG. 5, for example. It is possible to set the 90-day range to move one day at a time with the passage of time. That is, the 90-day period used for the calculation on a certain measurement date (determination date) is indicated by the range (reference numeral A) from 90 days before the measurement date to the measurement date including the measurement date. Further, the "predetermined condition" used for the calculation one day before the measurement date is indicated by the range (reference numeral B) from 91 days before the measurement date to the day one day before the measurement date. Further, the "predetermined condition" used for the calculation two days before the measurement date is indicated by the range (reference numeral C) from 92 days before the measurement date to the day two days before the measurement date. In this way, the 90-day range of the "predetermined condition" can be set to move one day at a time with the passage of time (direction of the arrow of the symbol T). This point is the same when it is used as the number of data for 30 pieces with different lengths of time (for example, several minutes, several hours, in one day).
 また、平均値算出手段14及び標準偏差算出手段15の算出の際に採用される「所定の条件」は、判定時点を含めて30個分のバイタル情報が利用されるように設定されているが、必ずしも、判定時点が起点となる必要はない。例えば、判定時点を除いて、「判定時点の前のデータ」を起点に30個分のバイタル情報が利用される設定も採用しうる。但し、判定時点を含めることで、直近の同一個体の状態を反映可能となり、その個体の個体内変動が捉えやすくなる点から、平均値算出手段14及び標準偏差算出手段15の算出の際に採用される「所定の条件」は、判定時点を含めて30個分のバイタル情報が利用されることが好ましい。 Further, the "predetermined condition" adopted when calculating the mean value calculation means 14 and the standard deviation calculation means 15 is set so that 30 vital information including the time of determination is used. , The judgment time does not necessarily have to be the starting point. For example, it is possible to adopt a setting in which 30 vital information is used starting from "data before the judgment time" except at the time of judgment. However, by including the time of judgment, it is possible to reflect the latest state of the same individual, and it becomes easier to grasp the intra-individual variation of that individual. Therefore, it is adopted when calculating the mean value calculation means 14 and the standard deviation calculation means 15. As the "predetermined condition" to be performed, it is preferable that 30 vital information including the time of determination is used.
 また、平均値算出手段14及び標準偏差算出手段15の算出の際に採用される「所定の条件」は、必ずしも連続した日付(個数)で計測されたバイタル情報である必要はない。例えば、対象者がバイタル測定を行っていない日(タイミング)があり、バイタル情報の記録がない日(タイミング)が存在するケースでは、所定の条件の日数(個数)が「合計で30日(30個分)」となるものであってもよい。 Further, the "predetermined condition" adopted when calculating the mean value calculating means 14 and the standard deviation calculating means 15 does not necessarily have to be vital information measured on consecutive dates (number of pieces). For example, in the case where there is a day (timing) in which the subject does not perform vital measurement and there is a day (timing) in which vital information is not recorded, the number of days (number) of a predetermined condition is "30 days in total (30 days). (Individual) ”may be used.
 例えば、図6の符号A(黒丸の図形)で示すように、毎日継続して、1日に午前と午後の2回バイタル情報を記録して、全ての情報を平均値算出手段14及び標準偏差算出手段15の算出に利用している。 For example, as shown by reference numeral A (black circle figure) in FIG. 6, vital information is recorded twice a day in the morning and afternoon continuously every day, and all the information is recorded by the mean value calculation means 14 and the standard deviation. It is used for the calculation of the calculation means 15.
 ここで、本発明では、設定した個数分のバイタル情報のデータ数が揃うのであれば、必ずしも、毎秒、毎分、毎時、毎日等、連続的に取得されたバイタル情報である必要はない。図6の符号B(バツの図形)や、符号C(白抜き三角)で示すバイタル情報のように、バイタル情報を取得した日(タイミング)が非連続的であり、数日(数回)に1回取得される態様であってもよい。更には、連続的なバイタル情報の記録が存在した状態で、設定した条件に基づいて部分的に抽出する態様であってもよい。設定した条件とは、例えば、毎週月曜日のバイタル情報のみ抽出する、午前中に取得したバイタル情報のみ抽出する、指定した日付のみ抽出するといったような内容である。 Here, in the present invention, if the number of vital information data for the set number is uniform, the vital information does not necessarily have to be continuously acquired such as every second, every minute, every hour, and every day. Like the vital information indicated by the reference numeral B (cross shape) and the reference numeral C (white triangle) in FIG. 6, the date (timing) at which the vital information is acquired is discontinuous, and may be several days (several times). It may be a mode acquired once. Further, it may be a mode in which the vital information is partially extracted based on the set conditions in the presence of a continuous record of vital information. The set conditions include, for example, extracting only vital information every Monday, extracting only vital information acquired in the morning, and extracting only a specified date.
 正規分布算出手段16は、所定の条件におけるバイタル情報の平均値及び標準偏差から正規分布を算出する部分である。対象者の各判定時点における正規分布を算出可能であり、算出した正規分布は、その確立密度関数をグラフ化した正規分布曲線が作成され、この正規分布曲線がタブレット端末3の表示部3bに表示される構成となっている。 The normal distribution calculation means 16 is a part that calculates a normal distribution from the average value and standard deviation of vital information under a predetermined condition. It is possible to calculate the normal distribution at each judgment time of the subject, and for the calculated normal distribution, a normal distribution curve that graphs the probability density function is created, and this normal distribution curve is displayed on the display unit 3b of the tablet terminal 3. It is configured to be.
 スコアリング基準設定手段101は、平均値算出手段14及び標準偏差算出手段15と連動して、各算出部から算出されたバイタル平均値及びバイタル標準偏差に基づき、スコアリング処理手段100がスコアリングに用いるスコアリング基準情報102、基準域条件220を作成する。作成されたスコアリング基準情報102、基準域条件220は情報記録部4に記録される。 The scoring standard setting means 101 is linked with the mean value calculation means 14 and the standard deviation calculation means 15, and the scoring processing means 100 performs scoring based on the vital mean value and the vital standard deviation calculated from each calculation unit. The scoring reference information 102 and the reference area condition 220 to be used are created. The created scoring reference information 102 and reference area condition 220 are recorded in the information recording unit 4.
 より詳細には、スコアリング基準設定手段101は、平均値算出手段14、標準偏差算出手段15、正規分布算出手段16と連動して、対象者から測定された体温、脈拍、収縮期血圧、拡張期血圧、脈圧及び呼吸数の測定値に対して、各算出手段から算出されたバイタル平均値及びバイタル標準偏差に基づき、スコアリングに用いるスコアリング基準情報102、基準域条件220を作成する。なお、スコアリング基準情報102としては、バイタル情報平均値及びバイタル情報標準偏差を用いた基準域条件220(μ±nσ)とは別に、予め設定しておく一定の数値範囲の基準が用いられてもよい。 More specifically, the scoring standard setting means 101 interlocks with the mean value calculation means 14, the standard deviation calculation means 15, and the normal distribution calculation means 16, and the body temperature, pulse, systolic blood pressure, and diastole measured from the subject. For the measured values of systolic blood pressure, pulse pressure, and respiratory rate, scoring reference information 102 and reference range condition 220 used for scoring are created based on the vital mean value and vital standard deviation calculated from each calculation means. As the scoring reference information 102, a standard in a certain numerical range set in advance is used in addition to the reference range condition 220 (μ ± nσ) using the vital information mean value and the vital information standard deviation. May be good.
 また、スコアリング基準情報102には、各算出手段の算出結果だけでなく、酸素飽和度の測定値に対してスコアリングする際に用いる、予め設定しておく一定の数値範囲の情報や、意識レベルの程度を区別可能な所定の観察状態の内容の情報も含まれている。 Further, the scoring reference information 102 includes not only the calculation result of each calculation means, but also information in a certain preset numerical range used when scoring the measured value of oxygen saturation, and consciousness. It also contains information on the content of a given observational state that can distinguish the degree of level.
 より詳細には、対象者から測定された酸素飽和度の測定値に対しては、タブレット端末3の入力部3aから所定の数値範囲を入力しておき、スコアリング基準情報102として設定することができる。設定されたスコアリング基準情報102は情報記録部4に記録される。 More specifically, for the measured value of oxygen saturation measured by the subject, a predetermined numerical range can be input from the input unit 3a of the tablet terminal 3 and set as the scoring reference information 102. it can. The set scoring reference information 102 is recorded in the information recording unit 4.
 また、対象者から取得された意識レベルの評価結果に対しては、意識レベルの程度を区別可能な所定の観察状態の内容を入力しておき、スコアリング基準情報102として設定することができる。設定されたスコアリング基準情報102は情報記録部4に記録される。なお、バイタル平均値、バイタル標準偏差、最頻値及びスコアリング基準情報102の算出の詳細や、複数の項目から構成されるスコアリング基準情報102の設定については、後述する。 Further, for the evaluation result of the consciousness level acquired from the subject, the content of a predetermined observation state capable of distinguishing the degree of the consciousness level can be input and set as the scoring reference information 102. The set scoring reference information 102 is recorded in the information recording unit 4. The details of the calculation of the vital mean value, the vital standard deviation, the mode, and the scoring reference information 102, and the setting of the scoring reference information 102 composed of a plurality of items will be described later.
[4.スコアリング処理手段]
 スコアリング処理手段100について説明する。スコアリング処理手段100は、本発明を適用したソフトウェアが演算部2に実行させる機能の1つであり、タブレット端末3の入力部3aを介して入力された判定時点のバイタル情報8aについて、平均値算出手段14、標準偏差算出手段15の処理情報や、予め設定した基準を含むスコアリング基準情報102、基準域条件220に基づき、バイタル情報の内容に応じたスコア値情報103(点数の情報)、複数のバイタルサインの各スコア値情報の合計点を算出する処理を行う。
[4. Scoring processing means]
The scoring processing means 100 will be described. The scoring processing means 100 is one of the functions executed by the software to which the present invention is applied to the calculation unit 2, and is an average value of the vital information 8a at the time of determination input via the input unit 3a of the tablet terminal 3. Based on the processing information of the calculation means 14, the standard deviation calculation means 15, the scoring standard information 102 including the preset standard, and the reference area condition 220, the score value information 103 (score information) according to the content of the vital information, Performs processing to calculate the total score of each score value information of a plurality of vital signs.
 スコアリング処理手段100にて算出されたスコア値情報103及び各スコア値情報の合計点は、上述したように、情報記録部4に記録される。その際、スコア値情報103及び各スコア値情報の合計点は、個体を識別可能な識別情報や、スコア値の算出基準となった情報に紐付けられて記録される。スコアリング処理手段100は、情報記録部4及び基準算出手段5と連動して、スコア値情報103及び各スコア値情報の合計点を出す構成となっている。 The score value information 103 calculated by the scoring processing means 100 and the total score of each score value information are recorded in the information recording unit 4 as described above. At that time, the score value information 103 and the total score of each score value information are recorded in association with the identification information that can identify the individual and the information that is the calculation standard of the score value. The scoring processing means 100 is configured to output the total score of the score value information 103 and each score value information in conjunction with the information recording unit 4 and the reference calculation means 5.
 また、スコア値情報103及び各スコア値情報の合計点は、タブレット端末3の表示部3bを介して、その内容を確認可能となっている。また、スコア値情報103及び各スコア値情報の合計点は、タブレット端末3の表示部3bだけでなく、タブレット端末3の情報送受信部3cを介して外部のサーバや、外部の端末にスコア判定結果情報12を送信して、これらの画面等でも確認することもできる。 Further, the contents of the score value information 103 and the total score of each score value information can be confirmed via the display unit 3b of the tablet terminal 3. Further, the score value information 103 and the total score of each score value information are sent to an external server or an external terminal via the information transmission / reception unit 3c of the tablet terminal 3 as well as the display unit 3b of the tablet terminal 3. Information 12 can also be transmitted and confirmed on these screens and the like.
[5.判定処理手段]
 判定処理手段6について説明する。判定処理手段6は、本発明を適用したソフトウェアが演算部2に実行させる機能の1つであり、タブレット端末3の入力部3aを介して入力された判定時点のバイタル情報がスコアリング処理手段100によってスコアリングされた各バイタルサインのスコア値情報103の合計点に対して、スコア判定基準情報18に基づき、スコア値情報103の合計点が異常な値であるか否かについて判定の処理を行う。 
[5. Judgment processing means]
The determination processing means 6 will be described. The determination processing means 6 is one of the functions executed by the software to which the present invention is applied to the calculation unit 2, and the vital information at the time of determination input via the input unit 3a of the tablet terminal 3 is the scoring processing means 100. With respect to the total score of the score value information 103 of each vital sign scored by, the determination process is performed as to whether or not the total score of the score value information 103 is an abnormal value based on the score determination criterion information 18. ..
 判定処理手段6にて判定された判定結果であるスコア判定結果情報12は、上述したように、情報記録部4に記録される。また、スコア判定結果情報12はタブレット端末3の表示部3bを介して、その内容を確認可能となっている。また、スコア判定結果情報12は、タブレット端末3の表示部3bだけでなく、タブレット端末3の情報送受信部3cを介して外部のサーバや、外部の端末にスコア判定結果情報12を送信して、これらの画面等でも確認することもできる。 The score determination result information 12, which is the determination result determined by the determination processing means 6, is recorded in the information recording unit 4 as described above. Further, the content of the score determination result information 12 can be confirmed via the display unit 3b of the tablet terminal 3. Further, the score determination result information 12 transmits the score determination result information 12 not only to the display unit 3b of the tablet terminal 3 but also to an external server or an external terminal via the information transmission / reception unit 3c of the tablet terminal 3. You can also check on these screens.
 また、スコア判定結果情報12は、タブレット端末3の表示部3b上への表示を行うだけでなく、アラート通知手段120(図4参照)を介して、スコア判定結果情報12が出されたことを通知する通知音やメールメッセージで、対象者に通知する構成とすることができる。 Further, the score determination result information 12 not only displays on the display unit 3b of the tablet terminal 3, but also indicates that the score determination result information 12 is issued via the alert notification means 120 (see FIG. 4). It can be configured to notify the target person with a notification sound or an e-mail message.
 また、アラート通知手段120は、例えば、スコア判定結果情報12の内容につき、「警告(例えば、スコア値情報103の合計点が2点以上)」の結果となった際にのみ、警報を通知する設定とすることができる。これにより、複数のバイタルサインのスコア値情報103の結果に基づき、対象者が異常であると判断された場合にだけ、外部に警報が通知されるものとなり、異常検知の精度を高めつつ、不用意に警報が通知されない仕組みとすることができる。なお、アラート通知手段120が警報を通知する設定については、適宜設定変更することができる。 Further, the alert notification means 120 notifies an alarm only when the result of "warning (for example, the total score of the score value information 103 is 2 points or more)" is obtained for the content of the score determination result information 12. Can be set. As a result, an alarm is notified to the outside only when the target person is determined to be abnormal based on the results of the score value information 103 of a plurality of vital signs, and the accuracy of abnormality detection is improved while being unsuccessful. It is possible to make it a mechanism that the alarm is not notified easily. The setting for the alert notification means 120 to notify the alarm can be changed as appropriate.
 続いて、本発明を適用したソフトウェアを機能させる際に使用する装置や、入力画面の具体的な内容について説明する。 Next, the device used when operating the software to which the present invention is applied and the specific contents of the input screen will be described.
 例えば、図7(a)に示すように、バイタル情報の取得は、ウェアラブル型のバイタル測定器21aや、体温計21b等で行い、これらで計測した測定値を、測定した時間の情報と共に、タブレット端末3の表示部3bに表示された画面を介して入力する。表示部3b上には、タッチパネル形式の入力部3aが表示され、ここにバイタル情報を入力する。本発明を適用したソフトウェアが導入されたタブレット端末3(第1のシステム構成)であれば、端末単体で、情報の記録、健康状態の判定、判定結果の表示が可能となる。 For example, as shown in FIG. 7A, the vital information is acquired by a wearable vital measuring device 21a, a thermometer 21b, or the like, and the measured values measured by these are combined with the measured time information on the tablet terminal. Input is performed via the screen displayed on the display unit 3b of 3. A touch panel type input unit 3a is displayed on the display unit 3b, and vital information is input here. If the tablet terminal 3 (first system configuration) into which the software to which the present invention is applied is installed, it is possible to record information, determine the health condition, and display the determination result by the terminal alone.
 また、図7(b)では、バイタル情報をスマートフォン端末22aや、パーソナルコンピュータ端末22b(以下、「PC端末22bと称する)から、上述の第2のシステム構成で述べた外部サーバである情報管理サーバ32aにアクセスして、スマートフォン端末22aやPC端末22bからバイタル情報の入力を行うこともできる。各端末から送信されたバイタル情報に基づき、情報管理サーバ32aで健康状態の判定がなされ、その結果の情報が各端末に送信され、各端末の画面で結果の情報が表示される。 Further, in FIG. 7B, the vital information is transmitted from the smartphone terminal 22a and the personal computer terminal 22b (hereinafter, referred to as “PC terminal 22b)” to the information management server which is the external server described in the second system configuration described above. It is also possible to access 32a and input vital information from the smartphone terminal 22a or the PC terminal 22b. Based on the vital information transmitted from each terminal, the information management server 32a determines the health condition, and the result is The information is transmitted to each terminal, and the result information is displayed on the screen of each terminal.
 また、タブレット端末3、スマートフォン端末22a及びPC端末22bの入力画面として、図8及び図9に示す画面を示す。図8及び図9は、病院の患者や、介護施設等の入居者を健康状態の判定対象とする際に利用する入力画面の例である。図8では、一人分の対象者の入力項目と、数字を表示したテンキー領域が表示される。対象者及び担当スタッフの氏名表示欄と、体温、血圧(上下)、脈拍、酸素濃度、体重、呼吸数における計測データの入力欄が設けられている。各バイタルサインの値は、テンキー領域をタッチパネルや、画面上でのカーソル操作で入力しうる。 Further, as input screens of the tablet terminal 3, the smartphone terminal 22a and the PC terminal 22b, the screens shown in FIGS. 8 and 9 are shown. 8 and 9 are examples of input screens used when a hospital patient or a resident of a long-term care facility or the like is used as a health condition determination target. In FIG. 8, input items for one target person and a numeric keypad area displaying numbers are displayed. There is a field for displaying the names of the subject and the staff in charge, and a field for inputting measurement data for body temperature, blood pressure (upper and lower), pulse, oxygen concentration, body weight, and respiratory rate. The value of each vital sign can be input by operating the cursor on the touch panel or on the screen in the numeric keypad area.
 また、図8の画面表示では、食事、排尿、排便、観察・問診の項目が設けられ、バイタルサインの値以外に、対象者の健康状態を確認する複数の項目が設けられている。これらの健康状態を確認する複数の項目を記録することで、対象者の日々の健康状態の記録が残せるものとなる。入力された情報は、送信ボタンをタッチ又はクリックすることで、装置内部の情報記録部4に記録される、又は、外部の情報管理サーバ32a(サーバの情報記録部)に送信される。 In addition, in the screen display of FIG. 8, items of meal, urination, defecation, observation / interview are provided, and in addition to the vital sign value, a plurality of items for confirming the health condition of the subject are provided. By recording a plurality of items for confirming these health conditions, it is possible to keep a record of the daily health condition of the subject. The input information is recorded in the information recording unit 4 inside the apparatus or transmitted to the external information management server 32a (information recording unit of the server) by touching or clicking the transmission button.
 図9に示す入力画面では、画面右側に複数のバイタルサインの計測データの入力欄と、対象者が自身で判断した体調の正常又は異常の選択項目が設けられている。また、自覚症状、他覚症状、熱型表を選択して、更なる体調の情報の入力や、対象者のバイタルの継時的な変化が確認できる構成となっている。 The input screen shown in FIG. 9 is provided with input fields for measurement data of a plurality of vital signs and selection items for normal or abnormal physical condition judged by the subject himself / herself on the right side of the screen. In addition, the subjective symptom, objective symptom, and fever type table can be selected so that further physical condition information can be input and the vital changes of the subject can be confirmed over time.
 また、図9の画面では、複数の対象者の氏名が表示され、名前の欄を選択することで、選択された対象者の画面が表示可能となる。また、バイタルサインの値の入力時の時間の情報が、同時に入力される。更には、バイタルサインの値の入力画面以外に、情報の登録に関する項目や、***、食事等の提供する介護の項目についての情報の記録や表示が可能となっている。 Further, on the screen of FIG. 9, the names of a plurality of target persons are displayed, and by selecting the name field, the screens of the selected target persons can be displayed. In addition, the time information at the time of inputting the vital sign value is input at the same time. Furthermore, in addition to the vital sign value input screen, it is possible to record and display information on items related to information registration and items of nursing care provided such as excretion and meals.
 このように、本発明のソフトウェアを利用する際の入力画面は、病院の患者や、介護施設等の入居者を対象者として、関連する項目と合せて、入力や情報の表示が可能なものにできる。また、入力画面の表示は、介護者等に関連付けられた内容に限定されるものではなく、例えば、健康管理のアプリケーションソフトウェアとして、各バイタルサインの値の入力や記録と、体重等の情報の管理とを組み合わせた画面構成でもよい。即ち、健康な対象者が、日常的な健康管理に使用する態様とすることもできる。 As described above, the input screen when using the software of the present invention is intended for hospital patients and residents of long-term care facilities, etc., and can be input and displayed together with related items. it can. In addition, the display of the input screen is not limited to the content associated with the caregiver, etc. For example, as application software for health management, input and record of the value of each vital sign and management of information such as weight. The screen configuration may be a combination of and. That is, it can be used by a healthy subject for daily health management.
 続いて、バイタル情報から得られたスコア値情報に対する具体的な判定の方法について説明する。 Next, a specific judgment method for the score value information obtained from the vital information will be described.
[6.バイタル平均値等の算出、スコアリング及び異常の判定について]
[6-1.体温、脈拍、収縮期血圧、拡張期血圧、脈圧、呼吸数の測定値について]
[6. About calculation of vital average value, scoring and judgment of abnormality]
[6-1. About body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure, respiratory rate measurements]
 バイタルサインのうち、体温、脈拍、収縮期血圧、拡張期血圧、脈圧、呼吸数の測定値については、設定したバイタル除外基準情報200の内容を構成するバイタル除外条件に基づき、入力されたバイタルサインの測定値が、バイタル情報8a及びバイタル情報8bに分類される。 Among the vital signs, the measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure, and respiratory rate are input vitals based on the vital exclusion conditions constituting the contents of the set vital exclusion standard information 200. The measured values of the signs are classified into vital information 8a and vital information 8b.
 このバイタル除外基準情報200は、1種類のバイタル除外条件、または、2種類以上のバイタル除外条件で構成される。設定するバイタル除外条件の内容及び組み合わせは、目的に応じて適宜設定可能である。 This vital exclusion standard information 200 is composed of one type of vital exclusion condition or two or more types of vital exclusion condition. The contents and combinations of vital exclusion conditions to be set can be appropriately set according to the purpose.
 入力されたバイタルサインの値は、設定されたバイタル除外条件を満たすバイタルサインの値が除外されて、バイタル情報8aが抽出される。なお、除外されたバイタルサインの値は、バイタル情報8bとなる。バイタル情報8a及びバイタル情報8bは、情報記録部4に記録される。 The entered vital sign value is excluded from the vital sign value that satisfies the set vital exclusion condition, and the vital information 8a is extracted. The value of the excluded vital signs is the vital information 8b. The vital information 8a and the vital information 8b are recorded in the information recording unit 4.
 このバイタル情報8aは、対象者の正常域に含まれやすい情報、統計的に見て外れ値が含まれない情報、正規性が担保された情報等、設定したバイタル除外条件の内容に応じて、バイタルサインの値として異常とみなされるような値が取り除かれたバイタル情報となる。 This vital information 8a is based on the set vital exclusion conditions such as information that is likely to be included in the normal range of the subject, information that does not include outliers statistically, and information whose normality is guaranteed. The vital information is obtained by removing values that are considered abnormal as the values of vital signs.
 また、バイタル情報8aは、バイタルサインの測定値をスコアリングする基準域条件220(μ±nσ)の算出根拠となる。バイタル情報8aが、バイタルサインの値として異常とみなされるような値が取り除かれた値であることから、基準域条件220(μ±nσ)は、対象者における通常の正常域とみなせるバイタルサインの範囲として絞り込まれた範囲となる。 In addition, the vital information 8a serves as a basis for calculating the reference region condition 220 (μ ± nσ) for scoring the measured values of vital signs. Since the vital information 8a is a value obtained by removing a value that is considered to be abnormal as the value of vital signs, the reference range condition 220 (μ ± nσ) is a value of the vital signs that can be regarded as a normal normal range in the subject. The range is narrowed down.
 即ち、基準域条件220は、異常検知の精度が高められた条件となる。異常検知の精度が高いとは、基準域条件220で、バイタルサインの測定値をスコアリングした際に、スコア値情報103として、1点(単一のバイタル異常)以上が出やすいことに繋がる。なお、スコアリングの配点と、スコア情報103の合計点に対する異常の有無の判定については後述する。 That is, the reference area condition 220 is a condition in which the accuracy of abnormality detection is improved. The high accuracy of abnormality detection means that when the measured value of vital signs is scored under the reference region condition 220, one point (single vital abnormality) or more is likely to be obtained as the score value information 103. The scoring points and the determination of the presence or absence of an abnormality with respect to the total points of the score information 103 will be described later.
 以下、個々のバイタル除外条件の内容について説明する。 The contents of each vital exclusion condition will be explained below.
 [1]「μ±2σ」の値を下限値及び上限値とするバイタル除外条件
 バイタル除外条件として、バイタル平均値情報及びバイタル標準偏差に基づき、「μ-2σ」の値を下限値とし、「μ+2σ」の値を上限値とする範囲内に、バイタルサインの測定値が含まれるか否かを条件の内容とする。
[1] Vital exclusion condition with the value of "μ ± 2σ" as the lower limit and upper limit As the vital exclusion condition, based on the vital mean value information and vital standard deviation, the value of "μ-2σ" is set as the lower limit and " The content of the condition is whether or not the measured value of vital signs is included in the range with the value of "μ + 2σ" as the upper limit value.
 即ち、体温、脈拍、収縮期血圧、拡張期血圧、脈圧及び呼吸数の測定値が、μ-2σ以下、または、μ+2σ以上の値となる場合には、バイタル除外条件を満たす値として、その測定値は、基準域条件220の算出根拠から除外される。 That is, when the measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure and respiratory rate are μ-2σ or less or μ + 2σ or more, the values satisfy the vital exclusion condition. The measured value is excluded from the calculation basis of the reference region condition 220.
 この条件によれば、体温、脈拍、収縮期血圧、拡張期血圧、脈圧及び呼吸数の測定値につき、対象者における通常の正常域とみなせるバイタルサインの測定値が集約されやすくなり、「μ±2σ」の範囲を外れる測定値を、バイタルサインの値として異常とみなされるような値として取り扱うことができる。 According to this condition, it becomes easy to aggregate the measured values of vital signs that can be regarded as the normal normal range in the subject for the measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure and respiratory rate, and "μ". Measured values outside the range of "± 2σ" can be treated as values that are considered abnormal as vital sign values.
 また、この条件での「μ±2σ」におけるバイタル平均値「μ」と、バイタル標準偏差「σ」自体の値も、バイタルサインの測定値が入力された際に、既に記録されているバイタル情報の中で、「μ±2σ」の範囲内に含まれるという条件を満たす測定値から算出される。 In addition, the vital average value "μ" in "μ ± 2σ" under this condition and the value of the vital standard deviation "σ" itself are also the vital information already recorded when the measured value of vital signs is input. Is calculated from the measured values that satisfy the condition that they are included in the range of "μ ± 2σ".
 このように、バイタル除外条件を「μ±2σ」の範囲内に設定することで、対象者の通常の正常域とみなせるバイタルサインの測定値が集約され、バイタル情報8aが抽出される。 By setting the vital exclusion condition within the range of "μ ± 2σ" in this way, the measured values of vital signs that can be regarded as the normal normal range of the subject are aggregated, and the vital information 8a is extracted.
 ここで、必ずしも、バイタル除外条件となる「μ±2σ」の範囲内の条件として、μ-2σ以下、または、μ+2σ以上と設定される必要はない。例えば、下限値は「μ-2σ未満」としてもよく、上限値は「μ+2σを超える値」としてもよい。 Here, it is not always necessary to set μ-2σ or less or μ + 2σ or more as a condition within the range of “μ ± 2σ” which is a vital exclusion condition. For example, the lower limit value may be "less than μ-2σ", and the upper limit value may be "a value exceeding μ + 2σ".
 以下、図10~図15を用いて、バイタル除外条件を「μ±2σ」の範囲内に設定する利点を説明する。 Hereinafter, the advantage of setting the vital exclusion condition within the range of “μ ± 2σ” will be described with reference to FIGS. 10 to 15.
 図10及び図11は、ある対象者の体温について、35.6℃の体温につき、「μ±2σ」の基準を設けて、この基準で、バイタルサインの値として正常または異常を判断したケースである。 10 and 11 show a case in which a standard of “μ ± 2σ” is set for the body temperature of a subject at 35.6 ° C, and normal or abnormal is judged as the value of vital signs based on this standard. is there.
 図10は、1回目の35.6℃の体温が異常と判断されたが、この異常と判断された値を除外せずに基準(μ±2σ)を設けて、2回目の35.6℃の体温につき、正常または異常を判断した結果である。また、図11は、1回目の35.6℃の体温が異常と判断されたが、この異常と判断された値を除外して基準(μ±2σ)を設けて、2回目の35.6℃の体温につき、正常または異常を判断した結果である。 In FIG. 10, the body temperature of 35.6 ° C. in the first time was judged to be abnormal, but a standard (μ ± 2σ) was set without excluding the value judged to be abnormal, and the body temperature of 35.6 ° C. in the second time was judged to be abnormal. This is the result of judging whether the body temperature is normal or abnormal. Further, in FIG. 11, although the body temperature of 35.6 ° C. in the first time was judged to be abnormal, a standard (μ ± 2σ) was set by excluding the value judged to be abnormal, and 35.6 in the second time. This is the result of judging whether the body temperature is normal or abnormal.
 図10に示すように、1回目の35.6℃の体温が異常と判断されたが、この異常と判断された値を除外せずに基準(μ±2σ)を設けた場合、2回目の35.6℃の体温は、基準の範囲が拡がったことから、「正常」と判断される結果となる。即ち、バイタルサインの値を異常と見なす範囲が広がり、異常の検知の精度が下がっている。 As shown in FIG. 10, the first body temperature of 35.6 ° C. was judged to be abnormal, but when the standard (μ ± 2σ) was set without excluding the value judged to be abnormal, the second time. The body temperature of 35.6 ° C. is judged to be "normal" because the range of the standard has been expanded. That is, the range in which the value of vital signs is regarded as an abnormality has expanded, and the accuracy of detecting an abnormality has decreased.
 一方、図11に示すように、1回目の35.6℃の体温が異常と判断され、この異常と判断された値を除外して基準(μ±2σ)を設けた場合、2回目の35.6℃の体温は、基準の範囲が絞られ、2回目の判断では「異常」と判断される結果となる。即ち、バイタルサインの値を異常と見なす範囲が絞られ、異常の検知の精度が上がっている。 On the other hand, as shown in FIG. 11, when the body temperature of 35.6 ° C. in the first time is judged to be abnormal and a standard (μ ± 2σ) is set by excluding the value judged to be abnormal, 35 in the second time. The body temperature of 6.6 ° C is narrowed down to the standard range, and the second judgment results in "abnormal" judgment. That is, the range in which the vital sign value is regarded as an abnormality is narrowed down, and the accuracy of detecting the abnormality is improved.
 同様に、図12及び図13は、血圧(下)の74の値につき、基準(μ±2σ)の算出根拠として、1回目に異常と判断された際に、除外するか否かで、2回目の判断の結果が異なることを示している。また、図14及び図15は、脈拍の53の値につき、基準(μ±2σ)の算出根拠として、1回目に異常と判断された際に、除外するか否かで、2回目の判断の結果が異なることを示している。 Similarly, in FIGS. 12 and 13, the 74 values of blood pressure (bottom) are excluded as the basis for calculating the reference (μ ± 2σ) when it is judged to be abnormal the first time. It shows that the result of the second judgment is different. Further, in FIGS. 14 and 15, when the value of 53 of the pulse is determined to be abnormal at the first time as the basis for calculating the reference (μ ± 2σ), the second judgment is made depending on whether or not to exclude it. It shows that the results are different.
 このことから明らかなように、バイタル除外条件を「μ±2σ」の範囲内に設定することで、バイタルサインの測定値をスコアリングする際の基準域条件220において、バイタルサインの異常の検知の精度を高めることができる。 As is clear from this, by setting the vital sign exclusion condition within the range of "μ ± 2σ", the detection of vital sign anomaly is detected in the reference range condition 220 when scoring the measured value of vital signs. The accuracy can be improved.
 [2]統計的な手法により外れ値を判定するバイタル除外条件
 バイタル除外条件として、統計的な手法により「外れ値」と判定できるバイタルサインの測定値を、バイタルサインの値として異常とみなされるような値として除外する。ここで、外れ値を除外する統計的な手法として、例えば、スミルノフ・グラブス検定が採用できる。
[2] Vital exclusion condition for judging outliers by statistical method As a vital exclusion condition, the measured value of vital signs that can be judged as "outlier" by statistical method is regarded as abnormal as the value of vital signs. Exclude as a value. Here, for example, the Smirnov-Grabs test can be adopted as a statistical method for excluding outliers.
 スミルノフ・グラブス検定は、バイタルサインの測定値の集合について、バイタルサインの値として異常とみなされるような値を除外するか否か検定する手法である。正規分布に従うバイタルサインにおいて利用される。 The Smirnov-Grabs test is a method for testing whether or not to exclude a set of measured values of vital signs that is considered to be abnormal as the value of vital signs. It is used in vital signs that follow a normal distribution.
 スミルノフ・グラブス検定では、平均値から最も離れた観測値を選び、その残差をσで割った値を検定統計量とする。そして有意性を判断して、外れ値とした場合は、これを除外して、検定のやり直しを続けていく。最終的に、外れ値が出力されなくなると、外れ値の無いデータセット(バイタル情報8a)を作ることができる。 In the Smirnov-Grabs test, the observation value farthest from the mean value is selected, and the value obtained by dividing the residual value by σ is used as the test statistic. Then, if the significance is judged and it is an outlier, this is excluded and the test is continued again. Finally, when the outliers are no longer output, a data set (vital information 8a) without outliers can be created.
 スミルノフ・グラブス検定は、次のような手順で進める。
(1)対象データ(バイタルサインの測定値の集合)に対して、平均値、分散、最大値(または最小値)を求める。
(2)検定統計量Tを求める。
(3)有意性を判断する。
(4)外れ値とした場合は、外れ値を除外して検定処理を実施し、外れ値が出力されなくなるまで繰り返す。
The Smirnov-Grabs test proceeds as follows.
(1) Obtain the mean value, variance, and maximum value (or minimum value) of the target data (set of measured values of vital signs).
(2) Obtain the test statistic T.
(3) Judge the significance.
(4) If an outlier is used, the outlier is excluded, the test process is performed, and the process is repeated until no outlier is output.
 例えば、脈拍の測定値の集合について、外れ値を除外する前では、図16(a)に示すQ-Qプロットと、図16(b)に示す分布となったとする。この脈拍の集合に対して、スミルノフ・グラブス検定を行うと、外れ値が除外された結果、図17(a)に示すQ-Qプロットと、図17(b)に示す分布となる。 For example, it is assumed that the set of pulse measurement values has the QQ plot shown in FIG. 16 (a) and the distribution shown in FIG. 16 (b) before excluding the outliers. When the Smirnov-Grabs test is performed on this set of pulses, the outliers are excluded, and as a result, the QQ plot shown in FIG. 17 (a) and the distribution shown in FIG. 17 (b) are obtained.
 このように、バイタル除外条件として、スミルノフ・グラブス検定に基づく、外れ値に該当するか否かという条件を採用することで、統計的に、バイタルサインの値として異常とみなされるような値を除外することができる。この結果、バイタル情報8aを、医学的に取り得ない値が算出根拠に含まれにくい情報とすることができる。 In this way, by adopting the condition of whether or not it corresponds to an outlier based on the Smirnov-Grabs test as the vital exclusion condition, a value that is statistically regarded as abnormal as a value of vital signs is excluded. can do. As a result, the vital information 8a can be made into information in which a medically unacceptable value is unlikely to be included in the calculation basis.
 [3]医師が医療介入した日・期間に関するバイタル除外条件
 バイタル除外条件として、医師が医療介入した日または期間に測定されたバイタルサインの値であるか否かを条件の内容とする。
[3] Vital exclusion condition regarding the date and period of medical intervention by the doctor The content of the vital exclusion condition is whether or not it is the value of vital signs measured on the day or period of medical intervention by the doctor.
 この医師が医療介入した日または期間とは、対象者を医師が診断して、医師による処方がなされた日、処方内容に含まれる期間、及び、入院期間が該当する。医師による処方とは、服薬、点滴、注射、経管栄養等の処置や、看取り(医療介入を望まない)の際の経過観察を含んでいる。 The date or period of medical intervention by this doctor corresponds to the date when the doctor diagnosed the subject and the prescription was made by the doctor, the period included in the prescription, and the length of hospital stay. Prescriptions by doctors include treatments such as medication, infusion, injection, tube feeding, and follow-up during care (not wanting medical intervention).
 また、ここでいう、処方内容に含まれる期間とは、例えば、服薬の開始から終了までの期間である。また、入院期間は、医師の診断の結果、対象者が病院等の医療機関に入院した日から退院するまでの期間である。 The period included in the prescription content referred to here is, for example, the period from the start to the end of taking the drug. The hospitalization period is the period from the day when the subject is admitted to a medical institution such as a hospital to the time when the subject is discharged as a result of a doctor's diagnosis.
 また、看取り(医療介入を望まない)とは、対象者が何等かの病気であると診断されたが、対象者の家族が、服薬等の治療のための処置を行うことを希望しない場合に、具体的な処置を行わずに経過を観察するように指示した状態を意味する。 In addition, care (not wishing for medical intervention) is when the subject is diagnosed with some kind of illness, but the subject's family does not wish to take treatment such as taking medication. , Means a state instructed to observe the progress without taking specific measures.
 この医師が医療介入した日または期間の情報は、対象者の個人情報7として、情報記録部4に記録される。例えば、服薬の処方がなされた場合、「臨時薬10日間投与」といった情報や該当する期間の情報が記録される。 Information on the date or period of medical intervention by this doctor is recorded in the information recording unit 4 as personal information 7 of the subject. For example, when a medication is prescribed, information such as "temporary medication 10-day administration" and information on the corresponding period are recorded.
 この医師が医療介入した日または期間において測定されたバイタルサインの値は、対象者が病気と判断された状態、または、何等かの処置が必要な状態でのバイタルとなる。そのため、このような条件下で測定されたバイタルサインの値を、異常とみなされるような値として除外することで、バイタル情報8aを、対象者における通常の正常域とみなせるバイタルサインの測定値が集約された内容とすることができる。 The value of vital signs measured on the day or period of medical intervention by this doctor is the vital sign when the subject is judged to be ill or needs some treatment. Therefore, by excluding the values of vital signs measured under such conditions as values that are considered to be abnormal, the measured values of vital signs that can be regarded as the normal normal range of the subject can be obtained from the vital information 8a. It can be an aggregated content.
 [4]「μ±2σ」の値が2回以上続く場合のバイタル除外条件
 バイタル平均値情報及びバイタル標準偏差に基づき、「μ-2σ」の値を下限値とし、「μ+2σ」の値を上限値とする範囲を設定する。また、一定の条件下で、複数回測定したバイタルサインの測定値について、μ-2σ以下、または、μ+2σ以上の値が2回以上続けて測定された場合に、1回目の測定値は除外せずにバイタル情報8aに含め、2回目以降の測定値を除外するという内容のバイタル除外条件である。
[4] Vital exclusion conditions when the value of "μ ± 2σ" continues twice or more Based on the vital mean value information and vital standard deviation, the value of "μ-2σ" is the lower limit and the value of "μ + 2σ" is the upper limit. Set the range of values. In addition, under certain conditions, when the measured values of vital signs measured multiple times are measured twice or more in succession with a value of μ-2σ or less or μ + 2σ or more, the first measured value is excluded. It is a vital exclusion condition that includes the vital information 8a and excludes the measured values from the second time onward.
 ここで、一定の条件とは、例えば、5分間の間に複数回血圧を測定するといった内容であり、同一条件で測定したバイタルサインとして取り扱えるような条件を意味する。なお、本バイタル除外条件は、その内容から、上記[1]で説明したバイタル除外条件とは重複して設定されない条件となる。 Here, the fixed condition means, for example, the content of measuring the blood pressure multiple times in 5 minutes, and means a condition that can be treated as a vital sign measured under the same condition. It should be noted that this vital exclusion condition is a condition that is not set in duplicate with the vital exclusion condition described in [1] above due to its contents.
 このように複数回のバイタル測定を行い、「μ±2σ」の範囲を外れた測定値が2回以上測定され、1回目の測定値はバイタル情報8aに含めることで、「μ±2σ」の範囲を外れた測定値を厳密に排除せずに、基準域条件220を設定することができる。また、2回目以降の「μ±2σ」の範囲を外れた測定値は除外されるため、基準域条件220での異常の検知の精度が過度に下がることが抑止できる。 In this way, the vital measurement is performed a plurality of times, the measured value outside the range of "μ ± 2σ" is measured twice or more, and the first measured value is included in the vital information 8a to obtain "μ ± 2σ". The reference zone condition 220 can be set without strictly excluding out-of-range measurements. Further, since the measured values outside the range of “μ ± 2σ” after the second time are excluded, it is possible to prevent the accuracy of detecting the abnormality under the reference region condition 220 from being excessively lowered.
 [5]t検定に基づくバイタル除外条件
 バイタル除外条件として、t検定により、「平均値から大きく外れた値」と判定できるバイタルサインの測定値を、バイタルサインの値として異常とみなされるような値として除外する内容である。正規分布に従うバイタルサインにおいて利用される。
[5] Vital exclusion condition based on t-test As a vital exclusion condition, a measured value of vital signs that can be determined to be "a value significantly deviated from the average value" by t-test is a value that is regarded as abnormal as a value of vital sign. It is the content to be excluded as. It is used in vital signs that follow a normal distribution.
 [6]主値以外を除外するバイタル除外条件
 一定の条件下で、複数回測定したバイタルサインの測定値について、所定の主値選択条件で選択された主値以外の測定値を除外するという内容のバイタル除外条件である。主値とは、複数の測定値の中から1つを選び出すことを意味する。
[6] Vital exclusion condition excluding other than the principal value Regarding the measured values of vital signs measured multiple times under certain conditions, the content is to exclude the measured values other than the principal value selected under the predetermined principal value selection condition. Vital exclusion condition. The principal value means selecting one from a plurality of measured values.
 ここで、所定の主値選択条件として、人為的、または、一定の条件を設けてシステム的に1つの値を選択する条件がある。人為的な選択とは、例えば、測定値の中から、明らかな入力ミスによる測定値とわかる数値を除いて、1つの測定値を選択するような行為が含まれる。 Here, as a predetermined principal value selection condition, there is a condition for artificially or systematically selecting one value by setting a certain condition. The artificial selection includes, for example, the act of selecting one measured value from the measured values, excluding the numerical value that can be recognized as the measured value due to an obvious input error.
 また、システム的な選択とは、例えば、血圧の測定において、複数の測定値の中から、「μ±2σ」の範囲に含まれる測定値を選択するような態様が考えられる。血圧の測定では、数回測定を行い、血圧に異常がある場合には、何回測定しても、正常な範囲の値が見られないようになっている。そのため、「μ±2σ」の範囲に含まれる測定値があれば、主値として選択しうる。 Further, as a systematic selection, for example, in the measurement of blood pressure, a mode in which a measured value included in the range of "μ ± 2σ" is selected from a plurality of measured values can be considered. Blood pressure is measured several times, and if there is an abnormality in blood pressure, no matter how many times it is measured, a value in the normal range cannot be seen. Therefore, if there is a measured value within the range of "μ ± 2σ", it can be selected as the principal value.
 また、システム的な選択とは、例えば、バイタルサインの測定値についてQ-Qプロットに基づき、プロットの範囲内から精度の高い測定値を選択するような態様が考えられる。 Further, the systematic selection may be, for example, a mode in which a highly accurate measured value is selected from the range of the plot based on the Q-Q plot for the measured value of vital signs.
 このように、バイタル除外条件として、複数回測定したバイタルサインの測定値について、所定の主値選択条件で選択された主値以外の測定値を除外する内容とすることで、バイタル情報8aを、信頼性の高い情報とすることができる。 In this way, the vital information 8a can be obtained by excluding the measured values of vital signs measured a plurality of times as the vital exclusion condition other than the measured values other than the principal value selected under the predetermined principal value selection condition. It can be highly reliable information.
 [7]正規性に基づくバイタル除外条件
 バイタル除外条件として、所定の検定法に基づき、正規性が担保されない値と判定できるバイタルサインの測定値を、バイタルサインの値として異常とみなされるような値として除外する。ここで、正規性を判定する手法として、例えば、シャピロ-ウィルク検定が採用できる。
[7] Vital Exclusion Condition Based on Normality As a vital exclusion condition, a measured value of vital signs that can be determined to be a value whose normality is not guaranteed based on a predetermined test method is regarded as an abnormality as a value of vital signs. Exclude as. Here, for example, the Shapiro-Wilk test can be adopted as a method for determining normality.
 シャピロ-ウィルク検定は、バイタルサインの測定値の集合についてp値を求め、例えば、有意水準5%と設定した場合には、p<0.05の場合は「正規分布に従わない」、p≧0.05であった場合は「正規分布に従う」と判断する検定法である。なお、p値とは、帰無仮説を棄却するための証拠を測定する確率である。 The Shapiro-Wilk test finds the p-value for a set of vital sign measurements, for example, when the significance level is set to 5%, "does not follow a normal distribution" when p <0.05, p ≧ If it is 0.05, it is a test method that determines that it follows a normal distribution. The p-value is the probability of measuring evidence for rejecting the null hypothesis.
 このシャピロ-ウィルク検定を用いて、バイタルサインの測定値の集合について、p<0.05の根拠となった「外れ値」となる測定値を抽出する。即ち、この外れ値を正規性が担保されないバイタルサインの測定値として除外する。 Using this Shapiro-Wilk test, for the set of measured values of vital signs, the measured values that are the "outliers" that are the basis of p <0.05 are extracted. That is, this outlier is excluded as a measured value of vital signs whose normality is not guaranteed.
 一例として、脈拍につき、測定値のデータを30から1つずつ増やし、各データについきp値を求めた内容に関して、その分布図を図18及び図19に示す。なお、各図のデータ数とp値は以下のとおりである。
図18(a):データ数30、p値:0.03854
図18(b):データ数31、p値:0.05124
図18(c):データ数32、p値:0.06584
図18(d):データ数33、p値:0.05696
図19(a):データ数34、p値:0.07926
図19(b):データ数35、p値:0.1135
図19(c):データ数36、p値:0.000000003445
図19(d):データ数36、p値:0.08062、
As an example, FIGS. 18 and 19 show distribution maps of the measured value data increased by 1 from 30 for each pulse and the p-value obtained for each data. The number of data and the p-value in each figure are as follows.
FIG. 18 (a): Number of data 30, p-value: 0.03854
FIG. 18 (b): Number of data 31, p-value: 0.05124
FIG. 18 (c): Number of data 32, p-value: 0.06584
FIG. 18 (d): Number of data 33, p-value: 0.05696
FIG. 19 (a): Number of data 34, p-value: 0.07926
FIG. 19 (b): Number of data 35, p-value: 0.1135
FIG. 19 (c): Number of data 36, p-value: 0.000000003445
FIG. 19 (d): Number of data 36, p-value: 0.08062,
 脈拍の測定値について、データ数を増やし、図19(c)において、脈拍の値「78bpm(beats per minute)」が入力されると、p値:0.000000003445となる。即ち、78bpmの値が、正規性が担保されない「外れ値」となる。そして、図19(d)において、「78bpm」の測定値を除外して、新たに「50bpm」の測定値が入力されると、p値:0.08062となり、正規性が担保されたデータとなる。 Regarding the measured value of the pulse, when the number of data is increased and the pulse value "78 bpm (beats per minute)" is input in FIG. 19 (c), the p value is 0.000000003445. That is, the value of 78 bpm is an “outlier” whose normality is not guaranteed. Then, in FIG. 19D, when the measured value of "78 bpm" is excluded and a new measured value of "50 bpm" is input, the p value is 0.08062, which is the data whose normality is guaranteed.
 このようにバイタルサインの測定値について、シャピロ-ウィルク検定のp値を用いて、正規性が担保されない測定値を、外れ値として除外することができる。このように、シャピロ-ウィルク検定により、バイタル情報8aを正規性が担保された情報とすることができる。 In this way, with respect to the measured values of vital signs, the measured values whose normality is not guaranteed can be excluded as outliers by using the p-value of the Shapiro-Wilk test. In this way, the vital information 8a can be used as information whose normality is guaranteed by the Shapiro-Wilk test.
 また、シャピロ-ウィルク検定により、バイタルサインの測定値の精度検証が可能となる。バイタル情報8aは、精度が悪いデータが除外され、品質が担保された「クオリティデータ」のみで集団が形成されるものとなる。 In addition, the Shapiro-Wilk test makes it possible to verify the accuracy of vital sign measurements. In the vital information 8a, data having poor accuracy is excluded, and a group is formed only by "quality data" whose quality is guaranteed.
 [8]正規性と測定者に基づくバイタル除外条件
 上記の[7]のバイタル除外条件に関連して、バイタルサインの測定を行った作業者の情報と、作業者が測定したバイタルサインの測定値の正規性の情報に基づき、バイタルサインの測定値を分類する。
[8] Vital Exclusion Conditions Based on Normality and Measurer Information of the worker who measured the vital signs and the measured value of the vital signs measured by the worker in relation to the vital signs exclusion condition of [7] above. Classify vital sign measurements based on normality information.
 本除外条件では、バイタルサインの測定値と共に、測定を行った測定者(例えば、対象者の家族、介護士等)の情報を入力及び記録する構成とする。また、バイタルサインの測定値について、シャピロ-ウィルク検定に基づき、正規性が担保された値か否かについても記録する。 In this exclusion condition, the measured value of vital signs and the information of the measurer (for example, the subject's family, caregiver, etc.) who performed the measurement are input and recorded. In addition, record whether or not the measured value of vital signs is a value whose normality is guaranteed based on the Shapiro-Wilk test.
 そして、ある測定者の測定により正規性が担保されない測定値が記録され、その測定者の情報に紐付けられる。本除外条件では、正規性が担保されない測定値の測定を行った測定者を記録し、その測定者が測定したバイタルサインの値を除外して、バイタル情報8aを抽出する。 Then, the measured value whose normality is not guaranteed by the measurement of a certain measurer is recorded and linked to the information of the measurer. In this exclusion condition, the measurer who measured the measured value whose normality is not guaranteed is recorded, the vital sign value measured by the measurer is excluded, and the vital information 8a is extracted.
 このような構成によれば、測定者の測定の仕方自体に問題がある場合に、その測定者が行った結果の値を、バイタル情報8aから取り除き、正確な測定を行った結果の値を収集しやすくなる。 According to such a configuration, when there is a problem in the measurement method itself of the measurer, the value of the result of the measurer is removed from the vital information 8a, and the value of the result of accurate measurement is collected. It will be easier to do.
 バイタルサインの種類、例えば、血圧の測定では、測定者の測定技術により、測定値がばらついたり、不正確であったりすることがある。そのため、本除外条件を設定することで、作業者の技術に起因するバイタルサインの測定値の正確性を担保しやすくなる。 In the type of vital signs, for example, blood pressure measurement, the measured value may vary or be inaccurate depending on the measurement technique of the measurer. Therefore, by setting this exclusion condition, it becomes easy to ensure the accuracy of the measured value of vital signs caused by the skill of the worker.
 なお、本除外条件では、例えば、ある測定者につき、正規性が担保されない測定値が一定数に至った場合に、その測定者が測定した測定値を除外するような構成とすることもできる。 In this exclusion condition, for example, when the number of measured values whose normality is not guaranteed reaches a certain number for a certain measurer, the measured value measured by that measurer can be excluded.
 [9]所定の時間条件に基づくバイタル除外条件
 バイタル除外条件として、バイタルサインの測定値が、所定の時間条件を満たして測定された値であるか否かを条件とする。本条件は、例えば、バイタルサインの測定値が、設定した時刻を基準に、1時間以内に測定されたかどうかといった内容で設定される。
[9] Vital Exclusion Condition Based on Predetermined Time Condition As the vital exclusion condition, it is a condition whether or not the measured value of vital signs is a value measured by satisfying the predetermined time condition. This condition is set, for example, as to whether or not the measured value of vital signs is measured within one hour based on the set time.
 このように時間の条件を設定して、決められた時間に適切に測定されなかったバイタルサインの測定値を除外して、バイタル情報8aを抽出する。例えば、病院等では、看護師の業務のタイミングや、対象者の行動により、設定した時刻にバイタル測定が行えないケースがある。そのような場合、測定が遅れたバイタルサインの測定値を除外して、バイタル情報8aを、信頼できる情報とすることができる。 By setting the time condition in this way, the vital sign 8a is extracted by excluding the measured values of vital signs that were not properly measured at the determined time. For example, in hospitals and the like, there are cases where vital measurement cannot be performed at a set time depending on the timing of the work of the nurse and the behavior of the subject. In such a case, the vital information 8a can be made reliable information by excluding the measured value of the vital sign whose measurement is delayed.
 [10]「μ±2σ」の値を下限値及び上限値とする複数回測定のバイタル除外条件
 バイタル平均値情報及びバイタル標準偏差に基づき、「μ-2σ」の値を下限値とし、「μ+2σ」の値を上限値とする範囲を設定する。また、一定の条件下で、複数回測定したバイタルサインの測定値について、「μ±2σ」の範囲を外れた測定値を除外する内容である。
[10] Vital exclusion conditions for multiple measurements with the value of "μ ± 2σ" as the lower and upper limits Based on the vital mean value information and vital standard deviation, the value of "μ-2σ" is the lower limit and "μ + 2σ" Set the range with the value of "" as the upper limit. In addition, the measured values of vital signs measured a plurality of times under certain conditions exclude the measured values outside the range of “μ ± 2σ”.
 ここで、一定の条件とは、例えば、5分間の間に複数回血圧を測定するといった内容であり、同一条件で測定したバイタルサインとして取り扱えるような条件を意味する。なお、本バイタル除外条件は、本除外方法は、上記[1]で説明したバイタル除外条件とは、複数回の測定を想定している点で異なっている。 Here, the fixed condition means, for example, the content of measuring the blood pressure multiple times in 5 minutes, and means a condition that can be treated as a vital sign measured under the same condition. The vital exclusion condition is different from the vital exclusion condition described in [1] above in that the exclusion method assumes a plurality of measurements.
 本除外方法は、一定の条件下で、複数回、バイタルサインの測定を行い、各測定には、厳密には多少の時間差があって測定しているので、それぞれの値について、全ての測定値を有効に取り扱うことを考慮して設定している。また、例えば、一連のバイタル測定の行為で5回測定したら、そのうち「μ±2σ」の範囲を外れた測定値である1~4回を除外する(通常、落ち着くまでの最初の場合が多い)ということを考慮して設定している。 In this exclusion method, vital signs are measured multiple times under certain conditions, and each measurement is strictly measured with a slight time lag. Therefore, all measured values are measured for each value. Is set in consideration of effective handling. Also, for example, if 5 times are measured in a series of vital measurement actions, 1 to 4 times, which is a measured value outside the range of "μ ± 2σ", is excluded (usually, it is often the first time to settle down). It is set in consideration of that.
 [11]測定者の判断によるバイタル除外条件
 上記の各バイタル除外条件以外にも、測定者の判断で「有効でない」と思われたバイタルサインの測定値を除外する構成も採用しうる。
[11] Vital Exclusion Conditions Based on the Judgment of the Measurer In addition to the above-mentioned Vital Exclusion Conditions, a configuration may be adopted in which the measured values of vital signs considered to be “ineffective” at the judgment of the measurer are excluded.
 以上で説明したバイタル除外条件について、単一の条件、または、複数の条件を組み合わせて、バイタル除外基準情報200を設定することができる。 Regarding the vital exclusion conditions described above, it is possible to set the vital exclusion standard information 200 by using a single condition or a combination of a plurality of conditions.
 バイタルサインの値として異常とみなされるような値が取り除かれたバイタル情報8aは、バイタルサインの測定値をスコアリングする際の基準域条件220の算出に用いられる。基準域条件220は、例えば、バイタル平均値情報及びバイタル標準偏差に基づき、「μ±nσ以内」として設定される。この基準域条件220は、スコアリング基準情報102の1つである。 The vital information 8a from which the value considered to be abnormal as the value of vital signs has been removed is used for the calculation of the reference range condition 220 when scoring the measured value of vital signs. The reference region condition 220 is set as “within μ ± nσ” based on, for example, vital average value information and vital standard deviation. This reference area condition 220 is one of the scoring reference information 102.
 バイタル平均値及びバイタル標準偏差は情報記録部4に記録されたバイタル情報8a及び再測定バイタル情報13aに基づき、演算部2が基準算出手段5の平均値算出手段14及び標準偏差算出手段15として機能して算出される。また、バイタル平均値及びバイタル標準偏差に基づき、体温、脈拍、収縮期血圧、拡張期血圧、脈圧、呼吸数の測定値に対するスコアリング基準情報102及び基準域条件220が設定される。 The vital average value and the vital standard deviation are based on the vital information 8a and the remeasured vital information 13a recorded in the information recording unit 4, and the calculation unit 2 functions as the average value calculation means 14 and the standard deviation calculation means 15 of the reference calculation means 5. Is calculated. Further, based on the vital mean value and the vital standard deviation, scoring reference information 102 and reference range condition 220 for measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure, and respiratory rate are set.
 バイタル平均値、バイタル標準偏差及びこれらに基づくスコアリング基準情報102及び基準域条件220の設定方法として、情報記録部4に記録されたバイタル情報8a及び再測定バイタル情報13aをバイタル平均値等の算出に利用する方法が挙げられる。本方法では、バイタル平均値とバイタル情報の分布に基づく標準偏差は、平均値算出手段14及び標準偏差算出手段15において、以下の式(3)及び式(4)を用いて算出される。 As a method of setting the vital average value, the vital standard deviation, and the scoring reference information 102 and the reference area condition 220 based on these, the vital information 8a and the remeasured vital information 13a recorded in the information recording unit 4 are calculated as the vital average value and the like. There is a method to use for. In this method, the standard deviation based on the distribution of the vital mean value and the vital information is calculated by the mean value calculating means 14 and the standard deviation calculating means 15 using the following equations (3) and (4).
 μ=(1/N)×ΣSi・・・式(3)
 σ=√((1/N)×Σ(Si-μ))・・・式(4)
 ここでμはバイタル情報の平均値、Siは各バイタル情報の計測値、Nは全バイタル情報のデータ数であり、σは標準偏差である。ΣSiは、全バイタル情報の計測値の合計を示す。また、各バイタル情報の計測値とは、上述したように、設定した所定の条件で取得したバイタル情報の値である。なお、ここでいう全バイタル情報の内容は、上述したように、情報記録部4に記録された情報の一部を抽出するものであってよい。また、ここでのバイタル情報とは、体温、脈拍、収縮期血圧、拡張期血圧、脈圧、呼吸数の測定値である。
μ = (1 / N) × ΣSi ・ ・ ・ Equation (3)
σ = √ ((1 / N) × Σ (Si−μ) 2 ) ・ ・ ・ Equation (4)
Here, μ is the average value of vital information, Si is the measured value of each vital information, N is the number of data of all vital information, and σ is the standard deviation. ΣSi indicates the total of the measured values of all vital information. Further, the measured value of each vital information is a value of vital information acquired under a set predetermined condition as described above. As described above, the content of all vital information referred to here may be a part of the information recorded in the information recording unit 4. The vital information here is measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure, and respiratory rate.
 ある判定時点において、対象者のバイタル情報を判定する際には、判定時点を起点に、情報記録部4に記録された同一の対象者のデータから、上記の式(3)、式(4)を用いて、バイタル平均値μ、バイタル標準偏差σが算出される。即ち、判定時点に測定した判定の対象となるバイタルサインの値を含めて、スコアリング基準情報102及び基準域条件220が算出される。 When determining the vital information of the target person at a certain determination time point, the above equations (3) and (4) are used from the data of the same target person recorded in the information recording unit 4 starting from the determination time point. Is used to calculate the vital mean value μ and the vital standard deviation σ. That is, the scoring reference information 102 and the reference area condition 220 are calculated including the value of the vital sign to be determined, which is measured at the time of determination.
 続いて、スコアリング基準設定手段101が、以下の式(1)又は式(2)で表される値を、基準域条件220として利用する。 Subsequently, the scoring standard setting means 101 uses the value represented by the following equation (1) or equation (2) as the reference region condition 220.
 μ-nσ・・・式(1)
 μ+mσ・・・式(2)
 ここでn、mは0より大きい数である。
μ-nσ ・ ・ ・ Equation (1)
μ + mσ ・ ・ ・ Equation (2)
Here, n and m are numbers larger than 0.
 また、スコアリング基準設定手段101が、以下の式(1)又は式(2)で表される値を、スコアリング基準情報102として利用してもよい。 Further, the scoring standard setting means 101 may use the value represented by the following formula (1) or formula (2) as the scoring standard information 102.
 μ-nσ・・・式(1)
 μ+mσ・・・式(2)
 ここでn、mは0より大きい数である。
μ-nσ ・ ・ ・ Equation (1)
μ + mσ ・ ・ ・ Equation (2)
Here, n and m are numbers larger than 0.
 基準域条件220では、上記の式(1)及び式(2)で表された値と、所定のスコア値情報103、即ち、0点~2点の点数の情報が組み合わされている。基準域条件220、スコアリング基準情報102と、スコア値情報103との組み合わせは、下記の表2に示す通りである。 In the reference area condition 220, the values represented by the above equations (1) and (2) and the predetermined score value information 103, that is, the information of the points of 0 to 2 points are combined. The combinations of the reference area condition 220, the scoring reference information 102, and the score value information 103 are as shown in Table 2 below.
Figure JPOXMLDOC01-appb-T000002
 なお、表2において、「-3σ」は、式(1)に基づく「μ-3σ」の値であり、「-2σ」は、式(1)に基づく「μ-2σ」の値であり、「+3σ」は、式(2)に基づく「μ+3σ」の値であり、「+2σ」は、式(2)に基づく「μ+2σ」の値を意味している。また、μ及びσは、所定の条件(例えば30個分のバイタル情報8a)で測定された各バイタルサインの測定値から算出される値である。
Figure JPOXMLDOC01-appb-T000002
In Table 2, "-3σ" is the value of "μ-3σ" based on the equation (1), and "-2σ" is the value of "μ-2σ" based on the equation (1). “+ 3σ” means the value of “μ + 3σ” based on the equation (2), and “+ 2σ” means the value of “μ + 2σ” based on the equation (2). Further, μ and σ are values calculated from the measured values of each vital sign measured under predetermined conditions (for example, 30 vital information 8a).
 表2に示すように、体温、脈拍、収縮期血圧、拡張期血圧、脈圧及び呼吸数の測定値について、その内容に基づいて、0点~2点の各スコア値にスコアリングする際には、上記の式(1)及び式(2)に基づき算出された「μ±2σ及びμ±3σ」の値が利用されている。 As shown in Table 2, when scoring the measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure and respiratory rate to each score value of 0 to 2 points based on the contents. The values of "μ ± 2σ and μ ± 3σ" calculated based on the above equations (1) and (2) are used.
 より詳細には、入力されたバイタルサインの測定値が、その判定時点において算出されたバイタル平均値及びバイタル標準偏差において、「μ-2σ超(以上)~μ+2σ未満(以下)」の値であれば0点のスコア、「μ-3σ超(以上)~μ-2σ以下(未満)」、又は、「μ+2σ以上(超)~μ+3σ未満(以下)」の値であれば1点のスコア、「μ-3σ以下(未満)」、又は、「μ+3σ以上(超)」の値であれば2点のスコアとなる。 More specifically, the input vital sign measurement value may be a value of "more than μ-2σ (or more) to less than μ + 2σ (or less)" in the vital mean value and vital standard deviation calculated at the time of the determination. For example, a score of 0 points, a score of 1 point if the value is "more than μ-3σ (greater than or equal to) to less than μ-2σ (less than)" or "more than μ + 2σ (greater than) to less than μ + 3σ (less than or equal to)". If the value is "μ-3σ or less (less than)" or "μ + 3σ or more (super)", the score is 2 points.
 入力されたバイタルサインの測定値に対するスコアリングは、判定時点において算出されたバイタル平均値、バイタル標準偏差により、判定時点ごとの基準が設定される。また、体温、脈拍、収縮期血圧、拡張期血圧、脈圧、呼吸数の測定値は、正規分布に従うバイタルサインであり、上記式(1)又は式(2)の基づき算出された基準域条件220は、対象者の個体内変動が反映された基準であり、かつ、その対象者の正規分布に基づき設定された基準となる。そのため、対象者の体調の変動を正確に捉えることが可能な指標となる。 For scoring of the input vital sign measurement value, the standard for each judgment time is set based on the vital average value and vital standard deviation calculated at the time of judgment. The measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure, and respiratory rate are vital signs according to a normal distribution, and are reference region conditions calculated based on the above equation (1) or (2). 220 is a standard that reflects the intra-individual variation of the target person and is a standard set based on the normal distribution of the target person. Therefore, it is an index that can accurately grasp the fluctuation of the physical condition of the subject.
 なお、表2で示すスコア値情報103の配点の内容は一例であり、必ずしも表2の内容に限定されるものではなく、各範囲とスコア値情報103の配点は適宜設定変更が可能である。 Note that the content of the score value information 103 shown in Table 2 is an example, and is not necessarily limited to the content of Table 2, and the settings of each range and the score value information 103 can be changed as appropriate.
 また、必ずしも、基準域条件220として「μ±2σ及びμ±3σ」の条件が設定される必要はなく、「2σ及び3σ」以外の数値が採用されてもよい。但し、「μ±2σ」の範囲には、通常、対象者のバイタルサインの約95%が含まれるため、「正常なバイタルの範囲(対象者の通常のバイタルの範囲)」と位置付けた基準にしやすい範囲である。そのため、基準域条件220の代表的な設定事例として、「μ±2σ」の条件が設定されることが好ましい。 Further, it is not always necessary to set the condition of "μ ± 2σ and μ ± 3σ" as the reference region condition 220, and numerical values other than "2σ and 3σ" may be adopted. However, since the range of "μ ± 2σ" usually includes about 95% of the vital signs of the subject, it is used as the standard positioned as "the range of normal vitals (the range of the subject's normal vitals)". It is an easy range. Therefore, it is preferable that the condition of "μ ± 2σ" is set as a typical setting example of the reference region condition 220.
 また、表2に示すスコアリング基準情報102では、スコア値情報103は0点から2点の範囲で設定されているが、必ずしもこの範囲に限定される必要はない。例えば、スコア値情報を0点、1点、2点及び3点の範囲でスコアリングする設定に変更することも可能である。更には、3点より大きな数値を採用することも可能である。スコア値情報103を変更する場合、これに合わせて基準域条件220及びスコアリング基準情報102を適宜設定可能であることは言うまでもない。 Further, in the scoring standard information 102 shown in Table 2, the score value information 103 is set in the range of 0 points to 2 points, but it is not necessarily limited to this range. For example, it is possible to change the score value information to a setting of scoring in the range of 0 points, 1 point, 2 points, and 3 points. Furthermore, it is possible to adopt a numerical value larger than 3 points. Needless to say, when the score value information 103 is changed, the reference area condition 220 and the scoring reference information 102 can be appropriately set accordingly.
[6-2.酸素飽和度の測定値について]
 対象者から測定された酸素飽和度の測定値に対するスコアリング基準情報102の設定方法として、一定の数値範囲の情報を基準として設定する。表2に示す内容では、酸素飽和度の測定値について、0~2点の各スコア値にスコアリングする際には、「93~100(%)」が0点のスコア、「90~92(%)」が1点のスコア、「85~89(%)」が2点のスコアとなるように設定されている。
[6-2. About measured oxygen saturation]
As a method of setting the scoring reference information 102 for the measured value of oxygen saturation measured from the subject, the information in a certain numerical range is set as a reference. In the contents shown in Table 2, when scoring each score value of 0 to 2 points for the measured value of oxygen saturation, "93 to 100 (%)" is a score of 0 points, and "90 to 92 (" %) ”Is set to have a score of 1 point, and“ 85 to 89 (%) ”is set to have a score of 2 points.
 入力された酸素飽和度の測定値に対して、表2に示すスコアリング基準情報102に基づき、0~2点のスコア値情報103が算出される。 With respect to the input measured value of oxygen saturation, score value information 103 of 0 to 2 points is calculated based on the scoring reference information 102 shown in Table 2.
 ここで、表2に示す酸素飽和度に対するスコアリング基準情報102の内容はこれに限定されるものではない。0~2点のスコア値情報を分ける数値範囲は、適宜設定を変更して、スコアリング基準情報102とすることができる。 Here, the content of the scoring reference information 102 for the oxygen saturation shown in Table 2 is not limited to this. The numerical range for dividing the score value information of 0 to 2 points can be set as the scoring reference information 102 by appropriately changing the setting.
[6-3.意識レベルについて]
 対象者に対して、介護者等が意識レベルを確認して、取得された結果について、スコアリング基準情報102として設定された所定の観察情報に当てはめる作業を行う。意識レベルの確認は、既知のAVPU評価を利用しうる。
[6-3. Consciousness level]
The caregiver or the like confirms the consciousness level of the target person, and applies the acquired result to the predetermined observation information set as the scoring reference information 102. A known AVPU assessment can be used to confirm the level of consciousness.
 AVPU評価では、正常(覚醒して見当識あり、A:alert)、異常(言葉により反応するが、見当識なし、V:verbal)、痛みに反応(痛みにのみ反応、P:Pain)、無意識(言葉にも痛みにも反応しない、U:Unresponsive)が所定の観察状態として設定されている。介護者等が対象者を観察して、その意識レベルがAVPU評価のどの項目に該当するかを判断して、その結果を、入力部3a等を介して入力する。 In the AVPU evaluation, normal (awakening and disorientation, A: alert), abnormal (verbal response, but no disorientation, V: verbal), pain response (pain only response, P: Pain), unconscious (U: Unresponsive, which does not respond to words or pain) is set as the predetermined observation state. The caregiver or the like observes the subject, determines which item of the AVPU evaluation the consciousness level corresponds to, and inputs the result via the input unit 3a or the like.
 意識レベルに対するスコアリング基準情報102は、表2に示す内容で設定されている。表2では、正常が0点のスコア、異常が1点のスコア、痛みに無反応が2点のスコアとなるように設定されている。介護者等が入力した情報により、スコアリング処理手段100がスコア値情報103を算出する。 The scoring standard information 102 for the consciousness level is set as shown in Table 2. In Table 2, normal scores are set to 0 points, abnormal scores are set to 1 point, and no response to pain is set to a score of 2 points. The scoring processing means 100 calculates the score value information 103 based on the information input by the caregiver or the like.
 ここで、表2に示す対象者の意識レベルの評価結果に対するスコアリング基準情報102の内容はこれに限定されるものではない。AVPU評価以外の意識レベルの評価手法が採用されてもよい。また、0~3点のスコア値情報を分ける観察状態は、適宜設定を変更して、スコアリング基準情報102とすることができる。 Here, the content of the scoring standard information 102 for the evaluation result of the consciousness level of the subject shown in Table 2 is not limited to this. A consciousness level evaluation method other than the AVPU evaluation may be adopted. Further, the observation state for dividing the score value information of 0 to 3 points can be set as the scoring reference information 102 by appropriately changing the setting.
 以上の内容では、対象者のバイタルサインのうち、体温、脈拍、収縮期血圧、拡張期血圧、脈圧、呼吸数、酸素飽和度の測定値と、意識レベルの評価結果を用いてスコアリングを行い、スコア値情報103を算出する。ここで、必ずしも、対象者のバイタルサインがこれらの内容に限定される必要はない。例えば、スコアリングを行う対象として、対象者から得られた尿量、体重、痛み(痛みの有無や程度)、その他の病状異常をバイタルサインの情報として採用することも考えられる。 In the above contents, among the vital signs of the subject, scoring is performed using the measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure, respiratory rate, oxygen saturation, and the evaluation result of the consciousness level. This is performed, and the score value information 103 is calculated. Here, the vital signs of the subject do not necessarily have to be limited to these contents. For example, it is conceivable to use the urine volume, body weight, pain (presence or absence or degree of pain), and other medical condition abnormalities obtained from the subject as vital sign information as the target for scoring.
[6-4.判定処理部による異常の判定について]
 各バイタルサインの種類ごとに、0点~2点のスコア値情報103が算出され、各スコア値情報103から、スコアリング処理手段100がスコア値情報103の「合計点」を算出する。即ち、収縮期血圧から意識レベルまでの各バイタルサインのスコア値情報103を足して、その合計点を算出する。
[6-4. Judgment of abnormality by the judgment processing unit]
Score value information 103 of 0 points to 2 points is calculated for each type of vital signs, and the scoring processing means 100 calculates the "total point" of the score value information 103 from each score value information 103. That is, the score value information 103 of each vital sign from the systolic blood pressure to the consciousness level is added to calculate the total score.
 そして、判定処理手段6は、各バイタルサインのスコア値情報103の合計点から対象者の体調における「正常又は異常(注意、警告)」の判定を行う。この判定は、以下、表3に示す内容(スコア判定基準情報18)に基づき結果が出されるものとなる。 Then, the determination processing means 6 determines "normal or abnormal (caution, warning)" in the physical condition of the subject from the total score of the score value information 103 of each vital sign. The result of this determination will be obtained based on the contents shown in Table 3 (score determination standard information 18).
Figure JPOXMLDOC01-appb-T000003
Figure JPOXMLDOC01-appb-T000003
 表3に示すように、判定処理手段6は、スコア値情報103の合計点について、0点が算出された際には、「正常」と判定する。また、スコア値情報103の合計点について、1点が算出された際には「単一のバイタル異常」と判定し、2点が算出された際には「注意」、3点が算出された際には「警告」と判定する。 As shown in Table 3, the determination processing means 6 determines that the total score of the score value information 103 is "normal" when 0 points are calculated. In addition, regarding the total score of the score value information 103, when 1 point was calculated, it was determined as "single vital abnormality", and when 2 points were calculated, "caution" and 3 points were calculated. In that case, it is judged as "warning".
 また、本発明における対象者の体調が「異常」であると判断されるのは、2点の「注意」、または、3点の「警告」の結果が出た場合が該当する。即ち、本構成では、「異常」の結果は、「注意」と「警告」の2段階に分けて判定されている。 In addition, the physical condition of the subject in the present invention is determined to be "abnormal" when two points of "caution" or three points of "warning" are obtained. That is, in this configuration, the result of "abnormality" is determined in two stages of "caution" and "warning".
 また、各バイタルサインの値から算出されたスコア値情報103の合計点と、この値に対する注意等のスコア判定結果情報12は、対象者に紐付けて情報記録部4に記録される。 Further, the total score of the score value information 103 calculated from the value of each vital sign and the score determination result information 12 such as attention to this value are recorded in the information recording unit 4 in association with the target person.
 また、判定処理手段6が各バイタルサインのスコア値情報103の合計点について「注意」または「警告」の判定を行った際には、アラート通知手段120、情報送受信部3cを介して、健康状態管理装置1で警告音を発したり、外部端末等に「警告」の判定がなされた旨のメールを送信したりする構成となっている。また、各結果に応じて、結果の情報を表示する際には、表に示す内容で、結果の情報を表示する色が異なるように設定されている。 Further, when the determination processing means 6 determines "caution" or "warning" for the total score of the score value information 103 of each vital sign, the health state is determined via the alert notification means 120 and the information transmission / reception unit 3c. The management device 1 emits a warning sound and sends an e-mail to the outside terminal or the like to the effect that a "warning" determination has been made. Further, when displaying the result information according to each result, the color for displaying the result information is set to be different according to the contents shown in the table.
 ここで、必ずしも、対象者の異常の判定が「注意」または「警告」の2段階に分けて出される構成となる必要はなく、「異常」なる結果として、1まとめにしてもよい。但し、対象者の体調に異常につき、程度を分けて確認可能となる点から、異常の判定が「注意」または「警告」の2段階に分けて出される構成となることが好ましい。 Here, it is not always necessary that the determination of the abnormality of the target person is made in two stages of "caution" or "warning", and as a result of "abnormality", it may be summarized as one. However, since it is possible to confirm the abnormality in the physical condition of the subject by dividing the degree, it is preferable that the abnormality is judged in two stages of "caution" and "warning".
 また、判定処理手段6がスコア値情報103について、異常(注意、警告)と判定する数値が2点以上に限定されるものではない。例えば、3点以上で異常(注意、警告)とする判定が採用されてもよい。 Further, the numerical value determined by the determination processing means 6 to be abnormal (caution, warning) with respect to the score value information 103 is not limited to two or more points. For example, a determination of 3 points or more as an abnormality (caution, warning) may be adopted.
 ここで、本発明では、各バイタルサインのスコア値情報103の合計点に対して異常か否かの判定を行う点、合計点が1点の場合、「単一のバイタル異常」として、対象者の「異常」と判定しない点、及び、アラート通知手段120により警報が通知されない点が重要な特徴となっている。 Here, in the present invention, a point for determining whether or not the total score of the score value information 103 of each vital sign is abnormal, and when the total score is one point, the subject is regarded as a "single vital abnormality". The important features are that it is not determined to be "abnormal" and that the alert notification means 120 does not notify the alarm.
 まず、本発明では、バイタル除外基準情報200を設けたことで、バイタルサインの測定値をスコアリングする際の基準域条件220の異常検知の精度が高められている。この基準域条件220は、対象者における通常の正常域とみなせるバイタルサインの範囲と見なせるが、この範囲は、バイタル除外条件を満たす測定値が除外され、バイタル情報8aが抽出されたことで、除外前よりも範囲が絞られることになる。 First, in the present invention, by providing the vital exclusion reference information 200, the accuracy of abnormality detection of the reference range condition 220 when scoring the measured value of vital signs is improved. This reference area condition 220 can be regarded as a range of vital signs that can be regarded as a normal normal area in the subject, but this range is excluded because the measured values satisfying the vital exclusion condition are excluded and the vital information 8a is extracted. The range will be narrower than before.
 つまり、基準域条件220の範囲が絞られたことで、個々のバイタルサインの異常は出やすくなる。そして、個々のバイタルサインの異常は、「μ±2σ」の範囲を超えると、少なくとも、スコア値情報103では、1点以上の結果になる。また、バイタルサインの異常の度合いが大きければ(3σの範囲を超える)2点の結果になる。 In other words, by narrowing down the range of the reference area condition 220, abnormalities in individual vital signs are likely to occur. Then, when the abnormality of each vital sign exceeds the range of “μ ± 2σ”, at least one or more points are obtained in the score value information 103. Further, if the degree of abnormality of vital signs is large (exceeding the range of 3σ), the result is 2 points.
 そのため、個々のバイタルサインで、その異常を見た場合、異常の検知の精度が高く、1点以上のスコア値情報103が出やすくなっているといえる。また、ここで、判定処理手段6は、各バイタルサインのスコア値情報103の合計点に対して異常か否かの判定を行い、合計点が2点以上にならなければ、最終的に、対象者が「異常(注意または警告)」であるとの判定はなされない。 Therefore, when the abnormality is seen in each vital sign, it can be said that the accuracy of detecting the abnormality is high and it is easy to obtain score value information 103 of 1 point or more. Further, here, the determination processing means 6 determines whether or not the total score of the score value information 103 of each vital sign is abnormal, and if the total score is not 2 points or more, the final target is No person is determined to be "abnormal (caution or warning)".
 言い換えれば、単一のバイタルサインにつき、異常として、1点の結果が出ても、その結果のみでは、対象者が「異常(注意または警告)」であるとの判定はなされない。対象者が「異常」と判定されるには、2種類以上のバイタルサインにおいて、1点の結果が出るか、単一のバイタルサインで、2点の結果が出るような深刻な異常が検知される必要がある。 In other words, even if one result is obtained as an abnormality for a single vital sign, it is not judged that the subject is "abnormal (caution or warning)" based on the result alone. In order for the subject to be judged as "abnormal", a serious abnormality such as one point result in two or more types of vital signs or two points result in a single vital sign is detected. Need to be.
 この結果、各バイタルサインが異常であるか否かは精度高く検知しつつ、単一のバイタルサインにつき、異常として1点の結果が出ただけでは、アラート通知手段120による警報は出ない。即ち、頻繁に警報が鳴ること(偽陽性の検出)が抑止できる。 As a result, while accurately detecting whether or not each vital sign is abnormal, if only one result is obtained as an abnormality for a single vital sign, the alert notification means 120 does not issue an alarm. That is, it is possible to suppress the frequent sounding of alarms (detection of false positives).
 また、判定処理手段6が、対象者が異常と判定した場合には、複数のバイタルサインの結果から判定がなされていることから、信頼性の高い判定結果として捉えることができる。 Further, when the determination processing means 6 determines that the target person is abnormal, the determination is made from the results of a plurality of vital signs, so that it can be regarded as a highly reliable determination result.
 従って、本発明では、各バイタルサインのスコア値情報103の合計点に対して異常か否かの判定を行う点、合計点が1点の場合、「単一のバイタル異常」として、対象者の「異常」と判定しない点、及び、アラート通知手段120により警報が通知されない点が重要な特徴となっている。 Therefore, in the present invention, a point for determining whether or not the total score of the score value information 103 of each vital sign is abnormal, and when the total score is 1, it is regarded as a "single vital abnormality" of the subject. The important features are that it is not determined to be "abnormal" and that the alert notification means 120 does not notify the alarm.
 ここで、表2に示す基準域条件220及びスコアリング基準情報102では、スコアリングされる対象(マーカー)として、収縮期血圧、拡張期血圧、脈圧、脈拍、体温、酸素飽和度、呼吸数、意識レベルが挙げられているが、これは一例に過ぎない。また、スコアリング基準情報102での点数を区別する閾値も一例に過ぎない。 Here, in the reference region condition 220 and the scoring reference information 102 shown in Table 2, systolic blood pressure, diastolic blood pressure, pulse pressure, pulse, body temperature, oxygen saturation, and respiratory rate are used as scoring targets (markers). , Awareness level is mentioned, but this is just an example. Further, the threshold value for distinguishing the points in the scoring reference information 102 is only an example.
 即ち、マーカーの種類や点数を区別する閾値は、対象者が有する疾患の種類や、対象者の性質によって異ならせて設定することが可能である。例えば、心不全を有する対象者と、***を有する対象者では、マーカーの種類や点数を区別する閾値を異ならせて設定する。また、マーカーとして、血圧において、収縮期血圧のみを採用する場合や、収縮期血圧と拡張期血圧の両方を採用する場合もある。また、例えば、健常者である対象者と、持病を有する高齢者である対象者では、やはり、マーカーの種類や点数を区別する閾値を異ならせて設定する。 That is, the threshold value for distinguishing the type of marker and the score can be set differently depending on the type of disease possessed by the subject and the nature of the subject. For example, a subject having heart failure and a subject having a urinary tract infection are set with different thresholds for distinguishing the type and score of markers. In addition, as a marker, there are cases where only systolic blood pressure is adopted, or both systolic blood pressure and diastolic blood pressure are adopted. Further, for example, a subject who is a healthy person and a subject who is an elderly person having a chronic disease are set with different threshold values for distinguishing the type and score of the marker.
 また、スコアリング基準情報102には、マーカーとして、対象者の既往歴や、対象者の家族や近親者における病的状態である家族歴、生活習慣等の種類を含めて、スコアリングする態様もある。 In addition, the scoring standard information 102 also includes a mode of scoring as a marker, including a history of the subject, a family history of a morbid state in the subject's family and close relatives, a lifestyle, and the like. is there.
 この場合、例えば、心臓病の既往歴の対象者や、家族に心臓病を患った人がいる対象者に対して、心不全の程度を判断するためにスコアリングを行う際には、既往歴または家族歴のマーカーに点数が付与され、スコア値情報103の合計点に加点される。また、例えば、喫煙の生活習慣がある対象者には、生活習慣のマーカーに点数が付与され、スコア値情報103の合計点に加点される。このように、マーカーとして別項目を設けて、合計点に加算する構成も採用しうる。 In this case, for example, when scoring a subject with a history of heart disease or a subject who has a family member with heart disease to determine the degree of heart failure, the history or A score is given to the family history marker, and points are added to the total score of the score value information 103. Further, for example, a subject who has a lifestyle of smoking is given a score as a marker of the lifestyle and is added to the total score of the score value information 103. In this way, it is possible to adopt a configuration in which another item is provided as a marker and the total score is added.
 続いて、複数の対象者のバイタル情報を利用して、異なる個体の情報に基づくバイタル情報の分布を作成した場合と、同一の対象者のバイタル情報を利用して、同一個体のバイタル情報の分布を作成した場合との違いについて、説明する。 Subsequently, when the vital information of a plurality of subjects is used to create a distribution of vital information based on the information of different individuals, and when the vital information of the same subject is used, the distribution of vital information of the same individual is used. The difference from the case of creating is explained.
 図20(a)及び図20(b)は、いずれも体温の情報を元に作成された正規分布曲線のグラフである。図20(a)及び図20(b)において、横軸は体温の確率変数、縦軸は確率密度である。(a)は多数の対象者で作成し、(b)は、同一の対象者のみで作成されている。図20(a)では、様々な平熱や、体温の変動をする人が含まれており、平均値μは多数の対象者の平均値である37.0℃となり、μ+2σの値は37.7℃、μ-2σの値は36.0℃となっている。 Both FIGS. 20 (a) and 20 (b) are graphs of a normal distribution curve created based on body temperature information. In FIGS. 20 (a) and 20 (b), the horizontal axis is a random variable of body temperature, and the vertical axis is a probability density. (A) is created by a large number of subjects, and (b) is created only by the same subject. FIG. 20 (a) includes people with various normal temperatures and fluctuations in body temperature, and the average value μ is 37.0 ° C., which is the average value of a large number of subjects, and the value of μ + 2σ is 37.7. The values of ° C and μ-2σ are 36.0 ° C.
 しかしながら、図20(b)では、同一個体のバイタル情報を記録したものであり、その人特有の平熱や、体温の変動となるため、平均値μは35.6℃、μ+2σの値は37.0℃、μ-2σの値は35.2℃となる。 However, in FIG. 20 (b), the vital information of the same individual is recorded, and the average value μ is 35.6 ° C. and the value of μ + 2σ is 37. The value of 0 ° C. and μ-2σ is 35.2 ° C.
 即ち、仮に、各分布を用いて、スコアリングをする際のあるスコア値に安定される基準値をμ+2σに設定すると、図20(a)の方では、37.0℃の体温はμの位置(図20(a)中の黒い丸)に該当する。一方、図20(b)の方では、37.℃の体温は、上限値であるμ+2σの位置(図20(b)中の黒い丸)になる。つまり、図20(a)に示す分布と、図20(b)に示す分布では、分布上における同じμ+2σの数値が全く違う値になる。そのため、スコアリング基準情報102やスコア値情報103も変わり、判定結果も異なるものとなる。換言すれば、図20(b)の対象者の判定を行う上では、多数の対象者のバイタル情報に基づくスコアリング基準情報102やスコア値情報103は、「異常な値」を捉えるために使用できないものといえる。多数の人数のバイタル情報を基準に用いることは、従来行われていた「個体間変動」での判定に他ならず、対象者に特有のバイタル情報の変動をみるためには、「個体内変動」が有効であることを示している。 That is, if each distribution is used and the reference value stabilized at a certain score value at the time of scoring is set to μ + 2σ, in FIG. 20 (a), the body temperature at 37.0 ° C. is at the position of μ. (Black circle in FIG. 20 (a)). On the other hand, in FIG. 20 (b), 37. The body temperature at ° C. is at the upper limit of μ + 2σ (black circle in FIG. 20B). That is, in the distribution shown in FIG. 20 (a) and the distribution shown in FIG. 20 (b), the same numerical value of μ + 2σ on the distribution is a completely different value. Therefore, the scoring reference information 102 and the score value information 103 also change, and the determination result also differs. In other words, in determining the target person in FIG. 20B, the scoring reference information 102 and the score value information 103 based on the vital information of a large number of target persons are used to capture the "abnormal value". It can be said that it cannot be done. Using the vital information of a large number of people as a standard is nothing but the conventional judgment based on "inter-individual variation", and in order to see the variation of vital information peculiar to the subject, "intra-individual variation" Indicates that is valid.
 なお、図20(b)に示す体温の平均値や変動を行う対象者は、特殊な事例にあたるものではない。また、体温に限って起こる現象ではなく、その他のバイタルサインである収縮期血圧、拡張期血圧、脈拍数、呼吸数でも、対象者に固有の変動が生じ、これらは正規分布に従うものとなる。上記の体温の例でいえば、図20(b)に示す温度域で体温が変化する高齢者は多く、このような高齢者の健康状態の判定をバイタルサインで行う際には、「個体内変動」が有効である。 It should be noted that the subject who performs the average value and fluctuation of the body temperature shown in FIG. 20 (b) does not correspond to a special case. In addition, not only the phenomenon that occurs only in body temperature, but also other vital signs such as systolic blood pressure, diastolic blood pressure, pulse rate, and respiratory rate cause fluctuations peculiar to the subject, and these follow a normal distribution. In the above example of body temperature, there are many elderly people whose body temperature changes in the temperature range shown in FIG. 20 (b), and when determining the health condition of such elderly people by vital signs, "individual" "Fluctuation" is effective.
[7.表示情報の作成]
 本発明を適用した健康状態判定装置1では、対象者のバイタル情報について、その内容を正規分布曲線として表示することが可能である。また、対象者のバイタル情報を熱型表として表示することも可能である。
[7. Create display information]
In the health condition determination device 1 to which the present invention is applied, it is possible to display the contents of the vital information of the subject as a normal distribution curve. It is also possible to display the vital information of the target person as a heat type table.
 熱型表の一例として、図21を示す。図21には、ある対象者に関する判定時点のバイタル情報と、バイタル情報の内容に基づくスコア値情報の値が異常な値であったか否かの情報(警告、注意、正常の情報)、対象者の観察や問診結果による異常の有無の情報、スコア値情報の合計点の情報が表示されている。 FIG. 21 is shown as an example of the heat type table. FIG. 21 shows vital information at the time of judgment regarding a certain target person, information on whether or not the value of the score value information based on the content of the vital information is an abnormal value (warning, caution, normal information), and the target person. Information on the presence or absence of abnormalities based on observations and interview results, and information on the total score of score value information are displayed.
 また、図21に示す熱型表では、対象者の健康状態のリスクファクターである既往歴の情報と、生活習慣に関する情報が表示されている。また、熱型表には、対象者の詳細な観察情報や、特記事項の情報が表示されている。熱型表に表示される情報は、入力部3a等を介して入力された情報を元に作成することができるものとなっている。 In addition, in the heat type table shown in FIG. 21, information on the medical history, which is a risk factor for the health condition of the subject, and information on lifestyle-related habits are displayed. In addition, detailed observation information of the subject and information on special notes are displayed on the heat type table. The information displayed on the heat type table can be created based on the information input via the input unit 3a or the like.
 また、図22には、病院等に設置した端末で利用する電子カルテにおいて、その電子カルテの表示情報の1つである熱型表の中に、バイタル情報の内容に基づくスコア値情報の値を示した画像を示している。例えば、複数のバイタル情報のスコア値を合計して、その日ごとのスコア値の合計値を表示するような態様が考えられる。この場合、入院患者の情報が記録された電子カルテの情報と併せて、スコアリングの結果に基づく情報を、対象者のリスク評価に利用することができる。 Further, in FIG. 22, in an electronic medical record used in a terminal installed in a hospital or the like, a value of score value information based on the content of vital information is displayed in a heat type table which is one of the display information of the electronic medical record. The image shown is shown. For example, it is conceivable to sum the score values of a plurality of vital information and display the total value of the score values for each day. In this case, the information based on the scoring result can be used for the risk evaluation of the subject together with the information of the electronic medical record in which the information of the inpatient is recorded.
 更に、図23には、本発明のソフトウェアの機能を有するアプリケーションソフトウェアをスマートフォン端末等で利用する際に、その画面上にバイタル情報の内容に基づくスコア値情報の値を示した画像を示している。例えば、スマートフォン端末の使用者個人のバイタル情報の記録(体温)と、そのスコア値情報の値を示す態様がある。この場合、スマートフォンでの健康管理や、在宅医療での健康状態の評価に、スコアリングの結果に基づく情報を活用することができる。 Further, FIG. 23 shows an image showing the value of the score value information based on the content of the vital information on the screen when the application software having the function of the software of the present invention is used on a smartphone terminal or the like. .. For example, there is an aspect of recording vital information (body temperature) of an individual user of a smartphone terminal and showing the value of the score value information. In this case, information based on the scoring result can be used for health management on a smartphone and evaluation of a health condition in home medical care.
[8.正規分布の有無による測定精度の判定及び異常な値の判定]
 本発明を適用した健康状態判定装置1では、測定したバイタル情報が正規分布に当て嵌まっているかを確認する手法として、Q-Qプロットが利用できる。例えば、横軸にバイタル標準偏差の値を、縦軸に標準偏差の累積確率に対応する標準正規分布のパーセント点の値をとり、対象者のバイタル標準偏差をプロットする。各プロットが直線上に位置していれば、取得したバイタル情報が正規分布していることが視覚的に確認可能となる。
[8. Judgment of measurement accuracy and judgment of abnormal values based on the presence or absence of a normal distribution]
In the health condition determination device 1 to which the present invention is applied, a QQ plot can be used as a method for confirming whether the measured vital information fits into the normal distribution. For example, the horizontal axis represents the value of the vital standard deviation, and the vertical axis represents the value of the percentage point of the standard normal distribution corresponding to the cumulative probability of the standard deviation, and the vital standard deviation of the subject is plotted. If each plot is located on a straight line, it is possible to visually confirm that the acquired vital information is normally distributed.
 続いて、本発明を適用したソフトウェアにおける情報処理の一連の流れについて、図24を用いて説明する。
 図24には、バイタル情報の入力から異常の判定、結果の情報の表示までの情報処理の流れを示している。
 まず、初めに、対象者のバイタルサインの値(体温、脈拍、収縮期血圧、拡張期血圧、脈圧、酸素飽和度、呼吸数の測定値)が各測定機器により測定され、計測値と測定日時の情報が入力される(S1)。また、この際、対象者の意識レベルの評価結果から、バイタル基準情報102の観察情報の該当する情報が選択又は入力される。入力された情報は、対象者のバイタル情報として、情報記録部4(DB)に記録される(S2)。また、この際、バイタル除外基準情報200に基づき、バイタル情報8は、バイタル情報8a及びバイタル情報8bに分離して記録される。
Subsequently, a series of flow of information processing in the software to which the present invention is applied will be described with reference to FIG. 24.
FIG. 24 shows the flow of information processing from the input of vital information to the determination of abnormality and the display of result information.
First, the vital sign values of the subject (measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure, oxygen saturation, and respiratory rate) are measured by each measuring device, and the measured values and measurements are taken. The date and time information is input (S1). At this time, the corresponding information of the observation information of the vital reference information 102 is selected or input from the evaluation result of the consciousness level of the subject. The input information is recorded in the information recording unit 4 (DB) as vital information of the target person (S2). At this time, the vital information 8 is separately recorded as the vital information 8a and the vital information 8b based on the vital exclusion standard information 200.
 情報記録部4に記録された判定の対象となるバイタル情報を含めて(または含めず)、演算部2が基準算出手段5として機能して基準域条件220及びスコアリング基準情報102の算出を行う(S3)。ここでは、バイタル平均値と、バイタル標準偏差が算出され、これらの値を元に、設定した条件での基準域条件220及びスコアリング基準情報102が作成される。ここで、体温、脈拍、収縮期血圧、拡張期血圧、脈圧及び呼吸数に関する基準は、都度、スコアリングの度に算出されるものとなる。 Including (or not including) the vital information recorded in the information recording unit 4 to be determined, the calculation unit 2 functions as the reference calculation means 5 to calculate the reference area condition 220 and the scoring reference information 102. (S3). Here, the vital mean value and the vital standard deviation are calculated, and based on these values, the reference region condition 220 and the scoring reference information 102 under the set conditions are created. Here, the criteria for body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure and respiratory rate are calculated for each scoring.
 次に、入力された判定の対象のバイタル情報について、基準域条件220及びスコアリング基準情報102に基づき、スコアリング処理手段100により、スコア値情報103がバイタル情報ごとに算出される(S4)。 Next, with respect to the input vital information to be determined, the score value information 103 is calculated for each vital information by the scoring processing means 100 based on the reference area condition 220 and the scoring reference information 102 (S4).
 スコア値情報103が算出されると、その合計点が算出され、判定処理手段6が、判定基準に基づき、スコア値情報の合計点が異常な値であるか否かを判定する(S5)。判定の結果「異常な値(注意又は警告)である」と判定されないものについては、判定結果情報が、情報記録部4(DB)に記録され(S9)、判定結果の情報が表示部3bに表示される(S11)。また、アラート通知手段120により警報が通知される。 When the score value information 103 is calculated, the total score is calculated, and the determination processing means 6 determines whether or not the total score of the score value information is an abnormal value based on the determination criteria (S5). If the result of the determination is not determined to be "abnormal value (caution or warning)", the determination result information is recorded in the information recording unit 4 (DB) (S9), and the determination result information is displayed in the display unit 3b. It is displayed (S11). In addition, the alert notification means 120 notifies the alarm.
 また、対象者のバイタル情報を元に、バイタルサインの値の経時的な変化をグラフ化した熱型表(図22参照)や、正規分布の確立密度関数(正規分布曲線のグラフ)が表示情報として作成され(S10)、これらの情報も表示部3bにて確認可能となる。 In addition, based on the vital information of the subject, the thermal type table (see FIG. 22) that graphs the changes in vital sign values over time and the probability density function of the normal distribution (graph of the normal distribution curve) are displayed. (S10), and these information can also be confirmed on the display unit 3b.
 また、入力された判定の対象のバイタル情報について、判定基準に基づき、スコア値情報が、判定の結果「異常な値(注意又は警告)である」と判定されたものについては、例えば、表示部3bに「再測定を行いますか?」といった表示や、バイタルの取得時の姿勢の注意喚起を表示し、再測定バイタル情報の有無について対象者に確認する(S7)。 In addition, regarding the entered vital information to be judged, if the score value information is judged to be "abnormal value (caution or warning)" as a result of the judgment based on the judgment criteria, for example, the display unit. In 3b, a display such as "Do you want to remeasure?" Or a warning of the posture when acquiring vitals is displayed, and the subject is confirmed whether or not there is remeasurement vital information (S7).
 ここで、対象者や介護者等が「再測定バイタル情報なし」と選択すると、異常な判定との判定結果情報が、情報記録部4(DB)に記録され(S9)、判定結果の情報が表示部3bに表示される(S11)。更に、熱型表(図22参照)や、正規分布の確立密度関数(正規分布曲線のグラフ)が表示情報として作成され(S10)、これらの情報も表示部3bにて確認可能となる。 Here, when the target person, the caregiver, or the like selects "no remeasurement vital information", the judgment result information of the abnormal judgment is recorded in the information recording unit 4 (DB) (S9), and the judgment result information is recorded. It is displayed on the display unit 3b (S11). Further, a thermal type table (see FIG. 22) and a normal distribution establishment density function (normal distribution curve graph) are created as display information (S10), and these information can also be confirmed on the display unit 3b.
 また、情報記録部4は、異常な判定との判定結果となったバイタルサインの値を、バイタル情報8に含まれるように記録する。これにより、バイタル情報8には、スコア値情報が正常な値と判定されたバイタル情報と、スコア値情報が異常な値と判定されたバイタル情報の両方が蓄積されていく。 Further, the information recording unit 4 records the value of the vital sign that is the determination result of the abnormal determination so as to be included in the vital information 8. As a result, both the vital information in which the score value information is determined to be a normal value and the vital information in which the score value information is determined to be an abnormal value are accumulated in the vital information 8.
 また、対象者や介護者等が「再測定バイタル情報あり」と選択すると、再測定したバイタルサインの値と測定日時の入力を促し、入力された再測定バイタル情報が入力された情報は、対象者の再測定バイタル情報として、情報記録部4(DB)に記録される(S2)。この後は、再度、基準域条件220及びスコアリング基準情報の算出(S3)、再度のスコア値情報の異常判定(S4)がなされるものとなる。判定において、異常な値であるとの判定でなければ、判定結果情報が、情報記録部4(DB)に記録される(S9)。また、異常な値との判定であった際は、再測定バイタル情報の有無の確認(S6)のステップに進んでもよいし、2回目の判定結果であることから、そのまま判定結果情報の記録(S9)に進んでもよい。 In addition, when the target person or caregiver selects "with remeasurement vital information", the input of the remeasured vital sign value and the measurement date and time is prompted, and the information in which the input remeasurement vital information is input is the target. It is recorded in the information recording unit 4 (DB) as the remeasurement vital information of the person (S2). After that, the reference area condition 220 and the scoring reference information are calculated again (S3), and the abnormality determination of the score value information is performed again (S4). If it is not determined that the value is abnormal in the determination, the determination result information is recorded in the information recording unit 4 (DB) (S9). If it is determined that the value is abnormal, the process may proceed to the step of confirming the presence / absence of remeasurement vital information (S6), or since it is the second determination result, the determination result information is recorded as it is ( You may proceed to S9).
 対象者が判定結果の情報を表示部3bで確認したこことで、一連の情報処理が完了する。以上のような流れで、本発明を適用したソフトウェアはバイタル情報から健康状態の判定を行う。 A series of information processing is completed when the target person confirms the judgment result information on the display unit 3b. In the above flow, the software to which the present invention is applied determines the health condition from the vital information.
 以下、本発明を適用した健康状態判定装置の内容の更なる活用事例について説明する。 Hereinafter, a further application example of the contents of the health condition determination device to which the present invention is applied will be described.
[電子カルテや医療システムとの連動]
 本発明を適用した健康状態判定装置は、病院に導入された電子カルテと連動させる態様が考えられる。電子カルテには、設置された病院の患者の情報が記録されているため、上述した本発明を適用したソフトウェアで管理する情報と連動させることで、対象者のより詳細な基礎疾患の状況、既往歴、服薬記録、経過観察の情報等を利用可能となる。
[Linkage with electronic medical records and medical systems]
It is conceivable that the health condition determination device to which the present invention is applied is linked with an electronic medical record introduced in a hospital. Since the electronic medical record records the information of the patient in the hospital where the patient was set up, by linking it with the information managed by the software to which the present invention is applied, the subject's more detailed underlying disease status and medical history. Medical history, medication records, follow-up information, etc. will be available.
 また、更に、医師による診断の経過の情報も確認可能となるため、健康状態の判定精度の向上や、診断支援ツールとしての使い勝手が良くなるものとなる。また、病院での診断結果や検査の結果を対象者の情報に追加して記録していくことで、個人の情報量が増え、より精度の高い判定につながるものとなる。また、診断支援ツールとしても、より有用性の高いものとなる。 In addition, since information on the progress of diagnosis by a doctor can be confirmed, the accuracy of determining the health condition is improved and the usability as a diagnosis support tool is improved. In addition, by adding and recording the diagnosis result and the test result in the hospital to the information of the subject, the amount of personal information increases, which leads to more accurate judgment. It will also be more useful as a diagnostic support tool.
 また、本発明を適用した健康状態判定装置と、遠隔画像診断のシステムを組み合わせる態様も考えられる。例えば、健康状態判定装置にカメラ等の画像情報の取得が可能な機器を接続し、対象者の画像情報を病院側に送信して遠隔診断することも可能である。また、その際に、対象者の熱型表の情報も病院側の端末等に送信することで、対象者のバイタル値の異常等を確認しながら、遠隔地から医師が診断することが可能となる。 It is also conceivable to combine a health condition determination device to which the present invention is applied with a remote image diagnosis system. For example, it is possible to connect a device such as a camera capable of acquiring image information to a health condition determination device and transmit the image information of the subject to the hospital side for remote diagnosis. In addition, at that time, by sending the information of the subject's heat type table to the terminal etc. on the hospital side, it is possible for the doctor to make a diagnosis from a remote location while checking the abnormality of the subject's vital value etc. Become.
 また、本発明を適用した健康状態判定装置は、使用者のレベルに合わせた複数の運用版のバリエーションが考えられる。例えば、上述したような電子カルテと連動した態様であれば、病院における医師の診断時の診断支援ツールとなる。ここで、診断装置で管理する情報は、病院での日々の診断の情報が蓄積されていくため、医師の診断レベルの引き上げにも寄与するものとなる。 In addition, the health condition determination device to which the present invention is applied may have a plurality of variations of operational versions according to the level of the user. For example, if the mode is linked with the electronic medical record as described above, it will be a diagnostic support tool at the time of diagnosis by a doctor in a hospital. Here, the information managed by the diagnostic apparatus contributes to raising the diagnostic level of the doctor because the information of the daily diagnosis in the hospital is accumulated.
 また、病院において、本発明の機能を備えるタブレット端末等を特定の看護師に持たせることで、看護師が医師の代わりに診断を行う際の補助ツールとして使用することも可能となる。更にはタブレット端末を持った看護師が、在宅や施設に入居した高齢者を訪問看護する際にも役立つものとなる。 Further, in a hospital, by giving a specific nurse a tablet terminal or the like having the function of the present invention, it is possible for the nurse to use it as an auxiliary tool when making a diagnosis on behalf of a doctor. Furthermore, it will be useful for nurses with tablet terminals to visit and care for elderly people who have moved into homes or facilities.
 また、介護施設等の職員が使用するものについては、入居者に特化した情報を蓄積することで、特定の対象者に対する診断レベルを向上させることが可能となる。 In addition, for items used by staff such as long-term care facilities, it is possible to improve the diagnostic level for a specific target person by accumulating information specific to the resident.
[疾患の予防技術への応用]
 脳疾患、肺炎、心不全及び脱水等のバイタルサインの変動によって、発症が予測できる代表的な疾患の予防技術に本発明を適用した健康状態判定装置を利用することが考えられる。上述した各疾患は、発症する際に、疾患特有のバイタルサインの変動をする場合が多く、この疾患特有のバイタルサインの変動を判定条件として設定することで、発症の予防に繋げることができる。
[Application to disease prevention technology]
It is conceivable to use a health condition determination device to which the present invention is applied to a typical disease prevention technique whose onset can be predicted by fluctuations in vital signs such as brain disease, pneumonia, heart failure and dehydration. When each of the above-mentioned diseases develops, the vital signs peculiar to the disease often fluctuate, and by setting the fluctuation of the vital signs peculiar to the disease as a determination condition, it is possible to prevent the onset.
 [PHR(Personal Health Records)及び医療ビッグデータへの活用]
 近年では、ICT(Information and Communication Technology)と言われる、情報通信技術の発展が著しく、スマートフォンのような情報端末や、無線LANを利用したインターネット通信環境、クラウドサーバーのような安価で大容量のデータベースの台頭により、大量なデータを高速で送受信可能となっている。これにより、世界中からあらゆるデータ、所謂ビッグデータが集まり、必要なデータを使って、様々な用途のサービスが行われている。
[Utilization for PHR (Personal Health Records) and medical big data]
In recent years, the development of information and communication technology called ICT (Information and Communication Technology) has been remarkable, and information terminals such as smartphones, Internet communication environments using wireless LAN, and inexpensive and large-capacity databases such as cloud servers have been developed. With the rise of, it has become possible to send and receive large amounts of data at high speed. As a result, all kinds of data, so-called big data, are collected from all over the world, and services for various purposes are provided using the necessary data.
 日本の厚生労働省では、超高齢社会において高齢者を地域全体で支えるために、医療、介護、予防、住まい、生活支援が包括的に確保された「地域包括ケアシステム」を2025年までに実現しようとしている。しかし、その土台となる医療情報の大部分は、それぞれの事業所で寸断されている。 Japan's Ministry of Health, Labor and Welfare will realize a "comprehensive community care system" that comprehensively secures medical care, nursing care, prevention, housing, and living support in order to support the elderly in the super-aging society as a whole by 2025. It is said. However, most of the underlying medical information is shredded at each business site.
 例えば、医療機関同士の情報共有は、未だファクシミリを使用する状態や、施設間でヘルスデータの継続性がない状態が珍しくなく、第4次産業革命といわれる時代の割には、前時代的な様相を呈している。全国各地170か所余りで医療情報連携ネットワークを試みられているものの、全国全地域、人口をカバーするには至らず、運用費用や利用率の低さなどの問題を抱え、共通のプラットフォームに統合されるには至っていない。 For example, information sharing between medical institutions is not uncommon for the use of facsimiles and the lack of continuity of health data between facilities, which is prehistoric for the era called the Fourth Industrial Revolution. It looks like it. Although medical information cooperation networks have been attempted at more than 170 locations nationwide, they have not been able to cover the entire country and population, and have problems such as low operating costs and low utilization rates, and are integrated into a common platform. It has not been done yet.
 そこで、日本の厚生労働省は、「国民一人ひとりが、本人自らの生涯にわたる健康、医療、介護情報を時系列的に管理し、その情報を自ら活用することにより、自己の健康状態に合致した良質なサービスの提供を受けることを目指す」PHR構想を検討している(総務省及び厚生労働省の「クラウド時代の医療ICTの在り方に関する懇談会」より)。PHRとはパーソナルヘルスレコード(Personal Health Records)の略称であり、個人が生涯にわたり自分自身に関する医療情報や健康情報を収集又は保存して、これを活用できる仕組みである。 Therefore, the Ministry of Health, Labor and Welfare of Japan stated, "Each citizen manages his / her own lifelong health, medical care, and nursing care information in chronological order, and by utilizing that information himself / herself, high quality that matches his / her health condition. We are considering the PHR concept, which aims to receive services (from the "Discussion on the Ideal Way of Medical ICT in the Cloud Era" by the Ministry of Internal Affairs and Communications and the Ministry of Health, Labor and Welfare). PHR is an abbreviation for Personal Health Records, and is a mechanism that allows an individual to collect or store medical information and health information about himself / herself for a lifetime and utilize it.
 これによると「直近の情報だけではなく、過去の情報も参照する必要があることから、本人が自らの生涯にわたる情報を管理し、使いたいときに使いたいサービスへ活用できるようにする」とあり、このPHR構想が実現すれば、たとえプラットフォームの統合がなくとも、「介護予防手帳の電子化」や「市区町村や職場での健診・検診情報の電子化及びバイタルデータ・生活関連情報との一元管理」など医療、介護、健康、個人の情報連携よる多様な運用が可能となる。 According to this, "Because it is necessary to refer not only the latest information but also past information, the person can manage his / her lifelong information and utilize it for the service he / she wants to use when he / she wants to use it." If this PHR concept is realized, even if there is no platform integration, "electronic care prevention notebook" and "electronic medical examination / examination information in municipalities and workplaces, and vital data / life-related information" Various operations such as "centralized management" will be possible through medical care, nursing care, health, and personal information linkage.
 また、各省庁が協力してビッグデータが活用しやすい環境を作ろうと、データの様式(API等)を統一して、必要なデータを取り出しやすくする「PHR構想」と併せて、医療マイナンバーと呼ばれた、個人データの特定し継続しやすくする「医療ID」構想、更に開発や治療のためには匿名化された情報は個人の許可なく活用できる「個人情報保護法の改正」が計画されている。 In addition, in order to create an environment where big data can be easily used in cooperation with each ministry and agency, the data format (API, etc.) will be unified, and along with the "PHR concept" that makes it easier to retrieve necessary data, medical my number will be used. A called "medical ID" concept that makes it easier to identify and continue personal data, and a "revision of the personal information protection law" that allows anonymized information to be used without personal permission for development and treatment are planned. There is.
 この構想の中では、バイタルデータに関して、次のように言及している。「本人の健康、医療、介護情報を匿名化した上で、ビッグデータとして分析及び活用する、いわゆる二次利用についても、PHRサービスの持続可能性を検討していく上で、重要な要素として視野に入れて検討すべきである。とりわけ、バイタルデータについては、現在、様々なデバイスやサービスが市場に存在しているが、PHRと統合してデータ活用していくに当たっては、健康管理の効果を分析する等の目的で二次利用することを視野に入れ、データの粒度やPHRを収集するプラットフォームとの間のAPIを統一することが望ましい」。 In this concept, vital data is mentioned as follows. "The so-called secondary use, in which personal health, medical care, and long-term care information is anonymized and then analyzed and utilized as big data, is also considered as an important factor in considering the sustainability of PHR services. In particular, regarding vital data, various devices and services currently exist in the market, but when integrating with PHR and utilizing the data, the effect of health management will be effective. It is desirable to unify the API with the data granularity and the platform that collects PHR, with a view to secondary use for purposes such as analysis. "
 今後、このPKR構想に対して、本発明を適用した健康状態判定装置(又は本健康状態判定方法)を連動させる態様も考えられる。本装置を統合してバイタルデータ活用をする際、既存の技術と大きく違うのは、健康管理を行う際に、一般的なデータと比較するのではなく、一人ひとりの特性に合わせた「テーラーメード診断」、所謂、「個別化医療」を用いる点である。更に、医療ビッグデータの解析により、予防医学の道が開け、その支援に「人工知能」が役立つものとなる。今後は、PHR構想の実現にあたって、本発明を適用した健康状態判定装置が大きく寄与することが考えられる。 In the future, it is conceivable that the health condition determination device (or the present health condition determination method) to which the present invention is applied is linked to this PKR concept. When integrating this device and utilizing vital data, the major difference from existing technology is that when performing health management, "tailor-made diagnosis" tailored to each individual's characteristics rather than comparing with general data. This is the point of using so-called "individualized medicine". Furthermore, analysis of medical big data will open the way for preventive medicine, and "artificial intelligence" will be useful for its support. In the future, it is considered that the health condition determination device to which the present invention is applied will greatly contribute to the realization of the PHR concept.
「クオリティデータの抽出]
 バイタルデータ解析には信ぴょう性が重要である。よって集積されたバイタル測定値をそのまま用いるのではなく、バイタル精度検定を行い、クオリティデータ(測定精度が高いデータ)による分析結果でなければ価値は乏しい。しかし従来、バイタル測定精度の良し悪しを判定する有力な手法は無かったため、例えば、在宅医療では医療従事者ではない患者自身が測定したデータの信用性は(判定方法が無いため)一様に低いとされ、そのデータ活用には課題があった。
"Extraction of quality data"
Credibility is important for vital data analysis. Therefore, instead of using the accumulated vital measurement values as they are, the value is scarce unless the vital accuracy test is performed and the analysis result is based on quality data (data with high measurement accuracy). However, in the past, there was no powerful method for judging the quality of vital measurement accuracy, so for example, in home medical care, the credibility of data measured by patients who are not medical staff themselves is uniformly low (because there is no judgment method). There was a problem in utilizing the data.
 しかし、本技術では統計学(シャピローウィルク判定等)を用い、正規性を検定することで、バイタル精度検証が可能である。よって集積されたバイタルデータを解析する際に、「クオリティデータを測定している対象者」もしくは「クオリティデータを測定している対象施設群」と、「それ以外の群」に分類することで、集積された全バイタルデータから「クオリティデータ群」だけを抽出することが可能となる。この技術により、精度が担保されているデータからの解析が可能となるため、初めて人工知能開発の有力な指標として採用できるなど、活用の領域が広がる。 However, this technology can verify vital accuracy by testing normality using statistics (Shapilow Wilk judgment, etc.). Therefore, when analyzing the accumulated vital data, it is possible to classify it into "targets measuring quality data" or "target facility groups measuring quality data" and "other groups". It is possible to extract only the "quality data group" from all the accumulated vital data. Since this technology enables analysis from data whose accuracy is guaranteed, it can be used as a powerful index for artificial intelligence development for the first time, expanding the range of applications.
[医師、看護師の教育ソフトウェア]
 また、本発明の健康状態判定装置は、医療従事者の教育用ツールとして使用することもできる。本発明に加え、病態鑑別フローチャートデータベースを組み合わせることで、これらの情報に基づき、設問と回答を組み合わせた教育用ソフトウェアを作成することが可能である。また、教育用ソフトウェアを使用する複数の医療従事者の点数を記録して、順位付けして、医師や看護師の評価表を作成することもできる。
[Educational software for doctors and nurses]
In addition, the health condition determination device of the present invention can also be used as an educational tool for medical professionals. By combining the pathological condition identification flowchart database in addition to the present invention, it is possible to create educational software that combines questions and answers based on this information. It is also possible to record and rank the scores of multiple healthcare professionals using educational software to create an evaluation table for doctors and nurses.
[看護師が薬を処方する際の参考ツール]
 また、看護師が薬を処方する際の参考ツールとしても使用が考えられる。例えば、対象者の個人情報に対象者の服薬履歴の情報を記録していく。これにより、「どのような症状の時にどのような薬が処方されたか」というデータが蓄積され、服薬の際に薬剤師が参考情報として活用できる。また、薬の種類によっては、薬剤師を介さずに服薬する用途にも展開できる。薬剤士による服薬履歴の確認作業も容易に行うことができる。
[Reference tool for nurses when prescribing medicine]
It can also be used as a reference tool for nurses when prescribing medicine. For example, the information on the medication history of the subject is recorded in the personal information of the subject. As a result, data on "what kind of medicine was prescribed at what kind of symptom" is accumulated, and the pharmacist can use it as reference information when taking the medicine. In addition, depending on the type of drug, it can be applied to take the drug without going through a pharmacist. The pharmacist can easily check the medication history.
[服薬管理と配送サービス]
 更には、服薬履歴の情報を記録と配送サービスを連動させることで、対象者が定期的に必要とする薬剤が、必要な時期に自動的に手元に届くようにすることもできる。
[Medication management and delivery service]
Furthermore, by linking the information of the medication history with the delivery service, it is possible to automatically deliver the medicines that the subject regularly needs at the required time.
[職場や学校での健康診断データとのリンク]
 本発明の健康状態判定装置は、職場や学校での定期的な健康診断の情報を記録して活用することも考えられる。なお、この際には、バイタル情報の取得期間が空くため、注意や警告、異常の判定は適宜設定するものとなる。これにより、対象者の健康管理に役立つものとなる。また、膨大な臨床データを取得する手段にもなる。更には、公的機関が実施する健康診断の情報とリンクさせることで、対象者の包括的な健康管理が可能となる。
[Link with health check data at work or school]
It is also conceivable that the health condition determination device of the present invention records and utilizes information on regular health examinations at work or school. In this case, since the vital information acquisition period is vacant, cautions, warnings, and abnormality determinations are appropriately set. This will be useful for the health management of the subject. It is also a means of acquiring vast amounts of clinical data. Furthermore, by linking with information on health examinations conducted by public institutions, comprehensive health management of the subjects becomes possible.
[遠隔地における現地での健康管理]
 本発明の健康状態判定装置は、遠隔地における現地での健康管理にも利用できる。例えば、海外出張中の当該国や、遠洋漁業に出た船舶、自衛隊の海外派遣先等に本発明の健康状態判定装置を設置する。これにより、医療レベルの低い国や、医療設備の存在しない場所においても、対象者の健康管理が可能となる。また、上述したような遠隔診断と組み合わせることで、医師による診断も行うことができる。
[Local health management in remote areas]
The health condition determination device of the present invention can also be used for on-site health management in a remote place. For example, the health condition determination device of the present invention is installed in the country concerned on an overseas business trip, a ship in a pelagic fishery, an overseas dispatch destination of the Self-Defense Forces, and the like. This makes it possible to manage the health of the target person even in countries where the medical level is low or where there is no medical equipment. In addition, by combining with the remote diagnosis as described above, a diagnosis by a doctor can be performed.
[地域別疾病発生状況確認]
 本発明の健康状態判定装置は、地域別疾病発生状況の情報とリンクさせることで、地域医療の予防医療に貢献しうるものとなる。例えば、インフルエンザの流行に関する情報とリンクさせることで、健康状態判定装置を使用する地域での予防対策に繋げることができる。また、流行地域での対象者の情報が臨床データとして活用できるものとなる。
[Confirmation of disease outbreak status by region]
The health condition determination device of the present invention can contribute to preventive medical care in regional medical care by linking with information on the outbreak status of diseases by region. For example, by linking with information on influenza pandemic, it is possible to lead to preventive measures in areas where health condition determination devices are used. In addition, the information of the subjects in the endemic area can be utilized as clinical data.
[空気環境の検知]
 更には、空気環境の検知機構と本発明の健康状態判定装置を組み合わせることもできる。空気環境の検知機構により、ホルムアルデヒドやPM2.5の濃度を検知して、その濃度から、地域の空気汚染度などを判定し、装置使用者に注意喚起を促す構成にできる。また、行政サービスと連動させ、対象地域住民への注意喚起や、環境改善のための情報取得ツールとしても活用できるものとなる。
[Detection of air environment]
Furthermore, the air environment detection mechanism and the health condition determination device of the present invention can be combined. The air environment detection mechanism can detect the concentration of formaldehyde or PM2.5, determine the degree of air pollution in the area from the concentration, and alert the device user. In addition, it can be used as an information acquisition tool for alerting local residents and improving the environment by linking with administrative services.
[室内環境の調整への活用]
 本発明の健康状態判定装置に記録された情報に基づき、空調機器による室内温度や湿度の調整を可能としたヘルスケアホームへの利用が考えられる。バイタルサインの値が異常な値であると判定された対象者に適した室内温度や湿度に環境を制御することや、健康な状態が維持しやすい適切な設定温度等に制御可能となる。
[Utilization for adjusting the indoor environment]
Based on the information recorded in the health condition determination device of the present invention, it can be considered to be used in a healthcare home where the room temperature and humidity can be adjusted by an air conditioner. It is possible to control the environment to a room temperature and humidity suitable for the subject who is judged to have an abnormal value of vital signs, and to control the temperature to an appropriate set temperature which makes it easy to maintain a healthy state.
[介護記録ソフトウェア及び介護請求ソフトウェア]
 本発明を適用した健康状態判定装置は、介護記録ソフトウェアや介護請求ソフトウェアと連動させる態様が考えられる。介護記録ソフトウェアに入力される介護記録の情報を情報管理部で管理することで、「どのような症状の時にどのような介護が適切か」というデータを蓄積する。これにより介護士の技能レベルに左右されず、介護対象者に対して均一なサービスを提供できるものとなる。介護記録ソフトウェアとの連動における更なる別の態様は後述する。
[Long-term care record software and long-term care request software]
The health condition determination device to which the present invention is applied may be linked with the long-term care recording software or the long-term care request software. By managing the information of the long-term care record input to the long-term care record software in the information management department, data such as "what kind of care is appropriate at what kind of symptom" is accumulated. As a result, uniform services can be provided to the care recipients regardless of the skill level of the caregiver. Yet another aspect of interlocking with the long-term care recording software will be described later.
 介護請求ソフトウェアと連動させた場合には、介護費用の算出等の支援ツールとして使用することができる。これにより提供した介護内容に対して発生する費用を容易に確認できるものとなり、業務効率の向上につなげることができる。 When linked with long-term care billing software, it can be used as a support tool for calculating long-term care costs. As a result, the costs incurred for the provided long-term care content can be easily confirmed, which can lead to improvement of work efficiency.
[介護職員の健康チェック]
 本発明を適用した健康状態判定装置は、介護する側の介護職員の健康状態のチェックに活用することもできる。介護職員自身のバイタル情報を測定し、健康状態判定装置に送信することで健康管理を行う。これにより介護現場の労働環境の改善につなげることができる。
[Health check of care staff]
The health condition determination device to which the present invention is applied can also be used for checking the health condition of the care staff on the care side. Health management is performed by measuring the vital information of the care staff and sending it to the health condition judgment device. This can lead to an improvement in the working environment at the nursing care site.
[見守り機能]
 また、介護施設や一人暮らしの高齢者用の見守りシステムと連動させた場合には、バイタル値の異常が判定された際や、対象者の動作に異常が見られた場合に、見守り対象者(例えば、家族等)に通知が行く構成が考えられる。例えば、家の中に人感センサーを設置して、トイレの中で住人が一定時間動かない時は、警備会社や家族に自動でアラートが行くようにする。その際には、見守り対象者のバイタル情報の記録をデータで同時に送信する構成とすることもできる。
[Watching function]
In addition, when linked with a nursing care facility or a watching system for the elderly living alone, when an abnormality in the vital values is determined or when an abnormality is found in the behavior of the target person, the person to be watched (for example) , Family, etc.) can be notified. For example, a motion sensor is installed in the house so that when a resident does not move in the toilet for a certain period of time, an alert is automatically sent to the security company and family members. In that case, the vital information record of the person to be watched over may be simultaneously transmitted as data.
[ダイエット、体調管理]
 本発明を適用した健康状態判定装置は、使用者のダイエットや体調管理をサポートする装置としても活用しうる。例えば、バイタル情報と、食事の摂取カロリーの情報に基づき、減量のためのアドバイスが表示される構成が採用しうる。また、トレーニングジム等の施設と提携し、複数の減量プログラムを提供することも可能である。
[Diet, physical condition management]
The health condition determination device to which the present invention is applied can also be used as a device that supports the diet and physical condition management of the user. For example, a configuration in which advice for weight loss is displayed based on vital information and information on calorie intake of a meal can be adopted. It is also possible to offer multiple weight loss programs in partnership with facilities such as training gyms.
[ウェアラブル装置への活用]
 本発明の健康状態判定装置をウェアラブル装置と連動される仕組みも考えられる。近年では、身体に装着可能な小型のウェアラブル装置が開発されており。これらの装置を用いて、体温、脈拍、収縮期血圧及び拡張期血圧等の各種バイタル情報をリアルタイムで取得することが可能となっている。本発明の健康状態判定装置において、バイタル情報の取得手段や、判定結果を表示する表示手段として、ウェアラブル装置と組み合わせることで、適用範囲を大きく広げることができる。また、自己で体調管理を行うセルフマネジメントのための機器としての活用に繋げることができる。
[Use for wearable devices]
A mechanism in which the health condition determination device of the present invention is linked with the wearable device is also conceivable. In recent years, small wearable devices that can be worn on the body have been developed. Using these devices, it is possible to acquire various vital information such as body temperature, pulse, systolic blood pressure, and diastolic blood pressure in real time. In the health condition determination device of the present invention, the applicable range can be greatly expanded by combining with a wearable device as a means for acquiring vital information and a display means for displaying the determination result. In addition, it can be used as a device for self-management that manages the physical condition by oneself.
[アプリケーションソフトウェアの活用]
 また、上述したが、本発明の健康状態判定装置の機能をアプリケーションソフトウェアとして提供し、携帯端末やタブレット端末で使用可能とする構成が考えられる。これにより手軽に本装置の機能を利用できるものとなり、利便性を向上させることができる。また、本装置の普及率の向上に寄与し、より広範な臨床データの取得にもつなげることができる。
[Utilization of application software]
Further, as described above, it is conceivable that the function of the health condition determination device of the present invention is provided as application software so that it can be used in a mobile terminal or a tablet terminal. As a result, the functions of this device can be easily used, and the convenience can be improved. In addition, it contributes to the improvement of the penetration rate of this device and can lead to the acquisition of a wider range of clinical data.
[買い物支援ソフトウェア]
 本発明の健康状態判定装置に記録された情報を、インターネット上の商品販売ウェブサイトや、商品購入を支援するソフトウェアと連動させることも考えられる。使用者の健康状態に合わせた食品や健康器具等をお勧めしてくれる機能を付与することで、商品購入時の参考情報が得られるものとなる。
[Shopping support software]
It is also conceivable to link the information recorded in the health condition determination device of the present invention with a product sales website on the Internet or software that supports product purchase. By adding a function that recommends foods, health appliances, etc. according to the user's health condition, reference information at the time of product purchase can be obtained.
[動物の健康管理]
 本発明の健康状態判定装置は動物を対象に使用することも考慮される。人間のみならず、ペット、動物園の動物の健康管理や野生動物の保護にも寄与しうるものとなる。また、動物の臨床データや診断情報を蓄積することで、医学的、学術的に有用な情報が得られるものとなる。
[Animal health care]
It is also considered that the health condition determination device of the present invention is used for animals. It can contribute to the health management of not only humans but also pets and zoo animals and the protection of wild animals. In addition, by accumulating clinical data and diagnostic information of animals, medically and academically useful information can be obtained.
[車両への設置]
 本発明の健康状態判定装置を車両に設置する態様が採用できる。例えば、運転手の座席にバイタル計測器(例えば、体温計、脈拍計、呼吸数センサー等)を設置しておき、運転手の体調不良が疑われる場合には、注意喚起を促すものとする。また、アルコール検知器と組み合わせて、飲酒運転のチェックを行う構成とすることもできる。
[Installation on vehicle]
An embodiment in which the health condition determination device of the present invention is installed in a vehicle can be adopted. For example, a vital measuring instrument (for example, a thermometer, a pulse rate monitor, a respiratory rate sensor, etc.) shall be installed in the driver's seat to call attention when the driver is suspected of being in poor physical condition. In addition, it can be configured to check drunk driving in combination with an alcohol detector.
 以上のように、本発明のソフトウェアは、対象者の個人差を考慮したバイタルサインや日々の体調を反映して、対象者ごとに異なる個体内変動を精度高く捉えることが可能であり、対象者の健康管理や、一人ひとりの個性にかなった医療の提供に寄与するものとなっている。
 また、本発明の健康状態判定装置は、対象者の個人差を考慮したバイタルサインや日々の体調を反映して、対象者ごとに異なる個体内変動を精度高く捉えることが可能であり、対象者の健康管理や、一人ひとりの個性にかなった医療の提供に寄与するものとなっている。
 また、本発明の健康状態判定方法は、対象者の個人差を考慮したバイタルサインや日々の体調を反映して、対象者ごとに異なる個体内変動を精度高く捉えることが可能であり、対象者の健康管理や、一人ひとりの個性にかなった医療の提供に寄与するものとなっている。
As described above, the software of the present invention can accurately capture the intra-individual variation that differs for each subject by reflecting the vital signs and daily physical conditions that take into consideration the individual differences of the subject. It contributes to the health management of the company and the provision of medical care that suits each individual's individuality.
In addition, the health condition determination device of the present invention can accurately capture individual fluctuations that differ from subject to subject by reflecting vital signs and daily physical condition in consideration of individual differences of the subject. It contributes to the health management of people and the provision of medical care that suits each individual's individuality.
In addition, the health condition determination method of the present invention can accurately capture individual fluctuations that differ from subject to subject by reflecting vital signs and daily physical condition in consideration of individual differences of the subject. It contributes to the health management of people and the provision of medical care that suits each individual's individuality.
   1   健康状態判定装置
   1a  ソフトウェア
   2   演算部
   2a  演算部
   3   タブレット端末
   3a  (タブレット端末の)入力部
   3b  (タブレット端末の)表示部
   3c  (タブレット端末の)情報送受信部
   4   情報記録部
   4a  情報記録部
   5   基準算出手段
   5a  基準算出手段
   6   判定処理手段
   6a  判定処理手段
   7   個人情報
   8   バイタル情報
   9   目安時刻情報
  10   姿勢情報
  11   気温情報
  12   判定結果情報
  13   再測定バイタル情報
  14   平均値算出手段
  15   標準偏差算出手段
  16   正規分布算出手段
  18   判定基準情報
  21a  バイタル測定器
  21b  体温計
  22a  スマートフォン端末
  22b  パーソナルコンピュータ端末(PC端末)
  23   情報入力手段
  24   情報記録手段
  24a  情報記録手段
  30a  インターネット
  32a  情報管理サーバ
  32b  ソフトウェア
  32c  ソフトウェア
  32d  ソフトウェア
  50a  ユーザ端末
  50b  外部端末
  60a  ユーザ端末
  60b  外部端末
  70b  管理端末
  100  スコアリング処理手段
  100a スコアリング処理手段
  101  スコアリング基準設定手段
  102  スコアリング基準情報
1 Health condition judgment device 1a Software 2 Calculation unit 2a Calculation unit 3 Tablet terminal 3a (Tablet terminal) Input unit 3b (Tablet terminal) Display unit 3c (Tablet terminal) Information transmission / reception unit 4 Information recording unit 4a Information recording unit 5 Criteria calculation means 5a Criteria calculation means 6 Judgment processing means 6a Judgment processing means 7 Personal information 8 Vital information 9 Estimated time information 10 Attitude information 11 Temperature information 12 Judgment result information 13 Remeasurement vital information 14 Average value calculation means 15 Standard deviation calculation means 16 Normal distribution calculation means 18 Judgment standard information 21a Vital measuring instrument 21b Body thermometer 22a Smartphone terminal 22b Personal computer terminal (PC terminal)
23 Information input means 24 Information recording means 24a Information recording means 30a Internet 32a Information management server 32b Software 32c Software 32d Software 50a User terminal 50b External terminal 60a User terminal 60b External terminal 70b Management terminal 100 Scoring processing means 100a Scoring processing means 101 Scoring standard setting means 102 Scoring standard information

Claims (17)

  1.  取得されたバイタルサインに関する情報であるバイタル情報をスコアリングして、得られたスコア結果情報に基づいて、個体の健康状態を判定するためのソフトウェアであって、
     情報処理機器を、
     同一個体から取得されると共に、正規分布に従うバイタルサインから選択される少なくとも1つの測定値を含む前記バイタル情報及び取得日時の入力を受け付ける情報入力手段と、
     入力された前記バイタル情報及び取得日時の情報を記録させる情報記録手段と、
     記録された複数の前記バイタル情報の全部又は一部の、平均μ及び標準偏差σを算出する基準算出手段と、
     所定のスコアリング条件を基準に、入力された所定のバイタル情報をスコアリングして、スコアの値であるスコア結果情報を算出すると共に、前記所定のスコアリング条件は少なくとも前記平均μをピーク値とした正規分布に基づき設定されるスコアリング処理手段と、
     複数の種類の前記バイタル情報に対応する前記スコア結果情報を総合して、所定のスコア判定条件を基準に、異常な値か否かを判定するスコア判定手段と、
     前記スコア判定手段の判定結果に基づき、アラートを通知するアラート通知手段と、
    を含む手段として機能させるためのソフトウェアであり、
     少なくとも30個分の測定データの前記バイタル情報には、個体に固有の個体内変動が反映され、
     前記正規分布は、少なくとも30個分の測定データの前記バイタル情報から作成され、
     前記バイタル情報は、
     前記バイタルサインである体温、血圧、脈拍、脈圧及び呼吸数から選択される少なくとも1つの測定値を含み、
     前記スコアリング条件は、
     体温、血圧、脈拍、脈圧及び呼吸数から選択される少なくとも1つの測定値に対しては、前記平均μ、前記標準偏差σ、0より大きい数であるn及びmを用いて表された下記の式(1)の値を下限値及び式(2)の値を上限値とし、下限値及び上限値の少なくとも一方を基準にする基準域条件を含み、
     前記基準域条件は、バイタルサインの測定値のうち、所定のバイタル除外条件を満たす測定値が除外されて設定され、
     前記スコア判定手段は、前記基準域条件に基づきスコアリングされた前記スコア結果情報を含めて、次回の判定を行う
     ソフトウェア。
     μ-nσ・・・式(1)
     μ+mσ・・・式(2)
    Software for scoring vital information, which is information on acquired vital signs, and determining the health condition of an individual based on the obtained score result information.
    Information processing equipment,
    An information input means that accepts input of the vital information including at least one measured value selected from vital signs that are acquired from the same individual and that follows a normal distribution, and an acquisition date and time.
    An information recording means for recording the input vital information and information on the acquisition date and time, and
    A reference calculation means for calculating the average μ and the standard deviation σ of all or a part of the plurality of recorded vital information, and
    Based on the predetermined scoring condition, the input predetermined vital information is scored to calculate the score result information which is the value of the score, and the predetermined scoring condition has at least the average μ as the peak value. Scoring processing means set based on the normal distribution
    A score determination means for determining whether or not the value is abnormal based on a predetermined score determination condition by integrating the score result information corresponding to a plurality of types of the vital information.
    An alert notification means for notifying an alert based on the judgment result of the score determination means, and
    It is software to function as a means including
    The vital information of at least 30 measurement data reflects the intra-individual variation peculiar to the individual.
    The normal distribution is created from the vital information of at least 30 measurement data.
    The vital information is
    Includes at least one measurement selected from the vital signs body temperature, blood pressure, pulse, pulse pressure and respiratory rate.
    The scoring condition is
    For at least one measurement selected from body temperature, blood pressure, pulse, pulse pressure and respiratory rate, the following is expressed using the mean μ, the standard deviation σ, and n and m, which are numbers greater than 0. The value of Eq. (1) is the lower limit value and the value of Eq. (2) is the upper limit value, and includes the reference range condition based on at least one of the lower limit value and the upper limit value.
    The reference range condition is set by excluding the measured values satisfying the predetermined vital exclusion condition from the measured values of vital signs.
    The score determination means is software that performs the next determination including the score result information scored based on the reference region condition.
    μ-nσ ・ ・ ・ Equation (1)
    μ + mσ ・ ・ ・ Equation (2)
  2.  前記バイタル情報は、
     前記バイタルサインである体温、血圧、脈拍、脈圧及び呼吸数から選択される少なくとも1つの測定値と、
     酸素飽和度の測定値と、
     意識レベルを観察して取得された意識レベル評価結果とを有し、
     前記スコアリング条件は、
     酸素飽和度の測定値に対しては、予め設定した所定の数値範囲であり、
     意識レベル評価結果に対しては、意識レベルの程度を示す所定の観察状態である
     請求項1に記載のソフトウェア。
    The vital information is
    At least one measured value selected from the vital signs such as body temperature, blood pressure, pulse, pulse pressure and respiratory rate, and
    Oxygen saturation measurements and
    It has the consciousness level evaluation result obtained by observing the consciousness level,
    The scoring condition is
    The measured value of oxygen saturation is within a predetermined numerical range set in advance.
    The consciousness level evaluation result is a predetermined observation state indicating the degree of consciousness level.
     The software according to claim 1.
  3.  前記所定のバイタル除外条件は、下記の式(1)の値を下限値及び式(2)の値を上限値とし、下限値及び上限値を基準にする
     請求項1または請求項2に記載のソフトウェア。
     μ-2σ・・・式(1)
     μ+2σ・・・式(2)
    The predetermined vital exclusion condition is described in claim 1 or 2, wherein the value of the following formula (1) is set as a lower limit value and the value of formula (2) is set as an upper limit value, and the lower limit value and the upper limit value are used as a reference. software.
    μ-2σ ・ ・ ・ Equation (1)
    μ + 2σ ・ ・ ・ Equation (2)
  4.  前記所定のバイタル除外条件は、所定の検定法に基づく外れ値に該当するか否かである
     請求項1、請求項2または請求項3に記載のソフトウェア。
    The software according to claim 1, claim 2 or claim 3, wherein the predetermined vital exclusion condition corresponds to an outlier based on a predetermined test method.
  5.  前記所定のバイタル除外条件は、医師による処方がなされた日、処方内容に含まれる期間、または、入院期間に測定された値であるか否かである
     請求項1、請求項2、請求項3または請求項4に記載のソフトウェア。
    The predetermined vital exclusion condition is whether or not the value is measured on the day when the prescription is made by the doctor, the period included in the prescription content, or the hospitalization period. Claim 1, claim 2, claim 3. Alternatively, the software according to claim 4.
  6.  前記所定のバイタル除外条件は、
     所定の条件で複数回測定したバイタルサインの測定値に対して、下記の式(1)の値を下限値及び式(2)の値を上限値とし、下限値及び上限値を基準にして、下限値以下または上限値以上となるバイタルサインの測定値が2回以上続けて測定された際に、2回目以降の測定値であるか否かである
     請求項1または請求項2に記載のソフトウェア。
     μ-2σ・・・式(1)
     μ+2σ・・・式(2)
    The predetermined vital exclusion condition is
    With respect to the measured values of vital signs measured multiple times under predetermined conditions, the value of the following formula (1) is set as the lower limit value and the value of formula (2) is set as the upper limit value, and the lower limit value and the upper limit value are used as a reference. The software according to claim 1 or 2, which is whether or not the measured value of vital signs that is equal to or greater than the lower limit value or greater than or equal to the upper limit value is measured twice or more in succession. ..
    μ-2σ ・ ・ ・ Equation (1)
    μ + 2σ ・ ・ ・ Equation (2)
  7.  前記所定のバイタル除外条件は、t検定に基づく平均値を基準とする
     請求項1、請求項2、請求項3、請求項4、請求項5または請求項6に記載のソフトウェア。
    The software according to claim 1, claim 2, claim 3, claim 4, claim 5 or claim 6, wherein the predetermined vital exclusion condition is based on an average value based on a t-test.
  8.  前記所定のバイタル除外条件は、
     所定の条件で複数回測定したバイタルサインの測定値に対して、所定の主値選択条件で選択された主値以外の測定値であるか否かである
     請求項1、請求項2、請求項3、請求項4、請求項5、請求項6または請求項7に記載のソフトウェア。
    The predetermined vital exclusion condition is
    Claims 1, 2, and 2, which are whether or not the measured value of the vital sign measured a plurality of times under a predetermined condition is a measured value other than the principal value selected under the predetermined principal value selection condition. 3. The software according to claim 4, claim 5, claim 6 or claim 7.
  9.  前記所定のバイタル除外条件は、所定の検定法に基づき、正規性が担保されたバイタルサインの測定値であるか否かである
     請求項1、請求項2、請求項3、請求項4、請求項5、請求項6、請求項7または請求項8に記載のソフトウェア。
    The predetermined vital exclusion condition is whether or not it is a measured value of a vital sign whose normality is guaranteed based on a predetermined test method. Claim 1, claim 2, claim 3, claim 4, claim. 5. The software according to claim 6, claim 7 or claim 8.
  10.  前記所定のバイタル除外条件は、バイタルサインの測定を行った作業者の情報と、前記作業者が測定したバイタルサインの測定値の正規性の情報を基準とする
     請求項1、請求項2、請求項3、請求項4、請求項5、請求項6、請求項7、請求項8または請求項9に記載のソフトウェア。
    The predetermined vital exclusion condition is claimed 1, claim 2, based on the information of the worker who measured the vital signs and the information on the normality of the measured value of the vital signs measured by the worker. 3. The software according to claim 4, claim 5, claim 6, claim 7, claim 8 or claim 9.
  11.  前記所定のバイタル除外条件は、バイタルサインの測定値が、所定の時間条件を満たして測定された値であるか否かである
     請求項1、請求項2、請求項3、請求項4、請求項5、請求項6、請求項7、請求項8、請求項9または請求項10に記載のソフトウェア。
    The predetermined vital exclusion condition is whether or not the measured value of the vital sign is a value measured by satisfying a predetermined time condition. Claim 1, claim 2, claim 3, claim 4, claim. 5. The software according to claim 6, claim 7, claim 8, claim 9 or claim 10.
  12.  前記所定のバイタル除外条件は、
     所定の条件で複数回測定したバイタルサインの測定値に対して、下記の式(1)の値を下限値及び式(2)の値を上限値とし、下限値及び上限値の範囲内に含まれるバイタルサインの測定値であるか否かである
     請求項1または請求項2に記載のソフトウェア。
     μ-2σ・・・式(1)
     μ+2σ・・・式(2)
    The predetermined vital exclusion condition is
    For the measured values of vital signs measured multiple times under predetermined conditions, the value of the following formula (1) is set as the lower limit value and the value of the formula (2) is set as the upper limit value, and is included within the range of the lower limit value and the upper limit value. The software according to claim 1 or 2, which is whether or not it is a measured value of vital signs.
    μ-2σ ・ ・ ・ Equation (1)
    μ + 2σ ・ ・ ・ Equation (2)
  13.  前記スコア判定手段は、異常な値と判定する際に、異常を少なくとも2つの段階に分けて判定する
     請求項1、請求項2、請求項3、請求項4、請求項5、請求項6、請求項7、請求項8、請求項9、請求項10、請求項11または請求項12に記載のソフトウェア。
    When determining an abnormal value, the score determining means determines the abnormality in at least two stages: claim 1, claim 2, claim 3, claim 4, claim 5, claim 6, 7. The software according to claim 7, claim 8, claim 9, claim 10, claim 11 or claim 12.
  14.  前記情報入力手段は、
     所定のバイタル除外条件を満たす測定値が入力された際に、バイタルサインの再測定を促す
     請求項1、請求項2、請求項3、請求項4、請求項5、請求項6、請求項7、請求項8、請求項9、請求項10、請求項11、請求項12または請求項13に記載のソフトウェア。
    The information input means is
    Claim 1, claim 2, claim 3, claim 4, claim 5, claim 6, claim 7 that prompts remeasurement of the vital sign when a measured value satisfying a predetermined vital exclusion condition is input. 8. The software according to claim 8, claim 9, claim 10, claim 11, claim 12 or claim 13.
  15.  取得されたバイタルサインに関する情報であるバイタル情報をスコアリングして、得られたスコア結果情報に基づいて、個体の健康状態を判定するための健康状態判定装置であって、
     同一個体から取得されると共に、正規分布に従うバイタルサインから選択される少なくとも1つの測定値を含む前記バイタル情報及び取得日時の入力を受け付ける情報入力手段と、
     入力された前記バイタル情報及び取得日時の情報を記録させる情報記録手段と、
     記録された複数の前記バイタル情報の全部又は一部の、平均μ及び標準偏差σを算出する基準算出手段と、
     所定のスコアリング条件を基準に、入力された所定のバイタル情報をスコアリングして、スコアの値であるスコア結果情報を算出すると共に、前記所定のスコアリング条件は少なくとも前記平均μをピーク値とした正規分布に基づき設定されるスコアリング処理手段と、
     複数の種類の前記バイタル情報に対応する前記スコア結果情報を総合して、所定のスコア判定条件を基準に、異常な値か否かを判定するスコア判定手段と
     前記スコア判定手段の判定結果に基づき、アラートを通知するアラート通知手段と、
     前記スコア判定手段が判定した判定結果を表示可能な表示手段とを備え、
     少なくとも30個分の測定データの前記バイタル情報には、個体に固有の個体内変動が反映され、
     前記正規分布は、少なくとも30個分の測定データの前記バイタル情報から作成され、
     前記バイタル情報は、
     前記バイタルサインである体温、血圧、脈拍、脈圧及び呼吸数から選択される少なくとも1つの測定値を含み、
     前記スコアリング条件は、
     体温、血圧、脈拍、脈圧及び呼吸数から選択される少なくとも1つの測定値に対しては、前記平均μ、前記標準偏差σ、0より大きい数であるn及びmを用いて表された下記の式(1)の値を下限値及び式(2)の値を上限値とし、下限値及び上限値の少なくとも一方を基準にする基準域条件を含み、
     前記基準域条件は、バイタルサインの測定値のうち、所定のバイタル除外条件を満たす測定値が除外されて設定され、
     前記スコア判定手段は、前記基準域条件に基づきスコアリングされた前記スコア結果情報を含めて、次回の判定を行う
     健康状態判定装置。
     μ-nσ・・・式(1)
     μ+mσ・・・式(2)
    It is a health condition determination device for scoring vital information, which is information on acquired vital signs, and determining the health condition of an individual based on the obtained score result information.
    An information input means that accepts input of the vital information including at least one measured value selected from vital signs that are acquired from the same individual and that follows a normal distribution, and an acquisition date and time.
    An information recording means for recording the input vital information and information on the acquisition date and time, and
    A reference calculation means for calculating the average μ and the standard deviation σ of all or a part of the plurality of recorded vital information, and
    Based on the predetermined scoring condition, the input predetermined vital information is scored to calculate the score result information which is the value of the score, and the predetermined scoring condition has at least the average μ as the peak value. Scoring processing means set based on the normal distribution
    Based on the score determination means for determining whether or not the value is abnormal and the determination result of the score determination means based on a predetermined score determination condition by integrating the score result information corresponding to the plurality of types of the vital information. , Alert notification means to notify alerts,
    It is provided with a display means capable of displaying the determination result determined by the score determination means.
    The vital information of at least 30 measurement data reflects the intra-individual variation peculiar to the individual.
    The normal distribution is created from the vital information of at least 30 measurement data.
    The vital information is
    Includes at least one measurement selected from the vital signs body temperature, blood pressure, pulse, pulse pressure and respiratory rate.
    The scoring condition is
    For at least one measurement selected from body temperature, blood pressure, pulse, pulse pressure and respiratory rate, the following is expressed using the mean μ, the standard deviation σ, and n and m, which are numbers greater than 0. The value of Eq. (1) is the lower limit value and the value of Eq. (2) is the upper limit value, and includes the reference range condition based on at least one of the lower limit value and the upper limit value.
    The reference zone condition, among the measured values of the vital signs measurements satisfying a predetermined vital exclusion condition is set is excluded,
    The score determination means is a health condition determination device that performs the next determination including the score result information scored based on the reference region condition.
    μ-nσ ・ ・ ・ Equation (1)
    μ + mσ ・ ・ ・ Equation (2)
  16.  コンピュータが実行する方法であり、取得されたバイタルサインに関する情報であるバイタル情報をスコアリングして、得られたスコア結果情報に基づいて、個体の健康状態を判定するための健康状態判定方法であって、
     同一個体から取得されると共に、正規分布に従うバイタルサインから選択される少なくとも1つの測定値を含む前記バイタル情報の入力を受け付けて記録する情報記録工程と、
     記録された複数の前記バイタル情報の全部又は一部の、平均μ及び標準偏差σを算出する基準算出工程と、
     所定のスコアリング条件を基準に、入力された所定のバイタル情報をスコアリングして、スコアの値であるスコア結果情報を算出すると共に、前記所定のスコアリング条件は少なくとも前記平均μをピーク値とした正規分布に基づき設定されるスコアリング処理工程と、
     複数の種類の前記バイタル情報に対応する前記スコア結果情報を総合して、所定のスコア判定条件を基準に、異常な値か否かを判定するスコア判定工程と、
     前記スコア判定工程の判定結果に基づき、アラートを通知するアラート通知工程とを備え、
     少なくとも30個分の測定データの前記バイタル情報には、個体に固有の個体内変動が反映され、
     前記正規分布は、少なくとも30個分の測定データの前記バイタル情報から作成され、
     前記バイタル情報は、
     前記バイタルサインである体温、血圧、脈拍、脈圧及び呼吸数から選択される少なくとも1つの測定値を含み、
     前記スコアリング条件は、
     体温、血圧、脈拍、脈圧及び呼吸数から選択される少なくとも1つの測定値に対しては、前記平均μ、前記標準偏差σ、0より大きい数であるn及びmを用いて表された下記の式(1)の値を下限値及び式(2)の値を上限値とし、下限値及び上限値の少なくとも一方を基準にする基準域条件を含み、
     前記基準域条件は、バイタルサインの測定値のうち、所定のバイタル除外条件を満たす測定値が除外されて設定され、
     前記スコア判定工程は、前記基準域条件に基づきスコアリングされた前記スコア結果情報を含めて、次回の判定を行う
     健康状態判定方法。
     μ-nσ・・・式(1)
     μ+mσ・・・式(2)
    It is a method executed by a computer, and is a health condition determination method for scoring vital information, which is information on acquired vital signs, and determining the health condition of an individual based on the obtained score result information. hand,
    An information recording step of receiving and recording the input of the vital information including at least one measured value obtained from the same individual and selected from vital signs according to a normal distribution.
    A reference calculation step for calculating the mean μ and standard deviation σ of all or part of the plurality of recorded vital information, and
    Based on the predetermined scoring condition, the input predetermined vital information is scored to calculate the score result information which is the value of the score, and the predetermined scoring condition has at least the average μ as the peak value. The scoring process that is set based on the normal distribution
    A score determination step of integrating the score result information corresponding to a plurality of types of the vital information and determining whether or not the value is abnormal based on a predetermined score determination condition, and
    It is provided with an alert notification process for notifying an alert based on the determination result of the score determination process.
    The vital information of at least 30 measurement data reflects the intra-individual variation peculiar to the individual.
    The normal distribution is created from the vital information of at least 30 measurement data.
    The vital information is
    Includes at least one measurement selected from the vital signs body temperature, blood pressure, pulse, pulse pressure and respiratory rate.
    The scoring condition is
    For at least one measurement selected from body temperature, blood pressure, pulse, pulse pressure and respiratory rate, the following is expressed using the mean μ, the standard deviation σ, and n and m, which are numbers greater than 0. The value of Eq. (1) is the lower limit value and the value of Eq. (2) is the upper limit value, and includes the reference range condition based on at least one of the lower limit value and the upper limit value.
    The reference range condition is set by excluding the measured values satisfying the predetermined vital exclusion condition from the measured values of vital signs.
    The score determination step is a health condition determination method for performing the next determination including the score result information scored based on the reference region condition.
    μ-nσ ・ ・ ・ Equation (1)
    μ + mσ ・ ・ ・ Equation (2)
  17.  取得されたバイタルサインに関する情報であるバイタル情報に基づいて、個体の健康状態を判定するためのソフトウェアであって、
     情報処理機器を、
     同一個体から取得されると共に、正規分布に従うバイタルサインから選択される少なくとも1つの測定値を含む前記バイタル情報及び取得日時の入力を受け付ける情報入力手段と、
     入力された前記バイタル情報及び取得日時の情報を記録させる情報記録手段と、
     記録された複数の前記バイタル情報の全部又は一部の、平均μ及び標準偏差σを算出する基準算出手段と、
     前記平均μ及び前記標準偏差σから選択される少なくとも1つに基づいて設定された所定の数値範囲を基準にして、入力された所定のバイタル情報が異常な値か否かを判定すると共に、前記所定の数値範囲は少なくとも前記平均μをピーク値とした正規分布に基づき設定される判定手段と、
    を含む手段として機能させるためのソフトウェアであり、
     少なくとも30個分の測定データの前記バイタル情報には、個体に固有の個体内変動が反映され、
     前記正規分布は、少なくとも30個分の測定データの前記バイタル情報から作成され、
     前記バイタル情報は、
     前記バイタルサインである体温、血圧、脈拍、脈圧及び呼吸数から選択される少なくとも1つの測定値を含み、
     前記所定の数値範囲は、
     体温、血圧、脈拍、脈圧及び呼吸数から選択される少なくとも1つの測定値に対しては、前記平均μ、前記標準偏差σ、0より大きい数であるn及びmを用いて表された下記の式(1)の値を下限値及び式(2)の値を上限値とし、下限値及び上限値の少なくとも一方を基準にする基準域条件を含み、
     前記基準域条件は、バイタルサインの測定値のうち、所定のバイタル除外条件を満たす測定値が除外されて設定される
     ソフトウェア。
     μ-nσ・・・式(1)
     μ+mσ・・・式(2)
    Software for determining the health condition of an individual based on the acquired vital information, which is information on vital signs.
    Information processing equipment,
    An information input means that accepts input of the vital information including at least one measured value selected from vital signs that are acquired from the same individual and that follows a normal distribution, and an acquisition date and time.
    An information recording means for recording the input vital information and information on the acquisition date and time, and
    A reference calculation means for calculating the average μ and the standard deviation σ of all or a part of the plurality of recorded vital information, and
    Based on a predetermined numerical range set based on at least one selected from the average μ and the standard deviation σ, it is determined whether or not the input predetermined vital information is an abnormal value, and the above-mentioned A predetermined numerical range includes a determination means set based on a normal distribution having at least the average μ as a peak value, and
    It is software to function as a means including
    The vital information of at least 30 measurement data reflects the intra-individual variation peculiar to the individual.
    The normal distribution is created from the vital information of at least 30 measurement data.
    The vital information is
    Includes at least one measurement selected from the vital signs body temperature, blood pressure, pulse, pulse pressure and respiratory rate.
    The predetermined numerical range is
    For at least one measurement selected from body temperature, blood pressure, pulse, pulse pressure and respiratory rate, the following is expressed using the mean μ, the standard deviation σ, and n and m, which are numbers greater than 0. The value of Eq. (1) is the lower limit value and the value of Eq. (2) is the upper limit value, and includes the reference range condition based on at least one of the lower limit value and the upper limit value.
    The reference area condition is software in which the measured values satisfying a predetermined vital exclusion condition are excluded from the measured values of vital signs.
    μ-nσ ・ ・ ・ Equation (1)
    μ + mσ ・ ・ ・ Equation (2)
PCT/JP2019/034634 2019-09-03 2019-09-03 Software, state-of-health determination device, and state-of-health determination method WO2021044520A1 (en)

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