Extensions to the Time-Oriented Database Model to Support Temporal Reasoning in Medical Expert Systems
Extensions to the Time-Oriented Database Model to Support Temporal Reasoning in Medical Expert Systems
复制标题
面向时间的数据库模型的扩展以支持医学专家系统中的时间推理
DOI：
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复制
发表时间：
1991
影响因子：
1.7
通讯作者：
S. Tu
中科院分区：
文献类型：
--
作者：
M. Kahn;Lawrence M. Fagan;S. Tu
面对诊断和治疗决策的医生必须对随时间变化的临床特征进行推理。数据库管理系统（DBMS）可以增加对患者数据的访问，但大多数系统在存储和检索复杂的时态信息的能力方面受到限制。面向时间的数据库（TOD）模型是医疗数据库系统中最广泛使用的数据模型，它将单个时间戳与每个观察结果关联起来。大多数临床数据的正确分析需要考虑可能改变原始数据解释的多个并发临床事件。大多数医疗数据库管理系统无法检索由多个临床事件索引的患者数据。我们描述了两个逻辑扩展到基于TOD的数据库，解决了一组时间推理问题，我们在构建医疗专家系统中遇到的。这两种扩展的一个关键特征是将存储的数据划分为分组，例如连续的临床访视、临床加重或具有临床决策相关性的其他抽象事件。时态网络（TNET）是一个面向对象的数据库，它扩展了ONCOCIN的时态推理能力，ONCOCIN是一个提供化疗建议的医学专家系统。TNET使用持久对象将观察结果与发生“临床关注事件”的时间间隔相关联。第二个面向对象的系统，称为扩展时态网络（ETNET），既是TNET的扩展，也是TNET的简化。像TNET一样，ETNET使用持久对象来表示相关的时间间隔;然而，与第一个系统不同的是，ETNET包含推理方法（规则），可以在事件“开始”时执行，并在事件“结束”时撤回。TNET和ETNET捕获在基于TOD的数据库中没有表示的记录信息之间的时间关系。虽然它们不能解决医疗决策中发现的所有时间推理问题，但这些新结构使患者数据库系统能够对复杂的时间关系进行编码，基于多个临床背景存储和检索患者数据，并且在ETNET中，基于特定临床事件的开始或结论修改专家系统可用的推理方法。
Physicians faced with diagnostic and therapeutic decisions must reason about clinical features that change over time. Database-management systems (DBMS) can increase access to patient data, but most systems are limited in their ability to store and retrieve complex temporal information. The Time-Oriented Databank (TOD) model, the most widely used data model for medical database systems, associates a single time stamp with each observation. The proper analysis of most clinical data requires accounting for multiple concurrent clinical events that may alter the interpretation of the raw data. Most medical DBMSs cannot retrieve patient data indexed by multiple clinical events. We describe two logical extensions to TOD-based databases that solve a set of temporal reasoning problems we encountered in constructing medical expert systems. A key feature of both extensions is that stored data are partitioned into groupings, such as sequential clinical visits, clinical exacerbations, or other abstract events that have clinical decision-making relevance. The temporal network (TNET) is an object-oriented database that extends the temporal reasoning capabilities of ONCOCIN, a medical expert system that provides chemotherapy advice. TNET uses persistent objects to associate observations with intervals of time during which “an event of clinical interest” occurred. A second object-oriented system, called the extended temporal network (ETNET), is both an extension and a simplification of TNET. Like TNET, ETNET uses persistent objects to represent relevant intervals; unlike the first system, however, ETNET contains reasoning methods (rules) that can be executed when an event “begins”, and that are withdrawn when that event “concludes”. TNET and ETNET capture temporal relationships among recorded information that are not represented in TOD-based databases. Although they do not solve all temporal reasoning problems found in medical decision making, these new structures enable patient database systems to encode complex temporal relationships, to store and retrieve patient data based on multiple clinical contexts and, in ETNET, to modify the reasoning methods available to an expert system based on the onset or conclusion of specific clinical events.
医学专家系统——医生的知识工具。
DOI：
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发表时间：
1986
期刊：
The Western journal of medicine
影响因子：
--
作者：
Shortliffe,EH
通讯作者：
Shortliffe,EH
基于计算机的癌症化疗方案顾问的治疗建议。
影响因子：
39.2
作者：
Hickam,DH;Shortliffe,EH;Bischoff,MB;Scott,AC;Jacobs,CD
通讯作者：
Jacobs,CD