Faculty Bibliography

We have developed a computerized method for performing bibliographic searches directly from patient data involving five steps: 1) identifying specific patient data which raises a question in the mind of the user, 2) selection (from a list of generic questions) of a small number of questions which fit the selected patient data, 3) automated translation of the patient data into appropriate terms used for bibliographic indexing, 4) conversion of the question selected by the user into a search strategy, and 5) transfer of the search strategy to a search engine for a bibliographic database. We have modified the Columbia-Presbyterian Clinical Information System to experiment with this method. The first implementation converts patient diagnoses and procedures coded in ICD9-CM into Medical Subject Headings (MeSH) and searches Medline using BRS/Onsite. Challenges include development of a useful set of generic questions and translation from ICD9-CM to MeSH using the Unified Medical Language System (UMLS).

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.