Ohboshi N, Kambayashi Y, Takahashi T
Department of Medical Informatics, Kyoto University Hospital, Shogoin Kawara-choyo 54, Sakyo, Kyoto 606-01, Japan.
Medinfo. 1995;8 Pt 1:680.
One of the advantages of current database systems is the capability to enforce global integrity constraints on a large amount of data. Input of contradicting data will be rejected by database systems in order to maintain correctness. On the other hand, in medical information systems it may be necessary to realize two or more databases in one system, where there are some controlled contradictions among these databases. For example, if a doctor wants to hide the real disease name from the patient in critical condition, the database viewed by the patient should be different from the real database, although each of these databases should be conflict free and large amounts of data are shared by both. This kind of problem was not discussed for commercial business-oriented databases. Data sharing and data security are important functions required for medical information systems. There are, however, cases when we need to show non-real data to some users. Security mechanisms usually prevent a user from retrieving critical data. If a request for retrieval of some data is rejected by the system, a user may find there is something secret being kept from him. In order to cope with these situations, we introduce the POSTGRES database system. POSTGRES is a generalized relational database system developed at the University of California. The form of POSTGRES rule is as follows: On event (To) object WHERE POSTQUEL-qualification Then Do [instead] POSTQUEL-command(s) The POSTGRES rule shows that event is retrieve, replace, delete, append, new (i.e., replace or append) or old (i.e., delete or replace). The concept of objects is introduced in object-oriented databases. In relational database systems, an object corresponds to each data value, an attribute, or a relation. The optional keyword "instead" indicates that the action indicated by POSTQUEL-command(s) is to be performed instead of the action which caused the rule to activate. This keyword plays very important role for our purpose. By preparing a standard story which is consistent with the patient's condition, the doctor can make a smooth explanation to the patient showing the stories instead of the critical data. So, if medical personnel and system designers prepare the standard stories or data for the explanation and store such data in the system, the users of medical information systems (doctors) can take the benefit of the data replacement. For such a purpose, medical personnel and system designers classify the patients' data according to their age, sex, occupational history, personal history, and diseases. Standard story or data should be prepared for each user class in advance. Using POSTGRES rule system in medical information systems, doctors can make a smooth explanation of a patientUs condition in serious cases, when hiding real data is required. The validity of POSTGRES rule system is proved where data exchange is needed for data protection. For example, when a doctor writes a prescription of a placebo through the ordering system, POSTGRES rule system will identify its existence. We believe that POSTGRES rule system can be applied to many fields in medical data processing.
当前数据库系统的优点之一是能够对大量数据实施全局完整性约束。为了保持数据的正确性,数据库系统会拒绝输入相互矛盾的数据。另一方面,在医疗信息系统中,一个系统中可能需要实现两个或更多数据库,而这些数据库之间存在一些可控的矛盾。例如,如果医生想要对病情危急的患者隐瞒真实疾病名称,患者查看的数据库应与真实数据库不同,尽管这些数据库各自都应无冲突且大量数据是共享的。这类问题在面向商业业务的数据库中并未被讨论。数据共享和数据安全是医疗信息系统所需的重要功能。然而,存在我们需要向某些用户展示非真实数据的情况。安全机制通常会阻止用户检索关键数据。如果系统拒绝了某些数据的检索请求,用户可能会发现有些秘密对其隐瞒着。为了应对这些情况,我们引入POSTGRES数据库系统。POSTGRES是加利福尼亚大学开发的一种广义关系数据库系统。POSTGRES规则的形式如下:在事件(To)对象 WHERE POSTQUEL条件 Then 执行 [替代] POSTQUEL命令(多个)POSTGRES规则表明事件可以是检索、替换、删除、追加、新建(即替换或追加)或旧有(即删除或替换)。对象的概念是在面向对象数据库中引入的。在关系数据库系统中,一个对象对应每个数据值、一个属性或一个关系。可选关键字“替代”表示将执行POSTQUEL命令(多个)所指示的操作,而不是导致规则激活的操作。这个关键字对我们的目的起着非常重要的作用。通过准备一个与患者病情相符的标准说明,医生可以向患者顺利地展示这些说明而非关键数据。所以,如果医疗人员和系统设计师为解释准备标准说明或数据并将其存储在系统中,医疗信息系统的用户(医生)就能受益于数据替换。出于这样的目的,医疗人员和系统设计师根据患者的年龄、性别职业史、个人史和疾病对患者数据进行分类。应提前为每个用户类别准备标准说明或数据。在医疗信息系统中使用POSTGRES规则系统,在需要隐瞒真实数据的严重情况下,医生可以顺利地向患者解释病情。在需要进行数据交换以保护数据的情况下,POSTGRES规则系统的有效性得到了证明。例如,当医生通过医嘱系统开出安慰剂处方时,POSTGRES规则系统会识别其存在。我们相信POSTGRES规则系统可应用于医疗数据处理的许多领域。