Medical support device

Abstract

To preliminarily prevent a division of opinions between physicians and patients.SOLUTION: A medical examination support device according to the present embodiment comprises: a setting unit; an acquisition unit; a derivation unit; and a presentation unit. The setting unit is configured to set at least one of reference objects to be compared with a patient. The acquisition unit is configured to acquire a first index serving as an index indicative of an impact of each of a plurality of medical examination candidates with respect to a disease on the patient, and a second index serving as an index indicative of an impact of each of the plurality of medical examination candidates on the reference object. The derivation unit is configured to derive a relative index of the first index of each of the plurality of medical examination candidates with respect to the second index. The presentation unit is configured to give a presentation of the relative index of each of the plurality of medical examination candidates.SELECTED DRAWING: Figure 1

Description

[Technical field]

[0001] The embodiments disclosed in the present specification and drawings relate to a medical assistance device. [Background technology]

[0002] For example, if a patient has not fully accepted their illness or prognosis, there is a possibility that the doctor and patient will not agree on anything. For example, if a doctor believes that medication or surgery will have a greater effect on improving the patient's prognosis than not treating the patient's illness, but the patient believes that it will not make much difference no matter how many years the treatment takes, and that it would be better to have as little pain as possible, there is a possibility that the doctor and patient will not agree on anything. [Prior art documents] [Patent documents]

[0003] [Patent Document 1] JP 2019-95960 A Summary of the Invention [Problem to be solved by the invention]

[0004] One of the problems that the embodiments disclosed in this specification and the drawings aim to solve is to prevent differences in opinion between doctors and patients. However, the problems solved by the embodiments disclosed in this specification and the drawings are not limited to the above problems. Problems corresponding to the effects of each configuration shown in the embodiments described later can also be positioned as other problems. [Means for solving the problem]

[0005] The medical support device according to the present embodiment includes a setting unit, an acquisition unit, a derivation unit, and a presentation unit. The setting unit sets at least one reference object to be compared with a patient. The acquisition unit acquires a first index which is an index indicating the influence of each of a plurality of treatment candidates for a disease on the patient, and a second index which is an index indicating the influence of each of the plurality of treatment candidates on the reference object. The derivation unit derives a relative index of the first index of each of the plurality of treatment candidates with respect to the second index. The presentation unit presents the relative index of each of the plurality of treatment candidates. [Brief description of the drawings]

[0006] [Figure 1] FIG. 1 is a diagram showing an example of the configuration of a medical support system including a medical support device according to the first embodiment. [Diagram 2] FIG. 2 is a diagram for explaining the problem. [Diagram 3] FIG. 3 is a diagram for explaining the problem. [Figure 4] FIG. 4 is a flowchart showing a procedure of processing by the medical support device according to the first embodiment. [Diagram 5] FIG. 5 is a diagram showing an example of a screen displayed on a terminal in the first embodiment. [Figure 6] FIG. 6 is a diagram showing an example of a screen displayed on a terminal in the first embodiment. [Figure 7] FIG. 7 is a diagram showing an example of a screen displayed on a terminal in the first embodiment. [Figure 8] FIG. 8 is a diagram showing an example of a screen displayed on a terminal in the first embodiment. [Figure 9] FIG. 9 is a diagram for explaining the process performed by the medical support device according to the second embodiment. [Figure 10A] FIG. 10A is a diagram showing an example of a screen displayed on a terminal in the second embodiment. [Figure 10B] FIG. 10B is a diagram showing an example of a screen displayed on a terminal in the second embodiment. [Figure 11A] FIG. 11A is a diagram showing an example of a screen displayed on a terminal in the second embodiment. [Figure 11B] FIG. 11B is a diagram showing an example of a screen displayed on a terminal in the second embodiment. [Figure 12A] FIG. 12A is a diagram showing an example of a screen displayed on a terminal in the second embodiment. [Figure 12B] FIG. 12B is a diagram showing an example of a screen displayed on a terminal in the second embodiment. [Figure 13A] FIG. 13A is a diagram showing an example of a screen displayed on a terminal in the second embodiment. [Figure 13B] FIG. 13B is a diagram showing an example of a screen displayed on a terminal in the second embodiment. [Figure 14A] FIG. 14A is a diagram showing an example of a screen displayed on a terminal in the second embodiment. [Figure 14B] FIG. 14B is a diagram showing an example of a screen displayed on a terminal in the second embodiment. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0007] (First embodiment) Hereinafter, an embodiment of a medical support device will be described in detail with reference to the accompanying drawings. Note that the following description will be given by taking a medical support system including the medical support device as an example.

[0008] Fig. 1 is a diagram showing an example of the configuration of a medical support system 1 including a medical support device 100 according to this embodiment. The medical support system shown in Fig. 1 includes the medical support device 100 and a terminal 10. The medical support device 100 communicates with the terminal 10.

[0009] For example, the terminal 10 includes a PC (Personal Computer), a tablet PC, a PDA (Personal Digital Assistant), a mobile terminal, etc. The terminal 10 is provided, for example, in a hospital and used by a doctor in charge of a patient.

[0010] The medical support device 100 includes a communication interface 110, a memory circuitry 120, and a processing circuitry 130.

[0011] The communication interface 110 is connected to the processing circuit 130 and controls the transmission and communication of various data between the medical assistance device 100 and the terminal 10 .

[0012] The memory circuitry 120 is connected to the processing circuitry 130 and stores various data. For example, the memory circuitry 120 is realized by a semiconductor memory element such as a RAM or a flash memory, a hard disk, an optical disk, or the like. The memory circuitry 120 is an example of a means for realizing a memory unit. Also, the memory circuitry 120 does not need to be built into the medical support device 100 as long as the medical support device 100 can access the memory circuitry 120 over a network.

[0013] The memory circuitry 120 stores a plurality of pieces of patient information from electronic medical records or the like created for a plurality of patients. Each of the plurality of pieces of patient information includes basic information and medical data of the patient. The basic information includes identification information for identifying the patient, name, date of birth, sex, blood type, height, weight, and the like. The medical data includes information such as numerical values ​​(measurements) and medical records, and information indicating the date and time of recording. For example, examples of the medical data include prescription data and nursing record data. Prescription data is medical data related to prescriptions. Nursing record data is medical data related to nursing records.

[0014] The data and information stored in the memory circuitry 120 and used in the embodiment will be described later.

[0015] The processing circuitry 130 controls the components of the medical support device 100. For example, the processing circuitry 130 executes a control function 131 and a presentation function 132 as shown in FIG. 1. Here, for example, each processing function executed by the control function 131 and the presentation function 132, which are components of the processing circuitry 130, is recorded in the storage circuitry 120 in the form of a program executable by a computer. The processing circuitry 130 is a processor that realizes a function corresponding to each program by reading each program from the storage circuitry 120 and executing it. In other words, the processing circuitry 130 in a state in which each program has been read has each function shown in the processing circuitry 130 in FIG. 1.

[0016] A display application (program) is implemented in the medical assistance device 100, and the display application can be read by the terminal 10. For example, an operator of the terminal 10 can use the display application read by the terminal to display display data transmitted from the medical assistance device 100 on the display of the terminal. The control function 131 is an example of a setting unit, an acquisition unit, and a derivation unit. The presentation function 132 is an example of a presentation unit.

[0017] The term "processor" used in the above description means a circuit such as a CPU (Central Processing Unit), a GPU (Graphics Processing Unit), an Application Specific Integrated Circuit (ASIC), a programmable logic device (e.g., a Simple Programmable Logic Device (SPLD), a Complex Programmable Logic Device (CPLD), and a Field Programmable Gate Array (FPGA)). When the processor is a CPU, for example, the processor realizes a function by reading and executing a program stored in the memory circuit 120. On the other hand, when the processor is an ASIC, for example, instead of storing a program in the memory circuit 120, the program is directly incorporated in the circuit of the processor. Note that each processor in this embodiment is not limited to being configured as a single circuit for each processor, and may be configured as one processor by combining multiple independent circuits to realize its function. Furthermore, the multiple components in FIG. 2 may be integrated into one processor to realize its function.

[0018] The above describes the overall configuration of the medical support system including the medical support device 100 according to the first embodiment. With such a configuration, the medical support device 100 prevents differences in opinion between doctors and patients.

[0019] For example, if a patient has not fully accepted their illness or prognosis, there is a possibility that the doctor and patient will not agree. The reason for this can be explained based on diminishing sensitivity and reference point dependence, which are principles of prospect theory, a representative theory of behavioral economics. Diminishing sensitivity is a characteristic in which the greater the absolute value of gain or loss, the duller the sense of it becomes, while reference point dependence is a characteristic in which, when people judge gain or loss, they determine value based on the magnitude of change from a certain point rather than on an absolute level.

[0020] For example, if a doctor believes that drug therapy or surgery will have a greater effect on improving the prognosis than not treating the patient's disease, then from the doctor's perspective, drug therapy or surgery is worth the loss of pain from surgery and side effects from drug therapy. In such a case, as shown in Figure 2, from the doctor's perspective, the "value of the patient" increases in the order of "no treatment," "medication," and "surgery." On the other hand, if a patient believes that, for example, compared to the 10 years he could have lived, it doesn't make much difference whether he was treated for six months or a year, and that it would be better to have as little pain as possible, then from the patient's perspective, the value is that not treating is better than drug therapy or surgery. In such a case, as shown in Figure 2, from the patient's perspective, the "value of the patient" increases in the order of "surgery," "medication," and "no treatment." In this case, there is a high possibility that the doctor and the patient will not agree on anything.

[0021] In addition, when a patient is already feeling distressed about their illness or treatment, doctors and patients may not agree on the outcome. This can be explained by the principles of loss aversion and reference point dependence in prospect theory, a behavioral economics field. Loss aversion is the characteristic of feeling the pain of loss more than the pain of gain.

[0022] For example, if a doctor thinks that he does not want to waste his efforts so far by undergoing high-risk treatment, that is, if the doctor wants to perform treatment that avoids risk, from the doctor's point of view, performing low-risk treatment is valuable to the patient. In such a case, as shown in Figure 3, from the doctor's point of view, the "patient value" is higher for "low-risk treatment" than for "high-risk treatment". On the other hand, for example, if the patient thinks that he has already suffered enough and is willing to take a gamble to obtain therapeutic effects that are worth the pain he has suffered so far, that is, if the patient thinks that he is willing to take risks and obtain therapeutic effects, then from the patient's point of view, performing high-risk treatment is valuable. In such a case, as shown in Figure 3, from the patient's point of view, the "patient value" is higher for "high-risk treatment" than for "low-risk treatment". In this case, it is highly likely that the doctor and the patient will not agree on anything.

[0023] In this way, doctors and patients have different values ​​because there is no set standard for what they value. For this reason, doctors and patients need to align their values ​​as much as possible.

[0024] Therefore, the medical support device 100 according to the first embodiment performs the following processing. First, in the medical support device 100 according to the first embodiment, the control function 131 sets at least one reference object to be compared with the patient. The control function 131 acquires a first index which is an index indicating the influence of each of a plurality of treatment candidates for a disease on the patient, and a second index which is an index indicating the influence of each of the plurality of treatment candidates on the reference object. The control function 131 derives a relative index of the first index of each of the plurality of treatment candidates with respect to the second index. The presentation function 132 presents the relative index of each of the plurality of treatment candidates.

[0025] Each function of the control function 131 and the presentation function 132 will be described below with reference to Fig. 4 to Fig. 8. Fig. 4 is a flowchart showing the procedure of processing by the medical support device 100 according to the first embodiment.

[0026] 4 is a step in which the processing circuitry 130 calls up a program corresponding to the control function 131 from the storage circuitry 120 and executes the program. In step S101, the control function 131 executes a setting process. Specifically, the control function 131 sets at least one reference object to be compared with the patient P.

[0027] Here, in this embodiment, for example, the memory circuitry 120 stores treatment impact information in addition to the above-mentioned multiple patient information. The treatment impact information is information on the impact of each of multiple treatment policies on a disease in a specific individual and a specific group. The specific individual represents, for example, an individual similar to the patient P. The specific group represents, for example, a group of patients with the same attributes as the patient P, or a group including individuals not suffering from the corresponding disease. For example, when the disease of the patient P is aortic valve stenosis, the treatment policies include surgery, catheter treatment, medication, no treatment, and the like. The treatment impact information also includes information such as age and gender of the specific individual and the specific group.

[0028] First, in the setting process, the control function 131 sets the type of index indicating the effect of each of a plurality of treatment candidates for a disease on the patient P. For example, the doctor in charge of the patient P uses the terminal 10 to specify the type of index as a specification of an outcome, and the control function 131 sets the specified type of index.

[0029] Here, since it is necessary for the values ​​of patient P and the doctor in charge of said patient P to be as aligned as possible, the outcome may be specified according to the user who is the doctor in charge, the outcome may be specified according to the wishes of patient P, or the outcome may be specified according to the combination of patient P and the doctor in charge.

[0030] The types of indices include survival rate, mortality rate, survival time, quality-adjusted life year (QALY), incidence rate of adverse events, re-admission rate, and quality of life (QOL) indices. Indices related to losses may also be used. Indices related to losses may include, for example, side effects, treatment costs, and treatment duration. Here, for example, in the case of survival rate, "3-year survival rate" represents the proportion of patients who survive for 3 years among a group of patients who have passed 3 years after surgery. In addition, for mortality rate, for example, "5-year mortality rate" represents the proportion of patients who have died among a group of patients who have passed 5 years after surgery. In addition, in the case of survival rate, not only "surgery date" but also "diagnosis date", "treatment start date", "today (at the time of information presentation)", etc. may be used as the reference date.

[0031] Next, in the setting process, the control function 131 sets at least one reference object to be compared with the patient P. For example, the doctor in charge of the patient P uses the terminal 10 to specify a reference object, and the control function 131 sets the specified reference object. Here, the reference object means the above-mentioned specific individual or the above-mentioned specific group, and includes information such as the age and sex of the specific individual and the specific group. Note that the specific individual also includes an arbitrarily selected individual. Also, the specific group also includes an arbitrarily selected group and a group of all people from whom information can be obtained.

[0032] Step S102 in Fig. 4 is a step in which the processing circuitry 130 calls up a program corresponding to the control function 131 from the storage circuitry 120 and executes the program. In step S101, the control function 131 executes an acquisition process. Specifically, the control function 131 acquires an index indicating the influence of each of a plurality of treatment candidates for a disease on the patient P, and an index indicating the influence of each of the plurality of treatment candidates on a reference subject. Here, the index indicating the influence of each of the plurality of treatment candidates for a disease on the patient P is an example of a "first index", and the index indicating the influence of each of the plurality of treatment candidates on the reference subject is an example of a "second index".

[0033] First, in the acquisition process, the control function 131 acquires an index indicating the impact of each of multiple treatment candidates for a disease on the patient P from the treatment effect information based on the type of index specified by the doctor in charge of the patient P using the terminal 10. Specifically, the control function 131 predicts an index for each of multiple treatment candidates for the patient P from the treatment effect information of a patient group having the same attributes as the patient P. For example, the control function 131 predicts the index for each of the multiple treatment candidates for the patient P by performing statistical processing, or predicts using a trained model obtained from machine learning.

[0034] Next, in the acquisition process, the control function 131 calculates an index indicating the influence of each of a plurality of treatment candidates for the disease on a reference target specified by the doctor in charge of the patient P using the terminal 10.

[0035] 4 is a step in which the processing circuitry 130 calls up a program corresponding to the control function 131 from the storage circuitry 120 and executes the program. In step S101, the control function 131 executes a derivation process. Specifically, the control function 131 derives a relative index of each index of a plurality of treatment candidates with respect to an index of a reference target.

[0036] For example, the control function 131 derives a relative index as a ratio, variance, or difference between the values ​​of an index for each of a number of treatment candidates relative to an index for a reference subject.

[0037] The control function 131 may exclude treatment candidates that are not appropriate for the patient P and derive a relative index for each of the multiple treatment candidates. For example, if a drug used for a drug treatment of a disease is incompatible with a drug that the patient P is taking for an underlying disease, the control function 131 excludes the drug treatment. In this case, the control function 131 excludes a treatment candidate that is an inappropriate treatment plan for the patient P from among the multiple treatment candidates for the index of the reference target, and derives a relative index for each of the multiple treatment candidates.

[0038] 4 is a step in which the processing circuitry 130 calls up a program corresponding to the presentation function 132 from the storage circuitry 120 and executes the program. In step S102, the presentation function 132 executes a presentation process. Specifically, the presentation function 132 presents relative indices for each of a plurality of treatment candidates.

[0039] 5 to 8 show an example of a screen displayed on the terminal 10 of the doctor in charge of the patient P. For example, in the setting process, the control function 131 sets "three-year prediction (three-year survival rate)" as the type of index by designation from the terminal 10, and sets two groups as reference objects: a patient group "treated" who has undergone various standard treatments including "surgery", "catheterization" (hereinafter referred to as "TAVI"), and "medication" for the disease, and a patient group "not treated" who has not undergone treatment for the corresponding disease. The patient group "not treated" is, for example, patients who have undergone only follow-up. In this case, in the acquisition process, the control function 131 predicts an index "three-year prediction" that indicates the influence on the patient P of each of a plurality of treatment candidates for the disease, "surgery", "TAVI", and "medication". In addition, the control function 131 calculates an index of the reference object.

[0040] Here, for example, the control function 131 derives, as the relative index, the ratio of the index value of each of the multiple treatment candidates "surgery", "TAVI", and "medication" to the index of the reference target. The doctor in charge of the patient P operates the terminal 10 to specify that the index value is to be derived as a ratio. At this time, the presentation function 132 displays the screen shown in FIG. 5 on the display of the terminal 10 as the relative index of each of the multiple treatment candidates "surgery", "TAVI", and "medication".

[0041] The screen shown in FIG. 5 displays that, in the index "prediction after 3 years," 77 out of 100 patients in the group of patients who received treatment, "treated," are alive, and 23 out of 100 patients in the group of patients who did not receive treatment, "not treated," are alive. In addition, the screen shown in FIG. 5 displays the relative ratios "60%, "93%, and "48%" of the representative values ​​(average, median, etc.) of the indexes predicted for each of "surgery," "TAVI," and "medication" as relative indices of patient P when the 3-year survival rate of "not treated" is 0% and the 3-year survival rate of "treated" is 100%. In the screen shown in FIG. 5, for example, when treatment is performed for a disease taking into account 3 years later, it can be seen that there is a high possibility of survival, and when treatment is performed, there is a high possibility that catheter treatment is effective. In this case, for example, when patient P, who thinks that no treatment is better than surgery or other treatment, sees the screen shown in Figure 5 and confirms the effect of catheter treatment, he or she may be able to share the same feeling as the doctor who thinks that drug treatment or surgery is worth the loss of pain from surgery and side effects from drug treatment. In other words, by sharing sensitivity regarding gains and losses between the doctor and patient P, the doctor and patient P may come to the same opinion.

[0042] Also, for example, the control function 131 derives, as a relative index, the variance of the index values ​​of each of the multiple treatment candidates "surgery", "TAVI", and "medication" relative to the index of the reference target. The doctor in charge of the patient P operates the terminal 10 to specify that the index value is to be derived as a variance. At this time, the presentation function 132 displays the screen shown in FIG. 6 on the display of the terminal 10 as the relative indexes of each of the multiple treatment candidates "surgery", "TAVI", and "medication".

[0043] In this case, the screen shown in FIG. 6 displays the variance of the index values ​​of the multiple treatment candidates "surgery", "TAVI", and "medication" relative to the index of the reference target as a relative index. In the screen shown in FIG. 6, when the 3-year survival rate of "without treatment" is 0% and the 3-year survival rate of "with treatment" is 100%, it is shown that the 3-year survival rate predicted when "surgery" is performed on patient P is in the range of "38 to 112%" for the 3-year survival rate of "with treatment" of "100%". Similarly, the screen shown in FIG. 6 shows that the 3-year survival rate predicted when "TAVI" is performed on patient P is in the range of "50 to 93%" for the 3-year survival rate of "with treatment" of "100%". Similarly, the screen shown in FIG. 6 shows that the 3-year survival rate predicted when "medication" is performed on patient P is in the range of "46 to 67%" for the 3-year survival rate of "with treatment" of "100%". In such a case, the effects of "TAVI" and "medication" can only be confirmed in the range below 100%. On the other hand, for "surgery", the effect varies widely, but the effect can be confirmed from the region above 100% to the region below 100%. In this case, for example, when patient P who believes that low-risk treatment is valuable sees the screen shown in Figure 6, he or she may wish to undergo surgery, and the doctor and patient P may come to an agreement.

[0044] Also, the reference object may be only one, and the relative may be a difference rather than a ratio. Specifically, in the setting process, the control function 131 sets the type of index to "prediction after 3 years" by specification from the terminal 10, and sets only a group of patients who have undergone some standard treatment for a disease, "treated", as the reference object. For example, the control function 131 derives the difference between the index values ​​of the multiple treatment candidates "surgery", "TAVI", and "medication" and the index of the reference object as the relative index. The doctor in charge of the patient P operates the terminal 10 to specify that the index value is derived as a difference. At this time, the presentation function 132 displays the screen shown in FIG. 7 on the display of the terminal 10 as the relative indexes of the multiple treatment candidates "surgery", "TAVI", and "medication".

[0045] The screen shown in FIG. 7 displays the difference between the index values ​​of the multiple treatment candidates "surgery," "TAVI," and "medication" as relative indices, "-9 people," "+5 people," and "-12 people," respectively, with respect to the index of the reference target. In the screen shown in FIG. 7, when the average of the "treated" group is "77 people out of 100 will survive" after three years, "-9 people" is displayed because the predictive index when "surgery" is performed on patient P is "68 people out of 100 will survive." Similarly, in the screen shown in FIG. 7, the predictive index when "TAVI" is performed on patient P is "82 people out of 100 will survive," so "+5 people" is displayed. Similarly, in the screen shown in FIG. 7, the predictive index when "medication" is performed on patient P is "65 people out of 100 will survive," so "-12 people" is displayed. In this case, maximizing the sensitivity to gain and loss is effective for patient P who believes that a treatment with a higher therapeutic effect than the average is valuable, and there is a possibility that the doctor and patient P will agree on the same opinion.

[0046] The control function 131 can set a time parameter for the index. Specifically, when the control function 131 accepts a change in the type of index, it acquires the changed type of index. For example, when the difference of "3-year prediction" in FIG. 7 is displayed, if the "reference date" is changed from "diagnosis date" to "2 years after diagnosis" by the setting from the terminal 10, the index is changed from "3-year prediction" to "1-year prediction" of "2 years after diagnosis". In other words, the index is changed, for example, from a 3-year survival rate to the probability that a group that was alive 2 years after diagnosis is alive one year after that (1-year survival rate of 2-year survivors).

[0047] The screen shown in FIG. 8 displays that, for the index "1-year prediction (for 2-year survivors)," 77 out of 100 patients in the "same age" group who received treatment are alive. In the screen shown in FIG. 8, when the average of the "same age" group who received treatment is "77 out of 100 alive" after 3 years, "-13 people" is displayed because the prediction index for when "surgery" is performed on patient P is "64 out of 100 alive." Similarly, in the screen shown in FIG. 8, the prediction index for when "TAVI" is performed on patient P is "67 out of 100 alive," so "-10 people" is displayed. Similarly, in the screen shown in FIG. 8, the prediction index for when "medication" is performed on patient P is "61 out of 100 alive," so "-16 people" is displayed. In this case, if the influence of the most recent gain / loss is too large, the doctor and patient P may agree by reducing the magnitude of the influence.

[0048] As described above, in the medical support device 100 according to the first embodiment, the control function 131 sets at least one reference object to be compared with the patient P, and obtains a first index which is an index indicating the influence of each of the multiple treatment candidates for the disease on the patient P, and a second index which is an index indicating the influence of each of the multiple treatment candidates for the disease on the reference object. Then, the control function 131 derives a relative index of the first index of each of the multiple treatment candidates with respect to the second index, and the presentation function 132 presents the relative index of each of the multiple treatment candidates, so that the doctor and the patient P can align their values ​​as much as possible. Therefore, in the medical support device 100 according to the first embodiment, it is possible to prevent a difference in opinion between the doctor and the patient P in advance.

[0049] For example, if we explain this on the basis of diminishing response and reference point dependency from prospect theory, which is a representative theory in behavioral economics, the presentation function 132 presents relative indices for each of a plurality of treatment candidates to the patient P and the doctor in charge of the patient P, it may be possible for the doctor who believes that performing drug treatment or surgery is worth the losses such as pain due to surgery and side effects of drug treatment, and the patient P who believes that no treatment is better than performing treatment such as surgery to share their feelings.

[0050] In addition, if we explain this on the basis of loss aversion and reference point dependency from the prospect theory of behavioral economics, by the presentation function 132 presenting relative indices for each of a plurality of treatment candidates to the patient P and the doctor in charge of the patient P, it is possible that a doctor who believes that low-risk treatment is valuable for the patient and a patient who believes that high-risk treatment is valuable can share their feelings.

[0051] In this way, by sharing the sensitivity to gains and losses between the doctor and the patient P, there is a possibility that the doctor and the patient P will come to an agreement. For this reason, the medical support device 100 according to the first embodiment sets a reference object and a type of index that the patient will be convinced of and will accept the doctor's proposal from the relative positional relationship on the outcome axis between the index value (reference point) of the reference object and the index values ​​predicted for each of a plurality of treatment candidates for the patient, and presents the result. In this way, in the first embodiment, it is possible to prevent the doctor and the patient P from coming to an agreement on the opinion.

[0052] Second Embodiment In the medical support device 100 according to the second embodiment, the reference candidate targets to be used as the reference target are narrowed down from the treatment candidates selected by the user, the doctor (the doctor in charge of patient P), and the reference target selected by the doctor in charge of patient P is set from the reference candidate targets.

[0053] First, the control function 131 acquires representative values ​​(average, median, etc.) and variations of indices showing the impact on the patient of each of multiple treatment options for a disease, "surgery," "TAVI," and "medication," from the treatment impact information for multiple indices. Examples of multiple indices include "three-year prediction (three-year survival rate)," "five-year prediction (three-year survival rate)," and "two-year survivor one-year prediction (one-year survival rate)."

[0054] Next, the control function 131 acquires candidates for reference targets for each index. For example, multiple combinations selected from multiple reference targets are set as reference candidate targets. Examples of multiple reference targets include a patient group "without treatment" who did not receive treatment such as "surgery", "TAVI", or "medication" for a disease, and a patient group "with treatment" who received treatment such as "surgery", "TAVI", or "medication" for a disease. In addition, examples of multiple reference targets, when "same age" is used as a reference point, include a patient group "without treatment in the same age" who did not receive treatment such as "surgery", "TAVI", or "medication" for a disease in the same age, and a patient group "with treatment in the same age" who received treatment such as "surgery", "TAVI", or "medication" for a disease in the same age.

[0055] Next, the control function 131 derives a relative index for each of a plurality of reference candidate subjects for each index, and creates a table shown in FIG. 9. The table shown in FIG. 9 is created for each type of index. For example, when the index is "3-year prediction (3-year survival rate)" and a representative value (average, median, etc.) of the index is specified, a relative index as shown in FIG. 9 is derived. For example, in the patient group "without treatment in the same age group", there is a difference in the relative index compared to the patient group "without treatment" when "same age" is not used as the reference point, and the relative index is higher in the order of "surgery", "TAVI", and "medication". Also, for example, in the patient group "with treatment in the same age group", there is no difference in the relative index compared to the patient group "with treatment" when "same age" is not used as the reference point. Also, for example, in the patient group "with treatment in the same age group", there is a difference in the relative index compared to the patient group "without treatment" when "same age" is not used as the reference point, and the relative index is higher in the order of "medication", "TAVI", and "surgery".

[0056] Next, the presentation function 132 presents the table shown in Fig. 9 to the doctor in charge of patient P by displaying it on the terminal 10. The doctor in charge of patient P refers to the relative indexes of each of the multiple reference candidate targets in the table displayed on the terminal 10 and selects a reference candidate target that matches the purpose of the doctor in charge of patient P. At this time, the control function 131 sets the reference candidate target selected by the doctor in charge of patient P as the reference target.

[0057] Then, when the reference target is set, the same process as in the first embodiment is performed, and the presentation function 132 displays on the terminal 10 a screen that the doctor in charge of the patient P wants to show to the patient P. An example of the screen display will be described below.

[0058] First, as an example of a screen display, a display example based on diminishing sensitivity and reference point dependency from the prospect theory of behavioral economics will be described.

[0059] For example, when the doctor in charge of the patient P wants to show the patient P a screen emphasizing the difference in effect, the doctor in charge of the patient P uses the terminal 10 to specify "one-year prediction" as the type of index, and specifies two groups as reference subjects: a group of patients "treated" who have been treated for a disease with "surgery", "TAVI", "medication", etc., and a group of patients "not treated" who have not been treated for the corresponding disease. In this case, the control function 131 sets a plurality of reference candidate subjects that meet the purpose of the doctor in charge of the patient P as reference subjects, and derives the value of the index of each of the plurality of reference candidate subjects as a relative index. As a result, the presentation function 132 displays the screen shown in FIG. 10A on the display of the terminal 10 as the relative index of each of the plurality of treatment candidates "surgery", "TAVI", and "medication".

[0060] The screen shown in FIG. 10A displays that, for the index "prediction after one year," 77 out of 100 patients in the group of patients who received treatment, "treated," are alive, and 23 out of 100 patients in the group of patients who did not receive treatment, "not treated," are alive. The screen shown in FIG. 10A also displays the relative ratios "60%, "93%, and "48%" of the representative values ​​(average, median, etc.) of the indexes predicted for each of "surgery," "TAVI," and "medication" as relative indexes for patient P when the one-year survival rate for "not treated" is 0% and the one-year survival rate for "treated" is 100%. In this case, the effectiveness of "TAVI" is emphasized, and for example, by showing the screen shown in FIG. 10A to patient P who places importance on the difference in effectiveness, the doctor and patient P may agree with each other.

[0061] On the other hand, for example, if the doctor in charge of the patient P wants to show the patient P a screen that does not emphasize the difference in effect, the doctor in charge of the patient P uses the terminal 10 to specify "one year later prediction" as the type of index, and specifies the group of patients of the same age as the patient P among the group of patients "treated" who have undergone treatment such as "surgery", "TAVI", and "medication" for the disease as the reference object. In this case, the control function 131 sets a plurality of reference candidate objects that meet the purpose of the doctor in charge of the patient P as the reference object, and derives the value of the index of each of the plurality of reference candidate objects as a relative index. As a result, the presentation function 132 displays the screen shown in FIG. 10B on the display of the terminal 10 as the relative index of each of the plurality of treatment candidates "surgery", "TAVI", and "medication".

[0062] The screen shown in FIG. 10B displays that, for the index "1-year prediction," 97 out of 100 patients of the same age group who received treatment, "average of the same age," are alive, and 10 out of 100 patients of the same age group who did not receive treatment, "no treatment of the same age group," are alive. In addition, the screen shown in FIG. 10B displays the relative ratios "53%, "67%, and "46%" of the representative values ​​(average, median, etc.) of the indexes predicted for each of "surgery," "TAVI," and "medication" as relative indices for patient P when the 1-year survival rate of "no treatment of the same age group" is 0% and the 1-year survival rate of "average of the same age group" is 100%. In this case, the difference in the effects of "surgery," "TAVI," and "medication" is not emphasized.

[0063] Next, as an example of a screen display, a first display example based on loss aversion and reference point dependence from the prospect theory of behavioral economics will be described.

[0064] For example, when the doctor in charge of the patient P wants to show the patient P a screen recommending a low-risk treatment as a screen for avoiding risks, the doctor in charge of the patient P uses the terminal 10 to specify "one-year prediction" as the type of index, and specifies two groups as reference subjects: a group of patients "treated" who have received treatment such as "surgery," "TAVI," and "medication" for a disease, and a group of patients "not treated" who have not received treatment for the corresponding disease. As a result, the presentation function 132 displays the screen shown in FIG. 11A on the display of the terminal 10 as relative indexes for each of the multiple treatment candidates "surgery," "TAVI," and "medication."

[0065] The screen shown in FIG. 11A displays that, in the index "prediction after one year," 77 out of 100 patients in the group of patients who received treatment, "with treatment," are alive. The screen shown in FIG. 11A also shows that, compared to the 77 survivals of "with treatment," the predicted one-year survival rate when "surgery" is performed on patient P is in the range of "-6 to 11." Similarly, the screen shown in FIG. 11A shows that, compared to the 77 survivals of "with treatment," the predicted one-year survival rate when "TAVI" is performed on patient P is in the range of "-3 to 8." Similarly, the screen shown in FIG. 11A shows that, compared to the 77 survivals of "with treatment," the predicted one-year survival rate when "medication" is performed on patient P is in the range of "2 to 3." In this case, the effect of "medication" can be confirmed in the range exceeding 100%. On the other hand, the effects of "surgery" and "TAVI" vary greatly, but the effects can be confirmed from the range greatly exceeding 100% to the range below 100%. In this case, for example, by showing the screen shown in FIG. 11A to a patient P who believes that low-risk treatment is valuable, there is a possibility that the doctor and the patient P will come to a consensus.

[0066] On the other hand, for example, if the doctor in charge of the patient P wants to show the patient P a screen that recommends high-risk treatment as a risk-loving screen, the doctor in charge of the patient P uses the terminal 10 to specify "one-year prediction" as the type of index, and specifies, as the reference subject, a group of patients of the same age as the patient P, among the group of "treated" patients who have undergone treatment such as "surgery," "TAVI," and "medication" for the disease. As a result, the presentation function 132 displays the screen shown in FIG. 11B on the display of the terminal 10 as relative indexes for each of the multiple treatment candidates "surgery," "TAVI," and "medication."

[0067] The screen shown in FIG. 11B displays that, in the index "one year later prediction," 97 out of 100 patients in the "average of the same age" who received treatment in the same age group are alive. In addition, the screen shown in FIG. 11B displays the index values ​​of the multiple treatment candidates "surgery," "TAVI," and "medication" for the index of the reference subject as relative indexes. In addition, the screen shown in FIG. 11B shows that the predicted one-year survival rate when "surgery" is performed on patient P is in the range of "-16 to 5" compared to the survival of 97 patients in the "average of the same age." Similarly, the screen shown in FIG. 11B shows that the predicted one-year survival rate when "TAVI" is performed on patient P is in the range of "-10 to 3" compared to the survival of 97 patients in the "average of the same age." Similarly, the screen shown in FIG. 11B shows that the predicted one-year survival rate when "medication" is performed on patient P is in the range of "-6 to -7" compared to the survival of 97 patients in the "average of the same age." In such a case, the effect of "medication" can only be confirmed in the range below 100%. On the other hand, for "Surgery" and "TAVI", the effects vary widely, but the effects can be seen from areas exceeding 100% to areas significantly below 100%. In this case, for example, by showing the screen shown in Fig. 11B to patient P who believes that high-risk treatment is valuable, the doctor and patient P may come to a consensus.

[0068] As an example of the screen display, a second display example based on loss aversion and reference point dependence from the prospect theory of behavioral economics will be described.

[0069] For example, when the doctor in charge of the patient P wants to show the patient P a screen that emphasizes low risk based on loss aversion and reference point dependency from the prospect theory of behavioral economics, the doctor in charge of the patient P uses the terminal 10 to specify "one year later prediction" as the type of index, and specifies the group of patients "treated" who have undergone treatment such as "surgery", "TAVI", and "medication" for a disease as the reference object. As a result, the presentation function 132 displays a screen that avoids risk as shown in FIG. 12A on the display of the terminal 10 as the relative index of each of the multiple treatment candidates "surgery", "TAVI", and "medication", similarly to the case of FIG. 11A. In this case, for example, by showing the screen shown in FIG. 12A to the patient P who thinks that low-risk treatment is valuable, the doctor and the patient P may agree on their opinions.

[0070] On the other hand, for example, there is a case where the doctor in charge of the patient P wants to show the patient P a screen that emphasizes the magnitude of the effect. In this case, for example, the doctor in charge of the patient P uses the terminal 10 to specify "one year later prediction" as the type of index, and specifies two groups as the reference subjects: a group of patients of the same age as the patient P among the group of patients "treated" who have been treated for the disease with "surgery", "TAVI", "medication", etc., and a group of patients "not treated" who have not been treated for the corresponding disease. In addition, as a method of deriving the index, it is assumed that a ratio is specified from the terminal 10 by the operation of the doctor in charge of the patient P. As a result, the presentation function 132 displays a screen that emphasizes the difference in effect as shown in FIG. 12B on the display of the terminal 10 as a relative index for each of the multiple treatment candidates "surgery", "TAVI", and "medication", similarly to the case of FIG. 10A. In this case, for example, by showing the screen shown in FIG. 12B to the patient P who emphasizes the difference in effect, the doctor and the patient P may agree with each other.

[0071] For example, when the doctor in charge of the patient P wants to change the outcome and show the patient P a screen that emphasizes short-term effects, the doctor in charge of the patient P uses the terminal 10 to specify "three-year prediction" as the type of index, and specifies two groups as the reference subjects: a group of patients "treated" who have been treated for the disease with "surgery", "TAVI", "medication", etc., and a group of patients "not treated" who have not been treated for the corresponding disease. In addition, as a method of deriving the index, a ratio is specified from the terminal 10 by the operation of the doctor in charge of the patient P. As a result, the presentation function 132 displays a screen showing the effect of the three-year survival rate on the display of the terminal 10 as a relative index for each of the multiple treatment candidates "surgery", "TAVI", and "medication", as shown in FIG. 13A. In this case, for example, by showing the screen shown in FIG. 12A to the patient P who emphasizes short-term effects, the doctor and the patient P may agree with each other.

[0072] On the other hand, for example, the doctor in charge of the patient P may want to change the outcome and show the patient P a screen that emphasizes long-term effects. In this case, for example, the doctor in charge of the patient P uses the terminal 10 to specify "prediction after 5 years" as the type of index, and specifies two groups as the reference subjects: a group of patients "treated" who have been treated for a disease with "surgery", "TAVI", "medication", etc., and a group of patients "not treated" who have not been treated for the corresponding disease. As a result, the presentation function 132 displays a screen showing the effect of the 5-year survival rate on the display of the terminal 10 as a relative index for each of the multiple treatment candidates "surgery", "TAVI", and "medication", as shown in FIG. 13B. In this case, for example, by showing the screen shown in FIG. 12B to the patient P who emphasizes long-term effects, the doctor and the patient P may agree with each other.

[0073] For example, when the doctor in charge of the patient P wants to show the patient P a screen that emphasizes the overall effect such as "3-year survival rate" as the survival rate, the doctor in charge of the patient P uses the terminal 10 to specify "3-year prediction" as the type of index, and specifies the patient group "same age" of the same age as the patient P among the group "treated" of patients who have received treatment such as "surgery", "TAVI", and "medication" for the disease as the reference subject. As a result, the presentation function 132 displays a screen showing the effect of "3-year prediction" as shown in FIG. 14A on the display of the terminal 10 as a relative index for each of the multiple treatment candidates "surgery", "TAVI", and "medication". In this case, for example, by showing the screen shown in FIG. 13A to the patient P who emphasizes the overall effect, the doctor and the patient P may agree with each other.

[0074] On the other hand, for example, the doctor in charge of the patient P may want to show the patient P a screen that emphasizes long-term effects such as "1-year survival rate (of 2-year survivors)" as a survival rate. In this case, for example, the doctor in charge of the patient P uses the terminal 10 to specify "1-year prediction" after 2 years have passed since diagnosis as the type of index, and specifies a group of patients of the same age as the patient P among "treated" groups of patients who have undergone treatment such as "surgery", "TAVI", and "medication" for a disease as the reference subject. As a result, the presentation function 132 displays a screen showing the effect of "1-year prediction" after 2 years have passed since diagnosis on the display of the terminal 10 as a relative index for each of the multiple treatment candidates "surgery", "TAVI", and "medication", as shown in FIG. 14B. In this case, for example, by showing the screen shown in FIG. 13B to the patient P who emphasizes long-term effects, the doctor and the patient P may agree with each other.

[0075] As explained above, in the medical support device 100 of the second embodiment, by narrowing down the reference candidate targets to be used as the reference target from the treatment candidates selected by the doctor in charge of the patient P, and setting the reference target selected by the doctor in charge of the patient P from the reference candidate targets, it is possible to align the values ​​of the doctor and the patient P as much as possible, thereby preventing differences of opinion between the doctor and the patient P in advance.

[0076] Here, in the medical support device 100 of the second embodiment, the table shown in FIG. 9 is presented to the doctor in charge of the patient P, and the control function 131 sets the reference candidate target selected by the doctor in charge of the patient P from the relative indices of each of the multiple reference candidate targets in the table shown in FIG. 9 as the reference target, but this is not limited to this.

[0077] For example, the control function 131 may accept a doctor's request such as "I want all treatment candidates to be presented with the same relative index," select a reference candidate target that meets the request from the relative indexes of the multiple reference candidate targets in the table shown in Figure 9, and set the selected reference candidate target as the reference target.

[0078] Specifically, for example, when the doctor in charge of the patient P considers that the surgery of the patient P is the top priority, the doctor in charge specifies information indicating that fact by the terminal 10, and the control function 131 selects a reference candidate target and a type of index according to the information specified by the terminal 10 from the relative indexes of each of the multiple reference candidate targets in the table shown in FIG. 9. For example, the control function 131 selects "prediction after one year" as the type of index, and selects two groups as the reference target: a group of patients "treated" who have been treated for the disease P with "surgery", "TAVI", "medication", etc., and a group of patients "not treated" who have not been treated for the corresponding disease. In this case, the control function 131 sets the selected reference candidate target as the reference target, and derives the value of the index of each of the multiple reference candidate targets as a relative index. As a result, the presentation function 132 presents to the patient P and the doctor in charge of the patient P by displaying on the terminal 10 a screen in which the effectiveness of the implementation of surgery is emphasized as the relative index of each of the multiple treatment candidates "surgery", "TAVI", and "medication". In this case, by showing the patient P, who is reluctant to undergo surgery, a screen emphasizing the effectiveness of the surgery, there is a possibility that the doctor and the patient P will come to a consensus.

[0079] For example, when the doctor in charge of the patient P thinks that medication is effective for the patient P who is physically unwell, such as a child or an elderly person, the doctor in charge of the patient P designates information indicating that effect by the terminal 10, and the control function 131 selects a reference target and a type of index according to the information designated by the terminal 10 from the relative indexes of each of the multiple reference candidate targets in the table shown in FIG. 9. For example, the control function 131 selects "prediction after one year" as the type of index, and selects a group of patients of the same age as the patient P from the group of patients "treated" who have been treated for a disease with "surgery", "TAVI", "medication", etc., as the reference target. In this case, the control function 131 sets the selected reference candidate target as the reference target, and derives the value of the index of each of the multiple reference candidate targets as a relative index. As a result, the presentation function 132 displays a screen on the terminal 10 in which the effectiveness of medication is emphasized as the relative index of each of the multiple treatment candidates "surgery", "TAVI", and "medication", thereby presenting it to the patient P and the doctor in charge of the patient P. In this case, by showing the patient P, who wants to undergo surgery despite concerns about his or her physical condition, a screen emphasizing the effectiveness of the medication, there is a possibility that the doctor and the patient P will come to a consensus.

[0080] Alternatively, for example, the control function 131 may automatically select the reference target and the type of index based on the tendency of the doctor who is the user (the doctor in charge of the patient P) or the team to which the doctor belongs.

[0081] Specifically, for example, the control function 131 refers to the past history selected by the user, and when the user has a tendency to select surgery as a patient attribute, automatically selects a reference candidate target and a type of index from the relative indexes of each of the multiple reference candidate targets in the table shown in FIG. 9. For example, the control function 131 selects "prediction after one year" as the type of index, and automatically selects "treated" as the reference target, a group of patients who have received treatment such as "surgery", "TAVI", and "medication". As a result, the presentation function 132 displays on the terminal 10, for example, a screen as shown in FIG. 11A, which emphasizes that surgery is effective. In this case, by showing the patient P a screen which emphasizes that surgery is effective, there is a possibility that the doctor and the patient P will agree on the same opinion.

[0082] Here, in the case of the automatic selection described above, the control function 131 sets the reference target according to the doctor (or the team to which the doctor belongs), but the reference target may also be set according to the patient, or the reference target may be set according to a combination of doctor and patient.

[0083] In addition, each component of each device illustrated in the present embodiment is a functional concept, and does not necessarily have to be physically configured as illustrated. In other words, the specific form of distribution and integration of each device is not limited to that illustrated, and all or a part of them can be functionally or physically distributed and integrated in any unit according to various loads and usage conditions. Furthermore, each processing function performed by each device can be realized in whole or in any part by a CPU and a program analyzed and executed by the CPU, or can be realized as hardware using wired logic.

[0084] The method described in this embodiment can be realized by executing a prepared program on a computer such as a personal computer or a workstation. This program can be distributed via a network such as the Internet. This program can also be recorded on a non-transitory computer-readable recording medium such as a hard disk, a flexible disk (FD), a CD-ROM, an MO, or a DVD, and executed by being read from the recording medium by a computer.

[0085] According to at least one of the embodiments described above, it is possible to prevent differences in opinion between doctors and patients.

[0086] Although some embodiments have been described, these embodiments are presented as examples and are not intended to limit the scope of the invention. These embodiments can be implemented in various other forms, and various omissions, substitutions, modifications, and combinations of embodiments can be made without departing from the spirit of the invention. These embodiments and their modifications are included in the scope of the invention and its equivalents as described in the claims, as well as in the scope and spirit of the invention. [Explanation of symbols]

[0087] 100 Medical support equipment 131 Control Functions 132 Presentation function

Claims

1. A storage unit in which treatment effect information is stored; an acquisition unit that acquires a first index from the treatment effect information, the first index being an index showing an effect of each of a plurality of treatment candidates for a disease on a patient, and acquires a second index being an index showing an effect of each of the plurality of treatment candidates on a reference subject to be compared with the patient; a derivation unit that provides a plurality of reference candidate objects based on one of the reference objects or a combination of a plurality of the reference objects, and derives a relative index of the first index with respect to the second index for each of the plurality of reference candidate objects; A presentation unit that presents a result of comparing the values ​​of the relative indexes of the respective treatment candidates for each of the reference candidate subjects; Equipped with The derivation unit changes a method for deriving the relative index depending on either an effect or a risk that a user wants to present, The presentation unit presents a screen emphasizing a difference in effect based on the relative index derived by the changed derivation method for each of the plurality of treatment candidates. Medical support equipment.

2. A setting unit for setting the type of the index; The medical support device according to claim 1 , further comprising:

3. The derivation unit derives, as the relative index, any one of a ratio, a variance, and a difference of the value of the first index for each of the plurality of treatment candidates with respect to the value of the second index. The medical support device according to claim 1 or 2.

4. A setting unit that sets a time parameter for the index; The medical support device according to any one of claims 1 to 3, further comprising:

5. When the setting unit accepts a change in the type of the index, the acquisition unit acquires an index of the changed type, The derivation unit derives the relative index for the index of the changed type. The medical support device according to claim 2.

6. a setting unit for setting a reference object corresponding to a reference candidate object that matches a user's purpose by specification from a terminal; The medical support device according to any one of claims 1 to 5, further comprising:

7. The setting unit sets a reference object corresponding to a reference candidate object designated by the user as the reference object for presenting the relative indicator. The medical support device according to claim 6.

8. a setting unit that sets the reference target according to any one of a user, the patient, and a combination of the user and the patient; The medical support device according to any one of claims 1 to 7, further comprising:

9. The derivation unit excludes treatment candidates that are not appropriate for the patient and derives a relative index of the index for each of the multiple treatment candidates. The medical support device according to any one of claims 1 to 8.

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