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Victor Babes UNIVERSITY OF MEDICINE AND
PHARMACY TIMISOARA

• DEPARTMENT OF
• MEDICAL INFORMATICS AND BIOPHYSICS
• Medical Informatics Division
• www.medinfo.umft.ro/dim
• 2007 / 2008

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MEDICAL DATABASES

• COURSE 2

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Operations with informations

• Generation
• Acquisition dep. on information nature
• Storage data bases, knowledge bases
• Processing for interpretation
• Commitment
• Protection
• Use

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1. PACIENT RECORD
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1.1. Terminology EHR - ELECTRONIC HEALTH
RECORD EPR - ELECTRONIC PATIENT RECORDCPR
COMPUTERIZED PATIENT RECORD
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• 1.2. PACIENT RECORD
• a. ON PAPER
• AVANTAGES / DISADVANTAGES
• EASY TO CARRY, EASY TO BROWSE
• LOW COST, FREE FORMAT
• FAST DATA ENTRY
• ACCESS FROM ONE PLACE ONLY
• b. ELECTRONIC
• AVANTAGES / DISADVANTAGES
• ACCESS FROM DIFFERENT PLACES, MORE PERSONS
• EASY TO READ, EASY TO SEARCH INFORMATION
• GOOD BASE FOR DATA ANALISYS, FOR TAKE DECISSION
• NEED FOR TRAINED PERSONNEL
• REQUIRE MORE TIME FOR DATA ENTRY
• HIGHER COST

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1.3. EHR STRUCTURE

• IDENTIFICATION DATA (apart file!!!)
• EVENTS consultation, hospitalisation, surgical
  intervention, X-ray, etc
• time scale
• ACTIONS
• OBSERVATIONS case history, lab.results,
  investigations signals, images
• DECISIONS diagnosis
• INTERVENTIONS, THERAPY prescriptions
• RELATIONS

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2. DATA FILES
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2.1. DATA FILES

• DEFINITIONS
• DATA formalized representations of concepts or
  facts, appropriate for processing (both human or
  automatic processing)
• FILE an organized set of data

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2.2 TYPES OF DATA

• QUALITATIVE Case history (descriptive)
• NUMERICAL Laboratory Investigations
• GRAPHICS Biosignals (EKG, EEG)
• SOUNDS Phonocardiogram
• STATIC IMAGES x-ray, NMR
• DYNAMIC IMAGES movies
• (MULTIMEDIA FILES)

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DATA FILE STRUCTURE - scheme
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• 2.3. DATA FILE STRUCTURE
• a) RECORDS ( Header EOF)
• b) FIELDS
• NAME
• TYPE
• NUMERICAL
• CHARACTER
• LOGICAL ( Y / N )
• DATE
• COMMENT
• SIZE

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2.4. PATIENT RECORD
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3. DATA BASES
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3.1. GENERAL NOTIONS

• DEFINITION DATABASE a structured set of data -
  comprises both data and relations between data
• STRUCTURE
• FILES (with at least 1 common field - ID)
• RELATIONS between records and/or data
• PROPERTIES independence on physical support or
  language

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3.2. Creating DataBases

• Data collecting
• Record Structure
• Coding
• Staff training for filling in
• Data validation
• Field type
• All possible relations

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3.3. Coding and classification

• Thesaurus - terms list
• Nomenclature - associated code list
• Types of codes
• numerical, mnemonical, hierarchical,
  juxtapositional
• Taxonomy classifications rules
• Taxonomic axes
• Nosology - classification in medicine

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3.4. Classification Systems

• ICD - International Classification of Diseases
  (10)
• ICPC - International Classification for Primary
  Care
• SNOMED System of NOmenclature in MEDicine -
  multiaxial
• Specialized Mental, Oncology, Procedures
• MeSH / UMLS - Medical Subject Headings
• Unified Medical Language System
• DRG - Diagnostic Related Groups for finance
• Case-Mix

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3.5. DB CLASSIFICATION

• On data distribution
• Local DB (all on 1 computer)
• Distributed DB (on several computers)
• On structure
• HIERARCHICAL DB
• RELATIONAL DB
• NETWORK DB
• OBJECT-ORIENTED

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a) HIERARCHICAL DB

• Tree structure each element is subordinated to
  only one element
• Fast search and processing
• No flexibility for procedure changes
• b) RELATIONAL DB
• Logical structure (rows columns)
• Several searching criteria
• Easy changes

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4. DBMSData Base Management Systems
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4. DBMSDataBase Management System

• 4.1. DEFINITION
• DBMS a set of software tools for
• building a DB
• control access to data
• assure data security and integrity
• Represented by
• specialized languages
• dictionaries, nomenclature

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• 4.2. DBMS Functions
• DESCRIPTION
• data structure
• relations
• access conditions
• DATA MANIPULATION
• create, delete, update a record
• search, sort, edit virtual records
• USE FUNCTION
• USER - DB dialogue

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4.3. DBMS Languages

• Languages based on relational algebra
• Languages using relational operators
• Transform oriented languages (SQL)
• Graphical relational languages (QBE, Paradox)
• Examples dBase, Foxpro, Access, Oracle

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