Use of the Infotronics CRS-75 S/12 Analog
to Digital Data Conversion System
CARL S. KLASS, M.A.
Department of Laboratories, The Long Island Jewish Medical Center,
New Hyde Park, New York 11040
ABSTRACT
Klass, Carl S.: Use of the Infotronics CRS-75 S/12 analog to digital data conversion system. Amer. J. Clin. Path. 55: 475-478, 1971. Results from multiple
sequential analyzers can be captured, stored, and recovered easily with use
of analog to digital converters that print the test results on teletype paper,
paper tape, and preprinted gummed result forms. T h e system allows complete
patient information to accompany each set of test results. T h e cost to volume
of data handling ratio makes these converters more economical than on-line
laboratory computers and they are as useful.
T H E RECORDING, transcription, storage, and
retrieval of numerical data are essential
clerical functions in clinical chemistry, but
consume valuable technical time.
With the introduction of multiple analyzers such as the SMA * series, the problem
of data handling has become acute, since
these instruments produce hundreds of results per hour. A variety of data handling
methods may be used. First, a technician
can read the strip chart, perform a mental
analog to digital conversion, and record
the result in a record book. T h e results may
be entered in the patient's chart either as
the strip chart recording or on a request
report form. Second, some laboratories keep
an electrostatic facsimile of the strip chart.
Third, the data from the instrument can
be fed directly on-line to a computer for
later permanent storage and report production. At its present state of development,
the laboratory computer must be examined
carefully in terms of its utility vs. initial
cost of acquisition, adaptability to standard
Received April 2, 1970; accepted for publication
May 26, 1970.
* Technicon Corporation, Tarrytown, New York.
laboratory routine, and cost of "clerical"
time needed to perform the daily task of
telling the computer what to expect in the
way of patient information and tests requested. At this writing, there is still a
need for a good automatic method to present the computer with the patient list and
tests ordered for each patient.
We have based our approach on the fact
that the 18 tests performed simultaneously
using the Technicon SMA 12/60 and the
SMA 6/60 comprise most of the clinical
chemistry workload. Hence, automatic capture of the data by a noncomputer instrument converting an analog signal to a digital output can perform the major part of
the clerical workload. An on-line digital
data processor has been described elsewhere. 1
Materials and Methods
The Infotronics ° CRS-75 S/12 analog to
digital converter is designed to accept signals from synchronous multiple analyzers.
Each analyzer may have as many as 12
channels. Each channel must present information about one kind of test. T h e con-
475
476
KLASS
U
A.J.CP.-Vol.
55
RESULTS, (Olhcf I
I
3
9
©
|
DATE REOUES1EO
FOR GIUCOSE TOLERANCE USTS CIRCLE,
SMA 6-60 REQUESTS
RIQUISUO Or I DIAGNOSIS
039
GLUCOSE
101
UREA NITROGEN
THESE TESTS ARE.
022
CARBON DIOXIDE CONTENT
[.]
ROUTINE AND MAT BE PROCESSED
WITHIN 5 HOURS.
019
CHIORIDE
0BB
SODIUM
BONAFIDE EMERGENCIES AND RESU1TS
ARE NEEDED WITHIN ONE HOUR.
0B8
POTASSIUM
[1
ALL OF THE ABOVE
[ ]
Glucote Tolerance-No. of Spocimani Ifci
PLEASE CIRCLE
THE
TESTS
AC1UAILY
WANTED
THIS AIDS THE LABORATORY
IN THE EVENT OF INSIRUMtNl FAILURE.
2 3 45 67 8
S it
NOTESi
1. DRAW ONE FUII ORANGE TOP TUBE.
THIS TUBE CONTAINS AMMONIUM FLUORIDE
AND OXALATE. THERE
IS. HOWEVER.
NO
SUBSTITUTE
FOR
PROMPT
TRANSPORT
OF
THE SPECIMEN TO LABORATORY
2. PLEASE INVERT THE TUBE 4-5
IMMEDIATELY AFTER FILLING.
TIMES
3. PLEASE SHUT I.V. DRIP FOR AT
SECONDS PRIOR TO OBTAINING
REPORTED BT
I I
©
GENTLY
LEAST 30
SPECIMEN.
D O N O T WRITE I N THIS SPACE
DATE BEOUtSIED
NOTE ON BILIRUBIN Tf ST NEWBORN BltlRUBIN
SHOULD BE ORDIREDONBIOCHIM. IORM I.
ON SMA I3/60PROMLESONIY I t l V A I L D
l O l A l BILIRUBINS W i l l B( INAC1IONAIID
FOR DIRECT REACHING BltlRUBIN. t ) 0 NOT
ORDER ADULT BILIRUBIN ON IORM " I 01
ORDER ONLY TESTS ACTUALLY REQUIRED FROM 1 2 / 6 0 LIST BELOW BY
CIRCLING CODE NUMBER
THESE TESTS CANNOI BE ORDERED S I A I !
IN SERUM
USE RED TOP TUBE 04796
076 TOTAL PROTEIN
027 CREATININE
079 ALBUMIN
011 TOTAL BILIRUBIN
013 CALCIUM
068 ALKALINE PHOSPHATASE
u
-NOTE I
069 INORG. PHOSPHORUS
02B CREATINE PHOSPHOKINASE
020 CHOLESTEROL
050 10H
102 URIC ACID
09B SGOT
GJUCOSE_AND BUN. Tilt SE TESTS ARE
PERFORMED ON AN SMA 6/60 ANAIY/ER.
REQUESTS FOR EI1HER OR BOIH SHOULD
BE MADE ON A BIOCHEMISTRY FORM IV-01
AND BE ACCOMPANIED BY ONE TUBE
CONTAINING
AMMONIUM
FLUORIDE
OXALATE-!ORANGE TOP)
S P f C I M E N REQUIREMENTS
. M I N I M U M OF IS M l
COLLECTED IN ONE
CIOTKD
IONG
BLOOD
RED
TOP
VACUlAINIR IUBEM4796.
. FAS1ING
SPLCIMEN
WHEN
POSSIBLE
. SEND TO LABORATORY WI1HOUI DELAY.
. NOTE: HCMOLYSIS CAN CAUSE
FALSE
ElEVATiONS IN SGOT, LDH, AND PHOS.
PHORUS IE5T5 AS WELL AS MAKING
OTHER DETERMINATIONS QUESTIONABLE.
-
FIG. 1. Biochemistry request forms for utilization with SMA 6/60 and SMA 12/60 multiple analyzers.
verier may be modified to accept different
analyses in many combinations should the
tests performed on the analyzers be changed.
The analog signals are generated by a
retransmitting potentiometer placed on the
rotating shaft of the SMA 12/60 and SMA
6/60 recorders. Signals proportional to the
position of the recorder pen are passed to
a bank of amplifiers and then to voltage-tofrequency converters. Nonlinearities in absorbance are corrected for by amplifiers activated by relays. The digital data may be
observed, stored, or both, in three ways:
(a) a digital tube display located on the
front panel of the CRS-75 presents the concentration for a particular test result; (b) a
teletype model TY-33 prints the results;
and (c) the results may be punched simultaneously on paper tape.
We use the system as follows. Test request forms for the SMA 12/60 or 6/60
are generated at the nursing unit (Fig. 1)
and are sent to the laboratory with the
blood sample. While the bloods are being
centrifuged and while the SMA's are pumping reagent baselines, the technicians assigned to the multiple analyzers type a master paper tape giving the patient information and the Standard and Control Serum
locations. We try to use a "static" sample
tray so as not to disturb the specimen location once the tape has been typed. It is
generally possible to sample at least 50 to
75 samples for electrolytes without disrupt-
April 1971
patient identification, standards, and control sera, in 12 months, and yet the Teletype records take up a volume of 81/," by
11" by 9". Simultaneously with the printing
of the digital residts, fresh paper tape can
be fed through the tape punch to retype
all patient and control serum information
as it is read from the original tape but now
to include all chemical results properly
identified. This new tape may be stored for
future computer use. The CRS-75 can be
programmed to print the letters " H " or
"L" to highlight a result occurring outside
the normal range.
Finally, the printout can be used to simplify data transfer from laboratory to nursing units and to provide a double check
on patient identification. T h e Teletype
paper is replaced by a multiple-layer form
which has on the top surface a preprinted,
gummed label. Subsequent layers are carbon copies (Fig. 2).t These labels are
stripped from their backing and placed directly across the face of the laboratory request form.
When a specimen substitution is made,
the name change is easily accomplished by
manual change of patient identification
after printout. Should one analyzer chan-
ing the sample order. Should a sample have
to be substituted for another that has had
patient information punched previously, a
sample substitution list is made and at the
end of the run a manual name change is
made on the printout. The only restriction
is that all information must be contained
within 63 characters.
Generally it takes about 20 min. to type
the paper tape, listing in proper order some
30 standards and control sera, and 100 to
125 patient samples. After identifying data
for a particular patient or control have
been typed, the "Here is" key is depressed
to punch automatically a coded line return
signal, any number of predetermined line
feeds (spaces), and a signal to the CRS-75,
alerting it to get ready for incoming test
data.
The printed results, recorded on Teletype paper, may be used as a permanent
laboratory record, whereas the strip charts
from the recorder can be sent to the patient chart. This method requires that all
patient SMA strip charts be labeled accurately. The patient's name may be handwritten on the chart or the original lab request may be stapled to the strip chart. We
have accumulated data for more than
16,000 SMA 12/60 profiles, complete with
f UARCO Business Forms, Great Neck, New York.
-»-..^.jy ~ ^ -
^gg-ac
Hong-*
'3.01
*»**
(
——-1
6 . 0 ^ S.IM I . I B
5.511 143.1
».9
£
477
DIGITAL DATA CONVERSION SYSTEM
8.4ll
,„•-
1HOAHD UHASSAYED
' I '18' 489 '
3.81" 2.Tt. 1 8 . 8 *
j j 3 o ««%_
6 . 4 * 140>i
*-- «•"<>*
•
".•: . • . • ! -
T
\ &i s«a%
«1.
«-('•'*
»f«l
T
i t-'
I
i
.
!
i f
1 ilk w«, 1
.
0 3«t.M »34;.?F
C I O E V s- [•cjeoitu >«i } t:no~j at
8 . 1 8 3 . I B 3.41* 8 9 7 . *
1 f
1 , 1
o ' • -:\
- • — - T ^ -
I
$ * * * • » *? 1 ". , .!m. '
Cf«
I O M " SCOT** " H i , ' H ^ F
I
•
fl.-
•
9.4$ 173
18.8*
0.8 7.5*
i57.»
6 t»t.a ! ! 7 ; * l
At f V . " 1 CT« 1 "iw***T "»OT*"E
V l ' r W ' - l frl18e.J,=t | WMOMU>J :>S0MU/al F
—~^~~r—JT^X
• f rf ' *<**•-
Vic. 2. Peel-away labels after printing of chemical data. Printout shows that the three sam
pies were Standard and controls, and that they occupied sample positions 16, 17, and 18. T h e
date was March 29 and the CPK channel was switched to "cancel" position. T h e " H " flags the
elevated values, and the " L " flags low values.
e
478
KLASS
nel become inoperative, its readout may be
eliminated from the digital readout by
switching a key on the CRS-75.
Available A/D converters identify each
patient sample with a preassigned six digit
number.}: Data retrieval is difficult, since it
is very time consuming to find a six-digit
number within a list of other six-digit
numbers, none of which are in sequence.
The CRS-75 described above allows more
information, such as the time the specimen
was drawn, etc., to accompany each patient
sample.
Data retrieval is rapid and simple; given
the patient name and an approximate date,
test results can be located within 2 min.
or less. The carbon copies are kept in a
| Technilogger,
New York.
Technicon
Corp.,
Tarrytown,
AJ.CP.—Vol.
55
binder with each month separated from
another.
Conclusions
When the cost versus output factors are
examined, one finds a definite advantage
in favor of an on-line analog to digital converter used in concert with sequential multiple analyzers. The purchase cost of these
devices is less than $8,000 per multichannel
analyzer. They can provide large volume
data handling, small volume data storage,
sure data identification, and rapid data retrieval for a fraction of the cost of the
larger in-laboratory computers.
Reference
1. Laessig RH, Tong PP, Hoffman GG: 802 on-line
digital data acquisition system for SMA Analyzers. Clin Chem 15:813, 1969