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Timing Is Everything: Temporal Reasoning and Temporal Data Maintenance in Medicine

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Artificial Intelligence in Medicine (AIMDM 1999)

Part of the book series: Lecture Notes in Computer Science ((LNAI,volume 1620))

Abstract

Both clinical management of patients and clinical research are essentially time-oriented endeavors. In this paper, I emphasize the crucial role of temporal-reasoning and temporal-maintenance tasks for modern medical information and decision support systems. Both tasks are important for management of clinical data, but the first is often approached mainly through artificial-intelligence methodologies, while the other is usually investigated by the database community. However, both tasks require careful consideration of common theoretical issues, such as the structure of time. In addition, common to both of these research areas are tasks such as temporal abstraction and management of variable temporal granularity. Finally, both tasks are highly relevant for applications such as patient monitoring, support to application of therapy guidelines, assessment of the quality of guideline application, and visualization and exploration of time-oriented biomedical data. I propose that integration of the two areas should be a major research and development goal. I demonstrate one integration approach by presenting a new architecture, a temporal mediator, which combines temporal reasoning and temporal maintenance, and integrates the management of clinical databases and medical knowledge bases. I present and discuss examples of using the temporal mediator for several of the application areas mentioned. I conclude by reemphasizing the importance of effective knowledge representation, knowledge reuse, and knowledge sharing methods to medical decision support systems in general, and to time-oriented systems in particular.

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References

  1. Downs, S.M., Walker, M.G., and Blum, R.L.: Automated summarization of on-line medical records. In: Salamon, R., Blum, B., and Jorgensen, M. (eds.): MEDINFO '86: Proceedings of the Fifth Conference on Medical Informatics. North-Holland, Amsterdam (1986) 800–804.

    Google Scholar 

  2. Keravnou, E.T., and Washbrook, J.: A temporal reasoning framework used in the diagnosis of skeletal dysplasias. Artificial Intelligence in Medicine 2 (1990) 239–265.

    Article  Google Scholar 

  3. Musen, M.A., Tu, S.W., Das, A.K., and Shahar, Y.: EON: A component-based approach to automation of protocol-directed therapy. Journal of the American Medical Informatics Association 3(6) (1996) 367–388.

    Google Scholar 

  4. Shahar, Y.: Dynamic temporal interpretation contexts for temporal abstraction. Annals of Mathematics and Artificial Intelligence 22(1–2) (1998) 159–192.

    Article  MATH  Google Scholar 

  5. Shahar, Y., Miksch, S., and Johnson, P.: The Asgaard project: A task-specific framework for the application and critiquing of time-oriented clinical guidelines. Artificial Intelligence in Medicine 14 (1998) 29–51.

    Article  Google Scholar 

  6. Shahar, Y. and Cheng, C. (1998). Knowledge-Based Visualization of Time-Oriented Clinical Data. Proceedings of the 1998 AMIA Fall Symposium, Orlando, FL.

    Google Scholar 

  7. Shahar, Y. and Musen, M.A.: Knowledge-based temporal abstraction in clinical domains. Artificial Intelligence in Medicine 8(3) (1996) 267–298.

    Article  Google Scholar 

  8. Russ, T.A.: Using hindsight in medical decision making. In: Proceedings of Symposium on Computer Applications in Medical Care. IEEE Computer Society Press, New York NY (1989) 38–44.

    Google Scholar 

  9. Shahar, Y.: A framework for knowledge-based temporal abstraction. Artificial Intelligence 90(1) (1997) 79–133.

    Article  MATH  Google Scholar 

  10. Keravnou, E.T.: A multidimensional and multigranular model of time for medical knowledge-based systems (submitted).

    Google Scholar 

  11. Fagan L.M., Kunz, J.C., Feigenbaum, E.A. and Osborn, J.J.: Extensions to a Rule-Based Formalism for a Monitoring Task. In: Buchanan, B.G. and Shortliffe, E.H., (eds.): Rule-Based Expert Systems. Addison-Wesley, Reading, MA (1984) 397–423.

    Google Scholar 

  12. De Zegher-Geets, I.M.: IDEFIX: Intelligent Summarization of a Time-Oriented Medical Database. M.S. Dissertation, Program in Medical Information Sciences, Stanford University School of Medicine, 1987; Knowledge Systems Laboratory Technical Report KSL-88-34, Department of Computer Science, Stanford University, Stanford, CA, 1988.

    Google Scholar 

  13. Kohane, I.S.: Temporal reasoning in medical expert systems. Technical Report 389, Laboratory of Computer Science, Massachusetts Institute of technology, Cambridge, MA, 1987.

    Google Scholar 

  14. Kahn, M.G.: Combining physiologic models and symbolic methods to interpret timevarying patient data. Methods of Information in Medicine 30(3) (1991) 167–178.

    Google Scholar 

  15. Larizza, C., Moglia, A,. and Stefanelli, M.: M-HTP: A system for monitoring hearttransplant patients. Artificial Intelligence in Medicine 4(2) (1992) 111–126.

    Article  Google Scholar 

  16. Haimowitz, I.J. and Kohane, I.S.: Automated trend detection with alternate temporal hypotheses. In: Proceedings of the Thirteenth International Joint Conference on Artificial Intelligence. Morgan Kaufmann, San Mateo (1993) 146–151.

    Google Scholar 

  17. Snodgrass, R. and Ahn, I.: Temporal databases. IEEE Computer 19(9) (1986) 35–42.

    Google Scholar 

  18. Caironi, P.V., Portoni, L., Combi, C., Pinciroli, F., Ceri, S.: HyperCare: A prototype of an active database for compliance with essential hypertension therapy guidelines. In: Proceedings of the 1997 AMIA Annual Fall Symposium (formerly the Symposium on Computer Applications in Medical Care). Hanley & Belfus, Philadelphia, PA (1997) 288–292.

    Google Scholar 

  19. Horn, W., Miksch, S., Egghart, G., Popow, C., and Paky, F.: Effective data validation of high-frequency data: time-point-, time-interval-, and trend-based methods. Computers in Biology and Medicine, Special Issue: Time-Oriented Systems in Medicine 27(5) (1997) 389–409.

    Google Scholar 

  20. Gal, A., Etzion, O., Segev, A.: Representation of highly-complex knowledge in a database. Journal of Intelligent Information Systems 3(2) (1994) 185–203.

    Article  Google Scholar 

  21. Das, A.K., and Musen, M.A.: A temporal query system for protocol-directed decision support. Methods of Information in Medicine 33 (1994) 358–370.

    Google Scholar 

  22. Melton, J.: An SQL3 Snapshot. In: Proceedings of the Twelfth International Conference on Data Engineering. IEEE Computer Society Press, Los Alamitos, CA (1996) 666–672.

    Chapter  Google Scholar 

  23. Snodgrass, R.T.: The TSQL2 Temporal Query Language. Kluwer Academic Publishers, Boston (1995).

    MATH  Google Scholar 

  24. Wiederhold, G.: Mediators in the architecture of future information systems. IEEE Computer 25 (1992) 38–50.

    Google Scholar 

  25. Wiederhold, G. and Genesereth, M.: The Conceptual Basis of Mediation Services. IEEE Expert 12(5) (1997) 38–47.

    Article  Google Scholar 

  26. Nguyen, J.H., Shahar, Y., Tu, S.W., Das, A.K., and Musen, M.A.: 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 (in press).

    Google Scholar 

  27. Das, A.K., Shahar, Y., Tu, S.W., and Musen, M.A.: A temporal-abstraction mediator for protocol-based decision support. In: Proceedings of the Eighteenth Annual Symposium on Computer Applications in Medical Care (1994) 320–324.

    Google Scholar 

  28. Stein, A., Musen, M.A., and Shahar, Y.:. Knowledge acquisition for temporal abstraction. In: Proceedings of the 1996 AMIA Annual Fall Symposium (formerly the Symposium on Computer Applications in Medical Care) (1996) 204–208.

    Google Scholar 

  29. Shahar, Y., Chen, H., Stites, D.P., Basso, L., Kaizer, H., Wilson, D.M., and Musen, M.A.: Semiautomated Acquisition of Clinical Temporal-abstraction Knowledge. Stanford Medical Informatics Tech Report SMI-98-0735 (1998).

    Google Scholar 

  30. Combi, C., Pinciroli, F., Musazzi, G., and Ponti, C.: Managing and displaying different time granularities of clinical information. In: Ozbolt, J.G. (ed.): The 18th Annual Symposium on Computer Applications in Medical Care., Hanley & Belfus, Philadelphia, PA (1994) 954–958.

    Google Scholar 

  31. Cousins, S.B. and Kahn, M.G.: The visual display of temporal information. Artificial Intelligence in Medicine 3(6) (1991) 341–357.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Stanford Medical Informatics, Stanford University, Medical School Office Building x215, 251 Campus Drive, Stanford, CA, 94305-5479

    Yuval Shahar

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  1. Yuval Shahar
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Editor information

Editors and Affiliations

  1. Austrian Research Institute for Artificial Intelligence, Schottengasse 3, A-1010, Vienna, Austria

    Werner Horn

  2. Department of Medicine and Computer Science, Stanford University, 251 Campus Drive, Stanford, CA, 94305-5479, USA

    Yuval Shahar

  3. Department of Medicine Karolinska Institutet, Huddinge University Hospital, Sweden

    Greger Lindberg

  4. Department of Medical Informatics and Image Analysis, Aalborg University, Fredrik Bajers Vej 7D, DK-9000, Aalborg, Denmark

    Steen Andreassen

  5. School of Public Policy, University College London, 29/30 Tavistock Square, London, WC1H 9EZ, UK

    Jeremy Wyatt

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© 1999 Springer-Verlag Berlin Heidelberg

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Shahar, Y. (1999). Timing Is Everything: Temporal Reasoning and Temporal Data Maintenance in Medicine. In: Horn, W., Shahar, Y., Lindberg, G., Andreassen, S., Wyatt, J. (eds) Artificial Intelligence in Medicine. AIMDM 1999. Lecture Notes in Computer Science(), vol 1620. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-48720-4_3

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  • DOI: https://doi.org/10.1007/3-540-48720-4_3

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-66162-7

  • Online ISBN: 978-3-540-48720-3

  • eBook Packages: Springer Book Archive

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