Diagnostic Systems

Abstract

The invention relates to a diagnostic system (1) comprising one or more support surfaces (11) on which a person (2) to be examined can be positioned. In order to be able to perform a diagnosis without specialized staff, the invention provides that electrodes (3) are arranged on various areas of said support surface (11), in particular on the leg areas (5), and on the arm areas (4), on the upper body area (6) and / or on the neck area (7), said electrodes being at least partially embodied as electrode pairs, each electrode pair having a feed electrode (8) and / or a measurement electrode (9), said feed electrodes (8) being arranged distally with respect to said measurement electrodes (9), a device is present for feeding a current between said feed electrodes, and said diagnostic system (1) is configured to measure the voltage drop between said measurement electrodes in order to be able to determine the impedance of the body area of ​​the person (2) located on said diagnostic system (1).

Description

[Technical field]

[0001] The present invention relates to a diagnostic system comprising one or more support surfaces on which a person to be examined can be positioned, in particular in a sitting or supine position. [Background technology]

[0002] Devices of this type are known from the prior art, for example for producing an electrocardiogram (ECG) of a person being examined. In particular, document AT 514017 B1 discloses an ECG device with chest and limb electrodes, in which, in addition to the chest and limb electrodes, at least one further electrode is attached to the body, which is suitable for feeding and / or measuring an alternating current.

[0003] At the same time, people's health consciousness has also changed significantly: people want to be precisely informed about their health status, which is why self-monitoring systems, such as heart rate measurement, ECG, self-recording of heart rate or oxygen saturation, have become widespread in recent years.

[0004] Examples of non-invasive diagnostic methods using body-attached sensors include temperature measurement, thermography, oximetry, blood pressure measurement, ECG, total body or partial impedance measurement and total body or partial impedance plethysmography.

[0005] The ECG provides information about the evolution and any deviations of the electrical cardiac impulse, and is therefore only able to provide a reliable diagnosis if all relevant leads are included as well, for example the Wilson leads. Diagnostic systems that do not include leads according to Einthoven, Goldberger and Wilson are therefore essentially unsuitable for cardiovascular diagnosis, and it is not yet possible to derive chest wall leads from electrodes attached to the back.

[0006] Whole body impedance using electrodes on the plantar surfaces provides inaccurate results regarding overall body composition and the composition of the individual body segments: thorax, abdomen, left arm, right arm, left leg, right leg.

[0007] On the other hand, partial impedance measurements provide accurate results regarding body composition, fluid content, extracellular volume, edema, overhydration, muscle mass and fat mass, or fat distribution in the body. When measuring impedance, it is important that electrodes are attached to physiologically relevant positions of the body so that all segments that contribute to the amount of material being measured are measured and series resistances that cause unwanted distortions are excluded. These include in particular the feet and hands, because they essentially consist of connective tissues such as tendons, fascia and bones, which give rise to high and variable resistances. Whole body impedance also produces poor results, even without separate consideration of the chest and abdomen and limbs.

[0008] Partial impedance plethysmography also provides results for myocardial fibre tone, detection of heart failure, cardiac output condition such as blood flow to the limbs, or pulse wave duration and therefore aortic health.

[0009] A disadvantage of diagnostic systems of the type mentioned at the outset is that personnel are required to examine a person, in particular to attach individual electrodes to each body area.

[0010] This is where the present invention comes in. The object of the present invention is to provide a diagnostic system for diagnosis and for producing electrocardiograms, which does away with the above mentioned drawbacks and which can be particularly easily operated without any personnel, especially medical personnel, and still be able to provide a detailed and correct diagnosis.

[0011] This object is achieved according to the invention by a diagnostic system of the type mentioned at the beginning, in which different areas of the support surface, in particular electrodes, are arranged on the leg area, on the arm area, on the upper body area and / or on the neck area, which are at least partially designed as electrode pairs, each pair of electrodes having a feed electrode and / or a measuring electrode, the feed electrode being arranged distal to the measuring electrode, a device is present for feeding a current between the supply electrodes, and the diagnostic system is set up to measure the voltage drop between the measuring electrodes in order to be able to determine the impedance of the body area of ​​the person located above the diagnostic system.

[0012] Preferred variants of the embodiment are the subject matter of the dependent claims.

[0013] An electrode through which current can be fed in is considered to be a feed electrode. An electrode across which a voltage drop can be measured is considered to be a measuring electrode.

[0014] Preferably, it is provided that the diagnostic system is set up to switch between individual electrodes or pairs of electrodes in pairs so that a current, in particular an alternating current, is fed between two supply electrodes and the voltage drop between the associated measuring electrodes can be measured in order to determine the impedance of an area of ​​the person's body in the diagnostic system.

[0015] With the diagnostic system according to the invention, manual attachment of electrodes to the respective body regions by trained personnel is no longer required, but the support surface, which comes into contact with the person under examination when the person is positioned on the diagnostic system, is provided with electrodes and sensors, and a corresponding electrocardiogram and a complete body and health analysis can be produced simply by correctly positioning the person on the diagnostic system. In use, the electrodes and sensors can be in direct contact with the skin. However, alternatively, it is also possible to carry out the measurements through clothing.

[0016] The preferred configuration of two measuring electrodes between two feed electrodes through which a current is applied has the particular advantage that a representative voltage drop, based on which the impedance of the body region can be determined, can be measured only at a certain distance between the electrodes through which the current is introduced into the body region. The background to this is that the current flow from the electrodes spreads in the body in an approximately cone shape, so that the nearby area around the electrodes has a higher resistance or a higher impedance due to the propagation of the current flow in the body. If a voltage drop is detected only at a certain distance from the feed electrodes, then this error is easily avoided by using measuring electrodes that are placed between the feed electrodes.

[0017] The measuring electrode may be spaced from the feed electrode by 1 cm to 20 cm, preferably 2 cm to 6 cm.

[0018] Therefore, using the diagnostic system of the present invention it is possible to record the physical properties and electrical resistance of an area of ​​a person's body positioned on the diagnostic system and to determine a health condition based on the results of the resistance and sensor measurements.

[0019] This is especially possible if capacitively coupled electrodes are used (see, for example, Lopez A et al, "Capacitive electrocardiographic and bioelectric electrodes," IEEE Transactions on Biomedical Engineering, no. 1, pp. 99-99, 1969), which are also flexible (Shuting Liu S et al, Flexible Non-contact Electrodes for Bioelectrical Signal Monitoring, Annual Int. Conf. IEEE Eng Med Biol Soc. 2018, Jul / 2018: 4305-4308). Impedance measurements and their subcomponents can also be performed using capacitive measurements (Swegundo A et al, Sensors 2019, 19, 2539). Impedance tomographic methods can also be realized in this way, especially if the number of non-contact electrodes is strategically increased and arranged, for example, in a circular manner on a chest strap (Yandan Jiang et al, 2019 Meas. Sei. Technol. 30 114001).

[0020] To be able to determine the impedance of individual body regions, individual feed or measuring electrodes can be paired and activated sequentially by switching off the electrodes that are not required, usually using a switching device as close as possible to the contact or coupling point to the support surface, i.e. to the electrodes on the support surface of the person or patient being tested or to the electrodes of a chest strap that may be used. Alternatively or in addition, two or more power sources can be provided, which are preferably galvanically isolated from each other and can be connected to the supply electrodes. The power sources can be AC ​​or DC current sources depending on the intended application.

[0021] To determine the impedance of a body area at different frequencies, it is advantageous if the diagnostic system is set up to feed current through separate feed electrodes at different frequencies, in particular at frequencies between 1 Hz and 1 MHz, in particular between 5 kHz and 500 kHz. The alternating current resistance or apparent resistance or phase angle of the individual body areas at different frequencies may make it possible to make a precise description of the disease in the respective body area. Corresponding correlations can also be made simply by determining the diagnosis with the diagnostic system according to the invention, for example using methods known from the prior art, in particular by magnetic resonance tomography, by computer tomography, whole body DXA, ultrasound and the like, in which the real part, the imaginary part and the phase angle determined with the diagnostic system according to the invention are compared with the sensor values, the impedance values ​​and the subcomponents of the impedance. This makes it possible to carry out an initial and subsequent continuously improving calibration of the diagnostic system, for example using methods of artificial intelligence, for example neural networks, in particular "deep convolutional neural nets" for this purpose.

[0022] In principle, several electrodes can be used simultaneously to carry out the corresponding diagnosis. In order to achieve a particularly high level of accuracy, a switch is preferably provided, by means of which individual electrodes at the connection points directly adjacent to the support surface or adjacent to the person can be switched. Then, all electrodes except for two pairs of electrodes are preferably connected directly to the support surface, preferably less than 10 cm away from the support surface, so that the impedance between two active electrodes can be determined without being influenced by the parasitic electrical effects of the other electrodes. Accordingly, the switches for the electrodes are usually arranged directly on the support surface.

[0023] For example, in a corresponding manner, to capture impedances at different frequencies in the left arm by applying alternating currents at different frequencies, a pair of electrodes in the left forearm area and a pair of electrodes in the upper body area can be activated first, and all other electrodes can be switched off directly on the support surface. In a next step, electrodes in the left lower leg area and the upper body area, for example, can then be activated. To detect impedances in the left leg, the voltage drop between the left and right legs must then be measured, and all other electrodes directly on the support surface are switched off. The part of the body through which no current flows, in this case the right leg, will then be used only as a conductor. As an alternative to detecting impedances in the left leg, a current can also be fed between the left and right lower legs, and the voltage drop between the upper body or arm and the left leg can be measured. In this case, the upper body is not exposed to the current and acts as a conductor. In a corresponding manner, the impedance of the examined body is determined in a similar manner at different frequencies for individual body areas or body segments, such as the arms, legs, lower legs, chest and abdomen. It is also usually useful to record laterality between the left and right limbs, since asymmetries are associated, for example, in edema or muscle mass. The electrical resistance or impedance network of the examined person's body can be determined, based on which, for example, body fat percentage, muscle mass, bone density, intracellular and extracellular fluid percentage, and the like can be determined. In this resistance network, only the parts of the body through which the alternating current flows are measured; the parts of the body through which the alternating current does not pass can be the measuring conductor, in which case this body part is not part of the measuring body segment.

[0024] It is advantageous if an electrode contact measurement is provided, which can be used to identify the electrode or electrode pair with the lowest contact resistance with the person under test, and the diagnostic system is set up to activate the electrode pair with the lowest contact resistance, in particular by means of a switch near the connection point. This means that the electrode with the lowest contact resistance with the body of the person under test can be used automatically for the diagnosis, i.e. for that electrode the electrical contact is the best, in order to exclude measurement errors as much as possible. Thus, for example, electrodes can be distributed throughout the diagnostic system, and for the measurement the electrode with the best contact and therefore the most meaningful measurement result can be activated. It goes without saying that individual electrodes can be used both as measuring electrodes and as feed electrodes, with the current being applied to the person via the feed electrodes and the voltage drop being measured between the measuring electrodes.

[0025] It would be advantageous if the electrode contact measurement were configured to apply a voltage to individual electrodes to effect a current flow through a body located on the diagnostic system, whereby contact resistance could be determined based on the level of current flow, and thus contact quality could be determined based on the contact resistance.

[0026] In order to avoid measurement errors during the test, it is preferably provided that the electrode contact measurement can be switched off, especially near the connection points to the person.

[0027] Alternatively, it is also provided that the current source is matched with the feed electrode, which is specifically placed, connected or connectable at or near the electrode to be synchronized.

[0028] Instead of using a precisely matched power supply, the power supply can also be adjusted to take into account the common mode voltage of the person, which is measured, for example, via the right leg drive electrode. Preferably, it is provided that the impedance measurement is performed as a pulse-synchronous plethysmographic measurement and a multi-frequency impedance measurement. From this, impedance spectroscopy and Cole-Cole plots can be generated with a small number of measurement frequencies. In particular, it is also planned to perform a partial pulse-synchronous impedance plethysmographic measurement, i.e. a change in the volume of the segments with the heart rate, so that no measurement current flows in part of the measurement path. For example, the measurement of the leg plethysmogram or the leg plethysmogram can be designed so that the measurement current is fed between the neck and the leg or between the arm and the leg, while the measurement of the leg plethysmogram can be performed between two measurement electrodes on the leg, the opposite leg, through which no current flows, only acting as a conductor. This means that if the leg through which the current flows is measured between the knee electrode and the leg electrode or between the knee electrode and the leg electrode, then only the leg plethysmogram can be measured, not the whole leg. This also applies to the arm and chest plethysmogram. To obtain an arm plethysmogram, for example, the current can be fed between two arms, or between the arm and the leg; the measurement will then be performed either between the leg (without current) and the arm through which the current flows, or else between both arms, one arm having no current flowing through it. For the chest plethysmogram, for example, the input can be between the arm and the leg and between the neck electrode (or the forehead electrode) and one of the chest wall ECG electrodes, or between the neck or forehead electrode and an electrode attached to a support surface in the torso area. The chest wall electrode or an electrode attached to a support surface in the torso area can also be used together with one of the limb electrodes to supply electricity.

[0029] The plethysmogram is preferably constructed from several to many heart beats and a so-called template is constructed, whereby precise properties of the template such as gradient, steepness, peak height fall gradient etc. and shape analysis can be used to generate diagnoses for e.g. measurement of cardiac output, detection of heart failure, volume wave transit time, blood flow differences in left and right limbs. Artificial intelligence, in particular neural networks and "deep convolutional neural networks" methods have proven to be particularly useful for the shape analysis of the templates.

[0030] Having a multi-lead ECG has proven useful.

[0031] To be able to reconstruct conventional ECG leads, especially Einthoven, I, II, III, Wilson V1-V6 and Goldberger leads aVR, aVL, aVF, from electrode positions available on the support surface, the leads should ideally be in the three-dimensional space of the torso configured on orthogonal x, y, z axes to accurately determine the cardiac vector and reconstruct the conventional leads. For example, the EASI leads by Dower (J Electrocardiology, Suppl 1988, S182-S187) have proven useful in the past, but they require electrodes on the anterior surface of the chest.

[0032] In the present application, we do not seek similarities between the back leads and the conventional ECG leads, but rather reconstruct the conventional leads based on physical principles from strategically optimally placed electrode positions on the support surface. In this case, this is made possible by the vector cardiography method by Frank (Circulation, 13, 737-49, 1956), which can be exploited to reconstruct the conventional leads according to Wilson, Einthoven and Goldberger. For this purpose, at least three ECG leads should be placed on the support surface, if possible at all three levels of space and as orthogonal as possible to the person positioned on the support surface: one lead approximately central and vertical in the upper region of the support surface, approximately corresponding to the longitudinal axis of the support surface (and therefore also to the longitudinal axis of the human body), a second lead approximately transverse to the longitudinal direction of the support surface (and therefore also corresponding to the horizontal axis of the human body) in the approximately central longitudinal region of the support surface, and a third lead approximately oblique in the upper region of the support surface and therefore corresponding to the sagittal axis of the human body lying on the support surface. Ideally, this sagittal axis should point at approximately 10:30, corresponding to the hour hand of a clock, or conversely at 4:30. Three-dimensionality arises because the base of the heart is in the center of the chest, while the apex of the heart is on the anterior chest wall. This can then be used by analogy with derivations from Dower (J Electrocardiology 21, Supplement, 1988, S182-S187) to reconstruct conventional leads, in particular according to Wilson. Reference is made to the corresponding literature cited herein.

[0033] Alternatively, the hour hand may point to 1:30, so that the third lead corresponds to the sagittal axis for a person lying on the support surface.

[0034] On the support surface, these leads were obtained from the electrode position “I” in the plane at approximately the level of the 10th to 12th vertebrae. r ","M r ","A r", which is approximately the fifth intercostal space at sternal level. Another electrode is placed in the neck, e.g., "N r " As the inventors have discovered, due to the oblique position of the heart in three-dimensional space, these electrode positions are located in such a way that reconstruction of standard leads according to Einthoven, Goldberger and Wilson is possible.

[0035] Since these leads are located on the back of the person, the coefficient I r , M r , A r are called "back faces", and N r represents the back of the neck. Due to the simplified positions of the electrodes, they no longer correspond exactly to the positions of the Frank network with xyz signals, but rather to their linear derivatives x'y'z'. In addition to the software-based correction, an analog correction box can also be connected to the ECG device to return to the original xyz positions according to Frank (Circulation, 13, 737-49, 1956). In addition, to further reconstruct the missing leads, the missing conventional 12-channel ECG leads can also be reconstructed using limb electrodes with leads I, II, III, avR, avL and avF, because these leads are connected by the feed ECG signals that can be obtained using measuring electrodes on the arms and legs that may be available in some way. For example, chest wall leads can be reconstructed similarly to the methods of Dower or Xue et al. (Computers In Cardiology, IEEE, 2007; 709-71).

[0036] The derived V = a(A r -I r )+b(M r -N r )+c(A r -N r )+d derivative A r ~I r represents the horizontal vector component, and M r ~N rrepresents the vertical vector component, and A r ~N r represents the anterior / posterior vector component. The anterior / posterior component can be enhanced by placing the neck electrode more ventrally in a U-shaped neck roll that partially surrounds the neck, or more ventrally in the area of ​​the larynx, e.g. on the sternum for a laryngeal microphone, or on the forehead, e.g. as a forehead electrode 45 in a headband, or on the support surface of e.g. virtual reality glasses, e.g. on the forehead (Front Fr). The equation then becomes: The derived V = a(A r -I r )+b(M r -N r )+c(A r -Fr)+d Such equations are created for leads V1-V6, and, if necessary, for the Einthoven and Goldberger leads, in order to reconstruct the other leads using their respective coefficients. Multiple, e.g., linear regression equations using the amplitudes of the individual segments of the ECG curve, i.e., the PR segment, the QRS complex, the ST-T segment, and the T wave, can be utilized to better reconstruct the conventional derivations, especially when each separate simultaneous equation is developed for the above sections of the ECG curve, taking into account the root-mean-square error. These Dower derivations have proven very useful in clinical practice as an alternative to the conventional Einthoven, Goldberger, and Wilson derivations (Klein ND, Computers in Cardiology 1997, 24: 721-24), and we now propose a similar approach using new positions of the electrodes on the support surface. A patient-specific segment-specific (PSSS) algorithm provides particularly accurate determination of leads V1, V2, V3, V4, V5, and V6 (Scherer JA, JACC 15:191A, 1990) and can be used here for the new leads. Therefore, the new ECG lead V=a(A r -I r )+b(Mr -N r )+c(A r -N r An orthogonal set of ECG leads derived from d can also be derived utilizing the Levkov transformation (Levkov, Med Biol Eng Comput 25:155, 1987). Frank vector diagrams can be predicted for all people or patients using a single simultaneous equation.

[0037] When creating a regression equation from a data set, overfitting must of course be avoided. Nonlinear methods such as the "Support Vector Regression Method" (KKU Engineering Journal, 2016; 43 (S2): 317-322) or similar nonlinear methods can also be implemented, often showing similar deviations in results. Here again, neural networks have proven themselves to be good, since they are better at representing nonlinear relationships.

[0038] To take into account differences in torso shape, three-dimensional recording of the torso, for example using a 3D camera, can be very useful as it is possible to record the deviation of the torso shape from a cylinder and the exact configuration of the electrodes in three-dimensional space.

[0039] It is advantageous if the support surface comprises a plurality of at least partially convex and / or concave, preferably elastic, deformations carrying the electrodes, which allows a particularly good electrical contact between the body part of the person to be examined and the electrodes.

[0040] It is advantageous if at least one electrode is attached to a deformable material that deforms when the person is positioned to establish a favorable electrical connection of the electrode to the human body. Appropriately designed electrodes can be provided in principle at any position, in particular in the wrist or forearm area, and on the lower leg just above the ankle or just below the knee joint. The electrodes can also be attached to a semi-cylindrical shell lined with the deformable material, the axis of this cylinder corresponding to the longitudinal axis of the associated limb, so that the person to be examined can easily position the arm and leg in the shell, while at the same time a favorable electrical connection is established through the deformable area. In order to avoid any kind of mechanics despite the possibility of selecting the optimal electrode position, several U-shaped concave support surfaces can be placed on the arm and leg, which can be optionally selected using a multiplexer. In that case, these electrodes for the associated limb will not be on the respective electrode axis, but will be outside the limb axis depending on the distance to the base of the limb, so that they do not interfere with each other. The person to be examined then selects a support surface that bears a U-shaped electrode directly above the wrist or above the ankle, for example by alternating adduction and abduction of the arms and legs. Depending on which electrode forms a closed circuit or which has the lowest contact resistance, or if any built-in pressure sensor at the electrode position signals the maximum contact pressure, the corresponding electrode is activated and the others are switched off. If the person lies on the support surface, the electrode pair in which the arms and legs are the best is forced to be created. This means that a continuous closed support surface can be created between the support surfaces without interruption, corresponding to the relief shaped along the body, which is absolutely necessary for hygienic reasons, since for example the support surface can be cleaned, for example sprayed. In addition, all electronic components and cables can then be welded between the support surfaces, which further increases the safety of the device. The support surface can best be sewn laterally in the center, so that it can be folded and well transported.

[0041] As elastic material any suitable material can generally be used, it being particularly preferred that the at least one electrode is arranged on a skin-friendly, robust elastomer.

[0042] To achieve a particularly good contact, it may also be provided that at least one electrode is arranged on a convex area protruding from the support surface. Thus, a good contact can be achieved, in particular in the area of ​​the neck, for example in the form of an electrode arranged on an elastic, possibly movable, neck roll, or in the area of ​​the upper body, since the correspondingly protruding convex area increases the pressure load on this area, which ensures a good contact. The contact caused by the body weight is particularly critical, which is why particularly corrosion-resistant and very well conductive electrodes with low contact resistance, such as gold-coated electrodes, should be used. In particular, this makes it possible to simply carry out the corresponding diagnosis even through clothing (in particular if they are conductive or wet). This is particularly certain if the contact area is wetted, for example by an electrode spray. The diagnostic system can therefore be used in particular in public areas such as shopping centers, waiting areas, etc.

[0043] It is preferably provided that at least one electrode, in particular the electrodes on the leg and arm areas, is concave to provide for the corresponding areas of the human body, in particular the leg and arm areas. Through a corresponding, for example U-shaped, design, which can in particular be formed by a part of a hollow cylinder, good contact can be achieved on the one hand and at the same time favorable handling can be achieved on the other hand. For example, in particular in the case of feeding, the hands and feet can also be used as electrode positions and also as positions for measuring electrodes, together with the conductive handle, but this means, however, that the series resistance increases.

[0044] In order to achieve a particularly good contact, it is preferably provided that the electrodes are easily deformable and are made, for example, from conductive rubber or fabric.

[0045] In order to be able to adapt the diagnostic system to people of different sizes, the diagnostic system can be easily adapted to people of different sizes if at least two electrodes are movable relative to each other, in particular the electrodes on the leg area relative to the electrodes in the upper body area and / or the electrodes on the arm area relative to the electrodes on the upper body area. This adaptability can be achieved, for example, by a portion of the support surface that is articulated or displaceably connected to the body or by a separate support surface on which the electrodes in the leg area and / or the electrodes in the arm area are arranged.

[0046] Adaptability to people of different sizes can also be achieved simply as an alternative to a mechanism that allows individual electrodes to move relative to the other electrodes, where several adjacent electrodes are placed on the leg, arm, neck and / or upper body areas, and the device is set up to activate one or more of these electrodes depending on the size of the person to be examined, with the electrode to be activated for the measurement having the best electrical contact with the respective body area and / or being anatomically correctly located. For this purpose, for example, a pressure sensor, in particular a piezo sensor, can be further provided on the electrode to determine which electrode the mechanical pressure caused by the weight of the person on the diagnostic system is the greatest at the corresponding position, and the optimal electrical contact or the electrical contact with the lowest contact resistance is also usually achieved. It is preferably provided that at least three electrodes are provided on the upper body area at approximately the same height, at least one electrode is preferably placed approximately in the center and two further electrodes are placed approximately symmetrically.

[0047] Therefore, impedance in the upper body area can also be accurately detected. In addition, this configuration also allows easy generation of an ECG using a diagnostic system.

[0048] In order to be able to determine the health condition of the person being examined particularly precisely, it may also be provided that an upper arm cuff and / or a pulse oximeter is provided. Such devices can simply be designed, for example, with Velcro fasteners or elastic clamping devices, so that the person being examined can also wear them themselves. Thus, the system can still be operated without personnel.

[0049] The pulse oximeter can be designed to detect oxygen saturation, for example, on the finger or on another part of the body, for example on the wrist, on the forehead, etc., and can be integrated into the VR glasses if necessary. In order that these glasses can be used by different people within a short interval, sterilization is necessary; this can be done within 60 seconds in a "clean box", in which the glasses are sterilized and dried, for example with UV radiation and drying, for the next person. After release, for example through payment, the person using the device receives a code or electronic key that is used to open the clean box, the 3D glasses are released and the test is activated.

[0050] It is advantageous if the support surface is made from a washable plastic, preferably a deformable material, and if below the positioning surface there is a support surface which is made in particular from a durable fabric.

[0051] The support surfaces can also be designed to be pressurized with a variable pressure, for example by using a chamber between the positioning and support surfaces, which is filled with a fluid, for example a gas, by means of a compressor. The U-shape of the support surfaces, especially in the area of ​​the limbs, is sufficient to apply pressure to the arteries from the outside, for example hydraulically, in order to measure the pressure oscillations with a corresponding counterpressure and to determine the blood pressure, for example by oscillometry and / or by auscultation, or to carry out a pulse wave analysis. This is possible, for example, especially for the wrist, because there is a bony border of the arm on the opening side of the U. To prevent the arm from being pushed out of the U, an area where no hydraulic pressure is applied can alternatively be provided at the bottom of the U.

[0052] It is advantageous if at least one, preferably each electrode, is arranged on an area that can be pressed against the human body with a variable pressure, said area being designed in particular as a bladder that can be filled with a fluid, the pressure of the fluid in the bladder being preferably variable by means of a pump. As a result, good contact can be achieved between the electrodes and the human body. The configuration of the electrodes on the corresponding area, in particular on the inflatable chamber or bladder, can be carried out with individual electrodes only, for example electrodes in the arm area, the leg area, the chest area or even all the electrodes. In particular, it can be provided that the electrodes arranged in the neck support or neck roll can be pressed against the person over such area or bladder with a variable pressure to allow precise measurements in the area of ​​the neck roll. Correspondingly, electrodes in the region of the chest strap with a variable pressure can also be pressed against the person. In particular, the chest strap can be designed with at least one inflatable chamber for this purpose.

[0053] For this purpose, one or more pressure sensors may be provided, which are capable of detecting pressure changes in the fluid. Furthermore, devices for changing the pressure in the fluid may be provided, in particular pneumatic and / or hydraulic devices, and pressure sensors are also provided for determining the pressure in the fluid.

[0054] It is advantageous if the diagnostic system has sensors and can detect the mechanical behavior of the body parts of the person located at the diagnostic system in response to applied forces and / or movements, so that it is possible to evaluate the mechanical stiffness of individual body areas, in particular depending on the frequency at which the forces and / or movements are applied. In this way, in addition to the impedance determination, in which the electrical properties of the individual body regions are determined, it is possible to determine, for example, fat content or muscle mass or bone density, so that additional information can be provided regarding the mechanical composition of individual body areas. In addition, it has been shown that, for example, liver disease can be inferred based on the stiffness of the liver, so that statements can be made regarding the health state of a person or a part of a person's body based on the mechanical parameters that can be determined. Forces and movements can be applied to individual body areas, for example using vibration devices that can optionally vibrate at different frequencies and / or different amplitudes or force intensities, or other devices known, for example from massage devices.

[0055] When the reaction of the person being tested to applied physical forces such as heat, cold, electric current, pressure, vibration, etc. is recorded, for example by acoustic, optical or tactile communication, the functioning of the nervous system, e.g. the sensory system or perception, of the person being tested can also be recorded and quantified.

[0056] It has proven to be particularly comfortable when the diagnostic system is designed as a bed, especially a tilted bed, where the tilt angle is detectable. On the one hand, this is a comfortable method for the person being examined. On the other hand, the tilt angle can also be used to easily determine the hydrostatic pressure difference between individual areas of the body, so that the measurement data can be better interpreted or corrected for the hydrostatic pressure difference. This can also be used to determine whether there is a sufficient reaction of the circulatory system and the autonomic nervous system, such as stroke volume, heart rate, vascular resistance, sympathetic nervous system, parasympathetic nervous system, etc., to the tilting operation.

[0057] In order to be able to analyze the person under examination beyond the impedance of individual body regions, it is particularly advantageous if one or more cameras, in particular also infrared cameras, and / or time-of-flight sensors are provided, with which the person located on the support surface can be determined three-dimensionally, with which the dimensions of the person under examination can be determined. The cameras can also be used to record the skin color of the person under examination and derive medical information therefrom. By detecting the three-dimensional contour map of the person under examination, the size and body segments of the person under examination can for example be recorded particularly precisely, which in turn allows electrodes for impedance determination to be activated, which are arranged according to the respective size. Taking advantage of the body size and length measured in this way, the position of the electrodes, in particular the neck electrodes on the neck roll and the electrodes on the legs, can also be automatically moved to the correct position, for example using auxiliary motors. This also provides a two-way communication between the imaging method and the electrical and other sensors, which further improves the measurement results and the diagnosis. In addition, the three-dimensional contour map can be used to determine additional information for determining the circumference and diameter of body segments, whose values ​​are likewise significant for health conditions, body fat, body mass index or waist / hip ratio.

[0058] To make the data acquired using the diagnostic system according to the invention easier to evaluate, an additional 3D measurement of the human body can be of great advantage. In recent years, methods for non-contact measurement of the body using optical methods have improved greatly in this regard. The human body can be represented using regular photography, stereo cameras, or time-of-flight methods, preferably in several planes, and when using a scale, the body dimensions can be represented in 2D or 3D. If the body dimensions can be included in the evaluation using a contact sensor, these two methods can be combined.

[0059] For example, the electrical resistance of the body or one of its segments does not depend only on the resistivity, but also on the length and cross-section of the body part or body being examined. Therefore, the combination of these two measurement methods provides more precise biological data. These two combined methods also allow feedback between the results of non-contact and contact measurements.

[0060] For example, the localization of the electrodes can be improved through direct feedback from the non-contact measurement and vice versa. Depending on the results of the non-contact measurement, it may also be possible to measure additional segments of the body by activating additional electrodes, for example in other locations, for example in the proximal leg to detect circulatory disorders, or in areas that are particularly affected by the non-contact measurement that appear critical. For this purpose, electrodes can be distributed over the entire support surface of the diagnostic system, i.e. over the surface where a person positioned as intended on the diagnostic system will come into contact with the diagnostic system, and these electrodes can be switched individually to determine the impedance of individual body regions. The electrodes can usually be switched near the surface or near the junctions.

[0061] In particular, it is useful to obtain thermographic images of a person in order to detect, for example, circulatory disorders, especially in the lower limbs, local inflammation caused by thrombosis, or infections that cause heat. Furthermore, traumatic or inflammatory changes in joints or local tumors can be detected by means of heat. Not only optical methods, but also thermographic methods are particularly suitable for this. Thermal imaging cameras can also be used to improve the three-dimensional representation of clothed persons.

[0062] Therefore, a thermal imaging camera is also preferred, which can detect the temperature of the person on the diagnostic system. On the one hand, this can be used to determine whether the person has a high temperature or fever. In addition, the recording of the temperature on the surface of the person under examination can also be used to draw conclusions regarding inflammation, tumors, and / or circulatory disorders. The temperature can be measured using a thermal imaging camera and / or a temperature sensor, which can be integrated, for example, into the support surface.

[0063] A chest strap is preferred, having external chest strap electrodes on the outside that correspond to contact electrodes on the support surface, so that electrical signals from the chest strap can be transmitted via the external chest strap electrodes to the contact electrodes on the support surface.

[0064] In a conventional ECG, the electrodes are placed on the upper body in front of the person being examined. The inventors have determined that it is essentially possible to make an electrocardiogram with electrodes placed on the back, which in this case can be positioned in the upper body area. This is another way in which a high level of accuracy can be achieved. However, for special cases, it may also be advantageous to use a chest strap that can be used to make electrical measurements on the front of the person being examined. In that case, the chest strap is preferably designed so that it can be installed by the person being examined, so that the device can continue to operate without personnel. Correspondingly, the contact between the electrodes of the chest strap and the support surface is also simple, in particular requiring only loose contacts rather than additional plug contacts, so that the diagnostic system can be easily operated and managed by the person being examined.

[0065] It is advantageous if an optical medium, for example a screen or a VR headset, is provided in the field of view of the person positioned at the diagnostic system, which is connected to the sensors of the diagnostic system via a data link, so that data, particularly related to the health condition of the person, can be displayed on the screen. The diagnostic system therefore preferably comprises all the electrodes and sensors as well as a data processing device connected to the screen. Based on the data acquired with the sensors and electrodes, this device can provide information about the health condition of the person being examined, which is usually displayed in real time. The combination of the display of the optical sensors in a 3D representation and the display of data as acquired from the measurements is particularly advantageous.

[0066] For example, the following diagnoses can be performed: all diagnoses are performed using a 12-channel ECG, e.g., stroke volume, cardiac output, vascular resistance, heart attack, coronary heart disease, pulmonary embolism, pulmonary congestion, pneumonia, myocarditis, pericarditis, right heart load, heart valve defects, Lown classification, arrhythmias, atrial fibrillation, risk of atrial fibrillation, etc. In addition, blood pressure (e.g., via an integrated blood pressure monitor or via a U-shaped support surface applied with variable pressure in the arm and leg region), central blood pressure via the transfer function of the peripheral blood pressure curve or via a modified wind tunnel model (McEniery European Heart Journal (2014) 35, 1719-1725). Cardiac output and heart failure detection can be recognized by forms of analysis of the plethysmogram with lower amplitude and slope (Skrabal F et al, Med Eng Phys. 2014 July; 36(7): 896-904). For this purpose, it is planned to use artificial intelligence, e.g. deep convolutional neural networks, genetic algorithms, in addition to conventional mathematical methods such as discriminant analysis etc., to use mean curves, so-called templates, from the raw data and to improve the accuracy of all calculated parameters.

[0067] Heart failure can also be recognized by changes in breathing with prolonged expiration, dry and wet breath sounds, by changes in extracellular fluid in the segments (Skrabal F et al Med Eng Phys. 2014 July; 36(7): 896-904), by the discovery of low muscle mass, etc. Pulmonary function can be measured via a breathing tube using the commonly known parameters FVC, FEV1, PEF, MEF25, MEF50, MEF75 and MMEF, and respiratory gases can be measured via CO2 and O2 sensors. The characteristic curve of the CO2 exhalation curve can be used to detect lung diseases, in particular COPD (Mieloszyk, IEEE Transactions on Biomedical Engineering 61, 2882-2890. 2014). Oxygen saturation can be measured specifically at electrode locations on the limbs or ears, preferably via an O2 sensor integrated into the band of the VR goggles. The visual test is performed by changing the size of objects in the visual medium and observing whether the patient recognizes them or not, particularly using the VR goggles with feedback (acoustic feedback in the form of voice or by having the patient press a button).Hearing tests are performed by changing the volume of the acoustic medium, detection or non-detection and the corresponding feedback, and the following measurements are made: polyneuropathy by measuring heart rate variability (through a spectral analysis of the heart rate intervals), tactile sensation (changes in impulses through actuators in the support surface with feedback by the person being tested), temperature sensation (changes in temperature of the support surface with feedback), vibration sensation (changes in vibrations in the support surface with feedback), autonomic nervous system to control circulation with sympathetic and vagus nerves by a spectral analysis of heart rate intervals and blood pressure fluctuations with a special evaluation of the 0.1 Hz and 0.3 Hz bands, baroreflex sensitivity through spontaneous blood pressure steps using heart rate intervals, hydration status to assess metabolism and risk of diabetes (characterized by a high waist / hip ratio, low muscle mass, high body fat mass, high abdominal fat), muscle mass, muscle strength, biological muscle age, body fat mass, abdominal (visceral) fat (Skrabal F et al,Med Eng Phys.2017 June;44:44-52), thrombosis, and lymphedema (characterized by changes and asymmetry of extracellular fluid in the legs).Pulse wave transit time over the transit time of the pulse wave or volume wave (Skrabal F et al, J Hypertens. 2020 October;38(10):1989-1999), as well as analysis of the shape of the pulse wave and wind tunnel models (Cohn J, Hypertension. 1995 September;26(3):503-8) or central arterial pressure (O'Rouke, Am J Hypertens. 2014 February;27(2):143-5), or methods of flow-mediated dilation (FMD) to assess vascular function via applied hydraulic compression of arteries and veins (FMD and venous occlusion plethysmography), pulse oximetry, and continuous beat-to-beat blood pressure via vascular unloading with measurement of arterial blood flow using a volume clamp that also uses a U-shaped support surface (Penaz J, Voigt A, Teichmann W, Z Gesamte Inn Med (1976) 31: 1030-3), ankle-brachial index (by measuring blood pressure in the arms and legs), circulatory disorders in the legs (using a different plethysmogram of the legs), central arterial pressure, for example, via a transfer function or modified wind tunnel model of peripheral blood pressure, carotid artery disease, for example, via blood flow noise in a U-shaped support surface on the neck, atherosclerosis, for example, via pulse wave transit time, pulse wave analysis, ankle-brachial index, liver compression using Fibroscan (elastography), in which low-frequency vibrations of approximately 50 Hz are applied to the liver and liver deformation is measured using a 5 MHz transducer (Piscaglia, Digestive and Liver Disease 49, 802-808, 2017). This requires the application of vibrations to the back in the area of ​​the liver, which should also be applied to other parts of the support surface in some way, as well as good contact with the ultrasound probe located there, preferably with ultrasound gel or the like. Also, it is much easier to assess renal function when lean body mass and appendicular muscle mass are known, because serum creatinine values ​​can be measured at the point of care and can be corrected for different lean body masses.With low muscle mass and low lean body mass, the creatinine clearance is erroneously calculated as excessively high using the MDRD formula and other formulas. However, with knowledge of muscle mass, a pure determination of the creatinine clearance is possible. It is also possible to achieve better drug doses, for example for cytostatics or anesthetics, because many drugs are administered according to lean body mass or fat mass. It can also be used to calculate the biological muscle age, for which there are standard values. Unexplained muscle and / or fat loss during follow-up with diagnostic devices; localized fever may also indicate debilitating diseases such as autoimmune diseases, inflammation, infection, latent tumors, malignancies, etc. Training monitoring with muscle mass progression and calculated aerobic capacity (calculated from age, waist / hip ratio using multiple regression equations or artificial intelligence, measured, for example, on a 3D recording of the person examined, the height and shape of the plethysmogram, measured muscle mass, body fat mass, abdominal fat, etc.) is very good and has already been used by the inventors (see the drawings). Many other diagnoses can be made that are not mentioned here. Furthermore, for example, thermographic methods can be used to detect inflammatory centers in the body, or thermography and pulse amplitude, brachial pressure index can be used to detect diabetic foot syndrome.

[0068] In the context of point-of-care measurements, metabolic diseases such as diabetes, bone metabolism disorders and disorders of all internal organs are also possible. Malignant tumors can also be easily detected, for example, by observing sudden and unexplained changes in fat or muscle mass during follow-up examinations, which can be carried out automatically thanks to the permanent storage of data. These are just a few examples of the many applications possible with this diagnostic system. Other possible applications are known to the expert without being limited to these examples.

[0069] The virtual reality glasses, which may themselves be equipped with biosensors and connected to sensors of the diagnostic system via a data link, may also be provided for displaying information and for interaction with the person's diagnostic system, whereby data relating to the person's health condition may be displayed, in particular using the virtual reality glasses.

[0070] In this situation, it is advantageous if the virtual reality glasses comprise sensors for recording health-related data of the person, in particular sensors for recording physical quantities such as electricity, light, gas, flow velocity and the like. Hence, the virtual reality glasses can also contribute to data collection and diagnosis, thereby achieving effects beyond the mere presentation of information.

[0071] Preferably, the virtual reality goggles are equipped with a breathing tube, including the nose, which is used to measure flow rate, breathing pressure, breathing volume and gas analysis. Thus, for example, lung function can be easily determined with a diagnostic system in order to obtain as complete a picture as possible of the person's health status. Differential pressure, turbine flow measurement and ultrasonic flow measurement are common methods for this, and any future developments in this field can also be integrated here. Ultrasonic flow measurement is usually performed on sensors placed approximately along the respiratory flow by measuring in both directions, taking into account the molar mass and temperature of the gas.

[0072] Interchangeable mouthpieces for measuring lung function and respiratory gases can also be used in the usual way, but this reduces the sophistication of the diagnostic system. Brain dysfunction such as epilepsy via EEG electrodes housed in the glasses and their bands, brain function deficits, visual testing, hearing testing, etc. are also possible through the use of virtual reality glasses and two-way communication, e.g. also via voice, if these are equipped with additional sensors.

[0073] For efficient diagnosis in complex cases, two-way communication online expert systems for the diagnosis of multiple diseases may be available, to which the diagnostic system is connected via a data connection, in particular the Internet. This means that if necessary, an expert or an automated expert system can be consulted, to which all measurement results determined by the diagnostic system can be made available, for example, via the Internet. For example, on the one hand, a mobile phone can be used to activate a measurement of a person, and on the other hand, the results can also be communicated afterwards.

[0074] The mathematical methods for determining the impedance from the current applied to the individual electrodes and the measured voltage are sufficiently well known from the state of the art.

[0075] It is preferably envisaged that individual electrodes and / or sensors, in particular pressure sensors, light sensors, sound sensors, electrical lines to actuators and the like, are arranged between the bearing surface and the support surface. The bearing surface can also be designed as a mat together with the bearing surface, which can, for example, possibly be reduced in size by rolling or folding, so that it can be easily transported and placed on any surface. To create an easy-to-transport package, a directional bearing surface with a fold in the longitudinal centre of the mat (the buttocks region of the body to be placed) is sufficient. Preferably, all electronic components, sensors, cables etc. are welded or glued between the bearing surface and the support surface. To mount the camera or measuring device fixedly on the mat above the examined living body, a stable bracket, for example a pipe, can be attached to the mat, and a bracket for the camera or imaging device is removably attached.

[0076] In order to achieve a particularly comfortable surface, it is preferably provided that a fluid is arranged between the bearing surface and the support surface, which results in a particularly good pressure distribution. This can be achieved, for example, by inserting a gas, in particular air, or a liquid, in particular water, between the bearing surface and the support surface.

[0077] In order to achieve a good electrical contact, it is preferred that the electrodes are designed as strip electrodes, such electrodes having a length to width ratio of at least 5, preferably at least 10, in order to achieve a good electrical contact.

[0078] It is particularly advantageous if microphones, pressure sensors and / or acceleration sensors are provided on the support surface, for example to make it possible to monitor the breathing via the breathing sounds of the person located at the diagnostic system. Furthermore, pressure sensors can also be used to obtain information about the weight, size and dimensions of the individual limbs of the person being examined, which can be used to perform the diagnosis.

[0079] The diagnostic system can also be used to determine the health of the nervous system of the person being examined. For this purpose, devices are preferably provided that generate predefined temperature and pressure or vibration signals at different positions in order to be able to determine the reaction of the body parts of the person located on the diagnostic system to apply temperature changes, mechanical effects via feedback from the person being examined. For example, the diagnostic system can be designed to apply temperatures (slightly) lower or higher than body temperature or mechanical signals of varying intensity via these devices, while at the same time obtaining feedback from the person being examined about when and where this temperature change or mechanical effect is perceived, for example through touch, depth sensitivity or vibration. This is a simple way to measure the conduction velocity and the health of the nerve pathways.

[0080] For this purpose, devices are preferably provided for emitting acoustic and / or optical signals to enable communication with the person on the diagnostic system. This can be achieved, for example, using loudspeakers and / or a screen, and optionally VR goggles. Correspondingly, microphones and input devices are usually provided, by means of which the person being examined can also provide feedback to the diagnostic system.

[0081] It is particularly preferred if the device is configured to reproduce a three-dimensional image of the person in the diagnostic system captured by the camera. For this purpose, a screen and / or VR glasses can be used, by means of which images and videos of the beating heart, pulsating arteries and breathing lungs of the person to be examined can be observed in a transparent and realistic representation of the person.

[0082] Typically, the diagnostic system is configured to display the diagnosis in real time, for example by coloring areas of the body on a screen within the field of view of the person on the diagnostic system according to the health status of the person's respective body area.

[0083] The electrodes are advantageous for contactless recording of measurement values ​​for ECG, especially if designed as capacitively coupled electrodes, which makes it possible to collect health-related data even through clothing, which is particularly advantageous for the application of the diagnostic system according to the invention in public places such as shopping centres.

[0084] Preferably, the diagnostic system is designed to use electrical measurements determined with electrodes and / or non-contact measurements, in particular measurements determined with a camera, to determine lean body mass and / or muscle mass and to correct the renal function based on lean body mass and / or muscle mass. This means that data on renal function determined using conventional measurement methods can be easily and quickly corrected for any higher or lower muscle mass, which does not take into account conventional assessments of renal function.

[0085] It is shown that one, preferably two microphones are provided in the chest area, which can be pressed against an area of ​​the body, preferably with an area having a variable pressure, in particular with a fluid-filled bladder, to detect lung sounds. This allows for an easy and automatic determination of lung function or pathological lung conditions such as pulmonary congestion, pneumonia or emphysema.

[0086] Further features, advantages and benefits of the present invention will become apparent from the following exemplary embodiments, in which: FIG. [Brief description of the drawings]

[0087] [Figure 1] FIG. 1 is a diagram of a diagnostic system of the present invention. [Diagram 2] FIG. 2 is a diagram of details of a diagnostic system according to the present invention. [Diagram 3] FIG. 1 shows a diagnostic system according to the present invention together with a person to be examined. [Figure 4] Details of the diagnostic system: undivided support surfaces for arms and legs. [Diagram 5] FIG. 13: Details of the diagnostic system: divided support surfaces for arms and legs. [Figure 6] 1A-1D are different views of a chest strap for a diagnostic system. [Figure 7] 1A-1D are different views of a chest strap for a diagnostic system. [Figure 8] FIG. 1 is a schematic circuit diagram of a diagnostic system having an AC power source. [Figure 9] FIG. 1 is a schematic circuit diagram of a diagnostic system having several AC sources. [Figure 10] FIG. 2 is a schematic circuit diagram of a matched AC current source. [Figure 11] FIG. 1 is a schematic diagram of a possible electrode contact measurement. [Figure 12] A three-dimensional image of the person being examined is recorded using a diagnostic system. [Figure 13] FIG. 2 is a diagram of a visual representation generated using a diagnostic system according to the present invention. [Figure 14] FIG. 2 is a diagram of a diagnostic report generated using the diagnostic system according to the present invention. [Figure 15] FIG. 2 is a diagram of a diagnostic report generated using the diagnostic system according to the present invention. [Figure 16] FIG. 2 is a diagram of a diagnostic report generated using the diagnostic system according to the present invention. [Figure 17] FIG. 2 is a diagram of a diagnostic report generated using the diagnostic system according to the present invention. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0088] 1 shows a diagnostic system 1 according to the invention, designed as a tilt couch with a tilt frame 16. As can be seen, the diagnostic system 1 comprises electrodes 3 arranged in the leg region 5, the arm region 4, the upper body region 6 and the neck region 7. This makes it easy to measure the resistance or impedance network of the human body.

[0089] In each case, one electrode further from the center of the body is designed as a feed electrode 8 and one electrode closer to the center of the body is designed as a measurement electrode 9, so that a current, usually an alternating current, can be applied via the two feed electrodes 8 and the voltage drop can be measured across a measurement electrode 9 placed between them.

[0090] The diagnostic system 1 is here for example designed as a tilting table, with which the height difference between the upper body area 6 and the leg area 5 can be easily changed, in particular by shifting the centre of gravity. Furthermore, angle sensors (not shown) are planned, with which the height difference can also be detected in order to determine the pressure difference caused by this.

[0091] If the diagnostic system 1 is attached to the scale 41, the weight of the person can be determined automatically at the same time. As is customary for couches, the diagnostic system 1 has two preferred bends, the lower one intended for the legs being convex and the upper one intended for the buttocks being concave. If mechanical joints, for example hinge joints, are provided at these points, they can be actuated using actuators, allowing for example physiotherapy of the joints using exercise therapy. Such mechanical joints can be provided for all joints of the human body. The diagnostic system 1 can also be used to integrate massage or vibration devices, such as "power plates", into the examination couch in order to utilize the examination time for further purposes.

[0092] The diagnostic system 1 has one or more support surfaces 11, on which the person 2 positioned on the diagnostic system 1 contacts the diagnostic system 1 and on which electrodes 3 are arranged in the arm region 4, the leg region 5, the upper body region 6 and the neck region 7, and also possibly in the knee region 40. In addition to the electrodes, pressure sensors and devices for applying forces and / or movements, as well as sensors for detecting movements, or in particular acceleration sensors, can be provided in order to detect not only the electrical conditions of the individual body regions but also the mechanical conditions and therefore to determine not only the electrical resistance network but also the mechanical evaluation of the individual body regions. If the support surface 11 is designed as a mat that can be placed on any surface, it is desirable to design it as a single support surface, which then also includes the arms and legs.

[0093] In the upper body area 6, I r , A r , M r , N r Electrodes labeled with and at slightly different heights r a, A r a, M r a, N rElectrodes labeled a are shown and labeled accordingly; these electrodes are labeled with the additional subscript "r" because they are placed dorsally, and serve for the mathematical reconstruction of all ECG leads.

[0094] The conductive electrodes integrated into the support surface 11 on the upper body region 6 are preferably deformable, in particular arranged on or formed by an elastomer, and establish contact with the person when the person lies on the support surface 11 of the test couch.

[0095] Furthermore, two electrodes are shown, which are preferably arranged on a support surface 11, here designed as a bolster 10, and which preferably run horizontally and parallel to the lateral diameter of the couch. These electrodes are used to inject alternating currents to determine the impedance of individual body areas at different frequencies, and are also used as ECG electrodes. The electrodes are made, for example, from a conductive material, conductive rubber or conductive plastic. The armrests, which form part of the support surface, are preferably equipped with concave support surfaces 11 for holding arm electrodes in the arm regions 4.

[0096] The arm electrodes in the arm region 4 should preferably be located just above the wrist and the leg electrodes in the leg region 5 should preferably be located just above the ankle. In order to achieve this for different arm and leg lengths, the concave holder forming the support surface 11 for the arms and legs is preferably designed to be movable, slidable and / or rotatable about one or more pivot axes 15, whereby the holder can accommodate arm and leg lengths by bending or extending the arms or legs to different degrees.

[0097] For example, for long arms, the elbow will be bent outward, while for short arms the concave support surface 11 of the arm will be approximately in line with the armrest. This may be necessary since the body dimensions of the person 2 vary greatly between individuals. These electrodes are used for applying impedance currents and for impedance measurements, as well as for Einthoven and Goldberger leads I of the electrocardiogram. Similarly, concave support surfaces 11, which also represent part of the support surface 11, can also be found for leg electrodes in the leg region 5 and the knee region 40, which are also attached to the test couch. These concave support surfaces 11 are also preferably movable and are preferably designed to tilt with respect to the pivot axis 15, so that they can make optimal contact with the legs regardless of their length. Alternatively, the subject may be able to choose from several U-shaped support surfaces the one that best fits the arms and legs, e.g. shorter arms can be tested with less abduction, i.e. the left and right U-shaped support surfaces can be placed closer together, longer arms and legs can provide greater extension, and therefore the left and right support surfaces for the limbs are placed further apart (or vice versa). This means that depending on the length of the arms and legs, only the intended, e.g. U-shaped, support surface is available, and other support surfaces for the limbs are outside the limb beam and do not interfere with the measurement. This design has the advantage that no moving parts are required and a hygienically clean, fully enclosed support surface is available.

[0098] As shown diagrammatically, the pivot axis 15 of the arm region 4 is approximately vertical, and the pivot axis 15 of the leg region 5 is approximately horizontal.

[0099] For long legs, the support surface 11 of the leg will be inclined away from the examination couch to accommodate the bent knee; for short legs, the support surface 11 of the holder will be approximately parallel to the examination couch or tilt couch.

[0100] The support surface 11 or the support surface 11 and the bolster 10 for the arms and legs can also be equipped with additional sensors, for example, for temperature, oxygen, or even pressure, or even actuators. A measuring module with a CPU 36 is preferred in the couch, which can include not only a 12-channel ECG, but also an alternating current source 35 of several frequencies, as well as a direct current source, for example for current stimulation therapy, which transmits measuring currents to activated electrodes, and at least one energy or pressure source and communication hardware.

[0101] In order to connect only the correct electrodes, i.e. those that will be activated for the impedance measurement, to the current source in the measurement module with the CPU, a switch, preferably a multiplexer, can be provided to switch off the patient connection lines and feed electrodes that are not required for the measurement in question.

[0102] This is advantageous because otherwise, especially at higher frequencies, parasitic effects on the circuit board and patient connection lines would create alternative current paths, which would result in measurement errors.

[0103] The measurement module with CPU 36 comprises a multi-channel ECG, circuits for impedance injection and impedance measurement, a multiplexer, an evaluation unit for contact and non-contact data and is preferably arranged as close as possible to the examination couch or examination mat.

[0104] Several galvanically isolated power sources can also be provided, which are connected to the individual electrodes, in particular to make it possible to carry out several measurements simultaneously. The individual power sources can also be designed to apply currents of different frequencies to the electrodes, so that currents of different frequencies can flow through the individual electrodes as required.

[0105] The distance between the paired electrodes 3 is preferably between 2 cm and 6 cm, ideally 3 cm to 4 cm. The electrodes in the leg region 5 and arm region 4 can be used for Einthoven and Goldberger leads and for impedance measurements and impedance injections. Furthermore, electrodes can be used in the leg region 5 for ECG leads II and III, in particular according to Einthoven or Goldberger leads II and III, and as reference electrodes. However, these leads can also be reconstructed from the so-called EASI leads according to Dower (Electrocardiology Suppl. 1988, pp. 182-187) or serve to reconstruct the Wilson leads from the EASI leads. Our experiments have shown that by moving the EASI electrodes to the back of the torso and therefore to the support surface 11 on which the examined body rests, it is also possible to reconstruct the classical Einthoven, Goldberger and Wilson leads. If the EASI leads are replaced by electrodes placed on the back, these too can be reconstructed from the I r , A r , M r , N r Leads in upper body region 6 can be labeled as -I. r -, -A r -, -M r Electrode-I is preferably placed on the body surface at the lower part of the sternum, approximately at the level of the heart, corresponding to the xiphoid process. r a-, -A r a- and -M r a- can be adjusted to different body sizes by height adjustment. In particular, regression equations, artificial intelligence or neural networks can be used to reconstruct conventional leads, for example using regression equations, according to Einthoven, Goldberger and Wilson.

[0106] The function of the electrode-S- according to EASI is the neck electrode N (for the back of the neck) r, this can be accomplished by electrodes 3 in the neck region 7 on the bolster 10 , which is optimally located at the highest point of the bolster 10 .

[0107] The electrodes 3 intended for the neck region 7, the arm region 4 and the leg region 5 and the knee region 40, in an exemplary embodiment, comprise two preferably parallel strip-shaped electrodes. The distance between the paired electrodes 3 is preferably between 2 cm and 6 cm, ideally 3 cm to 4 cm. The electrodes in the leg region 5 and the arm region 4 can be used for the Einthoven and Goldberger leads and for impedance measurements and impedance injections. Furthermore, electrodes can be used in the leg region 5 as impedance electrodes and as electrodes for the application of current, in particular for the Einthoven or Goldberger leads II and III according to the Einthoven or Goldberger leads.

[0108] For the reconstruction of conventional ECG leads according to Einthoven, Goldberger and Wilson, or for the construction of so-called vector loops, the measuring electrodes -I r -, -A r -, -M r -, -N r It was shown that the placement of - is particularly important.

[0109] Therefore, electrode-I r -, -A r -, -M r -, -N r -and-I r a-, -A r a-, -M r a-, -N rIt may be planned to use electrodes optimally placed from a-. The optical system described herein can be used to optimally place the electrodes, or pressure sensors 44 in the vicinity of the electrodes can be used to indicate which electrodes are ideally suited for measurements. For reconstruction of the standard leads, all three planes of space, i.e., horizontal, vertical and sagittal axes (XYZ axes), are recorded three-dimensionally for the various leads, -I r、 -A r、 -M r、 -N r It has proven useful to place the electrodes on the xyz plane. From these, all other leads can then be reconstructed using the xyz vector concept. The horizontal plane is the plane of lead I. r -A r The vertical plane is represented by the induction M r -N r and the sagittal lead is represented by plane A. r -N r In order to emphasize the three-dimensionality of the sagittal axis, the electrode N r can also be placed ventrally, for example in the area of ​​the larynx, in particular in combination with a mechanical or acoustic amplifier in the form of a microphone. To do this, the bolster placed behind the neck should also be U-shaped.

[0110] In principle, on the lower side on the support surface 11 r , A r and M r While it is possible to place the electrodes at the same height, this has the disadvantage of bringing them closer to the lower section of the subject's torso, which must also remain uncovered. r -, -A r -and-M r - is advantageous. For contact, the person being examined is placed on the electrode -I r -, -M r -and-A r It may be sufficient to roll up a shirt or other outerwear slightly to ensure that the wires are in contact with the body. Contact through wet or conductive clothing is also possible in principle.

[0111] A multiplexer then allows for the use of whatever electrode is best located. This part of the torso can be easily reconstructed using a 2D or 3D representation of the body, allowing the best electrode to be selected after an automatic evaluation of the body representation. Outermost electrode - I r -, -I r a-, -A r -, -A r a- or markings therefor should preferably extend outwards in the form of a band, so that the outermost electrode is also visible for 2D or 3D representations of the body in the 2D or 3D representation.

[0112] Electrodes located at trunk height, I r , M r , A r , especially the left side of the couch and trunk, electrode A r -or-A r a-, together with the dual electrodes in the neck region 7, can also be used to measure the impedance of the thorax and therefore the plethysmogram of the thorax. As can be seen from this document, some of the electrodes are active for current injection and other active processes may be provided, such as heat or cold to check blood flow, vibration to test sensitivity or application of pressure to measure blood pressure and record plethysmograms. In particular, one of the support surfaces 11 for the arms, which is concave, can be used to vary the pressure on this support surface 11, as controlled using a hydraulic device or stamp.

[0113] As shown in Figs. 1 to 5, this support surface 11 will be designed to be deformable, for example in the form of an open deformable U, so that not only the contact between the electrodes and the body is improved, but also it is possible to perform a blood pressure measurement at the same time. For this purpose, this U-shaped support surface 11 only has a relatively non-deformable support surface 19 on the outside, so that when pressure increases, this pressure is preferentially applied on the arm, in particular the forearm, in order to measure the blood pressure, in particular by oscillometry or auscultation. In this way, continuous pulse wave curves can also be obtained by setting a pressure at the U-shaped support surface 19, for example close to the mean arterial blood pressure. Beat-to-beat blood pressure measurements can also be performed using vascular unloading with the aid of optical sensors for blood flow. This U-shaped support surface 19 can also be used specifically to measure temperature and oxygen saturation. For this purpose, the support surface 19 can preferably be designed to be approximately translucent, or sensors can be arranged on the inner wall of the support surface 19 facing the human body.

[0114] Furthermore, a conventional blood pressure measurement using an upper arm cuff can also be integrated into the device to measure blood pressure. Alternatively or additionally, a pulse oximeter or a multi-frequency pulse oximeter can be integrated into the diagnostic system 1 to measure all parameters possible with it. When the person 2 to be examined is placed on the couch, the necessary contact between the electrodes and the person 2 to be examined is established only by the weight of the body part. To achieve this, it is advantageous that all the electrodes used, such as ECG electrodes, impedance spectroscopy electrodes, impedance plethysmography electrodes, current stimulation therapy electrodes, such as electrodes for TENS therapy as well for pain treatment, are arranged on the support surface 11 or on the arm support surface 11 in the arm area 4 and on the leg support surface 11 in the leg area 5. For therapeutic purposes such as mechanical effects on the person's body, it is also possible to use all areas of the support surface or diagnostic system, such as, for example, a head hood with or without virtual reality glasses, which include corresponding actuators. These can be physiotherapy devices that use shape changes, especially on the limbs and neck, to likewise activate exercise therapy for joints, when the support surface itself has mechanical joints, especially hinge joints, in the area of ​​the joints and these mechanical joints can be moved by actuators. The diagnostic device can also be designed as a massage therapy device or a vibration therapy device, if a suitable device is attached to the support surface. Or with the aid of electricity, electrotherapy, for example electrical stimulation or pain therapy, can be performed, for which existing electrodes and contact electrodes can be used. For example, pulsed ultrasound therapy has also proven effective for treating neurodegenerative diseases such as Parkinson's disease or Alzheimer's disease, since it appears to be able to temporarily open the blood-cerebrospinal fluid barrier, thus allowing the removal of harmful metabolic products (Adv.Sei.2020,7,1902583). For this purpose, a hood for the person being examined would be advantageous.

[0115] The first use of the diagnostic device can serve for diagnosis, then the use of these and further applications can serve for targeted treatment. A communication medium, such as a screen, VR glasses, loudspeakers or headphones, can display biological and medical findings during the first use. In the first and subsequent applications, information can also be provided, especially in the areas of relaxation, biofeedback, knowledge and advertising. In doing this, the information obtained from the diagnostic device can be given special consideration, for example stress reduction in cases of high sympathetic nervous system, nutritional advice for obesity, training and recommended training equipment for deficiencies in the muscular system, targeted person-specific advertising depending on the findings, especially if a medical history is included, etc.

[0116] By measuring different body segments at different frequencies of alternating current, it is possible to determine very precisely the body water, extracellular fluid, edema, muscle mass, muscle mass corrected for extracellular fluid, "dry muscle mass", and fat (Skrabal F et al, Med Eng Phys. 2014 July;36(7):896-904, Skrabal F et al, Med Eng Phys. 2017 June;44:44-52). Muscle strength and biological muscle age can also be estimated from the data. An in-built or connected dynamometer can be used for this purpose. As is well known, only a few frequencies are needed to construct a Cole-Cole plot for impedance spectroscopy. 32 In the case of plethysmography, inter alia, pulse-synchronous volume changes of individual body segments are recorded, as well as the volume changes before, during and after the application of external pressure, making it possible to detect not only cardiac output (Skrabal F et al, Med Eng Phys. 2014 July;v36(7):896-904), vascular properties such as pulse wave transit time (Skrabal F et al, J Hypertens. 2020 October;38(10):1989-1999), but also arterial and venous circulatory disorders.

[0117] This support surface 11 can be shaped as needed to establish better contact with the body being examined, but it is still essentially shaped as a flat surface without any folds. This support surface 11 can be single layer, as shown in FIG. 1, or it can be multi-layered.

[0118] For example, the cable could be made longer and, if necessary, spiralled, so that all the necessary electrical connections could be made between layers without any voltages being involved.

[0119] To keep the support surface 11 hygienically clean, it may be necessary to make the support surface 11 as uniform as possible without interruption, ensuring that the next person to be tested can be cleaned quickly and safely.

[0120] The support surface 11 for the torso, arms and legs should be relatively non-deformable so that the non-touch representation of the body is not distorted by excessive deformation of the support surface 11.

[0121] It is advantageous if a non-contact 3D measurement of the patient can be carried out at the same time. A camera 12 for non-contact 3D measurement of the body or for a further representation utilizing a 3D camera 12 or a thermal imaging camera 12 or a time-of-flight measuring device 12 for the representation and measurement of the person 2 being examined, and a device for the representation of color and temperature with which the person 2 positioned on the couch can be detected, can be attached to a bracket 29 mounted above the couch. The person 2 can be recorded in three dimensions, so that further data on the person 2 can be recorded, such as the volume, in addition to the impedance of the body area of ​​the person being examined. In addition, the camera 12 can be used to determine the color of the skin of the person 2, which can also be used to draw conclusions about its health condition.

[0122] A thermal imaging camera can also be used to realistically display a lightly dressed person 2 by temperature differences. The tiltable couch allows the examined person 2 to be presented in several different positions, either almost sitting or almost lying down, which increases the accuracy of the measurement. Measurement accuracy is important because the length and cross section of the body segments are included in the evaluation of the impedance measurement. In this way, the results of the non-contact measurement of the person can be used together with other physical, in particular electrical, data in simultaneous or simultaneous equations to obtain maximum accuracy.

[0123] The two- or three-dimensional representation can then be used to identify, from a multitude of electrodes, the electrodes to be used for ECG recording, impedance spectroscopy, impedance plethysmography. This is particularly important if the so-called EASI leads are to be used according to Dower (J Electrocardiology Suppl. 1988, p. 182-187) to reconstruct from these leads the conventional leads according to Einthoven, Goldberger and Wilson, in particular via regression equations, via xyz models or using artificial intelligence or neural networks.

[0124] Of course, a pivoting arm can also be used in a known manner with cables and electrodes (not shown) attached to it, in which case the electrodes would preferably be attached to a common belt, which is for example placed on the person's chest, and the contact to the examined person 2 is for example generated by gravity alone or by an elastic rubber belt or also by actively deformable areals, for example expanding chambers / blisters.

[0125] 2 shows details of the diagnostic system 1 of the invention, which comprises at least three contact electrodes 17 fixed to the chest belt 13, by means of which electrical signals can be transmitted to the chest belt 13. Again, no wiring is required; contact is made instead by positioning the person 2 to be examined on the diagnostic system 1, which is again formed by means of a swivel recliner. This person 2 can therefore optionally engage the chest belt 13 provided on the diagnostic system 1 without assistance, so that the diagnostic system 1 can continue to operate without additional personnel.

[0126] Thus, FIG. 2 shows how the support surface 11 can be embodied with a chest belt 13 used at the same time. The conductive electrode -E in FIG. 1 is applied in the upper body region 6. r -, -A r -, -S r , -Ir- or -E r a-, -A r a-, -S r a-, -I r a- can be replaced or supplemented by a chest belt with a chest wall electrode, which is in electrical contact with the electrode on the back of the chest belt 13. An electrode can be provided for electrical contact to ground, an electrode can be provided for the central terminal of Wilson (short-circuit electrode at positions I, II and III according to Einthoven), and a further electrode, preferably V4, can be provided for establishing electrical contact to at least one chest wall electrode.

[0127] The bars 29 may be removably mounted in bar brackets 38, which is particularly necessary when using mats as a supporting and bracing surface.

[0128] Fig. 3 shows the diagnostic system 1 of the invention together with a person 2 to be examined. As can be seen, the person 2 is wearing a VR headset 14, by means of which information can be displayed to the person 2, for example regarding the health state and the status of the examination to be performed. For example, during the examination, a visual representation of the person's body can be displayed to the user via the VR headset 14, which visual representation indicates how far the examination has already progressed and which data has already been determined. The health state of the individual body areas thus determined can be color-coded in the visual representation. The VR headset 14 can also be used for operation; therefore, the screen can be omitted; the keyboard can also be omitted if voice control is used.

[0129] Furthermore, a breathing tube 39 is shown, which is connected to the VR headset 14. When the patient or examined person 2 breathes through the nose, the breathing volume, the respiratory graph and the composition of the breathed air can be measured, in particular CO2, O2 and volatile gases, such as in particular acetone, and the like; as a result, the lung function and metabolism can be recorded without additional effort.

[0130] FIG. 3 further shows that in the neck region 7 a neck roll 10 is provided, which consists of an elastic material or an active inflatable surface and preferably comprises band-shaped electrodes, as in the arm region 4, the leg region 5 and the knee region 40. The electrodes in the leg region 5 and the knee region 40 are particularly suitable for detecting arterial and venous circulatory disorders in the leg by means of partial plethysmography, or in the lower leg by using the electrodes in the knee region 40. For this purpose, an additional compression cuff, for example U-shaped (possibly also circular, not shown), on the lower leg allows also the determination of the ankle-brachial pressure index ABI. For this purpose, methods of reperfusion and venous occlusion plethysmography are known, and volume changes can also be recorded. In particular in all joint regions the support surface can be mechanically actively adapted by actuators to the joint movements corresponding to the joint axis, thus also allowing physiotherapy measurements.

[0131] Furthermore, Fig. 3 shows a chest belt 13, with which an ECG can be generated, which is connected at the back to the diagnostic system 1 according to Fig. 2 with contact electrodes 17 hidden by the body, thus eliminating the need for wiring as is required in conventional devices to generate an ECG.

[0132] As shown in FIG. 3, the person 2 to be examined can also observe the results of the recording, if desired, using a personal screen mounted above the recliner or using a headset, for example in the form of a virtual reality headset 14. Using headphones 30, the person 2 can acoustically follow the procedure of the examination by explanation or be instructed. If a screen is used, it is advantageous to fix it so that unwanted observers cannot observe the personal data of the person displayed. If the person 2 can follow the collection of biological data in real time or simultaneously in time or possibly with only a short delay during the recording process, this also increases the motivation to carry out this examination.

[0133] The swivel recliner is also preferably positioned on a scale 41, preferably a surface scale or one or more load cells, so that the weight of a person can be determined automatically.

[0134] Between tests, the person to be tested 2 or the support personnel can clean the support surface 11 of the person with a cleaning wipe or cleaning spray. Preferably, a cleaning wipe or spray is used for this purpose, which simultaneously serves as the electrode contact liquid. For this purpose, a saline solution similar to saline can be used, in particular saline. This cleaning wipe or spray should be both bacteriostatic and, in particular against coronaviruses, virostatic, and should be soaked with a corresponding chemical, for example with 70% 2-propanol or 80% ethanol. There can also be a disposable cover made of paper or other disposable material for the parts of the support surface 11 that are not used for electrical contact. The combined diagnostic system 1 is then ready for testing the next person.

[0135] 4 and 5 show a detailed illustration of a support surface for the arms or legs, which can be used, for example, in the arm region 4 and in the leg region 5. In order to accommodate all the feed lines to the electrodes in a protected manner, the support surface must be embodied in two layers, and therefore comprises a body-proximal support surface 11, which can be made, for example, from washable plastic, and a body-distal bracing surface 19, which can be made, for example, from a durable fabric. This bracing surface 19 can be made from a durable plastic fabric for the torso of the person 2 to be examined, or, as shown here, from a hard material, in particular plastic or metal, for the electrodes 3 on the arm region 4 and on the leg region 5. Here, the electric lines and electronic components, such as electronic switches, pressure sensors 44, etc., are arranged between the support surface 11 and the bracing surface 19, so that they are not visible to the user.

[0136] The body-proximal support surface 11 can be embodied so as to be deformable. In a design example, a deformable intermediate layer 20 is arranged below the support surface 11. This intermediate layer 20 can consist, for example, of foam or of another deformable medium, for example a fluid, gas or liquid, which can also be actively expanded by changing the pressure. By changing the pressure in this intermediate layer 20, the body-proximal support surface 11 can be adapted particularly well to the human body. Thus, sensors, for example pressure sensors 44, light sensors 42, sound sensors and / or energy sources, preferably located opposite this, for example light sources 43, in particular LEDs, can press particularly well against the body and therefore ensure a good transmission of pulses or signals to the body. In addition to the electrical properties, the mechanical, light and acoustic properties of individual parts of the body can be analyzed in this way. If an air pressure source 21 and a pressure measuring device 22 for measuring pressure are present in this intermediate layer 20, as shown diagrammatically in the exemplary embodiment, the blood pressure can thus be determined by oscillometry and / or auscultation and / or a continuous pulse wave and pressure analysis can be carried out. As is known, the time points of appearance and disappearance of Korotkoff noises and specific sound levels are used for auscultatory measurements, the registration of pulse amplitudes at different pressures is used for oscillometric measurements, and the pulse amplitudes at the time of relaxed arterial walls are used for continuous pressure measurements, assuming that the blood pressures in the artery and in the compressed medium are the same. All of these methods can be achieved with the diagnostic system. The method of continuous blood pressure measurement can be used particularly well if the blood volume in the compressed arterial section is then measured, for example optically, for which the light source 43 and the light sensor 42 are well suited. For this purpose, the support surface (here: U-shaped) does not have to be closed, but a corresponding pressure can nevertheless be applied to the forearm or lower leg, since the limb is delimited by bones at this location at the exposed location. The body part can therefore also simply be inserted at this point into the U-shaped support surface without further manipulation.In order to prevent the arm from being pushed out of the U-shaped support surface when the pressure increases, a pressure-free zone 18 can alternatively be provided at the bottom of the U, in which no pressure is applied, since in this case the bone interface is again provided by the ulna. Therefore, in this embodiment, the U-shaped support surface is at least partially divided into two parts, both of which are pressurized with the same pressure. This same pressure does not have to be accumulated in the two parts of the cuff; different pressures may also be advantageous, for example to achieve the most intensive contact possible with the artery. This at least two-part configuration is one possible embodiment; of course, a one-piece embodiment is also possible, as shown in FIG. 4. For this purpose, the parts of the support surface that are not in contact with the body or the bracing surface 19 should be designed as pressure-resistant as possible, so that the pressure is mainly applied only to the human body. It goes without saying that if a liquid or gas is used as a medium, a hydraulic pressure source 21, for example in particular a pump, can of course also be used as pressure source 21.

[0137] Figures 6 and 7 show a chest belt 13 for the diagnostic system 1 of the invention, which is embodied for example for a particularly precise recording of an electrocardiogram. Figure 6 shows the front side of the chest belt 13, and Figure 7 shows the rear side of the chest belt 13. On the rear side of the chest belt 13, electrical contacts are provided; said contacts correspond to contact electrodes 17 on the diagnostic system 1 as shown in Figure 2 or on the supporting surface on the corresponding area of ​​the recliner, in order to allow the transmission of electrical signals from the supporting surface to the chest belt 13. The chest belt 13 can be applied without assistance by the person 2 to be examined, so that the electrical connection of the chest belt 13 to the diagnostic system 1 is possible without the use of a plug or the like.

[0138] The chest belt 13 comprises on the inside a number of chest wall electrodes 23, with which the so-called Wilson leads can be determined. The central terminal Wilson can be corrected accordingly with the aid of an appropriate algorithm. The individual chest wall electrodes 23 can be switched on and off with the aid of a multiplexer. A closure, for example a hook-and-loop closure, a buckle, a snap device 24 or the like, is arranged on the front side of the chest belt 13 so that the person 2 using the diagnostic device can easily fasten the chest belt 13 without assistance. Of course, an adjustment device can also be provided in order in this way to easily vary the length of the belt and to make it possible to easily adjust the belt to different size ratios. The chest belt can also comprise one or more inflatable chambers on the outside of the electrodes; said chambers actively press the electrodes against the body and the quality of the signal can be controlled by the contact pressure.

[0139] As an alternative or in addition to the chest wall electrodes 23, the chest belt 13 can naturally also have electrodes in positions E, A, S and I according to EASI in order to make it possible to create the so-called vector electrocardiogram and the EASI leads according to Dower (J Electrocardiology Suppl. 1988, p. 182-187; Dower GE, Clin. Cardiol. 3, 1980, 87-95).

[0140] A simple variant of the chest belt can also be provided as a tension strap 6, for example elastic or also inelastic, equipped with a tension device 47, which is fastened for example to a supporting or bracing surface. The person to be examined tensions the strap, for example over the lower part of the chest, and fastens it on the opposite side, for example by means of a snap device 24. If this tension strap is elastic or comprises a tension device 47, good electrode contact can be ensured. If the tension strap is accordingly fastened, for example behind the body, to a supporting or bracing surface, it creates good electrode positions around the body, which ensures a large number of possible electrode positions.

[0141] To be able to perform EASI induction on persons with small and large body circumferences, it is recommended to equip a chest belt or tension strap with several electrodes, among which the ones corresponding to the EASI positions are then activated. To determine the correct electrode positions, either the ECG signal itself or a 3D representation of the person can be used, especially if the electrode positions on the outside of the belt can be identified by marking, for example color coding.

[0142] For example, the tension belt is located at approximately the position I of the contact point of the bracing surface. r Or A r The support surface can then be fastened to the patient's back side in direction A. r In I r along the support surface of the r 1, or vice versa clockwise or counterclockwise around the patient's back, where the tension belt is closed with a snap device 24, as used for seat belts, for example. In this embodiment, the tension spring is best integrated into the snap device 24, so that fastening of the belt to the bracing and / or supporting surfaces is very easily implemented along the seam location 48, for example by a seam, or glued or welded. At this seam location 48, the electrodes I r , M r , A r , A, E and I, to the chest wall electrodes and / or to any other existing electrodes. As is known, the tensioning device can be implemented by a roller tensioned with a spring locking mechanism, as is known from many window roller blinds. The tensioning device can be adjusted so that the direction of travel of the further tensioning belt is predetermined, for example at approximately position A of the support surface. rIn the present study, loops for guiding the tension belts have been shown to be effective. Thus, complete or almost complete encirclement of the body with tension straps is possible. Therefore, the conventional positions I, E, A and I of the EASI guide on the front of the body are not possible. r , M r and A r Both positions, as well as all positions of the chest wall electrodes if necessary, can be equipped with electrodes inside the tension belt. Position S of the EASI lead can also be accommodated as a forehead electrode 45 for the forehead, for example at the edge of the VR headset. Given the corresponding tension of the tension belt, interference of the electrical signal with artifacts and electrical noise during physical movements is thus prevented.

[0143] It has also been shown that a correspondingly high spring force in the intermediate layer 20 is effective on the U-shaped support surface for the arms and legs, so that an increase in contact pressure can be achieved either by increasing the pressure in the fluid or similarly by mechanical spring force. By manufacturing all electrodes, including not only the chest wall and EASI electrodes, but also all electrodes of the diagnostic device from silver chloride or stainless steel, the noise of the electrode potential and the signal is reduced. This is particularly important because it is beneficial to rely on finding the impedance plethysmographic signal on the R wave of the ECG, which is why a stable R wave detector in the software is a great advantage. Therefore, all partial and whole body impedance plethysmographic signals can then be performed and evaluated very precisely, for example by feeding and reading the impedance between one or both arms and one or both legs. From these signals, the stroke volume and minute cardiac output, as well as the determination of the onset of propagation and valve closure, can then be determined in a known manner utilizing the calibration factor basic impedance zO, the duration of the cardiac cycle, the duration of the maximum amplitude of the impedance plethysmographic signal until the start of the next cardiac cycle. The calibration factor is calculated from the height, the electrical resistance of the blood, the hematocrit, the electrode distance and the height (see, for example, Kooebi, Intensive Care Med (1997) 23:1132-1137). The impedance plethysmographic signals of the whole body and / or of body segments, e.g. chest, abdomen, arms and legs, for several to many heart rates are superimposed and a template is formed. Characteristics such as amplitude, high amplitude pulses, low amplitude pulses, width, shape, etc. are determined from this. These templates can also be formed separately for inspiration and expiration, for example, since inspiration and expiration can also be detected via the impedance plethysmographic signal and / or via a 3D headset with a breathing tube.The impedance plethysmographic signals of the whole body and of the chest, arms and legs can then be used to calculate pump power, detect heart failure, detect pulse wave time or volume wave time, calculate performance under stress, with or without the use of extracellular fluid and / or calculated muscle mass and / or calculated body fat mass, with or without the use of calculated abdominal fat and other parameters. The extracellular fluid and total body water and segmental water come from the resistance of the body and its segments at low (e.g. 5 kHz) and high frequencies (e.g. 500 kHz), because high frequencies but not low frequencies can penetrate cell membranes. The accumulation of extracellular fluid is known to be an indication of cardiac and / or renal weakness, liver disease, thrombosis, lymphedema or dysproteinemia. Multiple regression equations, discriminant analysis or similar methods or even artificial intelligence, e.g. neural networks, can be used to determine the water compartments. The additional use of non-contact measurements of the person in the composite equations increases the accuracy. In addition, "gold standard methods" such as ergometry, echocardiography, whole body DXA, double gas breathing method or CO2 rebreathing, biochemical markers such as BNP can also be used for this purpose.

[0144] This allows all 12 leads of the standard ECG to be reconstructed with a small number of electrodes or parts thereof. In order to achieve positions V1 and V2 according to Wilson or position S according to EASI with a single chest belt 13, the chest belt 13 can also have an extension 26 on the chest side of the person 2 to be examined in the direction of the manubrium of the sternum of the person 2 to be examined. This extension 26 can also be pressed against the person 2 to be examined by a lever. For example, a small housing 25 can be arranged above the sternum, which presses the chest belt 13 against the person 2 to be examined, for example by means of a spring located behind the housing. The signals are amplified with electronics usually located in the housing 25 and can be transmitted wirelessly, for example by means of Bluetooth, to a measuring module with a CPU 36 attached to the diagnostic system 1, whereby the signals are evaluated and a diagnosis is inferred.

[0145] Figure 7 shows a rear view of the chest belt 13, which carries on its outer side, i.e. facing away from the body, a number of chest belt outer electrodes 27 which can be in contact with the contact electrodes 17 of the support surface in the upper body area 6, which contact electrodes are shown in Figure 2. The chest belt 13 shown therefore carries inner electrodes, i.e. the chest wall electrodes 23 shown in Figure 6, as well as outer electrodes, i.e. the chest belt outer electrodes 27. In addition, an additional extension 26 directed downwards is also provided on the rear side. Using this extension 26, the chest belt outer electrodes 27 can then be in contact with the contact electrodes 17 of the support surface 11, even if the person 2 to be examined is wearing a bra. The chest belt 13 attached to the person 2 to be examined is preferably an at least partially elastic chest belt 13; especially in those areas of the chest belt 13 which do not carry any chest belt outer electrodes 27 or chest wall electrodes 23, the chest belt 13 can be adapted very elastically so that the electrodes can actually be in close contact with the body.

[0146] This chest belt 13 can therefore also be worn during physiological interventions such as tilt table examinations, without the electrodes being able to shift. If the examination lounger is embodied as a tilt chair, hemodynamic measurements can also be carried out with this device after a change of position.

[0147] To compensate for different body dimensions, several chest belts 13 are provided, for example the person 2 to be examined is held in place with the aid of calipers, said chest belts 13 conforming to the body size of the person 2 to be examined. This means that electrical contact with the person is established without the use of personnel.

[0148] A chest belt 13 is generally not required. Therefore, it is possible to use electrode leads according to Einthoven and Goldberger or r , A r , S r and I r Diagnosis can already be carried out using induction; these are possible using electrodes in the support surface 11 .

[0149] As described, the design of diagnostic system 1 has significant advantages in terms of time when labor is the primary cost factor.

[0150] Versions of the combined diagnostic system 1 in which the person is, for example, in a reclining position are also possible. The arm electrodes should in this case also be advantageously embodied either as half shells on which the person places his forearm or as wrist bands. The electrodes in the leg region 5 can in principle also be placed on the soles or ankles, for example by the person standing on them or also by wearing a half shell over the calf. However, the measuring electrodes have the disadvantage of a high series resistance. For example, a scale can then also be used as a standing surface to simultaneously determine the weight of the person.

[0151] The person can also be rendered and sized in 2D or 3D by using an imaging device. Using this version of the combined diagnostic system, the person can then be examined in a horizontal position as well as in a near-vertical position, thereby simultaneously determining the autonomic and hemodynamic integrity of person 2. In addition, all hemodynamic and fluid parameters and their changes can be determined by orthostatic hypotension.

[0152] Fig. 8 shows a schematic representation of a section of the electrical circuit of the diagnostic system 1. In this case, the body part of the person 2 examined with the diagnostic system 1 is shown as an impedance 32 (consisting of its subcomponents such as real part, imaginary part and phase angle) connecting two electrodes, for example a feed electrode 8 in the arm region 4 and a feed electrode 8 in the upper body region 6, such that the impedance 32 can be detected via measurement electrodes 9, not shown here, in that a current is fed through the feed electrodes 8 using a power supply 35 and the voltage drop between the measurement electrodes 9 can be measured using the measurement electrodes 9 mapped to the respective feed electrodes 8, said voltage drop depending on the impedance 32. The subcomponents of the impedance, namely the effective resistance, the apparent resistance and the phase angle, can also be used to calculate the diagnosis.

[0153] A switch 31, here provided directly adjacent to the feed electrode 8, can be used by downstream electronics and patient connection lines to switch off the feed electrode 8. Switching off electrodes that are not required or activated prevents any influence of the inactive electrode cables or lines 34 on the measurement results.

[0154] Additionally, a switching device 33 is provided near the power source 35 .

[0155] A switch 31 arranged near the feed electrode 9 and a switching device 33 near the measurement module with CPU 36 usually operate synchronously. The patient connection line is embodied as a shielded line 34 and a so-called "shield driver" controls the potential of the shield based on the potential of the line 34. Any undesired current flow caused by the insulation resistance and coupling capacitance of the inner conductor shield on the currently active electrode is prevented.

[0156] The measurement module with CPU 36, which in this case may include a multi-channel ECG, circuits for impedance feed and impedance measurement, a multiplexer, one or more evaluation units for contact and non-contact data, etc., is preferably mounted as close as possible to the examination table or diagnostic system 1.

[0157] A power supply 35 is preferably connected to the feed electrode 8 via a shielded wire 34 in order to be able to transfer data relating to the determined impedance 32 to the CPU and to evaluate it.

[0158] The power supply 35 should be embodied as a bidirectional power supply in order to be able to detect the respective alternating current resistance, ie impedance 32, of the individual body parts of the person.

[0159] The ECG circuitry and other circuitry, e.g. for further physiological signals, are not shown in FIG. 8 for easier understanding.

[0160] A further schematic diagram of the diagnostic system 1 is shown in Fig. 9. Here, two galvanically isolated power sources 35 are provided, which can be connected to feed electrodes 8 at different positions of the support surface as shown diagrammatically. The dashed lines indicate the possible connections, the activated connections are represented by solid lines. As can be seen, the left power source 35 is thus connected here to a feed electrode 8 in the left arm region 4 and to a feed electrode 8 on the left leg region 5, so that a current can be applied to the body region between said feed electrodes 8 by means of the power source 35 in order to determine the impedance 32 of this region.

[0161] The right power supply 35 is correspondingly connected to the feed electrodes 8 in the right arm region 4 and upper body region 6, so that the impedance 32 of the upper arm, shown on the right in FIG. 9, can be determined with this power supply 35 or related to the measuring electrodes 9. Due to the galvanic isolation, measurements that do not influence each other can be carried out with two feed electrodes 8. More than two power supplies 35 can also be provided.

[0162] These modules can be as close as possible to the recliner or to the integrated electrodes. For simplicity, only two galvanically isolated power sources 35 are shown; their number can be increased as desired. As shown in FIG. 9, for example, the whole body and also the left arm can be measured. All other segments can also be measured depending on the electrode location, as shown using dashed lines; here, for example, dashed lines indicate the measurement of the chest segment and the left leg.

[0163] It may also be provided to realise the power supply 35 as a matched power supply (both positive and negative), as shown in Figure 10. However, it may alternatively be provided to use a regulated power supply, which means that close regulation of the power supply may be omitted.

[0164] For this purpose, FIG. 10 shows one of the possible embodiments, where the offset of the two power supplies 35 can be controlled with respect to each other by analog electronics or by a digital controller (in a microcontroller). For example, the common mode potential of the patient can also be used as a control variable. This common mode potential is usually measured in some way for ECG recording with an N electrode on the right leg (RLE), whereby this electrode can also be used as a measuring electrode. This then also reduces the number of electrodes required. Therefore, a corresponding circuit (see for example https: / / en.wikipedia.org / wiki / Driven right leg circuit) can be actively compensated for right leg driven electromagnetic interference, for example also by circuit network hum.

[0165] The AC resistance to be measured is marked with z1, the measuring electrodes are marked with EL in a dashed box, the unused electrodes are marked with EL outside the box, D / A is the abbreviation for digital / analog converter, CPU is the abbreviation for central processing unit for the measuring module. For simplicity, the additional measuring electrodes are not shown in this image.

[0166] FIG. 11 shows a circuit configuration for performing electrode contact measurements to ensure sufficient electrode contact, and also to select from a number of electrodes the one that has the lowest contact resistance to the person 2 being tested.

[0167] An input amplifier 37 and shield driver are provided for the measuring electrode 9 labelled V. However, electrode contact measurements reduce the input resistance and therefore cannot be performed simultaneously with current measurements and are preferably switched off during the same measurements.

[0168] Other electronic circuits are known from the prior art for contact measurements and these can also be used in the diagnostic system 1 of the invention.

[0169] Alternatively, as shown in FIG. 11, a measurement current can be fed in; a pressure sensor 44 can also be used for this purpose, whereby, for example, an electrode placed close to the pressure sensor and at which the maximum contact pressure is measured can be used for the measurement.

[0170] 12 shows a three-dimensional image of a person 2 under examination, obtained with the diagnostic system 1 of the invention. This image can also be captured for a clothed person 2, in that the contour of the person 2 is recorded three-dimensionally, in particular with an infrared camera and the like. This contour can firstly be used for rendering in the VR headset 14. In addition, this contour can contribute to the determination of a health condition, in particular providing information on the waist / hip ratio and the body mass index or the like, or can contribute to the formation of these values.

[0171] In this step, measurement points 28 are also drawn, here on both ankles, on the xiphoid process and on the upper edge of the sternum, which are preferably recorded automatically, in particular with the camera 12 positioned above the person. These measurement points 28 are advantageously used to determine the body compartment calculations utilizing multi-frequency impedance based on segment lengths. The arms, not shown here, can also be represented by their length, diameter and configuration.

[0172] 13 shows a corresponding image, which can for example also be displayed in a VR headset 14. Such an image can also be embodied as a glass image of the body of the examined person 2, for example by representing a beating heart, arteries pulsating in the body's own rhythm, and also breathing and other parameters (referred to as "etc."). As discussed, sensors can be used to acquire corresponding data at the support surface.

[0173] If pathological changes are observed, they can also be displayed in real time or over time, for example by flashing or changing color.

[0174] In combination with a representation of the human body in 2D or 3D, the location of any problem zones can then be displayed graphically to the person 2 being examined. The online presentation of changes during the recording is also particularly advantageous, since it can be used to motivate the patient to carry out this examination. For example, in a three-dimensional view obtained with 3D measurements, the activity of the blood vessels, such as the heart rate, heartbeat, blood pressure, aortic stiffness, cardiac output as well as a number of other parameters, the circulation of the organs and all other biological data obtained can be displayed in a two-dimensional or three-dimensional manner. For example, an online representation by flashing of conditions that are not in the optimal range, such as a lack of muscle mass, an excess of body fat mass, pathological changes in the organs, such as cardiac dysfunction due to heart failure, an excessively stiff aorta or a lack of blood flow to the legs, can be indicated by coloring or in another way online.

[0175] The pulsating columns in cardiac rhythm can indicate heart rate, blood pressure levels, aortic stiffness, cardiac output, and other physiological parameters, which can then motivate person 2 to change his / her lifestyle accordingly in order to halt or reverse the progression of the disease condition.

[0176] At the same time, the person 2 being examined can also be equipped with headphones 30 or speakers, preferably near the ears, to only inform the person being examined about the progress of the examination and possibly also to receive instructions regarding correct posture, or requests to activate a switching movement or information regarding the end of the examination.

[0177] Another example shown is that of the use of graphical representation of biological or biochemical data obtained from a patient.

[0178] FIG. 14 shows a simultaneous representation of a bar diagram, e.g., a bar chart, and a human figure for an illustration of an individual body function generated using the diagnostic system 1 of the present invention, the human figure corresponding either as recorded by non-contact measurements, or (if sufficient) as only a symbolic representation of the body to indicate findings that deviate from the norm by graphical labeling, e.g., grading, editing, or coloring.

[0179] This figure shows an exemplary embodiment of cardiac output, cardiac wall tension, hydration, leg perfusion with possible peripheral occlusive disease depiction, pulse wave time, physical performance, total body water, depiction of over- or underhydration in the area of ​​extracellular fluid, appendicular muscle mass in both upper and lower limbs, body fat mass, trunk body fat mass depiction. Individual parameters are shown in the labels.

[0180] The results are firstly shown in the form of a bar chart, the width of the bar representing the normal range. The position of the possibly colored marker indicates whether the corresponding parameter is within the normal range, below the normal range or above the normal range. Secondly, the right side of the figure shows a diagram of a human being, whereby the individual characteristics of the human body are shown only in separate diagrams. Thus, for example, it can be shown separately whether the cardiac output, blood vessels, leg circulation, muscle condition, body fat, autonomic nervous system are in the normal range or whether there are moderate or severe changes, indicated for example by gray coloring or black coloring.

[0181] For easier presentation, the corresponding parameters are also shown in the form of a human figure, whereby a special color, e.g. white coloring of the figure, means that all collected parameters are within normal ranges. Different coloring, e.g. gray or black coloring or even yellow or red coloring or another color of individual organs, indicates whether the physician should pay close attention to a particular test result and further tests should be performed in this regard.

[0182] The diagram first shows the heart and secondly the major blood vessels such as arteries, muscle mass, body fat mass, body fat percentage and arterial circulation in separate diagrams.

[0183] 15 shows an age-based norm diagram generated using the diagnostic system 1 of the present invention, in which a person's individual measurements are depicted by measurement points 28 in a nomogram using age-appropriate norm values. The nomogram graph shown here corresponds to age-adjusted physiological ranges; any measurements outside this physiological range are indicated by measurement points 28 outside the bars. Optimal ranges for the graph are indicated here by, for example, age ranges colored green, limit ranges in yellow, and clearly pathological ranges in red.

[0184] Fig. 16 shows a health report generated using the diagnostic system 1 of the invention, in which the measured values ​​are displayed in the form of traffic light colours green, yellow or red in comparison with an age appropriate population, green indicating sufficiently healthy values, yellow indicating limit values ​​and red indicating values ​​in an unfavourable range. Of course, other colours can also be used. The individual conditions and functions shown are also marked using commonly understandable symbolic images.

[0185] 17 shows a plot of measurements produced with the diagnostic system 1 of the invention when the person 2 to be examined takes part in the study more than once. The individual measurement points 28 are connected by lines, which allows more favorable or less favorable changes to be represented at a glance.

[0186] The above examples prove particularly useful when used in combination with known medical data, such as, for example, laboratory chemical tests, possibly obtained from point-of-care measurements, EMG, temperature measurements, oximetry, nerve conduction velocity, computed tomography, magnetic resonance, ultrasound, x-ray, endoscopy, etc.

[0187] The person 2 to be examined can then immediately transmit his findings online via Bluetooth, preferably with a color printout.

[0188] To facilitate management, the person 2 to be tested can also, upon confirmation of payment, read a ticket previously given to him / her to obtain authorization to carry out the test, for example via a barcode.

[0189] It is advantageous if the data and diagnoses recorded using the diagnostic system 1 of the present invention are stored in a database, thereby allowing the person 2 to easily understand the performance of his / her health condition when the diagnostic system is used several times.

[0190] It is particularly advantageous if automated measurements of the electrical values ​​of the human body, and if necessary other values, are combined with the diagnostic system 1 of the invention, based on a structured questionnaire.

[0191] The questionnaire is preferably implemented in the form of a dialogue tree, whereby an answer to a question leads to another question which is derived from the answer to the question. The questionnaire can also be carried out using a language program or in the form of a preformatted form, preferably in digital form, in which the corresponding answers can be entered by checking or editing.

[0192] In order to make it as easy as possible for the user to answer this questionnaire, the questions can be implemented in such a way that they can be answered with yes or no or only by entering numbers. The questionnaire can also be answered during the examination or only after the examination, in particular also online. The results of the questionnaire will then be linked to the collected biological data, for example by an expert system.

[0193] This data can be transmitted in a known manner to a central database, preferably in the case of using many of these composite diagnostic systems 1, which stores the measurement values ​​of many deployed composite diagnostic systems 1, preferably anonymously.

[0194] For example, the automated computer system can send remote suggestions to optimize the health of the examined person 2 or suggest visiting a doctor or medical institution in case of pathological findings. Additional online databases can also be used for this purpose, whereby data can be linked to other biological data. For example, laboratory data, performance data such as walking speed, kilometers traveled, altitude meters, calorie consumption and the like can then be linked to the data obtained here to enable better information on health and better health advice.

[0195] In addition to cardiovascular parameters and body composition, the diagnostic system 1 is also suitable for communicating information regarding respiration, metabolism, in particular glucose metabolism, liver and kidney function, and blood count. For this purpose, suitable sensors can be integrated into the diagnostic device.

[0196] For example, an accelerometer or microphone integrated in the support surface, e.g. at the location of the EASI electrodes, is well suited to monitor respiration; for example, breath sounds, respiration rate, depth of respiration, duration of inhalation and exhalation can be compared on each side and used to detect bronchial asthma, cardiac asthma, pulmonary congestion, pulmonary infiltrates, e.g. pneumonia, unilateral or bilateral pleural effusion. Breath sounds change, e.g. from alveolar breathing to strong breathing, dry rumble, wet rumble, weak breath sounds, etc. Impedance plethysmography signals can also be used to detect the duration of inhalation and the duration of exhalation by modifying the basic impedance for inhalation and exhalation, and also for better diagnosis of respiratory disorders and heart failure due to prolonged exhalation and dry and / or wet rumble noises, which can also be detected with a diagnostic unit using Cheyne-Stokes respiration.

[0197] Furthermore, all known methods for measuring blood glucose (see, for example, Clinical Chemistry 1999, 45:2 165-177) can be integrated into the diagnostic system 1; other techniques such as skin permeation methods (Chuang, J. Diabetes Science and Technology Volume 2, 595, 2008) or graphene thin film technology (Lipani L. Nature Nanotechnology, 2018, vol. 13, no. 6, pp 504-511) can also be used.

[0198] Disturbances in sweat gland secretion can be detected by recording the function of the sweat glands, such as in Sudoscan (Casellini CM, 2013, Diabetes Technology & Therapeutics Vol 15, 948). To do this, the palms and feet should be brought into contact with a stainless steel plate through which a low current of a few volts passes, for example. For example, the steel plate can be pressed against the exposed hand and foot using a spring. Sweat secretion can then be recorded via an electrical measurement of chloride ions, which can be disturbed not only in diabetes but also in borderline diabetes. In this way, unilateral disturbances can also be differentiated from bilateral disturbances. The concentration of ethane and n-pentane has the potential to detect oxidative stress.

[0199] Additionally, the camera 12 may be used to measure changes in kidney function, particularly through urochrome, by changing the color of the skin, or liver function through jaundice, which may be detected by changing the color of the skin and sclera using a non-contact indication.

[0200] Furthermore, a vibration mechanism can also be integrated into the support surface 11, which is positioned in the part of the support surface that contacts the liver. An ultrasound-based "vibration scan" can then be used, in a manner known from the prior art, to determine the travel speed of the emitted pulses and thus the stiffness of the liver and thus its connective tissue and / or fat content. Transient vibrations are particularly useful here, since the emitted and received sound and ultrasound can be separated in time.

[0201] On the one hand, acoustic or elastic waves can be analyzed. This allows chronic and acute liver diseases, such as fatty liver or chronic hepatitis and cirrhosis, to be detected. On the other hand, ultrasound can be used to determine bone density, for example of the heel or metacarpal bone, and to diagnose osteoporosis or the risk of fractures. Both broadband ultrasound methods, which evaluate the frequency dependence of ultrasound attenuation, and SOS methods, which use the speed of ultrasound propagation, can be used for this purpose. A fluid feed in the form of a deformable bladder may have advantages. The diagnostic system 1 according to the invention can therefore also have vibration devices and sensors, with which vibrations can be applied specifically to individual body areas and the mechanical reaction of the body to these vibrations can be measured.

[0202] Anemia can also be detected by optical methods, for which sensors on the eyes or extremities, in particular the wrist and fingers, are particularly suitable, whereby the camera 12 can be used to determine the erythema index (Collings S, PLoS One, 2016, Apr 12; 11(4): DOI:10.1371 / journal.pone.0153286), for which the capillary bed of the nail fold is particularly suitable.

[0203] For example, hemoglobin can be determined with sufficient accuracy relative to the radial artery pulse using a multi-wavelength pulse oximeter (Dreyfus J, Annals of Emergency Medicine Volume 57: 330 2011).

[0204] For all applications where the finger is examined, an additional finger cuff or groove with integrated sensor proves its worth, since it not only keeps stray light out, but also establishes a particularly good skin contact, regardless of the diameter of the finger, especially with an elastic design. Optical detection of iron deficiency, for example by measuring zinc protoporphyrin on the lips, wrist or fingers, or other methods (Hennig G, Nat. Commun. 2016, 7:10776 doi:10.1038 / ncomms10776), is also possible, which is of great importance in view of the worldwide spread of iron deficiency.

[0205] To capture facial details, the planned 3D headset should also be equipped with additional sensors, such as optical sensors. Not only the capillaries of the mucous membranes, but also the color of the sclera can be measured and evaluated. For example, hemolysis or liver disease can be detected by an increase in bilirubin, and also vitamin B12 deficiency, in which the skin is also characterized by paleness and sallowness. For this purpose, continuous illumination, both in terms of intensity and color tone, is preferred, which is made possible by a standardized and calibrated light source 43 for at least one part of the body.

[0206] The person 2 to be examined can also be equipped with a breathing mask to record the amount and rate of inhalation and exhalation, as well as the composition of the exhaled air. If the 3D headset or the VR headset 14 are equipped with a breathing tube 39, they will be particularly suitable for this purpose. For example, the amount and rate of exhalation or the composition of the exhaled air can be recorded using the rotation speed of a rotating fan, or by measuring the temperature curve or by ultrasonic measurements in the exhalation direction and in the opposite direction or one of the other common methods. In particular, the measurement of the CO2 and O2 concentrations of the breathed air allows the evaluation of the pulmonary and circulatory function. For example, the pulmonary function can also be recorded simultaneously using the 3D headset. Electrical contacts for recording electroencephalogram curves in the form of EEG can also be integrated into the edge of the 3D headset, or into the strap for attaching the 3D headset to determine the brain function, or an O2 sensor can also be integrated on the ear, for example, to determine the O2 saturation. The strap for attaching the headset can also be shaped as a hood or cap to include even more parts of the brain in the analysis.

[0207] It is also possible to use parameters collected from the carotid arteries and veins using pressure and flow sensors, for example if the bolster 10 is designed to be adjacent to or in contact with the cervical vessels. For example, the bolster 10 can be concave at the apex; again, good direct contact with the cervical vessels can be ensured by varying the pressure at the bolster 10.

[0208] In that case, all relevant sensors such as volume, pressure, ultrasonic or flow sensors used to measure arterial pulsation, flow velocity, venous diameter and venous pulsation, etc. can be housed in the bolster 10 or an equivalent part. By changing the position of the couch, the effect of the hydraulic pressure on the veins can be specifically examined.

[0209] To ensure complete contact with all electrodes and sensor complexes, contact should be ensured by electrode contact measurements.

[0210] Audio / visual communication with a person, for example to follow commands, is also possible, especially to eliminate failure of electrical or mechanical contacts. At least one operating switch or switches controlled by voice commands should also be present.

[0211] This communication can also be used to analyze other organ systems. For example, hearing, vision or smell can be evaluated by sending modified signals via these headsets to the person 2 being tested and asking via feedback whether a certain noise or sound is still audible or whether light signals such as letters are still visible or legible. It can also be used to monitor and measure intelligence, attention, comprehension and cognition by carrying out simple tests on the person, such as mini-mental tests or analogue test methods, in which the person answers via a communication medium (light, sound) or a communication button.

[0212] It may also be used to assess the perception of the stimulus transmitted by the actuator by acoustically communicating it over the communication medium, for example the strength or quality of a particular physical signal, such as a vibration signal, or whether a particular heat or cold intensity can still be felt.

[0213] Point-of-care measurements of urine and blood before, during or after monitoring are also possible.

[0214] Again, it is advantageous to integrate clinically proven products as OEM products into the diagnostic system 1. These point-of-care measurements from small blood samples taken from a finger prick can be used to further detect or confirm liver disease, kidney disease and cardiac disease, such as coronary heart disease or heart failure.

[0215] This system can be used to perform completely internal medical tests, with medical history captured online, without a doctor being directly involved in the test. This is especially beneficial in developing countries where medical care is scarce. All that is needed is a chair or couch with built-in sensors and an integrated diagnostic system, and, if necessary, a small point-of-care device. Therefore, this system is also very easy to transport to any location.

[0216] The diagnostic system 1 according to the invention allows to determine the health status of a person 2 in a particularly simple way without additional personnel. Accordingly, such a diagnostic system 1 can be used in publicly accessible places, such as fitness centers, shopping malls, pharmacies, rehabilitation facilities, health facilities or the like, and especially in developing countries with poor physical care, where patients do not have easy access to the medical system. This means that people 2 can easily get a good overview of their health status within a few minutes and detect any illnesses or disorders. Additional point-of-care measurements are ideal for this application, and personnel are useful here. Of course, the diagnostic system 1 is also preferably configured to issue recommendations for further actions if a corresponding deviation is detected, in particular whether a doctor should be consulted or not.

Claims

1. 1. A diagnostic system (1) having one or more support surfaces (11) on which a person (2) to be examined can be positioned, characterized in that electrodes (3) are arranged on different regions of the support surface (11), in particular on the leg regions (5), on the arm regions (4), on the upper body region (6) and / or on the neck region (7), which are at least partially designed as electrode pairs, each electrode pair having a feed electrode (8) and / or a measurement electrode (9), the feed electrodes (8) being arranged distally with respect to the measurement electrodes (9), and a device is provided for feeding a current between the feed electrodes, the diagnostic system (1) being configured to measure a voltage drop between the measurement electrodes in order to be able to determine the impedance of a body region of the person (2) located on the diagnostic system (1).

2. 2. The diagnostic system (1) according to claim 1, characterized in that the diagnostic system (1) is configured to switch between individual electrodes (3) or electrode pairs in pairs so that a current, in particular an alternating current, is fed in by means of two feed electrodes (8) and the voltage drop between the associated measurement electrodes (9) can be measured.

3. 3. Diagnostic system (1) according to claim 1 or 2, characterized in that the measurement path is designed in such a way that only a part of the measurement path has a current flowing through it and another part of the measurement path is designed as an electrical conductor.

4. Diagnostic system (1) according to any one of claims 1 to 3, characterised in that more than one current source (35) is provided, which are preferably electrically isolated from one another and connectable to the feed electrode (8).

5. 5. The diagnostic system (1) according to claim 1, characterized in that the diagnostic system (1) is configured to feed alternating currents by means of separate feed electrodes (8) at different frequencies, in particular at frequencies between 1 Hz and 1 MHz, in particular between 5 kHz and 500 kHz.

6. A diagnostic system (1) according to any one of claims 1 to 5, characterized in that a switch (31) is provided that can switch between the individual feed electrodes (8) directly adjacent to a connection point, in particular less than 3 cm away from the connection point, at which a person (2) positioned on the diagnostic system can make electrical contact with the electrodes.

7. 7. Diagnostic system (1) according to any one of claims 1 to 6, characterized in that an electrode contact measurement is provided, which can be used to identify the electrode (3) or electrode pair having the lowest contact resistance with the person (2) being examined, and the diagnostic system (1) is configured to activate the electrode pair (3) having the lowest contact resistance, in particular by means of a switch (31) arranged close to the connection point.

8. The diagnostic system (1) of claim 7, characterized in that the electrode contact measurement is configured to apply a voltage to individual electrodes to achieve a flow of current through a body located on the diagnostic system (1), thereby making it possible to determine a contact resistance based on the level of the current.

9. Diagnostic system (1) according to claim 7 or 8, characterized in that the electrode contact measurement can be switched off, in particular close to the connection point of the person (2).

10. Diagnostic system (1) according to any one of the preceding claims, characterised in that a matched current source is connected to the feed electrode (8).

11. Diagnostic system (1) according to claim 10, characterised in that one of the matched current sources is designed as a current source and the other one as a current sink.

12. The diagnostic system (1) according to any one of claims 1 to 11, characterized in that the diagnostic system is designed to perform the adjustment and matching of the current sources taking into account the common mode voltage of the person (2), measured via a right leg driven electrode.

13. Diagnostic system (1) according to any one of the preceding claims, characterized in that the impedance measurement is performed as a plethysmographic measurement and as a multi-frequency measurement, in particular as a partial impedance measurement.

14. Diagnostic system (1) according to claim 13, characterized in that the plethysmographic measurement is performed as a pulse-synchronous measurement.

15. Diagnostic system (1) according to claims 13 and 14, characterized in that partial and / or whole body plethysmographic measurements are provided, in which only a part of the measurement path is designed to have a current flowing through it and another part of the measurement path is designed as an electrical conductor.

16. 16. The diagnostic system (1) of claim 15, characterized in that the whole-body plethysmographic measurement is performed such that an alternating current is fed to at least one arm and one leg and the impedance measurement is performed between the arms and legs of the impedance feed.

17. The diagnostic system (1) according to claims 15 and 16, characterized in that the partial and / or whole body plethysmographic measurement is performed in such a way that an R-wave detector detects R-waves, utilizing which impedance plethysmographic signals of more than one signal are then superimposed, and a template of the impedance plethysmographic signal is generated, and cardiac function, physical performance, pulse waves or volume waves are calculated.

18. Preferably, there is a resiliently shaped tension strap (46) which is mechanically and electrically connected to the bearing surface (19) and / or the bearing surface (11) at a seam (48) and which is connected to the electrode position I ｒ , M. ｒ , A ｒ 18. Diagnostic system (1) according to any one of claims 1 to 17, characterized in that it establishes connections at E, A, I to electrodes (3) and to chest wall electrodes and possibly further electrodes.

19. Diagnostic system (1) according to any one of the preceding claims, characterised in that a multi-channel ECG is present.

20. 20. The diagnostic system (1) of claim 19, characterized in that at least three ECG leads are arranged between two electrodes, each as orthogonal as possible on the support surface, one approximately centrally in the upper region of the support surface and corresponding approximately to the longitudinal axis, a second approximately transversely to the longitudinal direction of the support surface and in an approximately central longitudinal region of the support surface, and a third approximately obliquely in the upper region of the support surface, preferably oriented approximately at 10h 30, alternatively approximately at 1h 30, corresponding to the hour hand of a clock.

21. Diagnostic system (1) according to any one of the preceding claims, characterised in that electrodes (3) are present at electrode positions E, A, S and I for determining EASI leads.

22. 22. Diagnostic system (1) according to claim 21, characterized in that the electrodes (3) for Lead S according to EASI are attached separately in the head, neck (7) or upper body region (6).

23. 23. Diagnostic system (1) according to claim 22, characterized in that the electrodes (3) at least in electrode positions E, A and I according to EASI are present on a common strap.

24. Diagnostic system (1) according to any one of claims 21 to 23, characterized in that the electrodes for Lead S according to EASI are present on a band, preferably on a VR headset, in the head, neck (7) or upper body region (6).

25. The diagnostic system measures the distance between the back of the person (2) and the support surface, in particular the electrode position I ｒ , A ｒ , M. ｒ , N ｒ 25. Diagnostic system (1) according to any one of claims 1 to 24, characterized in that it is designed to reconstruct conventional ECG leads according to Wilson, and / or Einthoven and / or Goldberger, Nehb and Frank using ECG signals derived from ECG leads Fr, Fr.

26. The diagnostic system may include a lead according to Wilson and / or Goldberger, Nehb and Frank, which may be used to determine the electrode positions on the support surface, in particular the I ｒ , A ｒ , M. ｒ , N ｒ 26. The diagnostic system (1) according to claim 1, characterized in that it is designed to calculate with the aid of a regression equation that uses the amplitudes of the individual segments of the ECG obtained from the PR segment, the QRS complex, the ST-T segment and the T wave, i.e. the ECG amplitudes of the PR segment, the QRS complex, the ST-T segment and the T wave, obtained from the ECG FR, Fr, in particular with the aid of a linear regression equation and / or a non-linear equation and / or a neural network and / or other artificial intelligence methods.

27. The diagnostic system may include a regression equation V=a(A ｒ -I ｒ ) + b(M ｒ -N ｒ ) + c(A ｒ -N ｒ 27. The diagnostic system (1) according to any one of claims 1 to 26, characterized in that it is configured to be calculated using the function a, b, c, d, where the coefficients a, b, c, d are linear or non-linear coefficients.

28. Diagnostic system (1) according to any one of claims 1 to 27, characterized in that the support surface (11) is preferably deformable, in particular elastically deformable, preferably as an elastomer and has a plurality of at least partially convex and / or concave, preferably elastic deformations supporting the electrodes.

29. Diagnostic system (1) according to any one of the preceding claims, characterized in that at least one electrode (3) is arranged in the neck region (7) on an elastic bolster (10), which in particular comprises an elastomer.

30. Diagnostic system (1) according to any one of claims 1 to 29, characterized in that at least one electrode (3), in particular a leg electrode on the leg and an arm electrode on the arm, is concave in order to be able to pick up a corresponding region of the human body, in particular the leg region (5) and / or the arm region (4) and / or the knee region (40) and / or the neck region.

31. Diagnostic system (1) according to any one of claims 1 to 30, characterized in that at least one arm electrode and at least one leg electrode are provided several times for the same limb, which are not arranged in a straight line along the limb beam when viewed from the leg base, but are displaced laterally relative to each other, so that only one electrode is able to pick up a limb in each case and the rest are placed next to it, so that it is possible to adapt the diagnostic system to persons of different sizes.

32. Diagnostic system (1) according to any one of claims 1 to 31, characterized in that in order to be able to adapt the diagnostic system (1) to persons (2) of different sizes, at least two electrodes (3) can be moved relative to each other, in particular the electrodes (3) on the leg regions (5) relative to the electrodes (3) in the upper body region (6) and / or the electrodes (3) on the arm regions (4) relative to the electrodes (3) on the upper body region (6).

33. Diagnostic system (1) according to any one of claims 1 to 32, characterized in that several electrodes (3) are arranged in the leg region (5), in the arm region (4), in the knee region (40), in the neck region (7) and / or in the upper body region (6), and the diagnostic system (1) is configured to activate one or more of these several electrodes (3) depending on the size of the person (2) under examination in order to ensure correct electrode positioning regardless of the size of the person (2) under examination.

34. Diagnostic system (1) according to any one of claims 1 to 33, characterized in that at least three electrodes (3) are provided at approximately the same height in the upper body region (6), one electrode (3) being approximately centrally arranged and two further electrodes (3) being approximately symmetrically arranged laterally therein.

35. Diagnostic system (1) according to any one of claims 1 to 34, characterized in that the support surface (11) which contacts a person (2) positioned on the diagnostic system (1) has a bearing surface (19) at least in the area of ​​the electrodes (3), which is made of a particularly durable pressure-resistant material.

36. 36. Diagnostic system (1) according to claim 35, characterized in that a fluid is arranged between the bearing surface (19) and the support surface (11).

37. Diagnostic system (1) according to claim 35 or 36, characterized in that electrical lines to the individual electrodes (3) and / or sensors, such as in particular pressure sensors (44), light sensors (42), sound sensors, acceleration sensors and the like, are arranged between the bearing surface (19) and the support surface (11).

38. Diagnostic system (1) according to any one of claims 35 to 37, characterised in that a device for varying the pressure in the fluid is provided and a further pressure sensor (44) is provided for determining the pressure in the fluid.

39. Diagnostic system (1) according to any one of claims 1 to 38, characterized in that actuators are provided by means of which mechanical or electrical forces and / or movements, in particular pressure, vibration, alternating current, direct current, temperature, light, can be applied to parts of the body of a person (2) located on the diagnostic system (1), in particular in the area of ​​the electrodes (3).

40. Diagnostic system (1) according to any one of claims 1 to 39, characterized in that the support surface (11) and the bearing surface (19) are U-shaped in some areas, in particular in the limb areas and in particular in the area of ​​the electrodes (3), and are designed to accumulate, in particular continuously, a precisely defined pressure in order to determine the pulse and / or blood pressure of a person (2) positioned on the diagnostic system (1) by oscillometry and / or by auscultation and / or by vascular unloading.

41. Diagnostic system (1) according to any of the preceding claims, characterised in that at least one upper arm cuff and / or one leg cuff and / or one pulse oximeter are provided.

42. A diagnostic system (1) according to any one of claims 1 to 41, characterized in that the diagnostic system (1) comprises sensors by means of which it is possible to detect the mechanical response of parts of the body of the person (2) located on the diagnostic system (1) to applied forces and / or movements, thereby making it possible to assess the mechanical stiffness and / or sensitivity of individual body areas of the person (2), in particular as a function of the frequency and amplitude at which forces and / or movements are applied.

43. Diagnostic system (1) according to any one of the preceding claims, characterized in that the diagnostic system (1) is designed as a couch, in particular as a tilt couch, and is capable of detecting the tilt angle.

44. Diagnostic system (1) according to any one of the preceding claims, characterized in that the support surface (11) and the bearing surface (19) are arranged together as a mat, in particular as a continuous mat.

45. Diagnostic system (1) according to any one of claims 1 to 44, characterized in that one or more cameras (12), and / or thermal imaging cameras and / or infrared cameras and / or time-of-flight sensors are provided, by means of which a person (2) located on the support surface (11) can be detected in three dimensions and / or by means of which physical characteristics, in particular dimensions, color and / or temperature, of the person (2) being examined can be determined.

46. The diagnostic system (1) according to any one of claims 1 to 45, characterized in that the diagnostic system is configured to combine data acquired via the electrodes (3) with data acquired without contact, in particular with data acquired via a camera, and an equation or simultaneous equations are created from the combined data in order to calculate biological data.

47. 47. The diagnostic system (1) according to any one of claims 1 to 46, characterized in that a chest strap (13) is provided having an inner chest wall electrode (23) and an outer chest strap outer electrode (27) which correspond to contact electrodes (17) on the support surface (11), whereby electrical signals from the chest wall electrode (23) can be transmitted via the contact electrodes (17) on the support surface (11).

48. A diagnostic system (1) according to any one of claims 1 to 47, characterized in that devices for generating physical effects, such as mechanical effects, such as vibrations, or temperatures, such as heat and cold, or electricity, are provided at different positions in order to be able to determine the reaction of a person (2) located at the diagnostic system (1) to applied physical changes.

49. A diagnostic system (1) according to any one of claims 1 to 48, characterized in that an optical (screen, virtual reality headset (14)) and / or acoustic communication medium, which can be formed, for example, as a microphone and / or headphones (30), is provided in the field of view and / or communication area of ​​a person (2) positioned on the diagnostic system (1), which is connected to the diagnostic system (1) via a data connection, whereby data, in particular relating to the health state of the person (2), can be displayed on the communication medium and / or communication with the person (2) is possible.

50. 50. Diagnostic system according to claim 49, characterized in that the communication medium is designed to be able to convey information in particular from the areas of relaxation, biofeedback, knowledge, in particular medical knowledge, and advertising, in particular user-specific advertising.

51. Diagnostic system (1) according to claim 49 or 50, characterized in that the communication medium is a virtual reality headset (14) and has sensors for recording health-related data of the person, in particular sensors for recording physical variables such as electricity, light, temperature, sound, etc.

52. Diagnostic system (1) according to any one of claims 49 to 51, characterized in that the communication medium is a virtual reality headset (14) equipped with a breathing tube (39) equipped for measuring flow rate, breathing volume, breathing pressure and / or for gas analysis, in particular for CO2, O2 and volatile gases.

53. The diagnostic system (1) according to any one of claims 1 to 52, characterized in that the diagnostic system (1) is configured to evaluate data, in particular for impedance plethysmographic and impedance spectroscopy data analysis, using artificial intelligence, e.g. deep convolutional neural nets, genetic algorithms and / or other methods.

54. Diagnostic system (1) according to any one of claims 1 to 54, characterized in that there is a bidirectionally communicating online expert system for the diagnosis of a number of diseases, with which the diagnostic system is connected via a data connection, in particular via the Internet, and / or which provides further suggestions regarding diagnosis and treatment.

55. The diagnostic system (1) is capable of detecting a variety of conditions including myocardial infarction, coronary heart disease, pulmonary embolism, right heart overload, valvular heart disease, arrhythmia, atrial fibrillation and risk of atrial fibrillation, heart rate variability, autonomic nervous system, sympathetic nervous system, vagus nerve, baroreceptor sensitivity, blood pressure, cardiac function, diagnosis of heart failure, hydration status, muscle mass, muscle strength, biological muscle age, body fat mass, abdominal fat to assess metabolic risk, thrombosis, lymphedema, pulse wave transit time, pulmonary function, respiratory gases, oxygen saturation, continuous beat-to-beat blood pressure, aortic stiffness, central arterial pressure, ankle-brachial index, leg circulation 55. The diagnostic system (1) according to any one of claims 1 to 54, characterized in that it is configured to diagnose at least one of the following: disorders, central blood pressure, carotid artery disease, atherosclerosis, liver compression, kidney function, drug dose for e.g. cytostatics or anesthetics, inflammation, diabetic foot, tumors, brain dysfunction, e.g. epilepsy, loss of brain function, polyneuropathy, visual examination, hearing examination, metabolic diseases, e.g. diabetes, osteoporosis or bone metabolic disorders and disorders of all internal organs, malignant tumors, follow-up and other diagnoses.

56. Diagnostic system (1) according to any one of claims 1 to 55, characterized in that a mechanical joint, in particular a hinge joint with an actuator for moving a joint as one or more therapeutic devices, is present in relation to the support surface on which the joint of the examined body, in particular a hip joint, a knee joint, ankle joint, a shoulder joint, an elbow joint, a wrist joint, is positioned.

57. Diagnostic system (1) according to claim 56, characterized in that the actuator is designed as a physiotherapy device, a massage device and / or a vibration device and / or a heat / cold application device and / or an application device for electric current.

58. A diagnostic system (1) according to any one of claims 1 to 57, characterized in that at least one, and preferably each, electrode (3) is arranged in an area which can be pressed with variable pressure against the body or person using the diagnostic system (1), said area being designed in particular as a bladder which can be filled with a fluid, the pressure of the fluid in the bladder being variable, preferably by means of a pump.

59. Diagnostic system (1) according to any one of claims 1 to 58, characterized in that there is an arrangement of at least three, preferably six, deformable areas to be subjected to a controllable pressure, at least one area located centrally with respect to the human body, i.e. approximately at said center of the body, equipped with at least three electrodes arranged substantially horizontally with respect to the body axis, and at least two, preferably five, peripherally located areas to be preferably subjected to a controllable pressure, at least partially equipped with at least two electrodes having an at least approximately vertical orientation with respect to said body axis.

60. Diagnostic system (1) according to claim 59, characterized in that the centrally located area is mainly located in front of the examined body and other regions are located at the rear of the body.

61. Diagnostic system (1) according to claim 59 or 60, characterized in that the area comprises a bladder or chamber filled with a fluid and having a variable pressure.

62. Diagnostic system (1) according to claim 61, characterised in that the fluid is a gas, for example air or CO2.

63. Diagnostic system (1) according to claim 61 or 62, characterized in that the deformation of the area can be performed by increasing the pressure in the fluid or by a hydraulic and / or mechanical device, for example a plunger.

64. Diagnostic system (1) according to any one of claims 61 to 63, characterised in that the electrodes consist of a deformable conductive fabric tape.

65. Diagnostic system (1) according to any one of claims 61 to 64, characterised in that at least one controlled pressure pump, preferably hydraulic, is provided for varying the pressure in the bladder.

66. Diagnostic system (1) according to any of claims 61 to 65, characterised in that the bladder is filled with a fluid, preferably water, and can serve as a fluid feed for further examinations and treatments.

67. Diagnostic system (1) according to any one of claims 61 to 66, characterized in that the bladders are shaped such that they function for the propagation of waves, e.g. light, temperature, sound, in particular also ultrasound, and therefore for diagnosis and therapy.

68. Diagnostic system (1) according to claims 61 to 67, characterized in that the U-shaped support surfaces, e.g. for the arms and legs, are subjected to a continuous or incrementally variable pressure, and thus e.g. blood pressure is measured by oscillometry and / or by auscultation, possibly also further continuously, e.g. using vascular unloading.

69. Diagnostic system (1) according to any one of claims 1 to 68, characterized in that there is a strap, preferably a safety strap, preferably with a snap-on device, on which there is at least one, preferably at least three, fluid-filled deformable and / or displaceable areas equipped with electrodes, said at least one area, preferably three areas, being arranged approximately horizontally with respect to the body axis, preferably carrying three electrodes arranged horizontally with respect to said body axis.

70. 70. Diagnostic system (1) according to claim 69, characterised in that a tensioning device is provided for the safety strap.

71. Diagnostic system (1) according to claim 69 or 70, characterized in that the area or bladder with horizontal electrodes is slidably attached to the straps, so that electrodes E and / or Mr can be positioned centrally with respect to the positioned person even if the body circumference is different.

72. Diagnostic system (1) according to any one of the preceding claims, characterised in that a bolster is movably, in particular displaceably, attached to the support surface.

73. Diagnostic system (1) according to any one of claims 1 to 72, characterised in that the bolster is U-shaped.

74. 74. Diagnostic system (1) according to any one of claims 1 to 73, characterized in that the ECG leads are present according to Einthofen, Wilson and Goldberger and / or are characterized by ECG leads between the electrode (3) located on the left side on the chest strap or on the supporting surface at electrode positions A, Ar and the electrode (3) located on the right side on the chest strap or on the supporting surface at electrode positions I, Ir, further between the electrode (3) located on the left side on the chest strap or on the supporting surface at electrode positions A, Ar and the neck electrode at electrode positions S or N, and finally between the electrode (3) located in the middle on the chest strap or on the supporting surface at electrode positions E, Er or also M and the neck electrode at electrode position S or also N.

75. 75. Diagnostic system (1) according to claim 74, characterized in that the ECG leads for the individual segments of the ECG curve, for example for the segments P-wave, PQ-wave, R-wave, ST-wave and T-wave, are reconstructed by separate simultaneous equations.

76. Diagnostic system (1) according to any of the claims 1 to 75, characterised in that a contactless measurement of the examined person is integrated, for example using optical and / or time-of-flight methods.

77. Diagnostic system (1) according to any of the preceding claims, characterised in that the thermal radiation of the person being examined is measured, for example by means of a thermal imaging camera.

78. Diagnostic system (1) according to any one of claims 1 to 77, characterized in that the diagnostic system (1) is designed to be used for the diagnosis and / or treatment of diseases of the central nervous system, in particular as well as the autonomic and sympathetic nervous system, the sensory organs, in particular the eyes, the ears, also the blood vessels, in particular the blood vessels of the neck and the peripheral blood vessels, the lungs, the heart, the liver, the kidneys, the bones, the muscles, the joints, the peripheral nervous system.

79. The diagnostic system (1) according to any one of claims 1 to 78, characterized in that the diagnostic system (1) is configured to record records of biological signals before, during and / or after a change in condition, e.g. a tilting maneuver, a change in respiratory condition, and therefore to use the changes in measurements of circulatory, fluid and vascular properties triggered by the maneuver for diagnosis.

80. A diagnostic system (1) according to any one of claims 1 to 81, characterized in that the electrodes (3) are arranged in an arm region (4) so ​​as to be displaceable or rotatable and / or the electrodes (3) are arranged in a leg region (5) so as to be rotatable or displaceable, and when the person (2) is positioned on the diagnostic system (1), preferably a rotation axis for the electrodes (3) in the arm region extends approximately perpendicular to the support surface and a rotation axis for the electrodes (3) in the leg region extends approximately parallel to the support surface.

81. Diagnostic system (1) according to any one of the preceding claims, characterized in that the electrodes (3) are designed for contactless detection of measurement values ​​for ECG, in particular as capacitively coupled electrodes (3).

82. Diagnostic system (1) according to any one of claims 1 to 81, characterized in that the diagnostic system is configured to determine lean body mass and / or muscle mass and to correct renal function based on the lean body mass and / or muscle mass using the electrical measurements determined by means of the electrodes and / or measurements determined without contact, in particular measurements determined by means of a camera.

83. Diagnostic system (1) according to any one of the preceding claims, characterized in that one, preferably two, microphones are provided in the chest area, said microphones being preferably pressable against the body with a variable pressure, in particular an area with a fluid-filled bladder, in order to detect lung sounds.

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