Abstract
BackgroundMedical records accumulate data concerning patient health and the natural history of disease progression. However, methods to mine information systematically in a form other than an electronic health record are not yet available. The purpose of this study was to develop an object modeling technique as a first step towards a formal database of medical records.MethodLive Sequence Charts (LSC) were used to formalize the narrative text obtained during a patient interview. LSCs utilize a visual scenario-based programming language to build object models. LSC extends the classical language of UML message sequence charts (MSC), predominantly through addition of modalities and providing executable semantics. Inter-object scenarios were defined to specify natural history event interactions and different scenarios in the narrative text.ResultA simulated medical record was specified into LSC formalism by translating the text into an object model that comprised a set of entities and events. The entities described the participating components (i.e., doctor, patient and record) and the events described the interactions between elements. A conceptual model is presented to illustrate the approach. An object model was generated from data extracted from an actual new patient interview, where the individual was eventually diagnosed as suffering from Chronic Fatigue Syndrome (CFS). This yielded a preliminary formal designated vocabulary for CFS development that provided a basis for future formalism of these records.ConclusionsTranslation of medical records into object models created the basis for a formal database of the patient narrative that temporally depicts the events preceding disease, the diagnosis and treatment approach. The LSCs object model of the medical narrative provided an intuitive, visual representation of the natural history of the patient’s disease.
Highlights
Medical records accumulate data concerning patient health and the natural history of disease progression
Translation of medical records into object models created the basis for a formal database of the patient narrative that temporally depicts the events preceding disease, the diagnosis and treatment approach
A rigorous visual specification for medical object models Live Sequence Charts (LSC) constitute a visual formalism for inter-object scenario-based specification and programming, which extends the classical language of UML message sequence charts (MSC) predominantly through addition of modalities [18]
Summary
Medical records accumulate data concerning patient health and the natural history of disease progression. Medical records are products of doctor-patient discussions that summarize the physical and mental health of the patient, with information being in the form of long textual descriptions that amass the patients’ medical conditions over years This information can be generalized and abstracted into a questionnaire that follows a diagnostic algorithm, consisting of a series of yes/no questions, which can be described as a decision tree that assess the likelihood that self-reported symptoms fit with a particular diagnosis. A systematic study of complex medicallyunexplained illnesses such as CFS could potentially identify common patterns in disease development and provide information concerning possible etiologies To pursue this direction, there is a requirement to integrate ‘piecemeal’ medical records into a single framework that makes possible a comprehensive view and systematic analysis
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