An introduction of standardizing representation of commodity code and bar code of medical materials in a medical institution is an important topic in the improvement of hospital management and safety in medicine.

 In order to achieve this purpose, the medical material distribution management committee analyzed the status of database registration continuously as well as conducted a research regarding the awareness of the standardization in hospitals to clarify a direction of a specification representing the commodity code and bar code in the medical material industry and specification of medical material database constructed by Medical Information System Development Center Foundation (MEDIS-DC). Being aware of the standardization in hospitals, the standardization has been introduced rapidly in a large number of companies in the medical industry.

 In addition, this committee created a specification of two dimensional symbol (proposal) not only for the medical material but also for a surgical equipment such as small equipment made of stainless used for operation, and then proposed the standardization to the medical industry.

 We are certain that the necessity of representation by bar code and database registration is understood more because a primary distributor, who handles products derived from life and special maintenance medical equipment, is obliged to record and maintain the place where the medical material and medical equipment are delivered to, address, and items defined by the Ministry of Health, Labor and Welfare by revision of the Pharmaceutical Affairs Law after 2003.

 This review mainly describes the activities of research and statistical consultation of the Research Organization of Biostatistical Method in JAMI.

 Research is one of the significant activities which must be addressed by this organization. Research may include the development of new theories and applied methodology in biostatistics. This organization obtained the following results.

(1) Kappa score is a very useful statistic to measure nominal scale agreement among raters. A practical method for comparing several kappa scores was developed using Jackknife methods. This statistical framework was similarly applied to the Brier score.

(2) The Bootstrap sampling method was applied to the discriminant analysis to adjust for the actual error rates. This method allows us to increase the precision of disease diagnosis, by means of the mixture of discriminant analysis and Bootstrap sampling.

(3) An alternative survival time model to the conventional Cox’s proportional hazards model was proposed to evaluate the treatment effects in randomized clinical trials more precisely. This model involves the piecewise linear model in the part of log-hazard.

 Avenues for research are discovered by experience with real statistical problems through statistical consulting activities, which we will present.

 In 1996, a research group for the study on domestic telemedicine trials was organized with a grant of Ministry of Health and Welfare. Our society took over the activities and a workshop for telemedicine. We have held the workshop three times and are continuing to introduce the latest cases of domestic telemedicine. Furthermore, our activities are expanded into comprehensive activities including a joint event with external groups and a proposal for the telemedicine policy.

 We examined the usability of remote diagnosis by videophone for patients with head injuries. For 76 patients with head injuries who were examined at a local hospital (Omachi Municipal Hospital), we conducted real time, remote diagnosis at the remote support hospital (Shinshu University Hospital), using Computed Tomography (CT) image transfer and videophone. In order to evaluate the difference between face-to-face treatment and remote diagnosis, first we performed face-to-face treatment at the local hospital, then compared the results with the remote diagnosis from the center hospital. As a result of the comparison between face-to-face treatment and remote diagnosis, we found that there was no significant difference in the diagnosis of traumatic impairment of consciousness, retrograde amnesia, impaired consciousness and focal symptoms. For all of these diagnoses, the sensitivity was 100%, the specificity was 96.7–100% and there was no statistically significant decrease. Remote diagnosis doctors were able to confirm head region subdermal hematoma, black eye and scalp laceration over the videophone. We asked 8 doctors who participated in the remote diagnosis about the usability of the videophone and all of them answered that it was useful. By using CT image transfer together with remote diagnosis by videophone, we were able to perform a diagnosis much closer to face-to-face treatment.

 We accumulated the incident reports from the ophthalmology clinic for three years between May 1999 and April 2002. We analyzed the waiting time (the registration time to the appointment time), the length of stay (the registration to the end of the medical treatment), and the treatment time (the appointment time to the end) in the incident days using time stump in electric medical record. We had 20 incidents including 5 falls, 3 patient identification errors, 4 medication errors, and 3 errors at refraction. The averaged stay time was 44 minutes, whereas it was 10 minutes longer at the days of medication error and errors at refraction. This increase implied 23% increase of patient number. Stay time in days of other incidents was around 44 minutes. When stay time is long, incident may occur. We need systematic consideration for prevention of incidents at the busy day, e.g. interdivisional rearrangement of employees etc.

 We have developed a decision-support system that assists a doctor on duty in an emergency room in diagnosing diseases more efficiently. This system classifies serious diseases in three steps: (1) Diagnose the disease(s) based on the patient’s primary complaint; (2) Classify the diseases according to probability using the results of clinical examinations, and (3) Evaluate the results of clinical laboratory tests for other possible diseases. In an evaluation of the prototype system revealed the following: (a) The system correctly classified diseases in all 90 patients; (b) The system could differentiate diseases 1.2 times more efficiently than conventional methods. The system is very simple and convenient for the doctor to use.