title: Desperately seeking data: knowledge base-database links.
abstract: 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.
authors.affiliation: Center for Medical Informatics, Columbia-Presbyterian Medical Center, New York, NY 10032.
authors.forename: G
authors.initials: G
authors.lastname: Hripcsak
authors.forename: S B
authors.initials: SB
authors.lastname: Johnson
authors.forename: P D
authors.initials: PD
authors.lastname: Clayton
mesh_terms: D000046:Academic Medical Centers; D001185:Artificial Intelligence; D003195:Computer Communication Networks; D016208:Databases, Factual; D006751:Hospital Information Systems; D006801:Humans; D009519:New York City; D011381:Programming Languages; D012984:Software