Method and system for validating parameters in a medical study

11532390 · 2022-12-20

Assignee

Inventors

Cpc classification

International classification

Abstract

A method and system for validating a parameter in a medical study are disclosed. The method includes receiving the medical study from a source. A processor determines a first parameter of the medical study to be validated. An imaging protocol is received from a configuration file in an imaging unit. The imaging protocol includes a second parameter corresponding to the first parameter in the medical study. The processor determines if there is a mismatch of the first parameter in the medical study and the second parameter in the imaging protocol. If there is a mismatch, the processor corrects the first parameter in the medical study based on the second parameter in the imaging protocol to validate the medical study.

Claims

1. A method of validating a parameter in a medical study, the method comprising: receiving, by an interface, the medical study from a source; determining, by a processor, a first parameter of the medical study to be validated; receiving an imaging protocol from a configuration file in an imaging unit by the interface, wherein the imaging protocol comprises a second parameter corresponding to the first parameter in the medical study; determining, by the processor, if there is a mismatch of the first parameter in the medical study and the second parameter in the imaging protocol; and generating a validated medical study when there is a mismatch, wherein generating the validated medical study comprises: in response to the mismatch, normalizing, by the processor, a phantom size in the imaging protocol based on an age of a patient; and correcting, by the processor, the first parameter in the medical study based on the normalized phantom size in the imaging protocol.

2. The method of claim 1, wherein the medical study is a digital imaging and communications in medicine (DICOM) study.

3. The method of claim 1, wherein determining if there is a mismatch of the first parameter and the second parameter comprises comparing, by the processor, the first parameter in the medical study with the corresponding second parameter in the imaging protocol.

4. The method of claim 1, wherein correcting the first parameter in the medical study comprises determining, by the processor, the age of the patient being examined, the phantom size, or the age of the patient being examined and the phantom size.

5. The method of claim 1, wherein correcting the first parameter in the medical study comprises: comparing, by the processor, the second parameter in the imaging protocol with the first parameter in the medical study; and when there is a mismatch: determining, by the processor, a dose index value in the imaging protocol; determining, by the processor, a scan length value in the imaging protocol; determining, by the processor, the second parameter, the determining of the second parameter comprising calculating a product of the dose index value and the scan length value; and correcting, by the processor, the first parameter in the medical study based on the determined second parameter.

6. The method of claim 5, wherein the first parameter is a dose length product value in the medical study, and the second parameter is a dose length product value in the imaging protocol.

7. The method of claim 1, wherein the first parameter of the medical study comprises dose values accumulated after an irradiation event of medical imaging.

8. The method of claim 1, wherein the first parameter of the medical study comprises a DICOM tag.

9. The method of claim 1, wherein the second parameter of the imaging protocol comprises dose values defined for an irradiation event of medical imaging.

10. The method of claim 4, further comprising: applying, by the processor, normalization of the phantom size as a default action when there is a mismatch between the age of the patient being examined and the phantom size.

11. A local transmission unit for validating a parameter in a medical study, the local transmission unit comprising: an interface configured to: receive the medical study from a source, wherein the medical study comprises a first parameter; and receive an imaging protocol from a configuration file in an imaging unit, wherein the imaging protocol comprises a second parameter corresponding to the first parameter in the medical study; and a processor configured to: determine the first parameter of the medical study to be validated; determine if there is a mismatch of the first parameter in the medical study and the second parameter in the imaging protocol; and generate a validated medical study when there is a mismatch, wherein generation of the validated medical study comprises: in response to the mismatch, normalization of a phantom size in the imaging protocol based on an age of a patient; and correction of the first parameter in the medical study based on the normalized phantom size in the imaging protocol.

12. The local transmission unit of claim 11, wherein the determination of if there is a mismatch of the first parameter and the second parameter comprises comparison of the first parameter in the medical study with the corresponding second parameter in the imaging protocol.

13. The local transmission unit of claim 11, wherein the correction of the first parameter in the medical study comprises determination of the age of the patient being examined, the phantom size, or the age of the patient being examined and the phantom size.

14. The local transmission unit of claim 11, wherein correction of the first parameter in the medical study comprises: comparison of the second parameter in the imaging protocol with the first parameter in the medical study; and when there is a mismatch: determination of a dose index value in the imaging protocol; determination of a scan length value in the imaging protocol; determination of the second parameter, the determination of the second parameter comprising calculation of a product of the dose index value and the scan length value; and correction of the first parameter in the medical study based on the determined second parameter.

15. A system for validating a parameter in a medical study, the system comprising: a medical scanner configured to scan an object and generate a medical study, wherein the medical study comprises a first parameter; a local transmission unit comprising: an interface configured to receive the medical study from the medical scanner; and a processor in a cloud computing environment, wherein the processor is configured to: determine the first parameter of the medical study to be validated; determine if there is a mismatch of the first parameter in the medical study and the second parameter in the imaging protocol; and generate a validated medical study when there is a mismatch, wherein the generation of the validated medical study comprises: in response to the mismatch, normalization, by the processor, of a phantom size in the imaging protocol based on an age of a patient; and correction, by the processor, of the first parameter in the medical study based on the normalized phantom size in the imaging protocol.

16. A non-transitory computer-readable storage medium that stores machine-readable instructions executable by a server to validate a parameter in a medical study, the instructions comprising: receiving, by an interface, the medical study from a source; determining, by a processor, a first parameter of the medical study to be validated; receiving, by the interface, an imaging protocol from a configuration file in an imaging unit, wherein the imaging protocol comprises a second parameter corresponding to the first parameter in the medical study; determining by the processing unit if there is a mismatch of the first parameter in the medical study and the second parameter in the imaging protocol; and generating a validated medical study when there is a mismatch, wherein generating the validated medical study comprises: in response to the mismatch, normalizing, by the processor, a phantom size in the imaging protocol based on an age of a patient; and correcting, by the processor, the first parameter in the medical study based on the normalized phantom size in the imaging protocol.

17. The non-transitory computer-readable storage medium of claim 16, wherein determining if there is a mismatch of the first parameter and the second parameter comprises comparing, by the processor, the first parameter in the medical study with the corresponding second parameter in the imaging protocol.

18. The non-transitory computer-readable storage medium of claim 16, wherein correcting the first parameter in the medical study comprises determining the age of the patient being examined, a phantom size or the age of the patient being examined and the phantom size.

19. The non-transitory computer-readable storage medium of claim 16, wherein correcting the first parameter in the medical study comprises: comparing, by the processor, a second parameter in the imaging protocol with the first parameter in the medical study; and when there is a mismatch: determining, by the processor, a dose index value in the imaging protocol; determining, by the processor, a scan length value in the imaging protocol; determining, by the processor, the second parameter, determining the second parameter comprising calculating a product of the dose index value and the scan length value; and correcting, by the processor, the first parameter in the medical study based on the determined second parameter.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

(1) FIG. 1 illustrates a block diagram of a client-server architecture that provides geometric modeling of components representing different parts of a real world object, according to an embodiment.

(2) FIG. 2 illustrates a block diagram of a local transmission unit in which an embodiment of a method for validation of a parameter in a medical study may be implemented.

(3) FIG. 3 illustrates a flow chart of an embodiment of a method of validating a parameter in a medical study.

(4) FIG. 4 illustrates a flowchart of an embodiment of a method of correcting a parameter in a medical study.

(5) FIG. 5 illustrates a flowchart of another embodiment of a method of correcting a parameter in a medical study.

(6) FIG. 6 illustrates an embodiment of a medical study containing dose length product value.

(7) FIG. 7 illustrates an embodiment of a medical study depicting phantom size values.

(8) FIG. 8 illustrates a flowchart of another embodiment of a method of correcting a parameter in a medical study.

(9) FIG. 9 illustrates a flowchart of an additional embodiment of a method of correcting a parameter in a medical study.

(10) FIG. 10 illustrates a block diagram of another client-server architecture that provides geometric modeling of components representing different parts of a real world object, according to an embodiment.

DETAILED DESCRIPTION

(11) Embodiments are described in detail below. The various embodiments are described with reference to the drawings, where like reference numerals are used to refer to like elements throughout. In the following description, for purpose of explanation, numerous specific details are set forth in order to provide a thorough understanding of one or more embodiments. Such embodiments may be practiced without these specific details.

(12) FIG. 1 provides an illustration of a block diagram of a client-server architecture that is a geometric modeling of components representing different parts of real-world objects, according to an embodiment. The client-server architecture 100 includes a server 101, a mobile device 106, a computing unit 108, and a medical scanner 107. The mobile device 106, the computing unit 108, and the medical scanner 107 are connected to the server 101 via a network 105 (e.g., local area network (LAN)), wide area network (WAN), WiFi, etc. In one embodiment, the server 101 is deployed in a cloud computing environment. As used herein, “cloud computing environment” refers to a processing environment including configurable computing physical and logical resources such as, for example, networks, servers, storage, applications, services, etc., and data distributed over the network 105 (e.g., the Internet). The cloud computing environment provides on-demand network access to a shared pool of the configurable computing physical and logical resources. The server 101 may include blob storage or a medical database 102 that includes medical images obtained from the medical scanner 107. The medical database 102 may contain medical data obtained from, but not limited to, one or more medical equipment (e.g., scanners, hospitals, medical professionals) and other providers that may be involved in patient care. The medical database may obtain patient medical information from, for example, picture archiving and communication system (PACS), hospital information system (HIS), laboratory information system (LIS), and radiology information system (RIS). The server 101 may further include a validation module 103 that is configured to validate a parameter in a medical study. The server 101 may include an interface 104 that receives medical data (e.g., medical images from the medical scanner 107) and transfers the medical images to the medical database 102. Additionally, the interface 104 may also communicate with the mobile device 106 and the computing unit 108 via the network 105.

(13) The mobile device 106 and/or the computing unit 108 are used by a user to access medical images to be validated. The medical images on the server 101 may be accessed by the user via a graphical user interface of an end user web application.

(14) FIG. 2 is a block diagram of a local transmission unit 101 in which an embodiment may be implemented, for example, as a system to validate a parameter in a medical image, configured to perform the processes as described therein. The server 101 is an exemplary implementation of the local transmission unit in FIG. 1. In FIG. 2, the local transmission unit 101 includes a processing unit 201 (e.g., a processor), a memory 202, a storage unit 203, an input unit 204, an output unit 205, a network interface 104, and a standard interface or bus 206. The local transmission unit 101 may be a computer (e.g., a personal computer), a workstation, a virtual machine running on host hardware, a microcontroller, or an integrated circuit. As an alternative, the local transmission unit 101 may be a real or a virtual group of computers (e.g., a “cluster” or a “cloud”, respectively).

(15) The processing unit 201, as used herein, may be any type of computational circuit, such as, but not limited to, a microprocessor, microcontroller, complex instruction set computing microprocessor, reduced instruction set computing microprocessor, very long instruction word microprocessor, explicitly parallel instruction computing microprocessor, graphics processor, digital signal processor, or any other type of processing circuit. The processing unit 201 may also include embedded controllers, such as generic or programmable logic devices or arrays, application specific integrated circuits, single-chip computers, and the like. In general, a processing unit 201 may include hardware elements and software elements. The processing unit 201 may be configured for multithreading (e.g., the processing unit 201 may host different calculation processes at the same time, executing either in parallel or switching between active and passive calculation processes).

(16) The memory 202 may be volatile memory and non-volatile memory. The memory 202 may be coupled for communication with the processing unit 201. The processing unit 201 may execute instructions and/or code stored in the memory 202. A variety of computer-readable storage media may be stored in and accessed from the memory 202. The memory 202 may include any suitable elements for storing data and machine-readable instructions, such as read only memory, random access memory, erasable programmable read only memory, electrically erasable programmable read only memory, a hard drive, a removable media drive for handling compact disks, digital video disks, diskettes, magnetic tape cartridges, memory cards, and the like. In the present embodiment, the memory 202 includes a validation module 103 stored in the form of machine-readable instructions on any of the above-mentioned storage media and may be in communication with and executed by processing unit 201. When executed by the processing unit 201, the validation module 103 causes the processing unit 201 to validate a parameter in a medical study. In an alternate embodiment, the memory may also include a notification module (not illustrated) that is configured to generate an alert or notification for a user operating the medical scanner in case of a mismatch identified in the parameter in the medical study and a parameter in a imaging protocol. Method acts executed by the processing unit 201 to achieve the abovementioned functionality are elaborated upon in detail in FIGS. 3, 4, 5, 8, and 9.

(17) The storage unit 203 may be a non-transitory storage medium that stores a medical database 102. The medical database 102 is a repository of medical information related to one or more patients that is maintained by a healthcare service provider. The input unit 204 may include an input such as keypad, touch-sensitive display, camera (e.g., a camera receiving gesture-based inputs), etc. capable of receiving input signal such as a medical data including patient information to be shared or allocated. The bus 206 acts as interconnect between the processing unit 201, the memory 202, the storage unit 203, the communication interface 104, the input unit 204, and the output unit 205.

(18) The hardware depicted in FIG. 2 may vary for particular implementations. For example, other peripheral devices such as an optical disk drive and the like, Local Area Network (LAN)/Wide Area Network (WAN)/Wireless (e.g., Wi-Fi) adapter, graphics adapter, disk controller, input/output (I/O) adapter may also be used in addition or in place of the hardware depicted. The depicted example is provided for the purpose of explanation only and is not meant to imply architectural limitations with respect to the present disclosure.

(19) A local transmission unit in accordance with an embodiment includes an operating system employing a graphical user interface. The operating system permits multiple display windows to be presented in the graphical user interface simultaneously with each display window providing an interface to a different application or to a different instance of the same application. A cursor in the graphical user interface may be manipulated by a user through the pointing device. The position of the cursor may be changed and/or an event such as clicking a mouse button may actuate a desired response.

(20) One of various commercial operating systems, such as a version of Microsoft Windows™, a product of Microsoft Corporation located in Redmond, Wash. may be employed if suitably modified. The operating system is modified or created in accordance with the present disclosure, as described.

(21) Disclosed embodiments provide systems and methods for analyzing medical data associated with a patient. For example, the systems and methods may perform validation of a parameter in a medical study.

(22) FIG. 3 illustrates an embodiment of a method 300 of validating a parameter in a medical study. At act 301 of the method 300, the medical study and imaging protocol are obtained from the medical scanner via the interface 104. In an embodiment, the medical study is a Digital Imaging and Communications in Medicine (DICOM) study. The DICOM study includes medical data accumulated after an irradiation event of medical imaging. A DICOM study may include one or more parameters, for example, but not limited to, the date of birth of a patient being examined and/or the age, the gender of the patient, phantom size value, dose values of the radiation a patient is exposed to, and DICOM tags. An imaging protocol includes data defined for the irradiation event of medical imaging. At act 302, a first parameter to be validated in the medical study is determined by the processing unit 201. One of the parameters in the medical study may be captured incorrectly. Because of this, the medical study may be rendered invalid for further analysis. Therefore, determination of a parameter to be validated in the medical study is to be provided. In an embodiment, the first parameter is a dose value. Alternatively, the first parameter may be any parameter in the DICOM study that may require validation.

(23) At act 303, a second parameter in the imaging protocol is determined by the processing unit 201. The second parameter in the imaging protocol is a parameter corresponding to the first parameter in the DICOM study. Therefore, if the first parameter is dose value, the second parameter determined from the imaging protocol is also dose value. The corresponding second parameter in the imaging protocol may be determined, for example, using DICOM tag values. At act 304, the first parameter and the second parameter are compared by the processing unit 201 to determine if there is a mismatch between the first parameter and the second parameter. An estimate of similarity between the first parameter and the second parameter is performed to identify a mismatch in the parameters. A high matching index indicates that the first parameter and the second parameter match. A low matching index may indicate a mismatch between the first parameter and the second parameter. The advantage of comparing the first parameter and the second parameter is the identification of mismatch between the values associated with the first parameter and the second parameter. Therefore, the inconsistency in the data included in the medical study and the imaging protocol is determined, based on which the validation of the medical study is initiated. If the values of the first parameter and the second parameter match, a structured report is generated by the processing unit 201 at act 306. A structured report encodes an imaging diagnostic report essential for Electronic Healthcare Record (EHR). If a mismatch between the first parameter and the second parameter is identified, the first parameter in the medical study is corrected based on the second parameter in the imaging protocol. A structured report is generated by the processing unit 201, at act 306, once the first parameter is corrected. This method enables correction of inconsistency in the data included in the medical study and the imaging protocol. Therefore, a valid medical study is generated for further analysis.

(24) FIG. 4 illustrates a flowchart of an embodiment of a method 400 of correcting a parameter in a medical study. At act 401 of the method 400, the age of the patient being examined is determined by the processing unit 201. The age of the patient may be present in the DICOM study/imaging protocol. Alternatively, the DICOM study/imaging protocol may include a date of birth of the patient being examined. The age of the patient may therefore be determined from the date of birth in the DICOM study/imaging protocol. The age of the patient enables determination of the quantity of radiation that the patient may be exposed to. At act 402 of the method 400, a phantom size is determined by the processing unit 201 from the imaging protocol. A phantom or an imaging phantom is an object that is scanned or imaged before a patient is examined so as to determine the performance of the imaging device/medical scanner. The size of the phantom is proportional to the radiation dose value to which a patient being examined is to be exposed. Therefore, the size of the phantom enables identification of the radiation dose value. Therefore, with a change in the phantom size, the quantity of radiation may also be modified. At act 403 of the method 400, the phantom size recorded in the imaging protocol is mapped to the determined age of the patient. This enables the processing unit 201 determining if the size of the phantom is appropriate for the determined age of the patient. If the size of the phantom is not appropriate based on the age of the patient, at act 404, the phantom size is normalized in the imaging protocol based on the determined age of the patient. For example, based on the determined age, if the patient is an adult, the phantom size (diameter) would be 32 centimeter. FIG. 7 illustrates an embodiment of a medical study 700 including phantom sizes. As illustrated in FIG. 7, the phantom size may not be recorded correctly and therefore require normalization. At act 405 of the method 400, the first parameter in the DICOM study (e.g., the dose value is corrected based on the normalized phantom size). Therefore, the method acts enable correction of dose value in the DICOM study based on the normalized phantom size. Therefore, a valid DICOM study that may be used for accurate medical analysis of the patient is generated. At act 406 of the method 400, a structured medical report is generated after the dose values are corrected or if the phantom size corresponds to the patient age.

(25) FIG. 5 illustrates a flowchart of yet another embodiment of a method 500 of correcting a parameter in a medical study. In an embodiment, the medical scanner 107 is a computed tomography scanner. At act 501 of the method 500, a first parameter in the medical study is determined by the processing unit 201. In an embodiment, the first parameter is a dose length product (DLP) value. A dose length product is the measure of total radiation that is to be provided to perform a computed tomography examination. The DLP value in the medical study may be recorded after the irradiation event. FIG. 6 illustrates an embodiment of a medical study 600 depicting dose length product value recorded. At act 502 of the method 500, a second parameter is identified from the imaging protocol by the processing unit 201. The second parameter corresponds to the first parameter determined from the medical study. Therefore, in the embodiment, the second parameter is the dose length product (DLP) value recorded in the imaging protocol. The DLP value in the imaging protocol may be defined before the irradiation event. The dose length product is a product of dose index or computed tomography dose index (CTDI) and the scan length. The dose index is the radiation intensity that is to be provided to perform a computed tomography examination. A scan length is the length of the area (e.g., in centimeter) on the patient being examined that may be irradiated for the medical examination. The first parameter and the second parameter are compared at act 503 of the method 500 to determine if there is a mismatch in the dose length product values in the medical study and the imaging protocol. If there is a mismatch, at act 504, a dose index value is determined. The dose index value may be recorded in the imaging protocol or may be obtained from the computed tomography scanner 107. At act 505, a scan length of the area being examined is determined by the processing unit to calculate a product of the dose index and the scan length. Therefore, the dose length product is determined. The dose length product in the medical study is corrected based on the determined dose length product value at act 507.

(26) FIG. 8 illustrates a flowchart of yet another embodiment of a method 800 of correcting a parameter in a medical study. At act 801 of the method 800, the age of the patient being examined is determined by the processing unit 201. The age of the patient may also be determined from the date of birth of the patient in the imaging protocol/medical study. At act 802 of the method 800, the recorded phantom size is determined by the processing unit 201. At act 803, the age of the patient and the recorded are compared to identify if the values match. If the values do not match, at act 804, a notification or alert is generated for a user who may be operating the medical scanner 107 on the mobile device 106 or the computing unit 108. In an embodiment, the notification or alert appears as a pop-up window on the display unit. The computing unit 108 or the mobile device 106 of the user may also be configured to generate a sound alert when the notification is received on the mobile device 106 or the computing unit 108. The notification or alert enables the user to choose an option to perform normalization or correction of the phantom size values. The user may input his choice through the graphical user interface by clicking or pressing a designated button on the graphical user interface so as to trigger an action to normalize the phantom size values. In an embodiment, the graphical user interface may contain an option to save the choice made by the user, to be applied as a default for all the future medical studies. For example, normalization of phantom size values may be performed as a default action if a mismatch is identified between the age of the patient and the phantom size value. If the user chooses to perform normalization/correction of the phantom size values, the processing unit 201 performs normalization of the phantom size at act 806 and corrects the dose values in the medical study at act 807, according to the normalized phantom size. At act 808, a structured report including the correct dose values corresponding to the normalized phantom size is generated.

(27) FIG. 9 provides an illustration of a flowchart of an embodiment of a method 900 for correcting a parameter in a medical study. In the embodiment, the parameter to be validated in the medical study is a DICOM tag. A DICOM tag enables identification of an attribute in a medical study. At act 901 of the method 900, a DICOM tag value to be validated is determined from the medical study/DICOM study by the processing unit 201. At act 902, a corresponding DICOM tag value in the imaging protocol is determined by the processing unit 201. The DICOM tag values from the DICOM study and imaging protocol are compared to identify if there is a mismatch, at act 903 of the method 900. If there is a mismatch, the tag value in the DICOM study is corrected based on the tag value presented in the imaging protocol, at act 905. A structured medical report is generated at act 904 with correct DICOM tag values such that the medical report is valid.

(28) FIG. 10 provides an illustration of another client-server architecture that provides a geometric modeling of components of a system 1000 for validation of a parameter in a medical study. The system 1000 includes a medical scanner 107 coupled to a local transmission unit 101. The local transmission unit includes an interface 104, a medical database 102, and a validation module 103 in a cloud computing environment 105. The medical scanner communicates with the cloud computing environment 105 through the interface 104 of the local transmission unit 101. In an embodiment, the medical scanner 107 includes a cloud adapter module that connects the medical scanner 107 with the cloud computing environment 105. Therefore, the medical study received/generated by the medical scanner is transferred to the cloud computing environment 105 through the cloud adapter module. The medical study is stored in the medical database 102. The cloud computing environment 105 includes components of the local transmission unit 101 such as the validation module 103. The validation module 103 is configured to validate a parameter in the medical study. In an embodiment, the cloud computing environment 105 includes an additional component of the local transmission unit 101 such as the notification module. The notification module is configured to generate an alert or notification on a user device (e.g., a mobile device 106 or a computing unit 108 of the user) to notify the user of the mismatch in the parameter in the medical study. The validation module 103 is further configured to receive a choice from the user through the graphical user interface of the mobile device 106 or the computing unit 108 for performing normalization and correction of the parameter in the medical study. Therefore, validation of the parameter in the medical study is performed in the cloud computing environment 105. The cloud computing environment 105 enables the medical study to be accessed by more than one user at the same time. The cloud computing environment 105 also provides a secure environment for performance of validation of the parameter and storing the corrected medical study.

(29) The foregoing examples have been provided merely for the purpose of explanation and are in no way to be construed as limiting the present invention disclosed herein. While the invention has been described with reference to various embodiments, it is understood that the words, which have been used herein, are words of description and illustration, rather than words of limitation. Further, although the invention has been described herein with reference to particular means, materials, and embodiments, the invention is not intended to be limited to the particulars disclosed herein; rather, the invention extends to all functionally equivalent structures, methods and uses, such as are within the scope of the appended claims. Those skilled in the art, having the benefit of the teachings of this specification, may effect numerous modifications thereto and changes may be made without departing from the scope and spirit of the invention in its aspects.

(30) The elements and features recited in the appended claims may be combined in different ways to produce new claims that likewise fall within the scope of the present invention. Thus, whereas the dependent claims appended below depend from only a single independent or dependent claim, it is to be understood that these dependent claims may, alternatively, be made to depend in the alternative from any preceding or following claim, whether independent or dependent. Such new combinations are to be understood as forming a part of the present specification.

(31) While the present invention has been described above by reference to various embodiments, it should be understood that many changes and modifications can be made to the described embodiments. It is therefore intended that the foregoing description be regarded as illustrative rather than limiting, and that it be understood that all equivalents and/or combinations of embodiments are intended to be included in this description.