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PubMed2001

Installation and experience of an automatic scheduling system for multiple diagnostic examinations: in search of maximum utilization of regional health care resources.

We installed a scheduling system that optimally schedules multiple appointments for various diagnostic examinations for a patient based on patient characteristics, disease characteristics and conditions, characteristics of diagnostic examinations, possible interactions between two successive examinations, and features and availability of diagnostic equipment. The system consists of four client terminals, 12 laboratory terminals, and one server. After the run-in period, the system started operation in July 2000. A total of 14353 examinations involving 11447 patients were managed over 7 months. On average, approximately 82 patients per day underwent approximately 103 examinations. On average, 16.1 patients a day requested 2 or more examinations in a scheduling session (approx. 2.3 examinations/patient; maximum 5 examinations for a single patient). After reading the request sheet(s) (OCR sheet(s)), suggested time/date slots of examination(s) were displayed on the client terminal within 10 seconds. The average time required for a patient to establish his or her schedule was approximately 2 minutes. Thus, the system greatly mitigated the load on health care professionals in scheduling appointments for examinations. In general, patients had a positive impression of the system. Furthermore, networking through these health care facilities and implementing this automatic scheduling system as a centralized appointment system can easily establish a "virtual diagnostic examination center" that fully utilizes the diagnostic equipment and staff available at community health care facilities. We estimate that approximately 30% of the diagnostic examinations in a health care facility can be referred to another facility in this cooperative system.

Algorithms↗
PubMed2002

Validity of the Framingham risk model applied to Japanese men.

OBJECTIVES: To examine whether the Framingham Risk Model can appropriately predict coronary heart disease (CHD) events detected by electrocardiography (ECG) in Japanese men. METHODS: Using the annual health examination database of a Japanese company 5611 male workers, between the ages of 30 to 59, who were free of cardiovascular disease, were followed up to observe the occurrence of CHD events detected by ECG over a period of five to seven years. The probability of CHD was calculated for each individual from the equations of the Framingham risk model (with total cholesterol). RESULTS: The incidence of CHD increased with the estimated CHD risk. The Hosmer-Lemeshow goodness of fit test showed an adequate fit of the risk model to the data of the study subjects. In the receiver operating characteristic analysis, the area under the curve reached 0.67 which indicated an acceptable discriminatory accuracy of the risk model. CONCLUSIONS: The Framingham risk model provides useful information on future CHD events in Japanese men.

Adult↗
PubMed2002

Theoretical considerations on the health checkup accuracy of combination testing.

OBJECTIVES: To find basic theoretical evidence for an optimum combination of multi-phasic health checkup testing obtained by considering how the health checkup accuracy changes with the number of tests (n) and kinds of combination methods (A, B, C, D and E). METHODS: To find how the health checkup accuracy changes with the number of tests and type of combination method, generalized formulas as functions of the number of tests, are obtained to calculate the over-all health checkup accuracy which is defined by sensitivity (alpha), specificity (beta) and odds-ratio (gamma), based on the two-by-two table. Five kinds of combination methods were considered: A) Sequential tests. B) Sequential tests after changing the order in A. C) Simultaneous tests using the Believe-the-Negative Rule. D) Simultaneous tests using the Believe-the-Positive Rule. E) Simultaneous tests using the Believe-all-Positive-all-Negative Rule. RESULTS: It was proved that combination methods A, B and C are "equivalent" for health checkup accuracy. Therefore, the five methods could be summarized into three patterns. For A, B and C: beta and gamma increased but a decreased with increasing n. For D: alpha increased but beta and gamma decreased with n. For E: alpha, beta and gamma increased with n. CONCLUSION: Health checkup accuracy of combination testing is the best in case of E, although problems exist concerning how to judge the borderline subjects.

Humans↗
PubMed2002

Standard protocol for exchange of health-checkup data based on SGML: the Health-checkup Data Markup Language (HDML).

OBJECTIVES: To develop a health/medical data interchange model for efficient electronic exchange of data among health-checkup facilities. RESULTS: A Health-checkup Data Markup Language (HDML) was developed on the basis of the Standard Generalized Markup Language (SGML), and a feasibility study carried out, involving data exchange between two health checkup facilities. The structure of HDML is described. RESULTS: The transfer of numerical lab data, summary findings and health status assessment was successful. CONCLUSIONS: HDML is an improvement to laboratory data exchange. Further work has to address the exchange of qualitative and textual data.

Computer Communication Networks↗
PubMed1975

[Automated multiphasic health testing (A.M.H.T.) in U.S.A. (author's transl)].

The functioning of two Automated Multiphasic Health Testing Centers in the United States is described. One is located in the U.S. Public Health Service Hospital in Baltimore, the other in the Kaiser Foundation Hospital in Oakland. Many tests performed are identical in both centers with a large use of computers technics. The goal of health testing is the detection of diseases, early signs of disease and risk factors evaluation. A considerable effort is made for health education which is one of the best preventive measure.

Audiometry↗