Abstract
The ability to reason with time-oriented data is central to the practice of medicine. Monitoring clinical variables over time often provides information that drives medical decision making (e.g., clinical diagnosis and therapy planning). Because the time-oriented patient data are often stored in electronic databases, it is important to ensure that clinicians and medical decision-support applications can conveniently find answers to their clinical queries using these databases. To help clinicians and decision-support applications make medical decisions using time-oriented data, a database-management system should (1) permit the expression of abstract, time-oriented queries, (2) permit the retrieval of data that satisfy a given set of time-oriented data-selection criteria, and (3) present the retrieved data at the appropriate level of abstraction. We impose these criteria to facilitate the expression of clinical queries and to reduce the manual data processing that users must undertake to decipher the answers to their queries. We describe a system, Tzolkin, that integrates a general method for temporal-data maintenance with a general method for temporal reasoning to meet these criteria. Tzolkin allows clinicians to use SQL-like temporal queries to retrieve both raw, time-oriented data and dynamically generated summaries of those data. Tzolkin can be used as a standalone system or as a module that serves other software systems. We implement Tzolkin with a temporal-database mediator approach. This approach is general, facilitates software reuse, and thus decreases the cost of building new software systems that require this functionality.
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Das, A.K. and Musen, M.A. (1994). A Temporal Query System for Protocol-Directed Decision Support, Methods of Information in Medicine, 33(4), 358–370.
Das, A.K., Tu, S.W., Purcell, G.P., and Musen, M.A. (1992). An extended SQL for temporal data management in clinical decision-support systems. Sixteenth Annual Symposium on Computer Applications in Medical Care (pp. 128–132). Baltimore, MD: McGraw-Hill.
Hripcsak, G., Ludemann, P., Pryor, T.A., and Wigertz, O.B. (1994). Rationale for the Arden Syntax, Computers in Biomedical Research, 27, 291–324.
Kahn, M.G., Fagan, L.M., and Tu, S. (1991). Extensions to theTime-Oriented Database Model to SupportTemporal Reasoning in Medical Expert Systems, Methods of Information in Medicine, 30, 4–14.
Kahn, M.G., Ferguson, J.C., Shortliffe, E.H., and Fagan, L.M. (1985). Representation and use of temporal information in ONCOCIN. Proceedings of the Symposium on Computer Applications in Medical Care (pp. 172– 176). New York, NY: IEEE Computer Society Press.
Giarratano, J. and Riley, G. (1994). Expert Systems: Principles and Programming. Boston, MA: PWS Publishing Company.
Melton, J. (1996). An SQL3 snapshot. Proceedings of the Twelfth International Conference on Data Engineering (pp. 666–672). Los Alamitos, CA, USA: IEEE Computer Society Press.
Minker, J. (1997). Logic and Databases Past, Present, and Future, AI Magazine, 18(3), 21–47.
Musen, M.A., Carlson, R.W., Fagan, L.M., Deresinski, S.C., and Shortliffe, E.H. (1992). T-HELPER: Automated support for community-based clinical research. Proceedings of the Sixteenth Annual Symposium on Computer Applications in Medical Care (pp. 719–723). New York: McGraw-Hill.
Musen, M.A., Tu, S., Das, A.K., and Shahar, Y. (1996). EON: A Component-Based Approach to Automation of Protocol-Directed Therapy, Journal of the American Medical Informatics Association, 3, 367–388.
Olson, M.A. (1997). DataBlade extensions for INFORMIX-universal server. Forty-Second IEEE Computer Society International Conference Proceedings (pp. 143–148). Los Alamitos, CA, USA: IEEE Computer Society Press.
Shahar, Y. (1994). A Knowledge-Based Method for Temporal Abstraction of Clinical Data, Ph.D. dissertation, Program in Medical Information Sciences, Stanford University School of Medicine, Stanford, CA.
Shahar, Y. (1997). A Framework for Knowledge-Based Temporal Abstraction, Artificial Intelligence, 90, 79–133.
Shahar, Y. (1998). Dynamic Interpretation Contexts for Temporal Abstraction, Annals of Mathematics and Artificial Intelligence, 22, 159–192.
Shahar, Y. and Cheng, C. (1998). Ontology-driven visualization of temporal abstractions. Proceedings of the Eleventh BanffWorkshop on Knowledge Acquisition, Modeling and Management (VKM-10, pp. 1–20). Calgary, Canada: SRDG Publications.
Shahar, Y. and Combi C. (1997a). Timing is Everything: Time-Oriented Clinical Information Systems, Western Journal of Medicine, 168, 105–113.
Shahar, Y. and Combi. C. (1997b). Temporal Reasoning and Temporal Data Maintenance: Issues and Challenges, Computers in Biology and Medicine, 27(5), 353–368.
Shahar, Y., Miksch, S., and Johnson, P. (1998). The Asgaard Project: A Task-Specific Framework for the Application and Critiquing of Time-Oriented Clinical Guidelines. Artificial Intelligence in Medicine, in press.
Shahar, Y. and Musen, M.A. (1996). Knowledge-Based Temporal Abstraction in Clinical Domains, Artificial Intelligence in Medicine, 8(3), 267–298.
Stein, A., Musen, M.A., and Shahar, Y. (1996). Knowledge acquisition for temporal abstraction. Proceedings of the 1996 AMIA Fall Symposium (pp. 204–208). Philadelphia, PA: Hanley & Belfus.
Snodgrass, R.T. (1995). The TSQL2 Temporal Query Language. Boston, MA: Kluwer Academic Publishers.
Snodgrass, R.T. and Ahn, I. (1985). Proceedings of ACM SIGMOD International Conference on Management of Data (pp. 236–246). Austin, TX: ACM.
Wiederhold, G. (1992). Mediators in the Architecture of Future Information Systems, IEEE Computer, 25, 38–50.
Wiederhold, G. and Genesereth, M. (1997). The Conceptual Basis of Mediation Services, IEEE Expert, 12(5), 38–47.
Zaniolo, C., Ceri, S., Faloutsos, C, Snodgrass, R.T., Subrahmanian, V.S., and Zicari, R. (1997). Advanced Database Systems. San Francisco, CA: Morgan Kaufmann Publishers.
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Nguyen, J.H., Shahar, Y., Tu, S.W. et al. Integration of Temporal Reasoning and Temporal-Data Maintenance into a Reusable Database Mediator to Answer Abstract, Time-Oriented Queries: The Tzolkin System. Journal of Intelligent Information Systems 13, 121–145 (1999). https://doi.org/10.1023/A:1008711006591
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DOI: https://doi.org/10.1023/A:1008711006591