JP2013109591A - Scenario creating device, scenario creating program, and recording medium therefor - Google Patents

Abstract

A scenario according to a desired condition is easily created as a scenario used in an emergency lifesaving simulation system.
The maximum number of victims arriving at a predetermined area per predetermined time, instructed by a scenario generation instructor for at least a part of conditions of a basic scenario prepared in advance, can be determined in priority order. Calculates the degree of congestion, which is the value divided by the estimated number of injuries per hour, the priority for minimizing the number of deaths, and the optimal solution for the treatment content. A scenario editing unit 211 is provided that changes according to setting values of parameters related to the conditions, such as a treatment order reversal rate that is a ratio of the number of injured patient groups to the total number of injured patient groups.
[Selection] Figure 3

Description

  The present invention considers the symptoms and the like of each patient for a plurality of patients, and performs the best treatment (for example, transportation, treatment, determination of treatment priority, etc.) effectively using limited medical resources. The present invention relates to a scenario creation device, a scenario creation program, and a recording medium for creating a scenario used in an emergency life-saving simulation system for performing training.

  In recent years, triage training has been conducted to simulate the transportation and treatment process of patients with the aim of training for lifesaving and emergency activities in major accidents and disasters, mainly at regional hospitals and DMAT (Disaster Medical Assistant Team). Has been done. The importance of triage has been pointed out not only in lifesaving and emergency activities in the event of a major accident or disaster, but also in the emergency outpatients of general hospitals where many victims visit.

  Triage refers to the classification of victims according to their severity and urgency in order to provide appropriate treatment and transportation to save more victims when a large number of victims occur at the same time. It is a method to determine the treatment priority of the victim. For example, in the triage based on the START (Simple Triage And Rapid Treatment) method, the victim is classified into four stages of green, yellow, red, and black. Green is a mild victim who does not need to be transported in an emergency, Yellow is not a life-threatening condition but needs to be transported, and Red is a life-threatening condition that can be saved Victim, black, is a victim who has died or is currently unable to save life. Treatment priorities are red, yellow, green, and black in descending order. The determination result is displayed by attaching a paper tag or the like to the victim.

  By the way, in order to quickly and accurately triage in the event of a major accident or disaster, it is necessary to carry out triage training on a regular basis for medical workers.

  In conventional triage training, on-site training may be performed by a large number of simulated victims, but due to cost constraints etc., desktop simulation training such as an Emargo training system (see Non-Patent Document 1) is performed There are many. In the Emargo Training System, multiple whiteboards are regarded as areas such as disaster sites and hospitals, and tags with magnets representing victims, medical workers, medical resources, etc. placed on the area are based on certain rules. Simulation while moving on the whiteboard.

  However, in conventional desktop simulations such as Non-Patent Document 1, it is possible to carry out training assuming a large-scale disaster, but due to the nature of desktop simulation, it is difficult to reproduce the change in the condition of the victim. In addition, there is a problem that temporal changes in biological information (vital signs) such as symptoms, pulse, respiratory rate, blood oxygen concentration, etc. of each patient cannot be reflected in training in real time.

  In addition, it is difficult to reproduce and verify the training results because the time log (history) of training cannot be taken, and the training results are used for education for improving the quality of the training participants. There is a problem that it is difficult to use.

  Therefore, the applicant of the present application developed a triage training simulator (lifesaving emergency simulation system) that runs on a computer, and conducted triage training using a plurality of computers in accordance with the disease state change scenario of the victim described by the trainer. It was made possible (see Patent Document 1).

  The most important scenes for determining the treatment order of victims during disasters are from disaster sites called prehospitals to initial treatment at hospitals. Pre-hospital limits the medical resources such as the number of medical workers, the number of victims that can be treated simultaneously, the number of ambulances, etc., so the order of treatment and delivery of victims should be changed based on the patient's biological information. It is thought that more victims can be saved.

  Therefore, in the simulator, the medical resources in the prehospital are limited so that the simulation paying attention to the order of treatment of the sick can be performed. Specifically, the simulator displays medical resources such as a treatment table and an ambulance and biological information of the victim on a computer screen. Thus, a medical worker (training participant) determines the treatment order of the victim based on the biological information or medical resource information displayed on the computer screen and operates the computer to perform the treatment. Selection can be executed. Each victim has a training scenario (simulation scenario) that describes the arrival time, treatment time, death period, etc. at the triage post, where the triage is conducted. It has come to end up.

Japanese Patent Laying-Open No. 2011-164773 (released on August 25, 2011)

Emergo Train System, [online], [searched on February 1, 2010], Internet <URL: http://www.emergotrain.com/>. M. Kendall, "A New Measure of Rank Correlation.", Biometrika, Vol. 30, No. 1/2, pp. 81-89, 1938 J. Kennedy and R.C.Eberhart, "Particle Swarm Optimization", In Proceedings of 1995 IEEE International Conference on Neural Networks, Vol. 4, pp.1942-1948, 1995

  By the way, in order to enhance the effect of the training by the simulator, it is required to set the difficulty level of training (training scenario) according to the skill level of the training participant that improves as the training is repeated.

  Moreover, in order to raise the proficiency level of training, it may be required to repeatedly perform training with the same degree of difficulty and different setting conditions. In such a case, it is necessary to prepare a plurality of training scenarios with the same degree of difficulty and different setting conditions.

  Moreover, in order to evaluate the technical level of a training participant, it is required to compare the training evaluation results of different players for training scenarios with similar difficulty levels.

  However, the technique of Patent Document 1 has a problem that the difficulty level is not clearly defined and it is difficult to set the difficulty level of the simulation.

  The training scenario assumes accidents / disasters, etc. that may occur in accordance with the daily work contents of the player (training participants) and the work area, etc. Since the number of injured persons and the pathological change scenarios of each injured person are manually input and set, there is also a problem that labor for creating one training scenario is very large.

  The present invention has been made in view of the above problems, and an object thereof is to provide a scenario creation device that can easily create a training scenario according to a desired condition.

  In order to solve the above-described problem, the scenario creation device of the present invention provides a simulation scenario used in a simulation system that performs a simulation for performing treatment according to the symptoms of each patient for a plurality of patients. The scenario creation device to create, the scenario includes a medical resource scenario indicating setting information of medical resources that can be used in the simulation, a symptom scenario indicating a change in symptoms according to the elapsed time of each patient, A symptom improvement scenario that associates the treatment details for the victim and the change in the symptoms of the victim according to the elapsed time after the treatment according to the treatment details, and each victim arrives at a predetermined area on the simulation And the victim scenario including arrival time information indicating the time to perform the simulation. Then, the one or more participants who participate in the simulation are assigned to any one of the predetermined areas or a plurality of treatment areas for performing treatment for the victims, and the victims who have arrived in the assigned area. Depending on the symptoms of the patient, at least one of the treatment content for the victim and the priority of treatment for each victim who arrives in the area is determined, and at least a part of the conditions of the basic scenario prepared in advance Is characterized in that it includes a scenario editing unit that changes according to the set values of one or a plurality of parameters related to the above condition instructed by the scenario creation instructor.

  According to the above configuration, the scenario editing unit changes at least a part of the conditions of the basic scenario created in advance according to the set values of the parameters related to the condition instructed by the scenario creation instructor. Thus, a scenario corresponding to the set value is automatically created. Thereby, compared with the case where the coordinator (training person) inputs and sets each component content of a scenario manually like the past, the scenario according to the desired conditions can be created easily.

  Further, the parameter is a value obtained by dividing the maximum value of the number of victims arriving at the predetermined area per predetermined time by the assumed number of patients per predetermined time at which the priority order can be determined in the predetermined area. The requested congestion level, which is a desired value of the scenario creation instructor regarding a certain congestion level, is included, and the scenario editing unit responds to the arrival level of at least some victims in the basic scenario according to the requested congestion level. Change the estimated value by changing the maximum value by changing the time information or changing the number of participants who can determine the priority among the setting information of the medical resource in the basic scenario By doing so, it is good also as a structure which changes the congestion degree of the said basic scenario. Note that the above assumed value is, for example, a known experiment relating to the average value of the number of persons who can perform processing for classifying a sick person into a plurality of predetermined categories according to the severity per doctor's time. It is set based on data.

  According to the above configuration, the scenario editor has arrival time information for at least some victims in the basic scenario or medical resource setting information in the basic scenario so that the desired congestion specified by the scenario creation instructor is achieved. The number of participants whose priority can be determined is changed. Thereby, the scenario according to the difficulty (desired congestion degree) desired by the scenario creation instructor can be easily created.

  In addition, the symptom scenario includes information indicating the death time of the victim for at least a part of the victim, and the symptom improvement scenario includes the sick and sick whose death time is indicated in the symptom scenario. Information indicating changes in the death time when a predetermined treatment is performed on a person is included, and the scenario editing unit includes the priority order for minimizing the number of deaths and the treatment details for each victim. And the order of precedence is inconsistent between the case where the priorities are determined in the order of arrival of each victim in the predetermined area and the case where the priorities are determined in the optimal order corresponding to the optimal solutions. A treatment order reversal rate calculating unit for calculating a treatment order reversal rate that is a ratio of the number of victims to the total number of victims, and the parameter includes a scenario creation instructor regarding the treatment order reversal rate. A desired treatment order reversal rate that is a desired value is included, and the scenario editing unit is configured to make the predetermined order of at least some patients in the basic scenario close to the desired treatment order reversal rate. It is good also as a structure which changes the arrival order to an area.

  According to the above configuration, the scenario editing unit calculates the priority order for minimizing the number of deaths and the optimal solution of the treatment content for each victim, and assigns the priority to the predetermined area of each victim. The treatment order reversal rate, which is the ratio of the number of victim groups whose order context is inconsistent between the case of determining the arrival order of the patient and the case of determining the optimal order corresponding to the optimal solution, to the total number of patient groups The calculation order is changed, and the arrival order of at least some of the victims in the predetermined area in the basic scenario is changed so that the treatment order reversal rate approaches the desired treatment order reversal rate. As a result, it is possible to easily create a scenario according to the degree of difficulty desired by the scenario creation instructor (requested treatment order reversal rate).

  In addition, the scenario editing unit determines the priority in the order of arrival, which is the ratio of the number of non-dead persons to the total number of injured persons when the priority order is determined in the order of arrival of each victim in the predetermined area, and the priority order. The life-saving rate difference, which is the difference from the optimal life-saving rate, which is the ratio of the number of non-dead persons to the total number of injured patients when determined in the above-mentioned optimal order, is calculated. The scenario editor is configured to bring the treatment order reversal rate closer to the desired treatment order reversal rate and to make the lifesaving rate difference closer to the desired lifesaving rate difference. In addition, a configuration may be adopted in which the arrival order of at least some of the victims in the basic scenario in the predetermined area is changed. For example, the scenario editing unit calculates the treatment order reversal rate and the lifesaving rate difference when the arrival order is changed for all victim groups that determine the priority order, and the treatment order reversal rate and the request Arrange the arrival order of at least some of the victim groups so that the difference between the treatment order reversal rate is small and the difference between the lifesaving rate difference and the desired lifesaving rate difference is not widened. The replacement process may be repeated a predetermined number of times.

  According to the above configuration, the scenario editing unit has an arrival order lifesaving rate that is a ratio of the number of non-dead to the total number of victims when the priority is determined in the order of arrival of each victim in the predetermined area; When the priority order is determined in the optimal order, a life-saving rate difference that is a difference from the optimal order life-saving rate that is a ratio of the number of non-dead to the total number of injuries is calculated, and the reversal rate of the treatment order is calculated as the desired treatment order. The order of arrival of at least a part of the victims in the basic scenario in the basic scenario is changed so as to approach the reversal rate and the lifesaving rate difference to the desired lifesaving rate difference. As a result, it is possible to easily create a scenario in accordance with the degree of difficulty desired by the scenario creation instructor (difference in the order of reversal of desired treatment order and difference in desired lifesaving rate).

  In addition, the symptom scenario includes information indicating the death time of the victim for at least a part of the victim, and the symptom improvement scenario includes the sick and sick whose death time is indicated in the symptom scenario. Information indicating changes in the death time when a predetermined treatment is performed on a person is included, and the scenario editing unit includes the priority order for minimizing the number of deaths and the treatment details for each victim. An optimal solution for the number of non-dead persons with respect to the total number of victims when the priority is determined in the order of arrival of each victim in the predetermined area, and the priority in the order of arrival. The life-saving rate difference, which is the difference from the optimal life-saving rate, which is the ratio of the number of non-dead persons to the total number of injured patients when determined in the optimal order, which is the order according to the optimal solution, is calculated. Regarding the rate difference The requested life-saving rate difference that is the desired value of the scenario creation instructor is included, and the scenario editing unit is information indicating the death time in the symptom scenario so that the life-saving rate difference approaches the desired life-saving rate difference. Alternatively, at least one of the information indicating the change in the death time in the symptom improvement scenario may be changed.

According to the above configuration, the above priority order for minimizing the number of deaths and the optimal solution of treatment content for each victim are calculated,
When the priority is determined in the order of arrival of each victim to the predetermined area, the lifesaving rate in order of arrival, which is the ratio of the number of non-dead to the total number of victims, and the priority in the order according to the optimal solution Calculate the life-saving rate difference, which is the difference from the optimal order life-saving rate, which is the ratio of the number of non-dead persons to the total number of injured patients when determined in a certain optimal order, and make the life-saving rate difference close to the desired life-saving rate difference At least one of the information indicating the death time in the symptom scenario and the information indicating the change in the death time in the symptom improvement scenario is changed. Thereby, the scenario according to the difficulty (desired lifesaving rate difference) desired by the scenario creation instructor can be easily created.

  In addition, the scenario editing unit calculates each of the victims as one particle and calculates the optimal solution by performing a particle group optimization calculation for minimizing the value of the objective function including the number of deaths. Also good.

  According to said structure, the optimal solution of the said priority for minimizing the number of deaths and the treatment content with respect to each sick person can be calculated accurately.

  In addition, an evaluation processing unit that calculates the relative value of the number of deaths in the result of performing the simulation using the scenario with respect to the number of deaths corresponding to the optimal solution as the evaluation value of the result of executing the simulation is provided. It is good also as a structure.

  According to said structure, the evaluation value for evaluating a simulation result quantitatively can be calculated.

  The scenario creation device may be realized by a computer. In this case, a program for causing the scenario creation device to be realized by the computer by causing the computer to operate as the scenario editing unit and the program are recorded. Computer-readable recording media are also included in the scope of the present invention.

  As described above, according to the scenario creation device of the present invention, it is possible to easily create a scenario according to a desired difficulty level.

It is explanatory drawing which shows the outline | summary of the simulation performed in the simulation system concerning one Embodiment of this invention. It is a block diagram showing a schematic structure of a simulation system concerning one embodiment of the present invention. It is a block diagram which shows the structure of each apparatus with which the simulation system shown in FIG. 2 is equipped. It is explanatory drawing which shows an example of the setting item regarding the symptom of each victim in the victim scenario included in the scenario used with the simulation system shown in FIG. It is explanatory drawing which shows the example of the conversion according to the elapsed time of the victim's biometric information in the victim scenario contained in the scenario used with the simulation system shown in FIG. It is explanatory drawing which shows an example of the display screen displayed on the display part of the operator terminal in the simulation system of FIG. It is explanatory drawing which shows an example of the display screen displayed on the display part of the terminal for participants in the simulation system of FIG. It is explanatory drawing which shows an example of the image displayed on a part of display part of the terminal for participants in the simulation system of FIG. It is explanatory drawing which shows an example of the display screen displayed on the display part of the terminal for participants in the simulation system of FIG. It is explanatory drawing which shows an example of the image displayed on a part of display part of the terminal for participants in the simulation system of FIG. It is explanatory drawing which shows an example of the image displayed on a part of display part of the terminal for participants in the simulation system of FIG. (A)-(c) is explanatory drawing which shows the treatment path | route of a sick person in the simulation implemented in the simulation system of FIG. It is explanatory drawing which shows the symbol which shows the constraint conditions in the scenario used with the simulation system of FIG. 2, and the meaning of the said symbol. In the simulation system of FIG. 2, when calculating the optimal solution for the scenario, an algorithm for calculating an optimal treatment order for the victim in order to improve the overall survival rate of the victim in consideration of the death period of the victim It is explanatory drawing which shows. FIG. 3 is an explanatory diagram showing the configuration contents of particles and particle groups when performing particle group optimization calculation in order to calculate an optimal solution for a scenario in the simulation system of FIG. 2. FIG. 3 is an explanatory diagram illustrating a process for smoothing a change in a treatment path due to movement of a solution space when performing a particle swarm optimization calculation in order to calculate an optimal solution for a scenario in the simulation system of FIG. 2. FIG. 3 is an explanatory diagram showing a method for acquiring a treatment order in each area of a patient when performing a particle swarm optimization calculation in order to calculate an optimal solution for a scenario in the simulation system of FIG. 2. 5 is a flowchart showing a modification example of the particle swarm optimization calculation performed when calculating the optimum solution for the scenario in the simulation system of FIG. 2. It is explanatory drawing which shows the method of the crossover calculation performed by the process shown in FIG. It is explanatory drawing which shows the outline | summary of the difficulty adjustment method (scenario creation method) of the scenario in the simulation system of FIG. It is explanatory drawing which shows the adjustment method of the congestion degree of the scenario in the simulation system of FIG. It is explanatory drawing which shows the adjustment method of the treatment order reversal rate of the scenario in the simulation system of FIG. In the adjustment method of the treatment order reversal rate of the scenario shown in FIG. 22, the calculation result for each victim group of the change amount of the treatment order reversal rate and the change amount of the lifesaving rate when the arrival order of the victim is changed. It is explanatory drawing which shows an example. It is explanatory drawing which shows the setting conditions in the evaluation experiment of the scenario produced in the simulation system of FIG. It is explanatory drawing which shows the setting conditions in the evaluation experiment of the scenario produced in the simulation system of FIG. It is explanatory drawing which shows the parameter setting in the particle swarm optimization calculation performed in the evaluation experiment of the scenario produced in the simulation system of FIG. It is explanatory drawing which shows the adjustment error when adjusting the treatment order reversal rate and lifesaving rate difference with respect to the initial scenario produced | generated at random in the simulation system of FIG. In the simulation system of FIG. 2, in the case of random scenario generation processing for generating a scenario by randomly changing the arrival time and death period of the victim, and in the case of generating a scenario by the difficulty level adjustment processing according to one embodiment of the present invention It is explanatory drawing which shows the comparison result with.

  An embodiment of the present invention will be described.

(1. Simulation system)
(1-1. Overview of simulation system)
FIG. 1 is an explanatory diagram showing an outline of setting conditions in a simulation example according to the present embodiment. As shown in FIG. 1, in this simulation, the countermeasure headquarters directs the placement of medical resources at disaster sites and hospitals. However, the initial placement of medical resources is set for each training scenario. Medical resources include: (i) human resources such as doctors, nurses, paramedics, hospital clerk, (ii) emergency transport means such as ambulances, emergency helicopters, (iii) operating rooms, radiograph rooms, examination rooms, Various equipment such as hospital rooms, (iV) pharmaceuticals, therapeutic instruments, therapeutic devices, materials such as stretchers, stretchers, and transport instruments such as wheelchairs are included.

  At the disaster site, a triage post (primary triage post, a predetermined area) is set up, and primary triage is performed on the victim who has been rescued at the triage post. In the present embodiment, triage based on a START (Simple Triage And Rapid treatment) method is performed as the primary triage. In the START method, each patient is classified into four categories of green, yellow, red, and black in ascending order of severity. Green is an injured patient who does not need to be transported in an emergency, Yellow is an injured person who is not in a serious condition but needs early treatment, Red is an injured person in a life-threatening serious condition that requires urgent treatment, and Black is an injured person It is a victim who has died or is unable to save with current medical resources. Victims who have undergone primary triage are hospitals, emergency centers, and other medical institutions (treatment areas), or first-aid centers (treatment areas) near the disaster site, in order from the victims classified in the red category with the highest priority for lifesaving. To be transported.

  In the present embodiment, when primary triage is performed at the triage post, an IC tag having a function of detecting biological information (vital sign) such as the pulse rate of the victim and blood oxygen concentration and transmitting it to a predetermined transmission destination ( It is assumed that the biological information of each victim can be monitored in real time on a triage system constituted by a computer or the like by attaching the biological information detection device to each victim. Examples of the IC tag and triage system include those proposed in Japanese Patent Application No. 2009-196450 (filed on Aug. 27, 2009) filed by the inventors of the present application. In the present embodiment, it is assumed that the biological information of each patient can be monitored in real time by attaching the IC tag to each patient. However, the present invention is not limited to this. For example, a simulation assuming an environment in which a paper tag corresponding to a triage result is attached to each victim may be used.

  In addition, the items of biological information detected from the victim are not limited to the items described above. For example, in addition to the items described above, information such as respiratory rate and blood pressure may be detected and input to the triage system. Good. Further, the means for detecting the biological information of the patient is not limited to the IC tag, and biological information detected by various conventionally known biological information detection devices may be input to the triage system. Moreover, you may make it change the item of the biometric information detected from each sick person according to the category classification | category result of a sick person, the treatment implemented in simulation, etc. FIG.

  In hospital emergency reception, secondary triage is performed to determine the priority of treatment for patients who are transported from disaster sites. For example, treatment priorities and delivery destinations in hospitals are determined for patients who are categorized in the same category, taking into account the severity and urgency, and the placement and use of medical resources. Is transported to a transport destination according to the result of the secondary triage.

  In the simulation in the present embodiment, a red initial treatment group, a yellow initial treatment group, a green initial treatment group, and a black area group are provided as treatment groups, and each patient is treated according to the classification result of the secondary triage. It is transported to the transport destination corresponding to. Patients who have undergone initial treatment by each treatment team are transported to the ICU (intensive care unit), OP room (operating room), general room, or other medical facilities as needed, and treated or progressed. Observations are made.

(1-2. Schematic configuration of simulation system 1)
FIG. 2 is a block diagram showing a schematic configuration of a simulation system (lifesaving emergency simulation system) 1 according to the present embodiment. As shown in FIG. 2, the simulation system 1 includes a server device 10, an implementer terminal (scenario creation device) 20 and a large number of participant terminals connected to the server device 10 via a network. 30. The number of participant terminals 30 is not particularly limited, and may be one or more.

  The practitioner terminal 20 sets a training scenario (simulation scenario) in response to an instruction input from a simulation practitioner (moderator; scenario creation instructor) that determines simulation setting conditions. The training scenario includes (i) the number of victims, the time when each victim first appears in the simulation (for example, the arrival time of each victim at the primary triage post (arrival time information)), and the symptoms of each victim. , Symptom scenario showing the change of symptoms according to the time course of each victim (patient scenario, information on the victim), change of symptoms according to the elapsed time when medical treatment is performed at each time (Ii) medical resource scenario (resource information), which is information indicating the type, number, and initial arrangement of each medical resource, (iii) each treatment (for example, Treatment scenario (treatment information), (iv) simulation showing the time required for the biological information detection device mounting treatment, medical examination processing, treatment treatment, movement treatment, transport treatment, etc.) and conditions under which each treatment can be performed Initial setting scenario (initial setting information) that is information such as the setting conditions of the elapsed speed of time above, and (v) the role of each participant corresponding to each participant terminal 30 during simulation and each participant terminal 30 Includes a terminal scenario (terminal information) including basic screen information to be displayed on the screen. In addition, it is not always necessary to set the change pattern of symptoms in the victim scenario, and only the initial symptoms should be set for victims whose symptoms are substantially constant throughout the simulation period regardless of the passage of time. It may be.

  The practitioner terminal 20 receives an input of a parameter (setting value) related to the difficulty level of the simulation from the simulation practitioner (scenario creation instructor), and a training scenario (basic scenario set in advance according to the parameter). ) Is changed, and a training scenario with a difficulty level corresponding to the instruction of the simulation operator (scenario creation instructor) is created. Details of how to create a training scenario according to the difficulty level will be described later.

  In the present embodiment, the simulation practitioner creates a training scenario using the practitioner terminal 20, but the present invention is not limited to this. For example, a file including data necessary for creating a training scenario is stored in an arbitrary device connected to the simulation system 1, and training is performed by accessing the file from an arbitrary device connected to the simulation system 1. Scenarios may be created. Further, a file storing data necessary for creating a training scenario is stored in a recording medium, the file is read from the recording medium using an arbitrary information processing apparatus, and the information processing apparatus is used. A training scenario may be created.

  In addition, the practitioner terminal 20 can change the setting conditions related to the training scenario being used in the simulation stored in the server device 10 during the simulation in response to an instruction input from the simulation practitioner. It is like that. As a result, for example, the addition or supplement of medical resources, the occurrence of an accident, etc. can be appropriately reflected in the simulation.

  Further, the practitioner terminal 20 has a function of issuing a simulation start instruction, a pause, and an end instruction in response to an instruction input from the simulation practitioner. When the simulation is paused, the display screen is locked in all terminals on the simulation system and cannot be operated.

  The server device 10 stores the training scenario set via the practitioner terminal 20, and for each participant terminal 30, information on the basic screen corresponding to the participant terminal 30 and the training scenario. The setting information related to the participant terminal 30 among the setting information is transmitted. As a result, a basic screen corresponding to the participant terminal 30 is displayed on each participant terminal 30, and an image corresponding to the setting information related to the participant terminal 30 is further displayed on the basic screen. . In addition, the server device 10 can be used for the victim at the current simulation time based on the settings in the training scenario, the operation information input from each participant terminal 30, the elapsed time (time information) from the start of the simulation, and the like. The current status information indicating the symptom and position of the patient, the placement and usage of medical resources is generated. Then, the generated information is transmitted to the associated participant terminal 30, and information stored in the victim information storage unit 107 and the resource information storage unit 108 is updated. When an operation on a certain participant terminal 30 affects a simulation situation corresponding to another participant terminal 30, information for reflecting the influence is transmitted to the participant terminal 30. To change the display contents. Thereby, the operation information input from the participant via each participant's terminal 30 is transmitted to the server device 10, and the symptom and position change of the victim and the arrangement state of the medical resources due to the treatment corresponding to this operation information The change in the usage status is reflected on the display of each participant terminal 30.

  In addition, the server device 10 periodically communicates with the implementer terminal 20 and each participant terminal 30 to advance the simulation time of each of these devices according to the set elapsed speed. Synchronize the simulation time of each device.

  Further, the server device 10 causes the log storage unit 111 to store the training scenario and the operation contents, victim information, resource information, and setting information history (log) of each participant terminal 30.

  The participant terminal 30 displays an image corresponding to each piece of information (such as victim information, resource information, setting information, and terminal information) transmitted from the server device 10, and accepts an operation input from the participant. The corresponding operation information is transmitted to the server device 10. Note that the participant terminal 30 may be provided for each participant who participates in the simulation, or may be provided for each of a plurality of participants. That is, one participant terminal 30 may be shared by a plurality of participants. When one participant's terminal 30 is shared by a plurality of participants, it is preferable that the participants belonging to the same group share the same.

  In addition, the number of participants participating in the simulation is not particularly limited, and may be one or more.

  In the present embodiment, each participant is assigned a primary triage post near the disaster site, a rescue center near the disaster site, a secondary triage post in front of the hospital, and a red initial stage in the hospital. It is designed to be assigned to any one of the treatment group, the yellow initial treatment group, the green initial treatment group, and the black area. Good.

(1-3. Configuration of the practitioner terminal 20)
FIG. 3 is a block diagram illustrating a configuration of each device provided in the simulation system 1. As illustrated in FIG. 3, the practitioner terminal 20 includes a practitioner terminal control unit 201, a transmission / reception unit 202, a display unit 203, an operation input unit 204, a voice output unit 205, a patient information generation unit 206, and resource information generation. Unit 207, initial setting information generation unit 208, terminal information generation unit 209, basic scenario storage unit 210, scenario editing unit (scenario creation device) 211, and evaluation processing unit 212.

  The practitioner terminal control unit 201 controls the operation of each unit of the practitioner terminal 20.

  The transmission / reception unit 202 transmits / receives various data to / from the server device 10 in accordance with instructions from the operator terminal control unit 201.

  The display unit 203 is a display unit that displays an image according to an instruction from the practitioner terminal control unit 201. For example, the display unit 203 displays an interface screen or the like when the simulation practitioner performs various settings related to the training scenario and an operation input for instructing the start, pause, and end of the simulation.

  The operation input unit (operation input unit for practitioner) 204 receives various instruction inputs from the simulation practitioner and transmits them to the terminal control unit 201 for practitioner. The operation input unit 204 may be configured with, for example, a mouse or a keyboard, or may be configured as a touch panel integrated with the display unit 203.

  The voice output unit 205 outputs a voice in accordance with an instruction from the practitioner terminal control unit 201.

  The injured person information generation unit 206 generates an injured patient scenario (injured person information) in accordance with an instruction from the simulation operator input via the operation input unit 204. The victim scenario includes the number of victims, the symptoms of each victim, the time when each victim first appears in the simulation (eg, the arrival time of each victim at the primary triage post), and the biological information of each victim. Information indicating a change in symptoms (a change in symptoms according to the passage of time and a change pattern in symptoms when a medical procedure is performed at each time) is included.

  In this embodiment, the area where each victim appears first in the simulation is set as the primary triage post. However, the present invention is not limited to this. The area to which the participant is assigned or the participant is assigned. What is necessary is just to set suitably according to the combination of the area currently performed.

  For example, if participants are not assigned to the primary triage post and the first aid station near the disaster site, the primary triage post and the first aid station are omitted, and the area where each victim appears first in the simulation is the second triage post. The arrival time of each victim at the secondary triage post may be included in the victim scenario.

  In addition, if no participant is assigned to the primary triage post, and a participant is assigned to a rescue center near the disaster site and a secondary triage post, the area where each victim appears first is the A secondary triage post may be used, and the victim scenario may include the arrival time of each victim's first aid station or secondary triage post in the victim scenario.

  In addition, the primary triage post located near the disaster site, the rescue center located near the disaster site, the secondary triage post located in front of the hospital, the early red treatment group, the early yellow treatment group, the early green stage in the hospital If a participant is assigned only to one of the treatment group and the black area, the area where each victim appears first is the area where the participant is assigned, and each victim's The arrival time at the area may be included in the victim scenario.

  FIG. 4 is an explanatory diagram illustrating an example of setting items related to symptoms of each patient in the patient scenario. As shown in this figure, “individual information”, “arrival time”, “symptom”, “necessary treatment”, “condition deterioration time”, and “biological information” are set for each victim.

  “Personal information” includes a name (or a personal ID for identifying each victim), age, and gender. In the “arrival time”, a time at which the victim arrives at the primary triage post and the simulation participant can execute an operation on the victim is set. In “symptoms”, the appearance of the patient, the injury site, and the appearance photograph are set. The appearance photograph is selected from a plurality of pieces of photograph data prepared in advance, for example. In “necessary treatment”, a time limit for each necessary treatment is set. In the “condition deterioration time”, a time at which the condition of the patient gets worse is set. “Biological information” includes circulation (selected from stable / unstable), consciousness level (selected from clear / 1 digit / 2 digits / 3 digits), conversation (selected from possible / impossible), RR (Respiratory Rate; 1 Items of respiratory rate (minutes / minute)), CRT (Capillary Refill Time; capillary refill time (seconds)), and HR (Heart Rate; heart rate per minute (times / minute)) are set. Is done. In addition, the biometric information before condition deterioration is an indispensable setting item, and is set about each sick person. The biometric information after the condition is deteriorated is set for the victim whose condition is deteriorated. A condition worsening time is also set for a patient whose condition worsens. The state after completion of all treatments is set as necessary when it is desired to reproduce more realistic changes in biological information. In addition, the setting item of biometric information is not restricted to said example, For example, you may add other setting items, such as the propriety of self-walking.

  Changes in the biological information of each victim are reproduced by conditional branching depending on the elapsed time and the therapeutic treatment performed so far. Condition determination time and biological information for each condition are designated in advance.

FIG. 5 is an explanatory diagram illustrating an example of a change in accordance with the elapsed time of the biological information of the patient. A set of selectable treatments _{T = t 1, t 2,} ···, and _{t m.} There are m _p necessary treatments for the injured person p, and a time limit d ^p _i is given for each necessary treatment t ^p _i εT (1 ≦ i ≦ m _p ≦ m). ^Let T ^p _i = (t ^p _i , d ^p _i ) be a set of time limits corresponding to the necessary treatments, and T ^p = {T ^p ₁ , T ^p ₂ ,..., T ^p _mp } and their set. To do. If the treatment ^t _{p i} have been made to the victim p, remove the ^T _{p i} from ^{T p.} If the d ^p _min and the closest time to the disaster occurrence time in the time limit of each element ^T _{p i} of ^{T p, p} is death in the case of a _{d p min} <current time. Note that when the victim p has died, the icon of the victim p is deleted from the screen. In addition, when the biological information after the condition deterioration is given to the sick person p, if Tp ≠ φ when the current time is the condition deterioration time, the biological information after the condition deterioration is changed. When Tp = φ, transition to treated biometric information is made. Injured persons who do not have the necessary treatment can also be placed.

  It should be noted that the simulation practitioner may input the scenarios relating to each victim one by one. A database storing examples of scenarios relating to many victims is prepared in advance, and the terminal control unit 201 for practitioners is prepared. May display a list of scenarios relating to the victims stored in the database on the display unit 203, and the scenario of the victims used in the simulation may be extracted from the displayed list. Further, the scenario regarding the victim extracted from the database may be appropriately changed by the simulation operator.

  Further, since a relatively large amount of data is accumulated by medical personnel regarding the relationship between the symptoms of the victim and the change in the biological information according to the elapsed time, the database can be created based on these data. Good. For example, the database may be created using biological information or the like actually collected from the victim in a disaster or accident that has occurred in the past.

  In addition, the scenarios related to each patient that are stored in the database are grouped according to the type and location of the disaster that is expected, and the simulation operator can determine the type of disaster, the location of the disaster, and the number of patients By specifying the conditions such as, the practitioner terminal control unit 201 automatically extracts the victim's scenario according to the designated condition from the scenarios related to the victim stored in the database. Also good.

  The resource information generation unit 207 generates resource information (resource information arranged in each area) used for the simulation in response to an instruction from the simulation operator input via the operation input unit 204. The resource information includes, for example, (i) personal names or IDs of human resources such as doctors and nurses participating in the simulation, personnel information such as departments, specialized fields, titles, and (ii) disaster sites such as ambulances and ambulance helicopters Information on the quantity and arrangement of transportation means from the hospital to the hospital, (iii) Facility information in hospitals such as operating rooms, treatment rooms (treatment rooms), X-ray rooms, (iv) various medical equipment and various medical facilities provided in hospitals This includes information on the quantity and arrangement of materials such as equipment, stretchers, stretchers, and various transport equipment such as wheelchairs. By adjusting these resource information, a more realistic simulation can be performed. In addition, by adjusting these resource information, the treatment ability for the sick in each area can be changed, and the difficulty level of the scenario can be adjusted.

  The simulation operator may input resource information on each medical resource one by one. A database storing a list of general resource information expected to be used in the simulation is prepared in advance. In addition, the resource information corresponding to the actual situation of the hospital, organization, or the like that performs the simulation may be extracted from the database by the simulation operator, and the resource information may be generated by appropriately modifying the information.

  The initial setting information generation unit 208 generates initial setting information in the simulation in response to an instruction from the simulation operator input via the operation input unit 204. Initial setting information includes each medical resource (human resources, transport means, medical equipment, medical device, medical instrument, transport instrument, etc.) used for simulation, initial arrangement of each medical resource, and various treatments (treatment, transport, movement, etc.) Time required for each treatment, type of human resources capable of performing each treatment (for example, only a doctor can perform a certain treatment), type and amount of medical resources required for various treatments, time during simulation at the start of simulation, Setting information such as the elapsed speed of time (for example, the elapsed speed of time in the simulation is set to 1 × speed, 2 × speed, 3 × speed, or 6 × speed with respect to the actual elapsed speed) is included.

  The terminal information generation unit 209 generates terminal information in which the terminal ID of each participant terminal 30 used for the simulation is associated with the role of the participant who uses each participant terminal 30 during the simulation. In addition, the terminal information generation unit 209 generates a basic display screen corresponding to the role or arrangement position of the participant during the simulation for each participant terminal 30, for each arrangement position of the participant, or for each group to which the participant belongs. Then, the terminal ID of each participant terminal 30 and the basic display screen corresponding to each participant terminal 30 are associated with each other and added to the terminal information. One participant terminal 30 may be shared by a plurality of participants belonging to the same team. In that case, the terminal ID of each participant terminal 30 used for the simulation and each participant terminal The terminal information in which the group corresponding to 30 is associated may be generated.

  The basic scenario storage unit 210 stores a simulation scenario (basic scenario) in which a victim scenario, resource information, initial setting information, and terminal information are set by the above-described units. The basic scenario acquired from the outside via the transmission / reception unit 202 may be stored in the basic scenario storage unit 210, or the basic scenario recorded in various recording media may be read out and stored in the basic scenario storage unit 210. Good. In addition, in order to store a plurality of basic scenarios in the basic scenario storage unit 210, a simulation operator can select a basic scenario to be used for simulation as a training scenario from the plurality of basic scenarios, or create a training scenario. A basic scenario to be used may be selected.

  The scenario editing unit 211 accepts input of parameter setting values related to at least a part of conditions (for example, conditions related to the difficulty level) of the basic scenario from the simulation operator via the operation input unit 204, and performs basic operations according to the setting values. The contents of the basic scenario stored in the scenario storage unit 210 are automatically changed to create a training scenario according to the instruction of the simulation operator (scenario creation instructor). Details of a training scenario creation method (basic scenario change method) according to the set value will be described later.

  The evaluation processing unit 212 calculates the simulation result based on the simulation result accumulated in the log storage unit 111 of the server device 10 and the optimal solution for the training scenario calculated when creating the training scenario applied to the simulation. The evaluation value of is calculated. A method for calculating the evaluation value will be described later.

  The practitioner terminal control unit 201 controls the transmission / reception unit 202 to transmit the training scenario created by the scenario editing unit 211 according to the degree of difficulty to the server device 10. As a result, the training scenario is stored in the server device 10 and the simulation can be started. Thereafter, when a simulation start instruction is input from the simulation operator via the operation input unit 204, the operator terminal control unit 201 controls the transmission / reception unit 202 to transmit the simulation start instruction to the server device 10. . Further, when an instruction input such as a primary stop instruction, an end instruction, or a change of various settings is made via the operation input unit 204 during the simulation, the terminal control unit 201 for performer responds to the instruction input. The transmitted information is transmitted from the transmitting / receiving unit 202 to the server device 10.

  FIG. 6 is an explanatory diagram illustrating an example of an interface screen displayed on the display unit 203. In the example shown in this figure, the simulation time is displayed in the display areas A1 and A2, and the simulation is started and stopped in the display area A3, the elapsed speed of time is selected, and instructions for transmitting each selected instruction content to the server device 10 are given. , And a button for starting creation of a new simulation scenario. In the display areas A4 and A5, images for setting medical resources used for the simulation are displayed. Specifically, an image for setting information on human resources such as doctors and nurses participating in the simulation is displayed in the display area A4, and information on medical equipment such as a syringe is set in the display area A5. An image is displayed. In the display area A6, an image for setting the victim information of each victim in the simulation is displayed.

  As conditions set in the training scenario, in addition to the above-described conditions, geographical restrictions, restrictions on medical practices, and the like may be set. Geographic constraints include travel time between areas. A more realistic simulation can be performed by reflecting the actual location of the disaster site or hospital in the travel time. Restrictions related to medical practice include the time required for various treatments, interview time, and time required for hospital transportation. These represent the treatment ability of the medical staff in charge of treatment, and are preferably set based on medical grounds.

(1-4. Configuration of Server Device 10)
The server device 10 includes a server control unit 101, a transmission / reception unit 102, a synchronization processing unit 103, an operation information acquisition unit 104, a patient information analysis unit 105, a resource information analysis unit 106, a patient information storage unit 107, and a resource information storage unit 108. A setting information storage unit 109, a terminal information storage unit 110, and a log storage unit 111.

  The server control unit 101 controls the operation of each unit of the server device 10.

  The transmission / reception unit 102 transmits / receives various types of information to / from the practitioner terminal 20 and each participant terminal 30.

  Based on the information regarding the simulation start time (for example, disaster occurrence time) and the elapsed speed of time during the simulation received from the practitioner terminal 20, the synchronization processing unit 103, the server device 10 itself, the practitioner terminal 20, And the time in simulation in each participant's terminal 30 is synchronized. Specifically, the synchronization processing unit 103 periodically or continuously generates time information indicating the simulation time, and the server control unit 101 generates the time information from the transmission / reception unit 102 to the performer terminal 20 and each participant. By transmitting to the terminal 30 for use, the simulation time of each of these devices is synchronized.

  The operation information acquisition unit 104 extracts operation information indicating the operation content of each participant from the information received by the transmission / reception unit 102 from each participant terminal 30.

  The victim information storage unit 107, the resource information storage unit 108, the setting information storage unit 109, and the terminal information storage unit 110 are the victim information, resource information, and initial setting received by the transmission / reception unit 102 from the operator terminal 20, respectively. Information and terminal information are stored.

  In addition, when the server control unit 101 receives the victim's biological information from the participant terminal 30 or a determination result related to triage determination, the server control unit 101 adds the information to the victim information.

  The injured person information analyzing unit 105 at the current time based on the operation content (treatment content) of each participant acquired by the operation information acquiring unit 104 and the injured person information stored in the injured person information storage unit 107. Analyzes the change in symptoms according to the symptoms and location of the victim and the subsequent time of the victim. Then, the server control unit 101 causes the transmission / reception unit 102 to transmit the victim information corresponding to the analysis result to the participant terminal 30 related to the victim, and displays the information on the display unit 303 of the participant terminal 30. The victim information to be updated is updated. In addition, the server control unit 101 adds information on the symptom and position of the patient at the current time to the patient information stored in the patient information storage unit 107, and also stores the patient information stored in the patient information storage unit 107. The person information is appropriately updated according to the analysis result.

  In addition, when it becomes necessary to display information on the victim on the participant terminal 30 different from the participant terminal 30 on which the operation input has been performed due to transport or treatment of the victim, or display on the victim When the content needs to be changed, the server control unit 101 identifies the participant terminal 30 based on the terminal information stored in the terminal information storage unit 110 and Send information to display it.

  The victim information analysis unit 105 analyzes each patient's symptom scenario, symptom improvement scenario, and symptom deterioration scenario based on the victim information stored in the victim information storage unit 107, and each victim is analyzed. The condition sudden change time, which is the time at which the condition changes suddenly or the time at which urgent treatment is required, is calculated. Then, when there is a victim who has reached the time when the condition suddenly changes or the time when urgent treatment is required, the sudden change or urgent treatment is performed on the terminal 30 for the participant related to the victim. Information for identifying the patient who has become necessary and information on sudden change in condition indicating that the condition has changed suddenly or that urgent treatment is required are transmitted.

  Note that threshold values for each piece of biological information or the amount of change of each piece of biological information per predetermined time for determining whether the condition suddenly changes or is in a state that requires urgent treatment are set in advance as initial setting conditions, for example. Just keep it. Further, the threshold value may be made different according to conditions such as symptoms, the age, weight, sex, and medical history of the patient. In addition, a setting algorithm for setting the threshold according to conditions such as symptoms, age, weight, gender, medical history, etc. of the victim is defined in advance, and the victim information analysis unit 105 sets the threshold for each victim. You may make it set.

  The resource information analysis unit 106 stores the operation content (treatment content) of each participant acquired by the operation information acquisition unit 104, the resource information stored in the resource information storage unit 108, and the setting information storage unit 109. Based on the initial setting information, the arrangement status and usage status of each medical resource at the current time on the simulation are analyzed. Then, the server control unit 101 transmits resource information corresponding to the analysis result of the resource information analysis unit 106 to the participant terminal 30 related to the resource information, and displays the resource information on the display unit 303 of the participant terminal 30. Update the displayed resource information. In addition, the server control unit 101 updates the resource information stored in the resource information storage unit 108 according to the analysis result.

  In addition, when it becomes necessary to display the information regarding the medical resource in the terminal 30 for participants different from the terminal 30 for participants in which operation input was performed by conveyance, consumption, etc. of medical resources, or a display content is changed. When the necessity arises, the server control unit 101 identifies the participant terminal 30 based on the terminal information stored in the terminal information storage unit 110 and causes the participant terminal 30 to display it. Send information for.

  For example, when the operation content of the participant is a treatment for the patient, the treatment time, equipment, materials, etc. required for the treatment are analyzed based on the initial setting information. Then, until the time when the treatment procedure is finished, resource information indicating that a doctor or nurse involved in the treatment procedure cannot perform another treatment is transmitted to the corresponding participant terminal 30, and the participation An image indicating that these doctors and nurses cannot perform other treatments is displayed on the terminal 30 for the person. In addition, resource information indicating that medical resources such as equipment and materials used for the treatment treatment cannot be used for other treatments until the time when the treatment treatment ends is transmitted to the corresponding terminal 30 for the participant. Then, an image indicating that the medical resource cannot be used for another treatment is displayed on the participant terminal 30. In addition, when medical resources such as pharmaceuticals are consumed by the therapeutic treatment, the display of the remaining amount of the medical materials and the like on the participant terminal 30 related to the medical resources is updated.

  In addition, the server control unit 101 stores, as log information (history information), the operation content received from each participant terminal 30, the time when the operation is performed, and the change in the victim information and resource information due to the operation. Stored in the unit 111.

  When the server control unit 101 receives a simulation start instruction, a pause instruction, or an end instruction from the practitioner terminal 20, the server control unit 101 sends a simulation start signal, a pause signal to each participant terminal 30 according to the received instruction. Alternatively, a simulation end signal is transmitted.

  Further, the server control unit 101 transmits terminal information corresponding to the participant terminal to each participant terminal 30 when the simulation is started or before the simulation is started. Thereby, when starting a simulation, each participant terminal 30 displays a basic display screen corresponding to the participant terminal and an image corresponding to the initial arrangement state of each medical resource.

(1-5. Configuration of Participant Terminal 30)
The participant terminal 30 includes a participant terminal control unit 301, a transmission / reception unit 302, a display unit 303, an audio output unit 304, an operation input unit 305, a terminal information storage unit 306, and a time information storage unit 307.

  The participant terminal control unit 301 controls the operation of each unit of the participant terminal 30.

  The transmission / reception unit (terminal-side transmission / reception unit) 302 transmits / receives various data to / from the server device 10 in accordance with instructions from the participant terminal control unit 301.

  The display unit 303 displays an image in accordance with an instruction from the participant terminal control unit 301.

  The audio output unit 304 performs audio output in accordance with an instruction from the participant terminal control unit 301. For example, when the condition sudden change information is received from the server device 10, a warning sound indicating the condition sudden change is output.

  The operation input unit 305 receives an operation input from a participant. The operation input unit 305 may be configured with, for example, a mouse, a keyboard, or the like, or may be configured as a touch panel that is fixed with the display unit 303.

  The terminal information storage unit 306 stores terminal information regarding the participant terminal 30 received from the server device 10. This terminal information includes a basic display screen, an initial arrangement state of each medical resource, and restriction information about each medical resource (for example, treatment execution availability information indicating treatments that can be performed and treatments that cannot be performed by each participant). It is.

  The time information storage unit 307 stores time information transmitted from the server device 10 periodically or continuously. The participant terminal control unit 301 updates the time information stored in the time information storage unit 307 every time the transmission / reception unit 302 receives new time information.

  FIG. 7 is an explanatory diagram showing an example of an image displayed on the display unit 303 provided in the participant terminal 30 of the participant belonging to the countermeasure headquarter group and the black area group. In the example shown in this figure, a display area (gathering area, on-site dispatch area, triage post area, red treatment room area, yellow treatment room area, green treatment room area, carry-in area, and so on) (Death determination / corpse refuge area) are displayed, and icons of human resources arranged in the arrangement locations corresponding to the display areas are displayed in these display areas.

  Then, when the icon of the person who instructs to move from the countermeasure headquarters is dragged and dropped on the display area corresponding to the placement location of the destination, as shown in the red treatment room area in FIG. 7, it corresponds to the placement location of the destination. In the display area, this human resource icon, an image indicating that this human resource is moving (or that other treatment cannot be performed), and the movement completion time (or the next treatment can be executed). Is displayed. The movement instructions from the countermeasure headquarters to the participants corresponding to the respective human resources may be performed by using various information transmission means such as oral, telephone, wireless, in-hospital broadcasting, and network. The server device 10 transmits a basic display screen, victim information, resource information, setting information, etc. according to the destination to the participant terminal 30 of the participant corresponding to the human resource who has received the movement instruction, The display of the participant terminal 30 may be changed.

  In the example shown in FIG. 7, icons indicating medical materials such as syringes, injection needles, and pharmaceuticals managed by the countermeasure headquarters, the number of these medical resources, and the respective medical resources in other locations. A transmission button for transporting is displayed. Then, the participant designates the number of medical resources to be transported, drags a transmission button corresponding to the medical resource, and drops it on the display area of the transport destination, thereby performing an operation input relating to transport of the medical resource. When the operation input is performed on the participant terminal 30, the participant terminal control unit 301 specifies the time when the operation input is performed based on the time information stored in the time information storage unit 307, Operation information including the content of the operation input and the time when the operation input is performed is generated and transmitted from the transmission / reception unit 302 to the server device 10. Alternatively, the participant terminal control unit 301 generates operation information indicating the contents of the operation input, transmits the operation information to the server device 10 from the transmission / reception unit 302, and the operation input is performed based on the time when the server device 10 receives the operation information. The performed time may be calculated. As a result, the server apparatus 10 analyzes the change of the resource information based on the operation information, and transmits the resource information updated according to the analysis result to the associated participant terminal 30. As a result, the number of the medical resources in the participant terminal 30 corresponding to the transport source decreases, and the number of the medical resources in the participant terminal 30 corresponding to the transport destination increases. In addition, the transport instruction from the countermeasure headquarters to the participants corresponding to the human resources who perform the transport processing of each medical resource may be performed using various information transmission means such as oral, telephone, wireless, in-hospital broadcasting, and network.

  Further, as shown in FIG. 7, an image indicating a time corresponding to the time information transmitted from the server device 10 is displayed on the display unit 303 of the participant terminal 30.

  In the example of FIG. 7, an image similar to that of the participant terminal 30 of the participant belonging to the countermeasure headquarters group is displayed on the participant terminal 30 of the participant belonging to the black area group. However, the operations that can be performed by the participants in the black area group are limited by the terminal information, and operations other than those corresponding to the actions assigned to the black area group (for example, death determination, transfer to the corpse) Input is disabled. In addition, a basic display screen corresponding to the participants belonging to the black area group is generated, and the basic display screen for the black area group is displayed on the participant terminal 30 of the participant belonging to the black area group. Also good.

  FIG. 8 shows an example of an image displayed on a part of the display unit 303 in the participant terminal 30 of the participant belonging to the first triage team. When the victim who performs the primary triage is selected on the basic display screen (not shown) of the participant terminal 30 of the participant belonging to the first triage group, the symptom data (not shown) of the victim at that time, A determination support image supporting the determination of the primary triage shown in FIG. 8 is displayed. The participant who performs the primary triage sequentially determines each item in the START method based on the determination support image. Specifically, the lamp below the determination item blinks one item at a time to indicate the determination target item, and the participant inputs either “O” (OK) or “×” (NG) for the determination target item. The lamp below the determined item is turned on, and the lamp below the undecided item is turned off. When all items have been determined, category determination is automatically performed according to the determination result for each item, and the lamp below each item is lit in a color according to the category determination result. Or you may display the determination result of a category by a character, a symbol, etc. Further, the category determination result and the determination result for each item are sequentially transmitted to the server device 10 as operation information for the participant terminal 30, and the victim information is updated accordingly.

  In addition, a participant of the first triage group (participant assigned to the first triage post) performs an operation input corresponding to a treatment for mounting an IC tag (biological information detection device) on the victim. As a result, operation information corresponding to the operation input is transmitted to the server device 10, and the patient information analysis unit 105 of the server device 10 converts the biological information detected by the IC tag into the simulation time and the patient information. Accordingly, the current state information of the victim is updated periodically or continuously, and transmitted to the participant terminal 30 according to the calculation result.

  In the simulation according to the present embodiment, it is assumed that the patient is automatically transported to any treatment group or black area according to the determination result of the primary triage. However, in the case where a human resource who transports a sick person also participates in the simulation as a participant, the sick person may be transported according to the operation input of these participants after the primary triage. That is, a treatment that requires an operation input by a participant and a treatment that is automatically performed by the server control unit 101 may be appropriately set according to the scale of the simulation, the number of participants, and the like.

  FIG. 9 is an explanatory diagram illustrating an example of a display screen displayed on the display unit 303 provided in the participant terminal 30 of the participant (participant assigned to the red initial treatment area) belonging to the red initial treatment group. .

  In the example of FIG. 9, the first treatment table (first treatment room) and the second treatment table (second treatment room) are arranged in the red initial treatment group, and these treatment tables are displayed in separate display areas. Has been. In addition, an image showing a simulation time, a display area showing a delivery location of the patient who has been transported, an image showing a patient waiting to enter the first treatment room or the second treatment room, the first treatment room or the first treatment room 2 Display area that displays personnel or materials waiting to enter the treatment room, display area that displays personnel or materials that are waiting for surgery, and display area that displays personnel or materials that are waiting to be transferred to another location Etc. are displayed.

  Participating doctors and nurses perform operation inputs related to their movements by dragging and dropping icons corresponding to the participants to desired movement destinations. In addition, by dragging and dropping the icon of the victim, an operation input relating to the transfer of the victim to the treatment table (treatment room) and the transfer from the treatment table to another transport destination is performed. In addition, an icon indicating the assumed treatment content is displayed on the display unit 303. By dragging the icon of the treatment content to be performed on the victim and dropping it on the victim's icon, the treatment for the victim is treated. The contents are input. The participant terminal control unit 301 generates operation information indicating these operation contents, and transmits the operation information from the transmission / reception unit 302 to the server device 10.

  When the operation information is transmitted from the participant terminal control unit 301 to the server device 10, current status information (patient information and resource information) reflecting the result of the treatment corresponding to the operation information is returned from the server device 10. . Based on these pieces of information received from the server device 10, the participant terminal control unit 301 displays the time until the treatment corresponding to the operation content is completed as shown in FIG. Until the operation is completed, other operation inputs relating to doctors and nurses corresponding to this procedure are disabled.

In addition, at the start of treatment, as shown in the display area of the second treatment table, information that is grasped at that time regarding the injured person to be treated is displayed. This information includes information acquired or generated by previous treatments (for example, the determination result of each item in the primary triage, the symptoms grasped by the examination treatment, etc.), and biological information detected from the patient at that time It is. A participant who corresponds to a doctor who treats a sick person determines the treatment content based on this information, and inputs an operation related to the treatment content. Further, when the victim's icon is selected, as shown in FIG. 10, the biological information (for example, heart rate, respiratory rate, blood oxygen concentration (SpO ₂ )) grasped about the victim at that time is displayed. Is displayed.

  When the sudden change in the condition of the victim is received from the server device 10, as shown in FIG. 11, an image showing the sudden change in the condition of the victim is displayed in the vicinity of the icon of the victim on the display unit 303. At the same time, a sound or warning sound indicating a sudden change in condition is output from the sound output unit 304.

(2. Modeling of triage training)
(2-1. Overview of modeling)
In this embodiment, the disaster medical simulation is formulated by reducing it to an IPPS (Integrated Process Planning and Scheduling) problem which is a kind of job scheduling problem.

  That is, if medical resources (triage posts, treatment tables, ambulances, etc.) for treating patients in each area are regarded as machines, the patients are considered to be jobs executed by machines. Further, it is considered that a treatment group that needs to be applied to each patient in each area is a task group that constitutes a job, and a deadline of each treatment corresponds to a deadline of each task. For this reason, the disaster medical simulation in this simulator can be regarded as a job scheduling problem.

  In the simulation, it is possible to freely select areas and medical resources for performing each treatment within a range not exceeding the deadline. For example, when a patient is treated, all treatments can be completed on site, or treatment can be performed after immediate delivery to the hospital by an ambulance without any treatment on site. Thus, since there are a plurality of options for the procedure for saving the victim, the disaster medical simulation according to the present embodiment can be regarded as an IPPS problem in which there are a plurality of process plans for completing a job among job scheduling problems. Therefore, disaster medical simulation can be reduced to an IPPS problem if the objective function of the IPPS problem is to minimize the number of victims who die.

(2-2. Modeling of branching treatment planning problems)
The modeling of the disaster medical simulation according to the present embodiment will be described more specifically. Here, as with the simulator described above, the triage post near the disaster site (primary triage post) and rescue center, the pre-hospital triage post, the initial treatment room for each category (initial treatment in red, yellow, and green) 6 areas) will be described as an example, but the object of modeling is not limited to this. In addition, here, conditions other than the treatment order and treatment route of the victim to be derived (the treatment table, the number of ambulances, the treatment speed at each treatment table, etc.) are set in advance and do not vary. Here, the rescue order of the victim (order of arrival at the primary triage post) is given in advance, and the triage of the victim is performed in the rescue order at the triage post (primary triage post) near the disaster site.

In the disaster medical simulation, the following treatments can be performed for each area.
Triage post near the disaster site (primary triage post): transport to the primary triage and rescue center.
First aid center: treatment, hospital transport by ambulance.
Pre-hospital triage post (secondary triage post): secondary triage, transport to initial treatment room according to category.
Red / yellow / green initial treatment room: treatment.

  Treatment for the victim can be carried out at a relief center near the disaster site and an initial treatment room of each category, and in the target example, the treatment route of the victim is limited to three ways of FIG. 12 (a) to FIG. 12 (c). The First, all necessary treatments are performed at a rescue center near the disaster site (solid arrows in FIG. 12A). Secondly, only life-prolonging treatment is performed at a rescue center near the disaster site, and the remaining necessary treatment is performed in the initial treatment room after transportation to the hospital (solid line arrow in FIG. 12B). The third is a method in which all necessary treatments are performed in the initial treatment room after transportation to the hospital without performing treatment at the disaster site (solid arrow in FIG. 12C).

The existence of multiple treatment routes is modeled as follows. That is, an action (task) performed in each area is a task set C, and an order relationship s [c _i , c _j ] is defined between arbitrary tasks c _i and c _j εC. Order relation _{s [c} i, _{c j]} and a binary variable that represents the processing order of tasks, a process with the _{c j} after _{c i} completion is possible if expressed as _c i _{<c j,} the following It is expressed by a formula.

By specifying the order relationship s [c _i , c _j ] between the tasks c _i and c _j , the respective treatment routes r as shown in FIGS. 12A to 12C are defined. c _{i <c j} become _{c i} is not present task _{c j} Start task _is referred to as End Task Task _{c i where c j} to be c i _{<c j} does not exist. The treatment route r represents a sequence of tasks that reach according to an order relationship from any one start task to any one end task. That is, r = {c ^r ₁ , c ^r ₂ ,..., C ^r _{| r |} | s [c ^r _i , c ^r _{i + 1} ] = 1, ∀ _i = 1, 2,. -1}. c ^r ₁ must be a start task and c ^r _{| r |} A medical resource that performs tasks such as triage posts, treatment tables, and ambulances is defined by defining a machine set M and a task _cm ∈C that can be executed by each machine m∈M.

In this model, it is assumed that the death period of each victim is known, so the victims in the black category are not treated. Therefore, the black category victims are not treated. When life-prolonging treatment is performed, the death period is extended by a specified time. In this model, n victims are treated as n jobs, and the treatment time and the treatment time that varies depending on the machine used (treatment table, ambulance, etc.) are modeled. Therefore, the task c ^r ₁ ^,. .., Cr ^r _{| r |} , the treatment time t _i [c ^r _h , m] and the deadline d _i [c ^r _h , when the task c ^r _h of the victim i is treated with the machine m m]. If the victim violates the deadline established for each treatment route and task, the victim will die.

(2-3. Formulation of job scheduling problem with branch)
(2-3-1. Problem input / output)
(Input problem)
There are roughly two types of problem inputs: (i) disaster medical environment scenarios and (ii) victim patients scenarios.

As an input of the disaster medical environment scenario, a task set C, a machine set M, a set of tasks C _m that can be executed by each machine, an order relation set S of tasks, and a treatment route set R are given.

For the victim scenario, a set J of jobs, a set D of deadlines d _i [c ^r _h , m], and a set T of treatment times t _i [c ^r _h , m] are given. A set D of deadlines d _i [c ^r _h , m] and a set T of treatment times t _i [c ^r _h , m] are given for each treatment route r, task c ^r _h , job i, and machine m. It is done. Each job i is given a time a [i] at which the start task can be executed.

(Problem output)
(I) Maximum lifesaving rate, (ii) Treatment route r [i] εR of each job i for obtaining the maximum lifesaving rate, and (iii) Start time T _i [c] of each task c ^r _h in each job i ^r _h ] is output. FIG. 13 shows symbols used for the constraint conditions and the meaning of each symbol.

(2-3-2. Restrictions)
FIG. 13 shows symbols indicating parameters used for constraint conditions and the meaning of each symbol. ^Let T _i [c ^r _h , m] be the end time when the task c ^r _h of the victim i is executed by the machine m. The start time, which is the problem output, can be calculated by subtracting the execution time from the end time. Further, the binary variable Y _m [i, j, c which becomes 1 when the task c ^r _h of the victim i is executed before the task c ^s _g of the victim j in the machine m, and 0 otherwise. ^r _h , c ^s _g ] and a binary variable X ^r [i] which is 1 when the treatment route r is selected in job i and 0 otherwise.

  There are two constraint conditions: (i) task execution order constraint and (ii) interrupt prohibition constraint. The task execution order constraint indicates that the task execution order cannot be changed and the next task cannot be executed unless the task is completed. However, in the case of a start task (h = 1), there is no task preceding it, so if time 0 is the simulation start time, the end time of that task needs to be after the task execution time.

  The interrupt prohibition constraint means that only one task is performed at the same time on the same machine, and interrupts are prohibited.

However, if the machine m is an ambulance, the time until the machine can execute the next task (carrying the victim) is different from the time until the job can execute the next task, so the following formula is used: .

That is, since the time required for the ambulance to carry out the next victim needs a round-trip time, in addition to twice the one-way conveyance time t _i [c ^r _h , m], the delivery time for handing over the victim α is required.

(3. Definition of difficulty considering the effectiveness of triage)
(3-1. Consideration of effectiveness of triage)
In order to define the difficulty level considering the effectiveness of triage, let us consider the case where the survival rate is improved by triage. When a severely ill patient is transported in a situation where a mildly ill patient is waiting for treatment, if the treatment is performed without performing triage, the treatment order becomes first come first served (FCFS). In this case, a severely ill patient may die while waiting for treatment. On the other hand, by performing triage appropriately, it is possible to save both severe and mild injuries by giving priority to the treatment of severe injuries over mild injuries.

  In the present embodiment, a scenario in which the lifesaving rate cannot be improved unless the triage is performed appropriately is a scenario in which the effectiveness of the triage is high, and it is considered that the difficulty level is high. For this reason, it is necessary to quantify the effectiveness of triage to define the difficulty level.

  The reason why triage is effective when a large number of patients are injured is that the lifesaving rate can be improved by determining the treatment priority of the victim and performing treatment according to the priority. That is, by performing triage on the victims who have been transported to the triage post, the treatment order of the victims is set in a different order from the arrival order, and as a result, the number of victims saved is increased. Therefore, first, (i) the number of victims waiting for treatment is defined as an index indicating whether or not the triage is effective. Furthermore, in order to quantify the lifesaving rate that changes due to triage, in this embodiment, (ii) difference in treatment order when comparing the order of arrival (FCFS) and the order of treatment when optimally triaged (optimum order) And (iii) Two indices corresponding to the degree of improvement in the lifesaving rate caused by the change of the treatment order are defined as the difficulty level.

(3-2. Definition of difficulty)
(3-2-1. Congestion degree)
The number of patients waiting for treatment for treatment c is defined as the degree of congestion Q (c) of treatment c, and is defined by the following formula (1).

  Here, s (c) is the average number of treatment persons per unit time in the treatment c, and λ (c) is the maximum number of arrival persons per unit time in the treatment c. The maximum number of injured victims λ (c) per unit time per unit time in the case where the victim p including the treatment c as a candidate treatment route is determined so that each victim p executes the treatment c. The number of victims who arrived. This is because the number of victims arriving per unit time for each medical resource varies depending on the treatment route of each patient selected in the schedule. By using the maximum number of victims, the degree of congestion can be calculated in a manner that does not depend on the schedule. The greater the degree of congestion, the more victims awaiting treatment with that medical resource.

(3-2-2. Treatment Order Reversal Rate)
The treatment order reversal rate K (c) in the treatment c is obtained by quantifying the difference between the schedule S _FCFS in the arrival order and the schedule S _{OPT in} the optimum order by the Kendall tau distance (see Non-Patent Document 2). Kendall tau distance is an index that represents the degree of disagreement between two ranks, and takes a value from 0 to 1. The closer to 0, the higher the rank is, and the closer to 1, the lower the rank.

P _{(S, c)} is a set of victims who have selected a treatment route for executing the treatment c in a certain schedule S, and the treatment order of the victim iεP _{(S, c)} in the schedule S and the treatment c is O _{(S, c) . c)} Assuming (i), the treatment order reversal rate K (c) is defined by the following equation (2).

The treatment order reversal rate K (c) means the ratio of the number of victims whose treatment order is not consistent with the total number of victims in the treatment c. However, S _FCFS or victim p only on either _SOPT before reaching the treatment c cases died, and calculates a treatment order reversal rate for the treatment order victim excluding the victim p .

(3-2-3. Lifesaving rate difference)
The ratio of the number of non-dead persons to the total number of injuries in the arrival order schedule S _FCFS from the _survival order l (S _OPT ) in the order of arrival, which is the ratio of the number of non-dead persons to the total number of injured persons in the schedule S _OPT in the optimal order A value obtained by subtracting the optimal order lifesaving rate 1 (S _FCFS ) is defined as the lifesaving rate difference L (formula (3)). l (S _OPT ) ≧ l (S _FCFS ), and the _survival rate difference takes a value from 0 to 1.

(4. Derivation method of optimal treatment order)
As described above, since the definition of the difficulty level is based on the difference between the FCFS schedule and the optimal schedule, it is necessary to derive the optimal schedule from the scenario in order to evaluate the difficulty level.

  There are several methods for deriving the approximate solution of the optimal treatment order. Here, the greedy method (FDFS) based on the dead period (FDFS) and the particle swarm optimization method (PSO) provided by the simulation according to the present embodiment are used. ; Particle Swarm Optimization).

  In the FDFS, the order of treatment is determined based on the death period for a victim who is waiting for treatment when medical resources are available. For this reason, the treatment order is determined based on the same information as the information actually obtained by the medical staff. Therefore, with FDFS, it is considered that a result close to the judgment made by the medical staff can be obtained.

  Since FDFS is a deterministic algorithm that always outputs one fixed solution if a scenario and a treatment route are given, there is an advantage that a solution can be obtained in a short time. On the other hand, since only the information of the victim who is waiting for treatment when the medical resources are available is used, the overall lifesaving rate may not be maximized depending on the situation of the victim who arrives after that.

  In PSO, the solution derivation time increases as the number of victims increases. However, unlike FDFS, the search for the optimal solution takes into account the possibility of treating victims who arrive later even if medical resources are available. Therefore, a good approximate solution can be derived for any scenario. For this reason, in this embodiment, the optimal treatment order is derived using PSO.

(4-1. Greedy method based on death)
In the greedy method based on mortality (FDFS), at the time when the medical resources are available, treatment is performed on the victim with the closest mortality among those who are waiting for treatment. However, in order to maximize the lifesaving rate based on the concept of triage, giving up the lifesaving of the victim i who is closest to death among the patients waiting for treatment, the lifesaving rate of the whole patient waiting for treatment at that time is improved. Only when it is done, it gives up the life-saving of the victim i and treats the victim whose death is second closest. This greedy method improved from FDFS is called FDFS +. The FDFS + algorithm is shown in FIG.

(4-2. Derivation method of optimal treatment order based on particle swarm optimization)
(4-2-1. Overview of Particle Swarm Optimization)
The particle swarm optimization method (PSO) is an optimization method based on the habits of social organisms and was proposed by Kennedy et al. (See Non-Patent Document 3). In creatures that form groups such as birds and fish, when deciding which direction to move when searching for food etc., not only the individual information but also information on the group is shared and searched efficiently It is believed that. In particle swarm optimization, paying attention to this feature, the movement of the individual considering the direction of movement of the individual, the best point discovered by the individual, and the best point of the whole swarm is incorporated into the search policy of the optimal solution, and the solution space is efficiently searched. Do. The search direction and search point are updated according to the following formula.

x ^t _i is the t-th search point of the individual i, p ^t _i is the best point discovered by the individual i in the past, and p ^t _g is the best point in the entire group. R ^t ₁ and R ^t ₂ are random numbers determined between 0 and 1 in each search. c _local and c _global are weighting constants and are used to control the priority of the best points of the individual and the best point of the whole group. w ^t is a parameter called inertia weight. If the value is large, the search range is widened and a global search is possible. If the value is small, the search is performed around the search point by performing a local search. By changing w ^t according to the number of searches t according to the following equation (6), an efficient and highly accurate search can be performed.

w ^max and w ^min indicate the maximum value and minimum value of w ^t , respectively, and T _max indicates the maximum number of searches. Each search flow first randomly generates initial search points and initial speeds for all individuals. The value of the objective function at the search point is calculated, the value is set as p ⁰ _i of each individual i, and the best point among the best points is set as p ⁰ _g . Thereafter, the following procedure is repeated. That is, the search point is determined by the equation (5) according to the traveling direction determined by the equation (4), and the value of the objective function is calculated. If the value is superior to the value of the objective function at p ^t−1 _i , then p ^t _i is updated to x ^t _i , otherwise p ^t _{i is set} to p ^t−1 _i . All the individuals finish the search, and ^pt _i obtained by calculating the value of the best objective function is defined as ^pt _g . As the search is repeated, the swarm approaches the best point and the search range becomes narrower, so the best point can be found by a more detailed search.

(4-2-2. Objective function)
The objective function is a simple decreasing function, and is defined so as to contribute to the improvement of the lifesaving rate as the value decreases. In this embodiment, the sum of three functions of (i) mortality, (ii) availability, and (iii) difference between death period and lifesaving time is used as an objective function, and the weight of each function is adjusted by a parameter. The mortality rate is the proportion of all victims who have died, and the bifurcated scheduling problem maximizes the survival rate, in other words, minimizes the mortality rate. However, if the objective function is only the mortality rate, the solution space becomes flat and it becomes difficult to determine the moving direction of the particles. For this reason, in this embodiment, the operating rate and the difference between the death period and the lifesaving time are added to the objective function.

  The operation rate is an average value of the ratio of the treatment time in each machine (medical resource) to the simulation time, where the time from the start of the simulation to the completion of treatment of the last patient is the simulation time. If the operation rate is improved, the treatment efficiency per unit time will be improved, and it will be possible to save more victims.

  The difference between the death period and the life time is an average value of the difference between the death period and the life time of the victim with respect to the simulation time. If the difference between the death period and the lifesaving time is smaller, if there is a margin before the death period, there is a tendency to wait for treatment after waiting as much as possible, so the time generated by waiting can be assigned to other treatments It becomes an index for searching sex. For the victim who died, the difference between the death period and the lifesaving time is set as the simulation time, and the victim whose death period is infinite is set to 0. The following describes each of the three functions.

(Mortality)
If D _i the victim i (1 ≦ i ≦ n) died 1, if 0 if life mortality (Death_rate) is expressed by the following equation (7).

_Di is obtained by confirming whether the treatment end time in each area of the patient satisfies the deadline immediately before that point.

(Occupancy rate)
The operation rate (utilization_rate) is defined by the following equation (8), where Tm is the total time for which the machine m is used for the treatment for each machine mεM. End represents the simulation time.

(Difference between death and lifesaving time)
When S _i is the difference between the death period and the death time of the victim i, the difference between the death period and the life saving time (margin) is defined by the following equation (9).

  The weighted sum of the values defined by the above formulas (7) to (9) is defined as an objective function and defined by formula (10).

(4-2-3. Application Method of Particle Swarm Optimization to Branched Job Scheduling Problem)
One particle used in particle group optimization represents a victim i (1 ≦ i ≦ n), and a set of n particles is defined as a particle group. This particle group is used to represent a treatment schedule for the entire simulation. FIG. 15 is an explanatory diagram showing the configuration contents of particles and particle groups in the disaster medical simulation targeted in this embodiment.

  One dimension represents the treatment to be performed on each victim, meaning treatment in a rescue center, hospital transport by ambulance, pre-hospital triage, and treatment in the hospital's initial treatment room. In addition, there are five dimensions of the particle, including the dimension representing the treatment route. Therefore, one particle moves in a five-dimensional solution space and optimizes the value of the objective function. The treatment route and treatment schedule for each patient are obtained using the coordinates of each dimension.

The instance that the particle representing the victim i holds in each dimension d _j (j = 1,..., 5) holds the coordinates p _i [d _j ], the velocity v _i [d _j ], and further the dimension d _j. Holds the id m_id _i [d _j ] of the medical resource (machine) used for the task to be performed in the above, the treatment route care _i [d _j ], and the processing time treat_t _i [d _j ] in the dimension d _j . Is determined treated order processing time of the victim i from the values in the dimension _{d j} is, thereby the dimension _{d j} Start Task victims i at time s_time _{i [d j]} and end time e_time _{i [d j]} is Calculated.

  In determining the treatment route, the first-dimensional coordinates of the particle representing the patient are used. In particle swarm optimization, if the continuity of the solution space is not maintained, it becomes easy to fall into a local optimum solution, and the possibility that a better solution can be obtained even when searching for the vicinity of good solution candidates is reduced. Therefore, the treatment route is determined using the coordinates so that the continuity of the solution space is maintained. Of the three treatment routes, the urgency of treatment is highest when all treatments are performed at a rescue center, and the remaining necessary treatments are performed at the hospital after life-extension treatment, and all necessary treatments are performed after delivery to the hospital. The urgency goes down. When particles move around in the solution space, it is not desirable from the characteristics of particle swarm optimization that the urgency suddenly changes when the surroundings are searched, and the result changes. For this reason, by using a sine function, a change in the treatment path due to movement of the solution space is smoothed.

  In FIG. 16, the x-axis is the first-dimensional coordinate, and the y-axis is the value of sin (x). If y> sin (π / 4), all treatments are performed at the rescue center. If -sin (π / 4) <y ≦ sin (π / 4), life-saving treatment is performed at the rescue center. The remaining necessary treatment is performed at the hospital, and if y ≦ −sin (π / 4), all treatments are performed after hospital transport. The determination range of each treatment route is allocated equally.

  FIG. 17 is an explanatory diagram showing a method of acquiring the order of treatment in each area of the patient. First, the coordinates of the particles of the particle group are sorted in ascending order for each dimension other than the first dimension ((i) in FIG. 17). Next, the treatment order of the victim for each treatment in each area is acquired from the obtained column for each dimension ((ii) in FIG. 17). Thereafter, the schedule is determined by obtaining the treatment start time s_time and the treatment end time e_tiime of the patient i in the order obtained by the sorting for each area. If multiple medical resources are available for treatment in each area, the most recently available medical resource is used. s_time is set to the latest time when the medical resource used for the treatment can be used after e_time of the previous task if it is a start task so that the constraint condition is satisfied. No further treatment will be performed for victims whose death has already been confirmed at the time of commencement of treatment.

(4-2-4. Application of genetic algorithm to particle swarm optimization)
FIG. 18 shows a flowchart of an improved algorithm (genetic algorithm) for particle swarm optimization.

  First, the scenario editing unit 211 of the practitioner terminal 20 receives an input of a scenario and parameters (congestion degree, treatment order reversal rate, and lifesaving rate difference) used for the simulation (S1). The scenario input method is not particularly limited. For example, a list of basic scenarios stored in the basic scenario storage unit 210 is displayed on the display unit 203, and the user can input an operation input unit from the displayed list. A desired basic scenario is selected using 204. As for the parameters, the user inputs desired parameters via the operation input unit 204.

  Next, the scenario editing unit 211 generates N particle groups based on the input scenario (S2), and initializes variables x and y to x = 1 and y = 1 (S3).

  Next, the scenario editing unit 211 determines whether or not the value of x is equal to or less than a preset number of searches T (S4).

  When it is determined in S4 that x ≦ T, the scenario editing unit 211 determines whether or not the value of y is equal to or less than the number of particle groups N (S5).

When it is determined that y ≦ N in S5, the scenario editing unit 211 calculates the value of the objective function (the above formula (10)), and if the calculated value is the best value, the best value p _{i of the} particle group. (S6), the value of y is incremented (y = y + 1) (S7), and the process returns to S4.

On the other hand, when determining that y ≦ N is not satisfied in S5, the scenario editing unit 211 sets y = 1 and increments the value of x (x = x + 1) (S8). Also, scenario editing unit 211, N pieces of the best value p _g of the entire herd if (best among those calculated after receiving an input scenarios and parameters S1) best value past best in particles Update to the best value (S9).

  Thereafter, the genetic algorithm is executed according to the probability (S10), and the process returns to S4. If it is determined in S4 that x ≦ T is not satisfied, the scenario editing unit 211 ends the process.

  In the genetic algorithm, three operations of mutation operation, crossover operation, and exchange operation are executed according to the probability given when the search of the entire set of particle groups is completed. As a result, it is possible to compensate for the disadvantage of particle swarm optimization that it is difficult to escape when falling into a local optimum solution.

In the mutation operation, one particle group is randomly selected from the N particle groups with probability P _m , and the coordinates of the dimension (first dimension) corresponding to the treatment route of all particles belonging thereto are randomly selected. Move. Thus, in one particles selected at random with probability P _m, so that the treatment path is changed at random. Changing the treatment route has a great effect on the survival rate, and only the first-dimensional coordinates are moved in order to search for as many possibilities as possible.

As shown in FIG. 19, in the crossover operation, two particle groups are randomly selected from the N particle groups with a probability P _c , and the particles serving as cutting points that bisect each selected particle group are randomly determined. Then, one of the two divided particle groups obtained by dividing one particle group at the cutting point is replaced with one of the two divided particle groups obtained by dividing the other particle group at the cutting point.

In the exchange operation, two particle groups are randomly selected from the N particle groups, and the positions and velocities of particles (existing for the number of victims) included in one particle group are changed to the other particle group. exchanged position and speed and the probability P _s of the particles (present only few people in the sick person) included in the. That is, when there are m victims, each particle group includes m particles. Then, for m particles included in one particle group, it is determined whether to exchange the position and speed with the particle corresponding to the particle included in the other particle group based on the probability P _s .

  In the particle group optimization, the process of calculating the best value of the entire group for N particle groups is performed T times, and the best value to be adopted is updated every time the past best value is calculated. The calculation processes of mutation, crossover, and exchange are executed each time the process of calculating the best value of the entire group for the N particle groups is completed once.

(5. Difficulty level adjustment)
(5-1. Overview of difficulty adjustment method)
FIG. 20 is an explanatory diagram showing an overview of the difficulty level adjustment method in the present embodiment. As shown in this figure, in the present embodiment, the scenario editing unit 211 of the implementer terminal 20 is initially set based on the requested difficulty level, which is a requested value related to the difficulty level input by the simulation implementer to the performer terminal 20. The congestion level, treatment order reversal rate, and lifesaving rate difference in the scenario (basic scenario) are adjusted in this order.

  In the present embodiment, a case will be mainly described in which the scenario editing unit 211 adjusts the difficulty level by changing the arrival time (arrival time at the primary triage post) and the death period of the victim.

  In the initial scenario (basic scenario), the death period of the victim is set within a medically realistic range according to the symptoms of the victim. For this reason, adjustment of the death period is performed within a certain limit range. On the other hand, the arrival time can be freely adjusted since every situation can be considered.

  The degree of congestion is the maximum number of people who arrive per unit time (the number of victims who arrive at the primary triage post per unit time) and the average number of patients (the number of victims per unit time that can be triaged at the primary triage post). (Assumed value). In order to adjust the degree of congestion, the number of arrivals per unit time or the setting of medical resources (average number of persons treated per unit time) may be changed. In this embodiment, for the sake of simplicity, the average number of medical resources treated per unit time is not changed from the initial scenario, but the importance adjustment method according to this embodiment is the setting of medical resources and the number of arrivals. It can be easily expanded when adjusting both.

  First, the scenario editing unit 211 adjusts the congestion level by expanding or reducing the arrival interval of the victim in the initial scenario so as to satisfy a desired congestion level.

  Next, the scenario editing unit 211 adjusts the treatment order reversal rate. In order to adjust the treatment order reversal rate, it is necessary to change the treatment order in the case of FCFS, that is, the arrival order of the victim to the primary triage post, but changing the arrival order changes the survival rate difference. there is a possibility. For this reason, the scenario editing unit 211 calculates a variation value of the treatment order reversal rate and the lifesaving rate difference caused by the replacement of the arrival order (arrival order) for each group of victims who execute all start tasks, A candidate for replacement is randomly selected from candidates whose treatment order reversal rate and life-saving rate difference approaches the desired difficulty level. This operation is repeated until the treatment order reversal rate reaches the required value. At this time, if the candidate to be replaced next is not found, the arrival order is adjusted again from the beginning. If the desired treatment order reversal rate cannot be achieved even if the arrival order adjustment is repeated a certain number of times, the arrival order that is closest to the desired treatment order reversal rate in the previous adjustment results is adopted.

  Finally, the scenario editing unit 211 adjusts the life-saving rate difference when the life-saving rate difference does not satisfy the required difficulty level for the scenario in which the adjustment of the congestion degree and the treatment order reversal rate is completed. In order to fix the degree of congestion and the rate of reversal of treatment order as adjusted results, adjustment of the difference in lifesaving rate adjusts the death period of the victim. At that time, the range of adjustable mortality is limited to a certain percentage of the mortality given in the initial scenario so that it does not result in a medically unrealistic victim scenario. If the desired life-saving rate difference cannot be achieved by adjusting the mortality, the same process is repeated after returning to the adjustment of the treatment order reversal rate. This is because it is difficult to distinguish either the required difficulty level that cannot be realized by adjustment from the given initial scenario or the adjustment result of the treatment order reversal rate is incorrect. If a scenario that completely satisfies the required difficulty level is not found, the treatment order reversal rate is satisfied, but the lifesaving rate difference does not satisfy the requirement, and vice versa. At that time, in order to determine the scenario closest to the required difficulty level, an error allowable weight is equally given to each of the treatment order reversal rate and the lifesaving rate difference, and the scenario closest to the required difficulty level is determined for the weighted sum.

(5-2. Difficulty level adjustment method)
(5-2-1. Adjustment of congestion level)
FIG. 21 is an explanatory diagram showing a method for adjusting the degree of congestion. Q (c) is the congestion level of the scenario before adjustment, Q ′ (c) is the requested congestion level (request difficulty level) input by the simulation operator, λ (c) is the arrival interval before adjustment, and the arrival interval after adjustment Is assumed to be λ ′ (c), the scenario editor 211 sets the arrival interval λ ′ (c) after arrival to Q ′ (c) of the arrival interval λ (c) before adjustment as shown in the following equation (11). ) / Q (c) times.

Specifically, when the arrival interval of the victims i and j is I _ij , the arrival time of the victim with the earliest arrival is a (p _min ), and the arrival time of each other victim is a (p), the most Based on the arrival time of the victim who arrives early, the arrival time of the other victim is changed based on the following formula (12). Thereby, a desired congestion degree can be satisfied on the basis of a (p _min ).

(5-2-2. Adjustment of treatment order reversal rate)
Assuming that the treatment order reversal rate of the scenario before adjustment is K (c) and the requested treatment order reversal rate (request difficulty level) input by the simulation operator is K ′ (c), the scenario editing unit 211 does not match the treatment order. The number is increased by the value calculated by the following equation (13).

  As described above, when the arrival order is changed, the difference in the lifesaving rate may change, and therefore, the adjustment of the treatment order reversal rate is performed by adjusting the arrival order of the victim while considering the difference in the lifesaving rate.

  First, the scenario editing unit 211 calculates a treatment order and a lifesaving rate according to FCFS when replacement is performed for all victim groups i and j that perform the treatment c. If the victim in the FCFS treatment order is i for the previous victim and j for the victim, the replacement is realized by changing the arrival time of j before i. At this time, since the optimal treatment order is derived by PSO, the intended adjustment result may not be achieved. However, the optimality of the treatment order is maintained even if arrival order adjustment is performed as long as the lifesaving rate does not deteriorate. .

Therefore, in the adjustment of the treatment order reversal rate, the scenario editing unit 211 calculates the treatment order in the FCFS when the arrival order is changed and the lifesaving rate when the treatment is performed in the FCFS, and further, the optimal treatment order is obtained by the PSO. And the lifesaving rate when treating in the optimal treatment order is calculated. Then, the scenario editing unit 211 calculates the change amount C ^diff _{i, j} (c) of the treatment order reversal rate and the change amount L ^diff _{i, j} (c) of the lifesaving rate difference based on these calculation results.

  Then, the scenario editing unit 211 replaces the treatment group so that the treatment order reversal rate approaches the desired treatment order reversal rate (request difficulty level) and the difference between the lifesaving rate difference and the requested lifesaving rate difference (request difficulty level) does not widen. A set is randomly selected from i and j, and the replacement is executed by adjusting the arrival time. If no replacement candidate is found, the scenario editing unit 211 restarts the arrival order adjustment process from the beginning. If the requested difficulty level cannot be satisfied even after repeating the predetermined number of times, the scenario editing unit 211 adopts the best solution found so far and uses it to adjust the life-saving rate difference.

  FIG. 22 is an explanatory diagram showing an overview of the adjustment process of the treatment order reversal rate (arrival order adjustment process). In the example shown in this figure, the victim has arrived in the order of A, B, C before the arrival order adjustment, the treatment is performed in the order of A, B, C in the FCFS schedule, and A, B, C in the optimal schedule. Treatment is performed in the order of C and B.

In the arrival order adjustment processing, as shown in FIG. 23, the scenario editing unit 211 changes the treatment order reversal rate change amount C ^diff _{i, j} (c) and the lifesaving rate difference when the arrival order is adjusted (replaced). The amount of change L ^diff _{i, j} (c) is calculated for each victim group.

  If it is desired to increase the treatment order reversal rate by 0.25 and increase the lifesaving rate difference by 0.1, in the example of FIG. 23, the replacement of the victim groups A and B deteriorates the treatment order reversal rate. Do not meet. In addition, the replacement order of the victim groups A and C is close to the desired value, but the condition is not satisfied because the difference in the lifesaving rate deteriorates. On the other hand, replacement of the victim groups B and C satisfies the condition because the treatment order reversal rate approaches the desired value and the difference in the lifesaving rate does not change. For this reason, in the example of FIG. 23, only the victim groups B and C are selected to be replaced. In addition, although there are a plurality of targets that satisfy the condition, it is selected at random, but since there is only one set in the example of FIG. 23, the arrival time of the patient C is changed before the arrival time of the patient B.

  After the arrival order adjustment, in the FCFS schedule, the treatment order is in the order of A, C, and B, and the treatment order reversal rate changes by 0.2. Therefore, the scenario editing unit 211 further adjusts and sets the treatment order reversal rate to 0. Repeatedly examine the victim group for a .05 increase and a survival rate difference of 0.1.

(5-2-3. Lifesaving rate difference adjustment)
After adjusting the treatment order reversal rate, if there is a difference between the difference in the lifesaving rate and the desired lifesaving rate, the scenario editing unit 211 adjusts the death period (adjustment of the lifesaving rate difference). In addition, when the lifesaving rate difference after the treatment order reversal rate adjustment is the desired lifesaving rate, the lifesaving rate difference need not be adjusted.

  (Lifesaving rate in the optimal schedule) ≧ (Lifesaving rate in the FCFS schedule). Therefore, the scenario editor 211 increases the number of deaths in the FCFS if the lifesaving rate difference is to be increased, and the FCFS if it is to be decreased. Adjust the death phase of the victim to reduce the number of deaths. In addition, you may adjust the life-saving rate difference by changing the life-saving rate in the optimal schedule, but it takes time because it is necessary to check whether the intended victim is dead or alive after each adjustment. . For this reason, here, the scenario editing unit 211 adjusts the life-saving rate difference by changing the life-saving rate in FCFS which is a definitive algorithm.

When increasing the difference in the survival rate, let f _S (i) be the life completion time of the victim i in the schedule S, p _S (i) = dead if they die, and p _S (i) = alive if they can be saved. In order to increase the number of deaths in the FCFS schedule, the scenario editing unit 211 sets the death period immediately before the life-saving completion time of the FCFS schedule by the operation of the following formula (14). In addition, the adjustment range of the death period is determined in advance, and the victim who needs to adjust the death period outside the range is not included in the target.

  This adjustment causes the victim to die on the FCFS schedule. Since it is desired to minimize the adjustment of the death period, the scenario editing unit 211 selects a victim whose adjustment range is the smallest among the life-saving victims as victims to be adjusted.

When reducing the survival rate difference, scenario editing unit 211, victim i earliest scheduled at was the action to take a c _i in the treatment could not be _completed, treatment c _i the treatment time t (c _i of ), The following equation (15) is performed to reduce the number of deaths in the FCFS schedule.

  The scenario editing unit 211 sets the death period for the victim who died in the FCFS schedule to the life saving completion scheduled time, so that the victim can be kept alive until the life is completed in the FCFS schedule. In the FCFS schedule, the treatment order when the death period is extended can be determined even for a victim who has died, and thus the estimated time to complete lifesaving can be calculated. The scenario editing unit 211 selects a victim who is within the range in which the treatment time is the shortest and the adjustment range is defined among the dead victims as victims to be adjusted. This is because, although the surviving victims may survive, other surviving victims may die, but those who have a short treatment time are unlikely.

  As a result of these adjustments, the number of deaths of victims due to FCFS schedules may increase or decrease, and the lives and deaths of other victims may change from those before adjustment. For this reason, if a plurality of victims are adjusted at the same time, the requested number of victims cannot be saved or killed. Therefore, each time the lifesaving rate difference is adjusted, the scenario editing unit 211 obtains a treatment schedule in each of FCFS and PSO, confirms whether the lifesaving rate difference is in accordance with the adjustment target, and the lifesaving rate difference is the desired lifesaving rate difference ( If it does not match the desired difficulty level), select the victim who has the second smallest adjustment range of the death period and adjust again. At that time, in the PSO, a constraint for fixing the adjusted treatment order is added and a schedule after the adjusted treatment is derived so that the adjusted treatment order reversal rate is maintained.

  If there is no victim candidate who can adjust the death period, the scenario editing unit 211 starts over from the adjustment of the treatment order reversal rate in consideration of the possibility of another better adjustment method by the replacement in the treatment order adjustment. If the scenario that satisfies the required difficulty level is not found even after adjusting the treatment order reversal rate and the lifesaving rate difference a predetermined number of times, the scenario editing unit 211 selects the scenario closest to the required difficulty level among the scenarios that have been found so far. Output.

(6. Performance evaluation)
(6-1. Evaluation environment)
In order to evaluate the performance of the difficulty level adjustment method according to the present embodiment, the requested difficulty level (the requested treatment order reversal rate and the requested lifesaving rate difference respectively) with respect to the treatment order reversal rate and the lifesaving rate difference with respect to the randomly given initial scenario. ) Was calculated as the difficulty level error. In addition, about the degree of congestion, since a request difficulty level can be achieved without fail, it is not subject to evaluation, and the required degree of congestion was set to 5.0 in all evaluation experiments.

  The training setting used for the evaluation is the same as in FIG. 12 described above, and the patient appears when the arrival time arrives at the disaster site triage post (primary triage post).

  The adjustable parameters are the victim's arrival time and death, and the adjustments that can be made by changing these parameters are limited to the triage post at the disaster site and the treatment area at the disaster site. Only the triage post at the disaster site that arrived was adjusted, and the rate of reversal of treatment order was adjusted only for the treatment area at the disaster site.

  FIG. 24 and FIG. 25 are explanatory diagrams showing the setting of the training scenario and the initial scenario used for the evaluation, respectively. FIG. 26 is an explanatory diagram showing parameter settings of the PSO used for evaluation. The specifications of the computer used for the evaluation experiment are CPU: Intel Xeon 2.66 GHz, memory: 23.6 GB.

  In addition, in order to confirm the adjustment efficiency of the difficulty level according to the present embodiment, a random scenario generation process for generating a scenario by randomly changing the arrival time and death period of the victim in the same environment as in FIGS. The difficulty level adjustment processing according to the present embodiment was performed, and the scenario generation time and the error of the generated scenario were calculated.

(6-2. Evaluation results)
(6-2-1. Request difficulty and scenario adjustment error)
FIG. 27 shows an adjustment error when the treatment order reversal rate and the lifesaving rate difference are changed with respect to a single initial scenario that is randomly generated. The left graph of FIG. 27 shows the error of the treatment order reversal rate with respect to the desired treatment reversal rate, and the right graph shows the error of the lifesaving rate difference with respect to the desired lifesaving rate.

  As shown in the left graph of FIG. 27, the error in the processing order reversal rate is small when the desired treatment order reversal rate is around 0.4 to 0.5. This is because the treatment order reversal rate in the initial scenario was 0.3, and the desired treatment order reversal rate could be achieved with a small adjustment. Further, when the requested lifesaving rate difference is other than 0.0, the error of the treatment order reversal rate is large at the desired treatment reversal rate 0. This is because (i) when the treatment order reversal rate is 0, the treatment order must be completely consistent with the initial scenario, the lifesaving rate difference is always 0, and (ii) the treatment order reversal rate In the adjustment, the replacement is repeated so that the difference between the treatment order reversal rate and the lifesaving rate approaches the required difficulty level, so if the desired treatment order reversal rate is 0, candidates for further replacement are found during the reversal rate adjustment. This is to give up adjusting the reverse rotation rate. For this reason, when the desired treatment order reversal rate is 0 and the lifesaving rate difference is greater than 0, the error in the treatment order reversal rate increases.

  In addition, when the difference in the requested lifesaving rate is 1, the error becomes large. When the requested treatment order reversal rate is 1, the treatment order must be completely inconsistent with the initial scenario. The difference in the lifesaving rate that can be achieved depending on the treatment time and death period of the victim in the initial scenario is limited, and no candidate for which the reversal rate can be adjusted is found as in the case where the desired reversal rate is 0. This is because the reverse rotation rate error may increase.

  Moreover, as shown in the graph on the right side of FIG. 27, when the desired life-saving rate difference is 0.4 or more, the error in the life-saving rate difference is increased by the increase in the life-saving rate difference. From this, it can be seen that for a given initial scenario, the maximum value of the lifesaving rate difference is 0.3 even if the arrival time and death period are adjusted.

(6-2-2. Comparison with random generation method)
FIG. 28 shows a case of random scenario generation processing (random generation) in which a scenario is generated by randomly changing the arrival time and death period of a victim, and a case of generating a scenario by difficulty level adjustment processing according to the present embodiment. The comparison result is shown. The initial scenario was given at random, the required difficulty level was 5.0, the treatment order reversal rate was 0.2, and the lifesaving rate difference was 0.3.

  As shown in FIG. 28, the difficulty level adjustment processing according to the present embodiment can generate a scenario that completely satisfies the requested difficulty level (the desired treatment order reversal rate and the requested lifesaving rate difference) in 963 seconds. On the other hand, in the case of random generation, the scenario can be generated in almost the same time, but the error of the treatment order reversal rate and the lifesaving rate difference with respect to the requested difficulty (difference in the desired treatment order reversal rate and the desired lifesaving rate difference) occurs about 10% It was.

(7. Modification of difficulty adjustment method)
In the present embodiment, the case where the difficulty level of the scenario is adjusted by changing the arrival time and death period of the victim at the primary triage post has been described. However, the adjustment method of the difficulty level is not limited to this. For example, in addition to the arrival time and the death period, or in place of at least one of the arrival time and the death period, other parameters that affect the difficulty level may be changed.

  For example, the difficulty level may be adjusted by changing the condition change time, which is the time when the condition of the patient is changed. Specifically, the difficulty level may be adjusted by increasing or decreasing the length of the period during which the condition from the simulation start to the condition change time in the graph shown in FIG. 5 is stable.

  Moreover, you may adjust difficulty by changing the setting value of medical resources, such as a doctor, a nurse, an ambulance, and a medical instrument.

  When a plurality of conditions are changed, each of the conditions may be weighted and combined.

(8. Evaluation of simulation results)
The evaluation processing unit 212 calculates the number of deaths in the result of actual simulation using the training scenario for the number of deaths corresponding to the optimal solution for the training scenario calculated by the scenario editing unit 211 when the training scenario is created. A relative value (for example, a value obtained by dividing the number of deaths in the simulation result by the number of deaths in the optimal solution) is calculated as an evaluation value of the simulation result. Thereby, an evaluation value for quantitatively evaluating the simulation result can be calculated.

(9. Conclusion)
As described above, the terminal for a practitioner (scenario creation device) 20 provided in the simulation system 1 according to the present embodiment determines at least a part of the conditions of a basic scenario created in advance as a simulation practitioner (scenario creation instructor). The scenario editing unit 211 creates a training scenario according to the set value by changing it according to the set value of one or a plurality of parameters related to the condition instructed from (1).

  Thereby, compared with the case where a simulation practitioner inputs and sets each content of a training scenario manually like the past, the training scenario according to the desired conditions can be created easily.

  Further, in this embodiment, the practitioner terminal (scenario creation device) 20 sets the setting values of the parameters relating to the difficulty level of the scenario (congestion degree, treatment order reversal rate, and lifesaving rate difference) as the setting values of the above parameters. The scenario editing unit 211 receives a simulation scenario and changes the basic scenario based on these setting values, thereby creating a training scenario.

  Thereby, the training scenario according to the desired difficulty level can be created easily. Moreover, the difficulty levels of the created training scenarios can be compared based on a common standard.

  In the present embodiment, a configuration is described in which the simulation operator (scenario creation instructor) specifies the setting values for the degree of congestion, the treatment order reversal rate, and the lifesaving rate difference as the parameter setting values related to the difficulty level of the training scenario. However, it is not limited to this. For example, any one or two of the degree of congestion, the treatment order reversal rate, and the lifesaving rate difference may be designated. Further, the parameters relating to the difficulty level are not limited to the congestion level, the treatment order reversal rate, and the lifesaving rate difference. For example, as the above parameters, in addition to the congestion level, the treatment order reversal rate, and the lifesaving rate difference, or in place of one or more of the congestion level, the treatment order reversal rate, and the lifesaving rate difference, an appropriate treatment is performed. The number of suddenly changing patients, which is the number of victims whose condition changes suddenly when there is not, may be used.

  In the present embodiment, the configuration in which the scenario editing unit 211 is provided in the practitioner terminal 20 has been described. However, the present invention is not limited to this. For example, the scenario editing unit 211 is provided in another device different from the practitioner terminal 20, and the training scenario created by the scenario editing unit 211 in the other device is supplied to the practitioner terminal 20, thereby the training scenario. You may enable it to perform the simulation using.

  In addition, the number of participants participating in the simulation is not particularly limited, and may be one or more. For example, the participant may access the server apparatus 10 and arbitrarily select an area to which the participant is assigned to start the simulation. Alternatively, the server device 10 may be configured to assign an area to which the participant is assigned based on a predetermined standard, or the server device 10 may be configured to randomly set the area to which the participant is assigned.

  In addition, areas where participants are not assigned (for example, primary triage posts located near disaster sites, relief centers located near disaster sites, secondary triage posts located in front of hospitals, reds in hospitals, etc.) The server of the server apparatus 10 determines the treatment content and / or triage (decision of treatment priority) for the victim in the initial treatment group, the yellow initial treatment group, the green initial treatment group, and the black area). The control unit 101 may perform this automatically.

  Also, in the above embodiment, a part or all of the blocks (particularly the scenario editing unit 211 and the evaluation processing unit 212) provided in the terminal (scenario creation device) 20 for the practitioner are software using a processor such as a CPU It may be realized by. In this case, the terminal 20 for the practitioner includes a CPU (central processing unit) that executes instructions of a control program that realizes each function, a ROM (read only memory) that stores the program, and a RAM (random access) that expands the program. memory), a storage device (recording medium) such as a memory for storing the program and various data. An object of the present invention is a recording medium in which a program code (execution format program, intermediate code program, source program) of a control program for the terminal 20 for the practitioner, which is software that realizes the functions described above, is recorded so as to be readable by a computer Is executed by the computer (or CPU or MPU) reading and executing the program code recorded on the recording medium.

  Examples of the recording medium include a tape system such as a magnetic tape and a cassette tape, a magnetic disk such as a floppy (registered trademark) disk / hard disk, and an optical disk such as a CD-ROM / MO / MD / DVD / CD-R. Card system such as IC card, IC card (including memory card) / optical card, or semiconductor memory system such as mask ROM / EPROM / EEPROM / flash ROM.

  Further, the practitioner terminal 20 may be configured to be connectable to a communication network, and the program code may be supplied via the communication network. The communication network is not particularly limited. For example, the Internet, intranet, extranet, LAN, ISDN, VAN, CATV communication network, virtual private network, telephone line network, mobile communication network, satellite communication. A net or the like is available. Also, the transmission medium constituting the communication network is not particularly limited. For example, even in the case of wired such as IEEE 1394, USB, power line carrier, cable TV line, telephone line, ADSL line, etc., infrared rays such as IrDA and remote control, Bluetooth ( (Registered trademark), 802.11 wireless, HDR, mobile phone network, satellite line, terrestrial digital network, and the like can also be used. The present invention can also be realized in the form of a computer data signal embedded in a carrier wave in which the program code is embodied by electronic transmission.

  In addition, each block of the practitioner terminal 20 is not limited to being realized using software, and may be configured by hardware logic. Hardware that performs part of the processing and the hardware It may be a combination of arithmetic means for executing software for performing the above control and residual processing.

  The present invention is not limited to the above-described embodiments, and various modifications can be made within the scope shown in the claims. That is, embodiments obtained by combining technical means appropriately modified within the scope of the claims are also included in the technical scope of the present invention.

  The present invention provides a scenario used in an emergency life-saving simulation system that performs training for performing the best treatment that effectively uses limited medical resources in consideration of the symptoms of each victim for a plurality of victims. Applicable to scenario creation device.

1 Simulation system 10 Server device 20 Implementer's terminal (scenario creation device)
30 Participant terminal 201 Executor terminal control unit 202 Transmission / reception unit 203 Display unit 204 Operation input unit 205 Audio output unit 206 Victim information generation unit 207 Resource information generation unit 208 Initial setting information generation unit 209 Terminal information generation unit 210 Basic Scenario storage unit 211 Scenario editing unit (scenario creation device)
212 Evaluation processing section

Claims (10)

A scenario creation device for creating a scenario for the simulation used in a simulation system for performing a simulation for performing treatment according to the symptoms of each victim for a plurality of victims,
In the above scenario,
A medical resource scenario showing setting information of medical resources that can be used in the simulation;
Associating the symptom scenario showing the change of symptoms according to the elapsed time of each victim, the treatment contents for each victim and the change of symptoms of the victim according to the elapsed time after the treatment according to the treatment contents A symptom improvement scenario, and a victim scenario including arrival time information indicating a time at which each victim arrives at a predetermined area on the simulation,
In the simulation, one or more participants who participate in the simulation are assigned to one of the predetermined areas or a plurality of treatment areas for performing treatment for the sick and arrive at the assigned area. According to the symptoms of the victim, at least one of the treatment content for the victim and the priority of the treatment for each victim arriving in the area is determined.
A scenario editing unit is provided that changes at least a part of conditions of a basic scenario created in advance according to a set value of one or a plurality of parameters related to the condition instructed by a scenario creation instructor. Scenario creation device. The parameter is a congestion value obtained by dividing the maximum value of the number of victims arriving at the predetermined area per predetermined time by the estimated number of patients per predetermined time at which the priority order can be determined in the predetermined area. The request congestion level, which is the desired value of the scenario creation instructor regarding the degree, is included.
The scenario editing unit changes the maximum value by changing the arrival time information for at least some of the victims in the basic scenario according to the desired congestion level, or the scenario editing unit 2. The congestion degree of the basic scenario is changed by changing the assumed value by changing the number of participants capable of determining the priority among the setting information of medical resources. The scenario creation device described. The above symptom scenario includes information about the victim's death time for at least some victims,
The above symptom improvement scenario includes information indicating a change in the death time when a predetermined treatment is performed on the victim whose death time is indicated in the above symptom scenario,
When the scenario editing unit calculates the priority order for minimizing the number of deaths and the optimal solution of treatment contents for each victim, and determines the priority order in the order of arrival of each victim in the predetermined area And calculating the treatment order reversal rate, which is the ratio of the number of victim groups whose order context is inconsistent with the case of determining the optimal order which is the order according to the optimal solution to the total number of victim groups,
The parameter includes a desired treatment order reversal rate that is a request value of the scenario creation instructor regarding the treatment order reversal rate,
The scenario editing unit changes an arrival order of at least some patients in the predetermined area in the basic scenario so that the treatment order reversal rate approaches the desired treatment order reversal rate. The scenario creation device according to 1 or 2. The scenario editor above
The lifesaving rate in order of arrival, which is the ratio of the number of non-dead to the total number of victims when the priority is determined in the order of arrival of each victim in the predetermined area, and the total number of cases where the priority is determined in the optimal order. Calculate the difference in survival rate, which is the difference from the optimal order lifesaving rate, which is the ratio of non-dead to the number of injuries,
The above parameters include the desired life rate difference that is the desired value of the scenario creation instructor regarding the above life rate difference,
The scenario editing unit is configured to set the predetermined area of at least some of the victims in the basic scenario so that the treatment order reversal rate approaches the desired treatment order reversal rate and the lifesaving rate difference approaches the desired lifesaving rate difference. The scenario creation device according to claim 3, wherein the arrival order is changed. The scenario editor calculates the treatment order reversal rate and the lifesaving rate difference when the arrival order is changed for all victim groups that determine the priority,
Among all the victim groups, the difference between the treatment order reversal rate and the desired treatment order reversal rate is reduced, and the difference between the lifesaving rate difference and the desired lifesaving rate difference does not widen. The scenario creation device according to claim 4, wherein the process of switching at least a part of the arrival order is repeated a predetermined number of times. The above symptom scenario includes information about the victim's death time for at least some victims,
The above symptom improvement scenario includes information indicating a change in the death time when a predetermined treatment is performed on the victim whose death time is indicated in the above symptom scenario,
The scenario editor above
Calculate the above priorities for minimizing the number of deaths and the optimal solution of treatment for each victim,
When the priority is determined in the order of arrival of each victim to the predetermined area, the lifesaving rate in order of arrival, which is the ratio of the number of non-dead to the total number of victims, and the priority in the order according to the optimal solution Calculate the life-saving rate difference, which is the difference from the optimal order life-saving rate, which is the ratio of the number of non-dead to the total number of injuries when determined in a certain optimal order,
The above parameters include the desired life rate difference that is the desired value of the scenario creation instructor regarding the above life rate difference,
The scenario editing unit includes at least one of information indicating the death time in the symptom scenario or information indicating a change in the death time in the symptom improvement scenario so that the difference in the lifesaving rate is close to the difference in the desired lifesaving rate. 6. The scenario creation device according to claim 1, wherein one of the scenarios is changed. The scenario editor above
7. The optimal solution is calculated by performing particle group optimization calculation for minimizing the value of an objective function including the number of deaths by regarding each victim as one particle. The scenario creation device according to any one of the above.   An evaluation processing unit that calculates a relative value of the number of deaths in a result of performing the simulation using the scenario with respect to the number of deaths corresponding to the optimal solution as an evaluation value of the result of executing the simulation; The scenario creation device according to claim 3, wherein the scenario creation device is a feature of the scenario creation device.   A program for operating the scenario creation device according to any one of claims 1 to 8, wherein the program causes a computer to function as the scenario editing unit.   A computer-readable recording medium on which the program according to claim 9 is recorded.

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