Research ArticleIMAGING

Development of a Relational Database to Capture and Merge Clinical History with the Quantitative Results of Radionuclide Renography

Russell D. Folks, Bital Savir-Baruch, Ernest V. Garcia, Liudmila Verdes and Andrew T. Taylor
Journal of Nuclear Medicine Technology December 2012, 40 (4) 236-243; DOI: https://doi.org/10.2967/jnmt.111.101477

Article Figures & Data

Figures

  • FIGURE 1.
    FIGURE 1.

    Organization of CLINICAL. History table (A) includes fields summarizing patient’s history of conditions affecting urinary system and other systems, interventional procedures that have been performed, and left and right kidney and ureter findings. Imaging results table (B) contains same set of left and right kidney and ureter fields, derived from imaging study reports rather than narrative history. Interventions and other history are not included on this table. Demographics are present on both tables so that patient records can be matched to their imaging studies.

  • FIGURE 2.
    FIGURE 2.

    Algorithm for matching patient records across database tables.

  • FIGURE 3.
    FIGURE 3.

    Example of how small subset of fields in CLINICAL would be converted to structured text for physician review. (A) Fields as they appear on graphic layout with which user interacts. (B) Database’s internal manipulation of same fields by text functions, performed in calculated field not seen by user. (C) Text file extracted by database script. Fields with value “no data” are not included, greatly simplifying narrative.

  • FIGURE 4.
    FIGURE 4.

    Reporting of hydronephrosis for 112 CT scans performed within 1 y of MAG3. Hydronephrosis was not reported as either present or absent for 38% (43/112) of left kidneys, 29% (33/112) of right kidneys, and 12% (13/112) of both left and right kidneys.

Tables

  • TABLE 1

    Profile of Databases

    CLINICAL (2 tables)
    ProfileRENAL (1 table)Q2 (1 table)TotalHistoryImaging
    Fields1428835527580
    Layouts32220155
    Scripts41149**
    Value lists0527**

    • ↵* Same scripts and value lists are used for history and imaging tables.

  • TABLE 2

    Database Fields for Clinical History Table

    FieldType of dataValue list contents
    HistoryValue listNormal, absent, no comment
    UrinomaValue listNo data, not present, equivocal, present
    Renal parenchymaValue listNo data, normal, equivocal, atrophied
    Renal scarValue listNo data, not present, equivocal, present
    HydronephrosisValue listNo data, not present, equivocal, present, mild, moderate, severe
    HydroureterValue listNo data, not present, equivocal, present, mild, moderate, severe
    StrictureValue listNo data, not present, equivocal, present
    Renal calculusValue listNo data, not present, equivocal, present
     Largest size (mm)Literal value
    Ureteropelvic junction calculusValue listNo data, not present, equivocal, present
     Largest size (mm)Literal value
    Ureteral calculusValue listNo data, not present, equivocal, present
     Largest size (mm)Literal value
    Calculus, obstructiveValue listNo data, not obstructive, obstructive
    Solid renal massValue listNo data, not present, equivocal, present
     Largest size (cm)Literal value
    Cystic renal massValue listNo data, not present, equivocal, present
     Largest size (cm)Literal value
    Mixed renal massValue listNo data, not present, equivocal, present
     Largest size (cm)Literal value
    Mass, obstructiveValue listNo data, not obstructive, obstructive
    Renal artery stenosisValue listNo data, not present, equivocal, mild, moderate, severe
    SurgeryCheckbox options (1 or more)Prior stent, current stent, prior nephrostomy, current nephrostomy, ureteral reimplantation, pyeloplasty, total nephrectomy, partial nephrectomy, nephrolithotomy
    Stent removal dateLiteral date
    Nephrostomy removal dateLiteral date
    Flank pain on arrivalValue listNo data, not present, equivocal, present
    Flank pain after diureticValue listNo data, not present, equivocal, present
    UreteroceleValue listNo data, not present, equivocal, present
    Duplicated urinary systemValue listNo data, not present, equivocal, present
  • TABLE 3

    Joint Judgment of 2 Readers Regarding Presence of Current Ureteral Stent Based on Narrative Summaries of Hospitalizations and Patient Visits

    Reader 2
    Reader 1Stent presentStent absentTotal
    Stent present303
    Stent absent59297
    Total892100
  • TABLE 4

    Joint Judgment of 2 Readers Regarding Presence of Obstruction Based on Narrative Summaries of Hospitalizations and Patient Visits

    Reader 2
    Reader 1Hydronephrosis presentHydronephrosis absentTotal
    Hydronephrosis present171936
    Hydronephrosis absent65864
    Total2377100
  • TABLE 5

    Joint Judgment of 2 Readers Regarding Presence of Obstruction Based on Imaging Reports

    Reader 2
    Reader 1Hydronephrosis presentHydronephrosis absentTotal
    Hydronephrosis present41849
    Hydronephrosis absent04949
    Total415798
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