Creating Ignorant Data for Healthy People: an Essential Intermediate Step for Making Digitally Accessible Records of Diagnostic Events for Support of Patient-Centred Clinical Judgements.
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Abstract
Background. The Latin verb ignoro refers to the action of not knowing. Data almost by definition does not know anything. However, for rhetorical purposes we propose the term “Ignorant Data†to refer to a new way to format digital diagnostic data so as to maximize its utility. We will demonstrate how the method enables primary digital diagnostic data to be recorded in a way that can remain ignorant of why or how that data will be used yet still enable someone knowledgeable about the diagnostic procedure to make sense of data meaning and significance. This is achieved by embedding as much contextualizing metadata as necessary in the file holding the primary data during the diagnostic event. Additional analysis and commentary can also be accommodate within that envelope without ever erasing the original recorded data. Our innovation is supported by steadily decreasing costs of storing and sharing digital data, widely available commodity equipment and free and open operating systems.
Take the example, a diagnostic service based on microscopic examination of a pathology slide prepared from a patient sample and rendered into a digital slide format for distribution. The utility of the resulting clinical judgement dependents on the rigour of the laboratory preparation, data accession and subsequent analysis, as well as the reliability of the clinical picture archiving and communication system (PACS) latter used in examining the digital information. Another layer of complexity emerges as the clinical judgement is abstracted in various ways determined by complex and expensive relational databases use to track performance of the clinical system and the patients progress trough that system. Often contextualizing information, that could increase the patient centredness of care, is lost because it is deemed too complicated to be recorded and tracked.
Method. In collaboration with gDial Inc, we have developed an open source software platform called BioTIFF for extending the .tif digital format standard for recording digital images in a way accommodates as many additional tag fields as is necessary to make apparent its purpose and significance. Furthermore, any image file format that can be converted into a .tif format can be accommodated by the software. We have also developed a highly adaptable indexing system that uses the tag names and their content to generate searchable taxonomies systems, unique identifiers.
Results. Because the .tif format can accommodate multiple pages, series of images and data derived from analysis of those images can be wrapped up in a single envelope. We have enabled the 64 bit BigTIFF version of .tif so that exabytes of information to be stored in that envelope. The system is also self-authenticating, enabling patients and their circle-of-care to take custody of the data and mediate transfer between regulated databases that are smart in different but incompatible ways.
Conclusion. By being deliberately ignorant about how digital diagnostic data be used in the future this method allows people to be smart in how the data is used to promote the health of patients.
Take the example, a diagnostic service based on microscopic examination of a pathology slide prepared from a patient sample and rendered into a digital slide format for distribution. The utility of the resulting clinical judgement dependents on the rigour of the laboratory preparation, data accession and subsequent analysis, as well as the reliability of the clinical picture archiving and communication system (PACS) latter used in examining the digital information. Another layer of complexity emerges as the clinical judgement is abstracted in various ways determined by complex and expensive relational databases use to track performance of the clinical system and the patients progress trough that system. Often contextualizing information, that could increase the patient centredness of care, is lost because it is deemed too complicated to be recorded and tracked.
Method. In collaboration with gDial Inc, we have developed an open source software platform called BioTIFF for extending the .tif digital format standard for recording digital images in a way accommodates as many additional tag fields as is necessary to make apparent its purpose and significance. Furthermore, any image file format that can be converted into a .tif format can be accommodated by the software. We have also developed a highly adaptable indexing system that uses the tag names and their content to generate searchable taxonomies systems, unique identifiers.
Results. Because the .tif format can accommodate multiple pages, series of images and data derived from analysis of those images can be wrapped up in a single envelope. We have enabled the 64 bit BigTIFF version of .tif so that exabytes of information to be stored in that envelope. The system is also self-authenticating, enabling patients and their circle-of-care to take custody of the data and mediate transfer between regulated databases that are smart in different but incompatible ways.
Conclusion. By being deliberately ignorant about how digital diagnostic data be used in the future this method allows people to be smart in how the data is used to promote the health of patients.
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