Showing papers by "James J. Cimino published in 1991"

The Columbia-Presbyterian Medical Center decision-support system as a model for implementing the Arden Syntax.

Abstract: Columbia-Presbyterian Medical Center is implementing a decision-support system based on the Arden Syntax for Medical Logic Modules (MLM's). The system uses a compiler-interpreter pair. MLM's are first compiled into pseudo-codes, which are instructions for a virtual machine. The MLM's are then executed using an interpreter that emulates the virtual machine. This design has resulted in increased portability, easier debugging and verification, and more compact compiled MLM's. The time spent interpreting the MLM pseudo-codes has been found to be insignificant compared to database accesses. The compiler, which is written using the tools "lex" and "yacc," optimizes MLM's by minimizing the number of database accesses. The interpreter emulates a stack-oriented machine. A phased implementation of the syntax was used to speed the development of the system.

Conceptual data model for a central patient database.

Abstract: This paper presents methods used to develop a conceptual model for a patient database forming the centerpiece of a clinical information system under development. Various modeling techniques are discussed using a simplified fragment of the model. A method for mapping the model onto a relational design optimized for single patient retrievals is described. The results section discusses a number of issues pertaining to the flexibility and usability of this architecture.

Adding your terms and relationships to the UMLS Metathesaurus.

Abstract: The National Library of Medicine's Unified Medical Language System [1] Metathesaurus contains the richest single corpus of biomedical names in existence. Yet, developers wishing to make use of the Metathesaurus will be confronted by users who want to add local terminology and relationships not already represented there. We urge developers to fill those needs, while, at the same time, they plan for the many consequences of unilateral Metathesaurus enhancement. Foremost among these consequences is the need to maintain local enhancements across subsequent releases of the Metathesaurus. These problems are illustrated via examples of candidate Metathesaurus enhancement terms in use at the Columbia-Presbyterian Medical Center (CPMC), at the Mayo Clinic, and in Current Disease Descriptions (CDD). Sharing and reuse of Metathesaurus enhancement methods may permit local enhancements to be used at other sites, and it may permit the global Metathesaurus utilization effort to benefit from economies of scale.

Representation of clinical laboratory terminology in the Unified Medical Language System.

Abstract: The Unified Medical Language System (UMLS) was examined to determine its coverage of clinical laboratory terminology in use at the Columbia-Presbyterian Medical Center (CPMC). The Metathesaurus (Meta-1) contains exact matches for 30% of 1460 CPMC laboratory terms and near matches for an additional 42%, with better coverage of atomic-level concepts ("substance" terms) than complex ones (tests and panels). The Semantic Network includes types for representing laboratory procedures (2), measured substances (at least 56) and sampled substances (at least 14), but no type to represent specimens. Few of the UMLS semantic relationships are applicable to the CPMC vocabulary. These results have implications for the utility of the UMLS for linking clinical databases to electronic medical information sources.

Using the UMLS to bring the library to the bedside.

Abstract: This paper presents an algorithm that can be used to convert ICD9 terms to related MeSH terms. Preliminary evaluation indicates that together, the algorithm and the UMLS provide a reasonable resource for facilitating such conversions.

IAIMS and UMLS at Columbia-Presbyterian Medical Center.

Abstract: The authors use an example to illustrate combining Integrated Academic Information Management System (IAIMS) components (applications) into an integral whole, to facilitate using the components simultaneously or in sequence. They examine a model for classifying IAIMS systems, proposing ways in which the United Medical Language System (UMLS) can be exploited them.