Extended SQL for manipulating clinical warehouse data.
(65/2017)
Health care institutions are beginning to collect large amounts of clinical data through patient care applications. Clinical data warehouses make these data available for complex analysis across patient records, benefiting administrative reporting, patient care and clinical research. Data gathered for patient care purposes are difficult to manipulate for analytic tasks; the schema presents conceptual difficulties for the analyst, and many queries perform poorly. An extension to SQL is presented that enables the analyst to designate groups of rows. These groups can then be manipulated and aggregated in various ways to solve a number of useful analytic problems. The extended SQL is concise and runs in linear time, while standard SQL requires multiple statements with polynomial performance. The extensions are extremely powerful for performing aggregations on large amounts of data, which is useful in clinical data mining applications. (+info)
Quality criteria and access characteristics of Web sites: proposal for the design of a health Internet directory.
(66/2017)
The increasing volume of information available on the Internet today is a problem for health care professionals who want to access rapidly data of high quality. Usual search engines and directories are not sufficient to satisfy their needs. Moreover, the information published by Web sites is not always guaranteed. Some institutions around the word deal with the definition of a set of criteria for the evaluation of medical Web sites. We base our current work on the technologies we developed previously in order to integrate sources of information of various kinds using the "Unified Medical Language System" knowledge bases. This paper focuses on quality criteria and access characteristics Web sites should satisfy to be registered in a "Health Internet Directory". The design of such a system is proposed and discussed. (+info)
Construction of a virtual EPR and automated contextual linkage to multiple sources of support information on the Oxford Clinical Intranet.
(67/2017)
We have used internet-standard tools to provide access for clinicians to the components of the electronic patient record held on multiple remote disparate systems. Through the same interface we have provided access to multiple knowledgebases, some written locally and others published elsewhere. We have developed linkage between these two types of information which removes the need for the user to drill down into each knowledgebase to search for relevant information. This approach may help in the implementation of evidence-based practice. The major problems appear to be semantic rather than technological. The intranet was developed at low cost and is now in routine use. This approach appears to be transferable across systems and organisations. (+info)
A strategy for statistical Master Person Index linking.
(68/2017)
A linking program used by Connecticut Healthcare Information Management and Exchange to maintain the Master Person Index for its large, state-wide patient data repository is being stretched beyond its limits by the growing size and complexity of the database. This paper presents the early work into developing a second-generation linking program. Like the original program, the new linker will use a unique multi-step process to allow effective linking of data from a large number of dissimilar data sources. The new linker will use parallel multi-processing to allow improved performance and scalability. These changes will also make possible more sophisticated statistical methods of defining link confidence. The system is implemented using a scalable collection of inexpensive, PC based systems running the Linux operating system, a freely available database engine, and the Java programming language. (+info)
The Senior Assessment Coupler: point-of-care decision support and data acquisition tool.
(69/2017)
In an effort to provide more effective, point-of-care management of the elderly population in the state of Vermont and to begin to collect data on health care outcomes across this population, the Vermont Department of Aging and Disabilities partnered with the PKC Corporation to pilot test the Senior Assessment Coupler. Results of this pilot have shown that the Coupler is an effective tool for collecting health status information, providing decision support at the point of care, facilitating reporting to various state and federal agencies, and empowering elderly Vermonters to make informed decisions about their health care and quality of life. (+info)
Evaluation of the Information Sources Map.
(70/2017)
As part of preliminary studies for the development of a digital library, we have studied the possibility of using the UMLS Information Sources Map (ISM) database to provide the means to connect and map different terminologies, as well as to facilitate access to available information sources. The main issues discussed are the indexing of and connection to relevant online sources. We found the features of the ISM to be consistent with the need to support automated source selection and retrieval. However, attention should be paid to three aspects of the information: granularity, completeness, and accuracy. We found the ISM to be potentially useful; however, significant modifications will be required if the ISM is to be able to support automated source selection and retrieval. (+info)
Exploring three approaches for handling incomplete patient histories in a computer-based guideline for childhood immunization.
(71/2017)
A significant problem faced by immunization registries is that the dates of a patient's previous vaccinations may not be known. These incomplete histories can pose a problem when attempting to use a computer-based guideline to produce patient-specific immunization recommendations automatically. This paper describes an overall approach, together with 3 specific strategies, developed to help deal with this problem. The paper then describes our experience applying the approach to a database containing over 400,000 immunization histories. The paper also discusses a number of the issues raised in adapting a computer-based guideline to accommodate incomplete patient data of this sort. (+info)
Optimizing healthcare research data warehouse design through past COSTAR query analysis.
(72/2017)
Over the past two years we have reviewed and implemented the specifications for a large relational database (a data warehouse) to find research cohorts from data similar to that contained within the clinical COSTAR database at the Massachusetts General Hospital. A review of 16 years of COSTAR research queries was conducted to determine the most common search strategies. These search strategies are relevant to the general research community, because they use the Medical Query Language (MQL) developed for the COSTAR M database which is extremely flexible (much more so than SQL) and allows searches by coded fields, text reports, and laboratory values in a completely ad hoc fashion. By reviewing these search strategies, we were able to obtain user specifications for a research oriented healthcare data warehouse that could support 90% of the queries. The data warehouse was implemented in a relational database using the star schema, allowing for highly optimized analytical processing. This allowed queries that performed slowly in the M database to be performed very rapidly in the relational database. It also allowed the data warehouse to scale effectively. (+info)