DK3043707T3 - Indretning til evaluering af smerte - Google Patents

Indretning til evaluering af smerte Download PDF

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DK3043707T3
DK3043707T3 DK14758999.8T DK14758999T DK3043707T3 DK 3043707 T3 DK3043707 T3 DK 3043707T3 DK 14758999 T DK14758999 T DK 14758999T DK 3043707 T3 DK3043707 T3 DK 3043707T3
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patient
pain
screen
tool according
areas
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DK14758999.8T
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Philippe Rigoard
Farid Guetarni
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Centre Hospitalier Univ De Poitiers
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/48—Other medical applications
    • A61B5/4848—Monitoring or testing the effects of treatment, e.g. of medication
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Measuring devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/107—Measuring physical dimensions, e.g. size of the entire body or parts thereof
    • A61B5/1072—Measuring physical dimensions, e.g. size of the entire body or parts thereof measuring distances on the body, e.g. measuring length, height or thickness
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/48—Other medical applications
    • A61B5/4824—Touch or pain perception evaluation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/48—Other medical applications
    • A61B5/4824—Touch or pain perception evaluation
    • A61B5/4827—Touch or pain perception evaluation assessing touch sensitivity, e.g. for evaluation of pain threshold
    • A—HUMAN NECESSITIES
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    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/74—Details of notification to user or communication with user or patient; User input means
    • A61B5/742—Details of notification to user or communication with user or patient; User input means using visual displays
    • A61B5/7435—Displaying user selection data, e.g. icons in a graphical user interface
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B7/00—Instruments for auscultation
    • A61B7/02—Stethoscopes
    • A61B7/04—Electric stethoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/3605—Implantable neurostimulators for stimulating central or peripheral nerve system
    • A61N1/3606—Implantable neurostimulators for stimulating central or peripheral nerve system adapted for a particular treatment
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    • G06T11/60—Creating or editing images; Combining images with text
    • G—PHYSICS
    • G06—COMPUTING OR CALCULATING; COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T11/00—Two-dimensional [2D] image generation
    • G06T11/80—Creating or modifying a manually drawn or painted image using a manual input device, e.g. mouse, light pen, direction keys on keyboard
    • G—PHYSICS
    • G09—EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
    • G09G—ARRANGEMENTS OR CIRCUITS FOR CONTROL OF INDICATING DEVICES USING STATIC MEANS TO PRESENT VARIABLE INFORMATION
    • G09G5/00—Control arrangements or circuits for visual indicators common to cathode-ray tube indicators and other visual indicators
    • G09G5/14—Display of multiple viewports
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
    • G16H40/60—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices
    • G16H40/63—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for local operation
    • G—PHYSICS
    • G06—COMPUTING OR CALCULATING; COUNTING
    • G06F—ELECTRIC DIGITAL DATA PROCESSING
    • G06F2203/00—Indexing scheme relating to G06F3/00 - G06F3/048
    • G06F2203/048—Indexing scheme relating to G06F3/048
    • G06F2203/04803—Split screen, i.e. subdividing the display area or the window area into separate subareas
    • G—PHYSICS
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    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T2207/00—Indexing scheme for image analysis or image enhancement
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    • G06T2207/30004—Biomedical image processing
    • G—PHYSICS
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    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T2207/00—Indexing scheme for image analysis or image enhancement
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    • G06T2207/30196—Human being; Person
    • G—PHYSICS
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    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
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    • G06T2210/62—Semi-transparency
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    • G—PHYSICS
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    • G09G—ARRANGEMENTS OR CIRCUITS FOR CONTROL OF INDICATING DEVICES USING STATIC MEANS TO PRESENT VARIABLE INFORMATION
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    • G09G2320/0693—Calibration of display systems
    • G—PHYSICS
    • G09—EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
    • G09G—ARRANGEMENTS OR CIRCUITS FOR CONTROL OF INDICATING DEVICES USING STATIC MEANS TO PRESENT VARIABLE INFORMATION
    • G09G2380/00—Specific applications
    • G09G2380/08—Biomedical applications
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
    • G16H10/20—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for electronic clinical trials or questionnaires

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  • Engineering & Computer Science (AREA)
  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Physics & Mathematics (AREA)
  • Theoretical Computer Science (AREA)
  • Biomedical Technology (AREA)
  • General Physics & Mathematics (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Medical Informatics (AREA)
  • General Engineering & Computer Science (AREA)
  • Veterinary Medicine (AREA)
  • Animal Behavior & Ethology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Surgery (AREA)
  • Molecular Biology (AREA)
  • Pathology (AREA)
  • Biophysics (AREA)
  • Pain & Pain Management (AREA)
  • Human Computer Interaction (AREA)
  • Hospice & Palliative Care (AREA)
  • Psychiatry (AREA)
  • Acoustics & Sound (AREA)
  • General Business, Economics & Management (AREA)
  • Epidemiology (AREA)
  • Primary Health Care (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Business, Economics & Management (AREA)
  • Dentistry (AREA)
  • Neurosurgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Radiology & Medical Imaging (AREA)
  • Neurology (AREA)
  • Computer Hardware Design (AREA)
  • Electrotherapy Devices (AREA)
  • Measuring And Recording Apparatus For Diagnosis (AREA)
  • Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)
  • Measurement And Recording Of Electrical Phenomena And Electrical Characteristics Of The Living Body (AREA)

Claims (22)

1. Hjælpeværktøj til evaluering/overvågning af smerte og en behandling, omfattende: et grafisk værktøj (TG) udstyret med en skærm (102), såsom en grafiktablet, en lokal applikation (TGapps) installeret i det grafiske værktøj til på skærmen (102) at vise en grafisk afbildning (100) af en patients krop, mens det muliggøres for en bruger, såsom patienten, at afgrænse et område (104) af den på skærmen (102) viste grafiske afbildning (100), en styreapplikation (TGappmain), der samarbejder med den lokale applikation (TGapps) for at registrere (CCSapps) hvert afgrænset område (104) i forbindelse med tilsvarende fladedata, hvor styreapplikationen (TGmainapp) har en første modus (S5), hvori den lokale applikation (TGapps) muliggør patientens afgrænsning af smerteområder, hvor styreapplikationen har en anden modus (S6) , hvori den lokale applikation (TGapps) muliggør patientens afgrænsning af behandlede områder, hvor styreapplikationen (TGappmain) er indrettet til at styre grafiske og/eller numeriske sammenligninger mellem smerteområdernes flader og de behandlede områders flader, hvilket gør det muligt at evaluere smerten og virkningerne af behandlingen, kendetegnet ved, at den lokale applikation (TGapps) er indrettet til mellem resultaterne af to besøg at bestemme: en bruttoydelseskoefficient, en vægtet ydelseskoefficient som funktion af forholdet mellem et behandlingsområde og områder med smerteintensitet og en specificitets-/dispersionskoefficient som funktion af forholdet mellem behandlingsområdet og mindst nogle af områderne med smerteintensitet, idet alle disse koefficienter (R indeks) leverer en stærk indikation på tilstrækkeligheden af en behandling.
2. Værktøj ifølge krav 1, kendetegnet ved, at den lokale applikation (TGapps) i den første modus (S5) er indrettet til, at en patient kan afgrænse smerteområder selektivt efter smertetypen og smerteintensiteten.
3. Værktøj ifølge krav 2, kendetegnet ved, at smertetyperne omfatter mindst nogle af typerne blandt gruppen: noniceptiv smerte, triggersmerte, neuropatisk smerte, mekanisk smerte.
4. Værktøj ifølge et af kravene 1-3, kendetegnet ved, at de behandlede områder svarer til paræstesiområder, der er et resultat af exciteringen af en i patienten implanteret nervestimuleringsindretning, og ved, at den lokale applikation (TGapps) i den anden modus (S6) er indrettet til at muliggøre afgrænsningen af paræstesiområder selektivt, afhængigt af om det drejer sig om en nervestimuleringselektrode i centralnervesystemet eller en nervestimuleringselektrode i det perifere nervesystem.
5. Værktøj ifølge et af kravene 1-4, kendetegnet ved, at den lokale applikation (TGapps) er indrettet til at evaluere første fladedata (Sdol) i forhold til mindst et smerteområde og andre fladedate (Spar) i forhold til mindst et paræstesiområde, mens styreapplikationen (TGappmain) er indrettet til at sammenligne disse fladedata såvel som til at beregne et niveau for paræstesidækning og et specificitetsniveau for paræstesidækningen, hvilket gør det muligt at tilpasse paræstesidækningen ved at forbedre specificiteten.
6. Værktøj ifølge et af kravene 1-5, kendetegnet ved, at hver grafisk afgrænsning udføres ved områdeopfyldning med selektive grafiske attributter, især af farve, idet mindst nogle af områderne er delvis transparente.
7. Værktøj ifølge et af kravene 1-6, kendetegnet ved, at den lokale applikation (TGapps) er indrettet til at gøre det muligt at knytte en reel metrik til de grafiske afgrænsninger .
8. Værktøj ifølge krav 7, kendetegnet ved, at den reelle metrik opnås ved at anvende en reel målestok på patientens silhuet (100) ud fra en målt reel størrelse såsom patientens størrelse.
9. Værktøj ifølge krav 7, kendetegnet ved, at den reelle metrik opnås ved behandling af billeder af patienten fra den medicinske billeddannelse.
10. Værktøj ifølge et af kravene 1-9, kendetegnet ved, at den lokale applikation (TGapps) er forsynet med en funktiona-litet til deling af skærmen (102) i to områder, det ene til patienten og det andet til det medicinske personale, og på hvilke visningsmåden af mindst nogle af dataene er forskellig.
11. Værktøj ifølge et af kravene 1-10, kendetegnet ved, at styreapplikationen (TGappmain) er indrettet til at styre en patientautokalibreringsfunktion (appCalib2), der kan bestemme afvigelserne mellem en flerhed af mål-punkter udpeget ved kontakt på patientens fysiske krop og tilsvarende punkter angivet ved patientens pegning på den kartografiske afbildning (100) vist på skærmen (102), mens patientens afgrænsning på skærmen (102) af et område (104) på den kartografiske afbildning (100) ændres som funktion af disse patientautokalibreringsafvigelser (appCalib2).
12. Værktøj ifølge et af kravene 1-11, kendetegnet ved, at det grafiske værktøj (TG) er udstyret med en skærm (102) og ved, at styreapplikationen (TGappmain) ligeledes er indrettet til fremkalde en patient/skærmkalibreringsfunktion (appCalibl), der kan bestemme afvigelserne mellem sigtepunkterne på skærmen (102) og områderne på den berøringsfølsomme skærm (102), som patienten faktisk berører, mens patientens afgrænsning på skærmen (102) af et område (104) på den kartografiske afbildning (100) ændres som funktion af disse patient/skærmkalibrerings-afvigelser (appCalibl).
13. Værktøj ifølge et af de foregående krav, kendetegnet ved, at dataene for den grafiske afgrænsning og fladerne lægges i en dateret historik indført i en patientjournal.
14. Værktøj ifølge et af de foregående krav, kendetegnet ved, at det grafiske værktøj (TG) er netforbundet med mindst en anden computer (CCS) på en måde, der muliggør mobilitet.
15. Værktøj ifølge krav 14, kendetegnet ved, at den centrale computer (CCS) er forsynet med applikationer (CCSapps), der kan vedligeholde en database (Neuro-DB) såvel som udføre statistiske analyser på dataene i denne base.
16. Værktøj ifølge krav 15, kendetegnet ved, at de statistiske analyser på dataene i basen (Neuro-DB) er indrettede til at levere behandlingsforudsigelser som funktion af subpopulationer af patienter.
17. Værktøj ifølge et af kravene 15 og 16, kendetegnet ved, at de statistiske analyser på dataene i basen (Neuro-DB) er indrettede til at levere sammenligningstests på forskellige elektrodemodeller.
18. Værktøj ifølge et af de foregående krav, kendetegnet ved, at koefficienterne afbildes grafisk med indikatorer, der omfatter en sammenligning med de respektive tærskler, ledsaget af mindst et diagram af firkanter, der på den ene side viser forholdene mellem smerteintensitetsområderne og delen af behandlingsområdet, som hver især påvirker dem, og på den anden side delen af behandlingsområdet, som ikke påvirker mindst nogle af smerteintensitetsområderne (Fig. 18).
19. Værktøj ifølge et af de foregående krav, kendetegnet ved, at den lokale applikation (TGapps) er indrettet til mellem resultaterne af to besøg at bestemme: mindst tre koefficienter (YS, YI, YPC), der hver især viser formindskelsen af smertefladen, formindskelsen af smerteintensiteten og ændringen af smertens typologi, og mindst tre koefficienter (XP, XS, XP3), der hver især viser behandlingsindretningens ydelse, behandlingsindretningens selektivitet og persistensen af virkningerne af behandlingsindretningen, idet alle disse koefficienter (indeks FRG) leverer en anden stærk indikation på tilstrækkeligheden af en behandling.
20. Værktøj ifølge krav 19, kendetegnet ved, at koefficienterne vises grafisk i form af mindst et multiaksialt polygondiagram.
21. Værktøj ifølge et af kravene 19 og 20, kendetegnet ved, at det multiaksiale polygondiagram understøtter visningen af mindst to grupper af koefficienterne med forskellige grafiske attributter, især farve, idet de to grupper angår mindst delvist forskellige behandlingsbetingelser.
22. Værktøj ifølge et af kravene 19 til 21, kendetegnet ved, at den grafiske afbildning omfatter mindst to sidestillede multiaksiale polygondiagrammer svarende til mindst delvist forskellige behandlingsbetingelser eller forskellige tider.
DK14758999.8T 2013-09-13 2014-08-14 Indretning til evaluering af smerte DK3043707T3 (da)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
FR1358850A FR3010624B1 (fr) 2013-09-13 2013-09-13 Procede et systeme de cartographie, procede et systeme d'evaluation de l'efficacite d'une stimulation medullaire
PCT/FR2014/000186 WO2015036660A1 (fr) 2013-09-13 2014-08-14 Dispositif et procédé d'évaluation de dispositifs de neurostimulation a visée antalgique

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WO2015036191A1 (fr) 2015-03-19
FR3010624B1 (fr) 2015-09-25
EP3043706B1 (fr) 2017-10-25
DK3043705T3 (da) 2019-12-16
WO2015036660A1 (fr) 2015-03-19
FR3010624A1 (fr) 2015-03-20
EP3043705A1 (fr) 2016-07-20
EP3043707B1 (fr) 2018-08-01
US20160220179A1 (en) 2016-08-04
EP3043706A1 (fr) 2016-07-20
US9999387B2 (en) 2018-06-19
US20160220181A1 (en) 2016-08-04
US10058280B2 (en) 2018-08-28
EP3043705B1 (fr) 2019-10-02
US9986946B2 (en) 2018-06-05
WO2015036661A1 (fr) 2015-03-19
DK3043706T3 (da) 2018-01-29
US20160220178A1 (en) 2016-08-04
EP3043707A1 (fr) 2016-07-20

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