Cross Neuro Database
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Introduction


Each EMG system stores its data in its own format, unreadable by standard programs, such as the Microsoft Office programs.

The Cross Neuro Database program has an automatic Import function that scans your EMG systems data files and imports all data and curves into a MySQL or MS-SQL database.

Once in the database, data extraction, statistics and result presentation possibilities are almost unlimited.
The built-in Data Mining features (search and filter) presents extracted data, curves and graphs in MS-Excel® and MS-PowerPoint®.

Supported EMG systems


Cross Neuro Database is compatible with the following EMG systems:
  • Keypoint®Classic

Installation


1) Get a Product key

Visit Order and order the number of licenses you need.
You will receive a Product Key in a mail, required to activate the program.

2) Log in

Ensure to be logged in to Windows as the user who is going to use the program,
since the installation/activation is done per user.
This account must have Administrative rights during installation.

3) Select Database Engine

Before running the Cross Neuro Database program, it is necessary to install a local database or connect to an existing remote database server.
Both MySQL and MS-SQL database engines are supported by Cross Neuro Database.
Choose database engine and download neccessary software modules from here.

4) Install Database


Install MySQL database engine


These steps are NOT required to connect to a MS-SQL Database.
A MySQL server program and a MySQL ODBC connector program need to be installed.
MySQL shall be installed locally or on a remote server. Read more here.
The ODBC connector shall be installed locally.
Install MySQL server instructions.
Install ODBC Connector instructions.

Install MS-SQL modules


These steps are NOT required to connect to a MySQL Database.
A program called BCP.EXE is used by Cross Neuro Database during import of data into a MS-SQL database.
This program is free and available from Microsoft in a software package called "SQL Command Line Utilities".
It needs to be installed locally on each client computer.
Install SQL Command Line Utilities instructions.

Technical note: The SQL Database must have the server role 'dbcreator' set. The Cross Neuro Database creates the databases from the client software, i.e. no separate software or database installation is required on the server.

5) Install Cross Neuro Database
The follow steps are required to install and activate Cross Neuro Database:

  • Download the Cross Neuro Database installer package from Download
    Many Internet browsers will warn about a downloaded installer EXE-file for safety reasons.
    Confirm and accept to keep the downloaded file. In Chrome you need to click the 'Keep' alternative.



  • Click on the downloaded file to start the installation procedure.
  • Follow the screen instructions


  • After completed installation, start Cross Neuro Database from the double clicking on the desktop icon  
    At first startup after installation, the Activation window is seen.
    To continue, the program must first be Activated using either Online or Offline activation.

  • Online Activation may be used if Internet is available.
    Insert the Product Key you received from Stalberg Software, in the lower left area and click [Activate] just below.



  • Offline Activation is used if Internet is not available from the computer where the program is installed.
    • Visit Stalberg Software Activate page from another, Internet connected device.
    • Insert the ProductKey and the MyID code manually and click [Get Activation Key]
    • An Activation Key is shown.
    • Insert the Activation Key and click [Activate] (lower right area).



  • If correct codes are entered, the program is activated and continues.
    A ProductKey can only be used once.
    An Activation Key is unique for one computer.
    In case of hard drive crash or computer replacement, please Contact Stalberg Software for instructions.


Network configurations


The Cross Neuro Database works both on local data as well as across networks.
A Database Server software (MySQL or MS-SQL) shall be installed on the computer where the database is located.
MySQL: An ODBC Connector driver shall be installed on each computer running the Cross Neuro Database application.
MS-SQL: 'SQL Comand Line Utilities' shaqll be installed on each computer running the Cross Neuro Database application.

Several typical configurations are supported:

"No network - manual copy"
Data files from the EMG system are saved on the EMG equipment.
Copy the data files to the computer where Cross Neuro Database is installed.
Start Cross Neuro Database program and Import the copied data.
Note: Cross Neuro Database requires Windows 7 or later. I.e. it cannot run on an EMG System with Windows XP.
The EMG System application does not need to be installed on the Cross Neuro Database computer. Just the EMG Data files is enough.

"Small network"

Data files from the EMG system are saved on the EMG equipment.
Cross Neuro Database is running on a computer which has direct network access to the EMG System data files.

"Large network"
Both data files from the EMG system and the Cross Neuro Database are saved on a server.
Multiple EMG Systems can reach EMG data, and multiple Cross Neuro Database users can reach the database.



Database Setup


Several databases can be configured and accessed. Up to 10 databases residing on the local computer and up to 10 remote servers with 10 databases each can be configured. A scenario is to have a large database holding all data and curves from the department. This can be one of the local databases or a remote. Other databases can be used for special projects and holding imported data sent from other clinics.



Local:
  • Database type: Select database engine type.
  • Password protected: tick if database is password protected.
  • Server name:
    MySQL: Insert 'localhost'.   
    MS-SQL: Insert name of SQL server service.
  • User:
    MySQL: Insert 'root'. 
    MS-SQL: Leave blank or insert user name according to SQL configuration.
  • Connection string options: Additional options to connect to the local database. If database is not password protected, insert 'Integrated Security=SSPI' (without quotes) to establish a trusted connection, using only Windows login security.
  • Database: Select one of the 10 local databases.
  • Active: Check to enable the database. Active databases will be selectable from the Login page.
  • Display name: Database name/description (free text comment).

Remote Server:
  • Server: Select one of 10 Remote Servers.
  • Display name: Server name/description (free text comment).
  • Database type: See Local.
  • Password protected: See Local.
  • Server/IP: Enter IP address or URL of the server. Contact your IT-administrator.
  • User: Enter User name to the database. Contact your IT-administrator.
    MySQL: This is the "Username" as inserted during MySQL installation.
  • Connection string options: See Local. Contact your IT-administrator.
  • Database: See Local.
  • Port: Database access port.
    MySQL: Default is 3306. To change this, edit both the my.ini and config.xml files (see Files and Folders)
    MS-SQL: Default is 1433.

Login


If multiple databases are Active (see Database Setup), select the database to be used. The last used database will be selected by default.
Local MySQL database: enter the "Root password" as inserted during MySQL installation.
Remote MySQL database: enter the "User password" as inserted during MySQL installation.
Local or remote MS-SQL database: enter the password set during MS-SQL database configuration. This field is not seen if a trusted connection is established, i.e. no password is used.
Insert password and click [Login] to continue. To switch database, click [Switch DB] on the Analysis tab (see Logout) or exit and restart the Database program.
Click [Setup] to access the Database Setup.



If an Import procedure is in progress by someone else, the database is locked and a warning is shown:



Wait until the Import is completed and then retry to login.
If the database is locked for other reasons, e.g. previous server crash, restart the database server and try to login again.
Easiest way to restart a local database is to restart the computer.
For restarting a remote server, contact your IT-administrator.
The table shows all open connections to selected database.

Logout


To logout, change database or exit, select the Analysis tab.



[Switch DB] Switch to login page and allow selection of new database (local/remote).
[Logout] Switch to login page. Use this when leaving the computer to avoid unauthorized access.
[Exit] Close the program. Same as clicking the red [X] close button.

Import Data and Curves


The Import function clears the currently selected database and then scans specified folders and reads all found EMG system data files.
All data and curves (if selected) are imported into the database in data tables, one per test type.
If you wish to include new recorded data, a new Import procedure has to be performed again.
The databases not currently selected are not affected.
The EMG system program itself is not required to be installed. Only the EMG system datafiles are accessed.
Before starting the Import process, ensure the path to the patient data files to be imported is correct. Select [Options] from the main menu.



The window header shows currently selected database, i.e. the destination of imported data. If it’s not the correct database, select [Analysis] followed by [Switch DB] and select correct database from the login window.
Select the EMG System data folder(s) to be scanned/imported, using the [Add] and [Delete] buttons.
If Include subfolders is checked, all sub folders below the specified folder name will also be scanned recursively.
Check Import Curves to include all curves in the database. The Import time will be significantly longer. Data are always imported and cannot be deselected.
Select language for muscle and nerve names. To change anatomy language, a new Import is required.
Check Anonymous to exclude patient ID and name during Import. Use this options to increase patient integrity.

Click [Import] followed by [Start Import] to scan all folders listed in Options, search for EMG/EP data and insert them into currently selected database.



Importing both data and all curves, takes about 1 hour per 20.000 patients, depending on computer performance.
Excluding curves (in Options), significantly reduces the total import time.
Note: The database is completely cleared and refreshed at each Import.

All EMG/EP data and curves (if selected) are now saved inside the database and ready to be processed by Data Mining features.

The database is locked (not accessible by others) during the Import procedure.
If someone else is logged into the database without locking, a warning will be shown.
If someone else has locked the database (started an Import), a warning will be shown and it will not be possible to continue to perform an Import.

Do not delete the original EMG/EP data files!
It is likely that the database needs to be refreshed by future versions and the data files are required at each Import procedure.

Single Patient Review


Select Single Patient Review in the Analysis window from the main menu.





  • Insert patient ID.
  • All visits found for the patient are listed.
  • Select result options.
    • Summary Data = An Excel sheet with selected parameters from selected data tables for all visits.
      Tables and parameters are selected using [Setup].
    • Detailed Data = One Excel sheet per data table. All parameters from all visits.
    • Curves = A Powerpoint presentation with selected curves.
      Included curve types are selected using [Setup].
      Select resolution of curves.
      • High resolution: all samples.
      • Standard resolution: plots every Nth sample depending on curve type.
  • Select Setup to change content of output.





    • Click on a Data table to view selected parameters.
    • Use the control buttons to add, deselect and position selected tables and parameters.
    • The layout is saved when pressing OK.

  • Click Start to produce results.
  • The displayed results are overwritten next time you do a Single Patient Review.
    Use 'Save As' in Excel and PowerPoint to save files permanently.


Summary Data presented in an Excel sheet:



Detailed Data presented in one Excel sheet per type:



This table layout allows follow up on one or multiple parameters for a selected patient.

This is how to do it:
  • Select datatable using the bottom tabs.
  • Filter the nerve, side etc. to be included in the follow up using the arrow in the field header.
  • Select the entire Study Date column (click on the header letter).
  • Select parameter(s) to monitor by holding the keyboard Ctrl-button down while clicking on the parameters column header letter.
  • Select Insert-Line chart

An example:


Curves in a Powerpoint presentation:



Curves of same type are drawn with same X and Y scales to allow graphical comparison (eg. superimpose).
Use Powerpoints rescale features to resize individual curves.

Data Mining


Select Data Mining in the Analysis window from the main menu.

Select Patients
As the first step of the Data Mining process, insert filtering details for the patient group to be extracted. Number of patients found in the database, matching the inserted filters are shown on the last line. Wildcards (*=any text and ?=any character) may be used for text fields (Technician, Physician, Diagnosis). E.g. Diagnosis = 'N35*' will select both N351 and N35678. Diagnosis = 'P3?X' selects all 'P31X' and 'P32X'.



Link File selects the patients listed in a text-file.
The file may consist of either KeypointNr, PatientID, PatientNr or StudyNr.
Inserting PatientID or PatientNr will select all studies for the specified patient.
Create a text file (e.g. using Notepad) and enter one number per row.
Save the Link files in \MyDocuments\Cross Neuro Database\LinkFiles.
Click on […] and select the text file.
Select contents of the file. A warning will be given if any typing errors i found. Duplicate numbers will only be included once.



The four study identification fields are used as follows:
Study Nr: Unique sequential number that identifies a study. This number is stored in all data tables to link all results and curves from one study.
Patient Nr: Unique number for each patient (person). Same for all studies for each patient.
Visit Nr: Visit number for a patient. Sorted by investigation date, starting with 1.
Keypoint Nr: The original Keypoint®Classic file number.
All indentification fields except KeypointNr is updated during Import.
Patients matching current filter can be reviewed in Excel.



Click the green right arrow at the top (Next) when the patient group is selected.

Select Parameter type
Each test type is stored in a ‘table’ inside the database. One parameter per column and one recording per row. Take a look at the MNCS Sites table as one example:



Curves are stored in tables as well, with one curve per row and each sample value per column. Like this:


Similar tables are created during Import in the database for each test type. Some tests are divided in to several tables, e.g. MNCS Sites, MNCS Segments. There are in total 32 data tables, 21 curve tables and one Study table. The field ‘Study Nr’ is available in all tables. It is unique for each study and used to connect all tables and link information belonging to the same study.

Extracting data and curves using the Data Mining features are divided into three output structures.



Select Data Parameters
Output will have same format as the database table, but with possibility to select/exclude parameter columns. This type shall be used to analyse parameter(s) for one test type, e.g. MNCS Median Distal Latency. Anatomies (nerves/sites, muscles) will be placed under each other.



Left column:
  • Select Table type
  • Specify the anatomy filter settings. Leaving a field empty or *ALL* means no filter. All table rows matching the filter will be extracted.
  • Click [Add] to save the filter.

Right Column:
  • Topmost section shows all added data table types.
  • The section below shows all anatomy filters for the selected table type.
  • Select parameters for each table type to be included in the output.
  • Select additional patient data fields to be added to the output.
  • To save time, use [Save Setup] to save current filter settings and [Load Setup] to load previously saved settings.

Click the green right arrow to Start Extraction (see below)

An example of a Data Parameters table:


Select Data Parameters – Merged

Output will be one merged table, with columns extracted from one or multiple database tables. This allows comparison of for example MNCS Site with an EMG parameters recorded on the same patient. This type shall also be used when comparing parameters from the same table, but different anatomies. E.g. MNCS Left Motor Median Wrist-APB Latency --- MNCS Left Motor Ulnar Above Elbow – ADM Latency.



Left column:
  • Select Table type
  • Specify the anatomy filter settings.
  • All fields must be inserted.
  • All table rows matching the filter will be extracted.
  • Select parameter(s) to be included. Click [Add] to save the filter.

Right Column:
  • Topmost section shows all added parameters. Each parameter will result in one column in the output file.
  • Use control buttons to delete and rearrange the parameters/columns.
  • Select Keep rows filter rules.
    • Data in all columns: Only rows with data in all columns will be included.
    • Data in any column: rows with data in any column will be included. Fields with missing data will be grayed in the output file.
    • No data: include all rows for selected patients, even if no measurement data is available. This mode is useful when merging output result files to get data from the same patient on the same row.
  • Select additional patient data fields to be added to the output.
  • To save time, use [Save Setup] to save current filter settings and [Load Setup] to load previously saved settings.

Click the green right arrow to Start Extraction (see below)

Below is an example of a Merged Data table. Grayed field indicates that no data were recorded for the patient/parameter.



Select Curves

Output will be curves from one or multiple test types.



Left column:
  • Select Table type
  • Specify the anatomy filter settings.
    Leaving a field empty or *ALL* means no filter.
    All table rows matching the filter will be extracted.
  • Click [Add] to save the filter.

Right Column:
  • Topmost section shows all added data table types.
  • The section below shows all anatomy filters for the selected table type.
  • Select parameters for each table type to be included in the output.
  • Select additional patient data fields to be added to the output.
  • Select output format
  • To save time, use [Save Setup] to save current filter settings and [Load Setup] to load previously saved settings.

Click the green right arrow to Start Extraction (see below)

An example of MS-PowerPoint output:



Sample values are saved in uV in MS-Excel output:



Start Extraction
Click [Start], insert a project name and click [OK] to start the Extraction. The project name will be used as the folder name where all result files will be saved. The default location for output results is: \MyDocuments\Cross Neuro Database\Results.

When the Extraction is completed, Windows Explorer will be displayed showing the result folder. Double click on the result files to review the result. If sensitive patient data is included in the resulting file, such as ID or name, the file will be password protected. The same password as for the database/login will be used. To change it, please read about passwords for Excel file on the Internet. A ReadMe.txt file is created and saved in the output folder. It contains information about which filter criteria etc. that was used for the extraction.

Production Statistics


Select Production Statistics in the Analysis window from the main menu.

Click [Start] and select result output folder.

Detailed numerical results for patient and test statistics are saved on sheets 3 (Patient Data) and 4 (Test Data). On sheet 1 (Patient Summary) and sheet 2 (Test Summary), Pivot tables and Charts are created automatically. The Pivot table function in MS-Excel is very powerful and gives large possibilities to display and format data in various ways. Please read more about “Excel Pivot tables” on the Internet.
A few examples are shown below.

Number of patients per year over many years:


Number of patients per month for a selected year:


Total number of tests (EMG’s, MNCS’s….) over many years:


Total number of EMG’s over many years:


20 most commonly studied muscles:

Patient Integrity


Patient integrity has high priority in a medical database system. To address this subject and maximize integrity while still have the required analysis features, the Cross Neuro Database has the following security/integrity features:
  • Database password For a local database, define the password in Database Setup. For a remote server database, contact your IT-administrator.
  • Automatic logout Specify the logout time under Options-Autologout Time.
  • Anonymous Import Activate under Options-Anonymous. Patient name and ID will be excluded during the Import procedure. I.e. not physically available in the database. Patient name is set to 'Mr X/Mrs Y' and PatientID will be set to PatientNr.
  • Anonymous Data Mining The output from Data Mining will never include Patient Name or ID in resulting MS-Excel® and MS-Powerpoint® files.
  • Patient Filter Data Mining does not allow filter on name or ID.
  • Single Patient Review Allows search on Patient ID, but will not include name or ID in any resulting files.
  • Logging All searches in Single Patient Review will be saved in a hidden log-table inside the database.




Files and Folders


Files and folders Purpose
C:\program (x86)\Cross Neuro Database Application executable files
C:\program files\MySQL\MySQL Server 5.6\my.ini MySQL server settings. Edit Port number if default 3306 is already occupied.
C:\program files\MySQL MySQL server application
C:\program (x86)\MySQL\Connector ODBC 5.2 ODBC communication driver files
C:\program data\MySQL\MySQL Server 5.6\data\db# Local databases
C:\Users\[myName]\Documents\Cross Neuro Database\Analysis Additional analysis programs (.exe and .xlsm). Listed in the left column on the main menu page.
C:\Users\[myName]\Documents\Cross Neuro Database\ParameterSetups Saved data Mining parameters files.
C:\Users\[myName]\Documents\Cross Neuro Database\LinkFiles Text files holding patient group lists. Edit using e.g. Notepad.
C:\Users\[myName]\Documents\Cross Neuro Database\Results\.... Output results from Data mining, Patients and Production statistics. One folder per Extraction. One of multiple files depending on extraction type.
C:\Users\[myName]\Documents\Cross Neuro Database\Temp Temporary files used during Import. All files in this folder will be cleared.
C:\Users\[myName]\AppData\Local\Stalberg Software\Cross Neuro Database\Config.xml Settings files, holding current Options.
C:\Users\[myName]\AppData\Local\Stalberg Software\Cross Neuro Database\SinglePatientReviewConfig.xml Settings files, holding current Single Patient Review Options.
C:\Users\[myName]\AppData\Local\Stalberg Software\Cross Neuro Database\mu.dat Muscle name list. Replace this file with C:\KP\SysData\mu.dat if changes have been made in Keypoint Classic.
C:\Users\[myName]\AppData\Local\Stalberg Software\Cross Neuro Database\nrv.dat Nerve name list. Replace this file with C:\KP\SysData\nrv.dat if changes have been made in Keypoint Classic.

Requirements


  • Windows 7/8/10
  • Microsoft .NET framework, version 4-Full or later
  • MS-Excel 2007 or later
  • MS-PowerPoint 2007 or later
  • Internet connection for online Activation and Help

To use MySQL:
  • MySQL Server application, local or remote.
  • MySQL ODBC Connector driver

To use MS-SQL:
  • MS-SQL Server application, local or remote.
  • Microsoft SQL Command Line Utilities (BCP.EXE)