Search tips
Search criteria 


Logo of procascamcLink to Publisher's site
Proc Annu Symp Comput Appl Med Care. 1993 : 639–643.
PMCID: PMC2850654

Desperately seeking data: knowledge base-database links.


Linking a knowledge-based system (KBS) to a clinical database is a difficult task, but critical if such systems are to achieve widespread use. The Columbia-Presbyterian Medical Center's clinical event monitor provides alerts, interpretations, research screening, and quality assurance functions for the center. Its knowledge base consists of Arden Syntax Medical Logic Modules (MLMs). The knowledge base was analyzed in order to quantify the use and impact of KBS-database links. The MLM data slot, which contains the definition of these links, had almost as many statements (5.8 vs. 8.8, ns with p = 0.15) and more tokens (122 vs. 76, p = 0.037) than the logic slot, which contains the actual medical knowledge. The data slot underwent about twice as many modifications over time as the logic slot (3.0 vs. 1.6 modifications/version, p = 0.010). Database queries and updates accounted for 97.2% of the MLM's total elapsed execution time. Thus, KBS-database links consume substantial resources in an MLM knowledge base, in terms of coding, maintenance, and performance.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (859K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Evans RS, Larsen RA, Burke JP, Gardner RM, Meier FA, Jacobson JA, Conti MT, Jacobson JT, Hulse RK. Computer surveillance of hospital-acquired infections and antibiotic use. JAMA. 1986 Aug 22;256(8):1007–1011. [PubMed]
  • McDonald CJ, Hui SL, Smith DM, Tierney WM, Cohen SJ, Weinberger M, McCabe GP. Reminders to physicians from an introspective computer medical record. A two-year randomized trial. Ann Intern Med. 1984 Jan;100(1):130–138. [PubMed]
  • Barnett GO, Winickoff RN, Morgan MM, Zielstorff RD. A computer-based monitoring system for follow-up of elevated blood pressure. Med Care. 1983 Apr;21(4):400–409. [PubMed]
  • Wyatt J. Computer-based knowledge systems. Lancet. 1991 Dec 7;338(8780):1431–1436. [PubMed]
  • Miller RA. INTERNIST-1/CADUCEUS: problems facing expert consultant programs. Methods Inf Med. 1984 Jan;23(1):9–14. [PubMed]
  • Miller RA, McNeil MA, Challinor SM, Masarie FE, Jr, Myers JD. The INTERNIST-1/QUICK MEDICAL REFERENCE project--status report. West J Med. 1986 Dec;145(6):816–822. [PMC free article] [PubMed]
  • Barnett GO, Cimino JJ, Hupp JA, Hoffer EP. DXplain. An evolving diagnostic decision-support system. JAMA. 1987 Jul 3;258(1):67–74. [PubMed]
  • Safran C, Porter D, Lightfoot J, Rury CD, Underhill LH, Bleich HL, Slack WV. ClinQuery: a system for online searching of data in a teaching hospital. Ann Intern Med. 1989 Nov 1;111(9):751–756. [PubMed]

Articles from Proceedings of the Annual Symposium on Computer Application in Medical Care are provided here courtesy of American Medical Informatics Association