Active Data base

An active database is a database with the event monitoring scheme for detecting when certain data is INSERTED, DELETED, UPDATED, or SELECTED, and a tomatica!!" e#ec ting the actions in res$onse when certain events ha$$en and $artic !ar conditions are met% An active database s"stem is a database management s"stem endowed with active r !es, i%e% stored $roced res activated b" the s"stem when s$ecific events occ r% T"$ica!!" an active r !e consists of three $arts& event, condition, and action, norma!!" written as& '(EN event I) condition T(EN action% *event* s$ecifies a !ist of events, *Condition* is a + er" on the database, *action* genera!!" consists of one or more $dates or + eries on the database%

http://www.psychcrawler.com/plweb/info/help/dbfund.html A text database is a collection of related documents assembled into a single searchable unit. The individual documents can be massive or minuscule, but they should bear some relation to each other. A database is composed of smaller units called records. In a text database, a record can be an entire document, a section within a document, a single page or a fragment of text within a page. hen you search a database, you will retrieve one or more records containing information that satisfies your !uery. A record can contain smaller regions of data called fields. A field usually defines a particular type of data common to several or all records within a database. "or instance, in a database of corporate memos, wherein each memo ma#es up a record, the following fields might be used: TO, FROM, DATE, SUBJECT and TEXT. $ou can narrow the scope of a search by restricting it to one or more fields. In this example, you might limit your search to the FROM field when searching for a sender%s name. &nly those records with the specified name in that field would be retrieved A parallel database system see#s to improve performance through paralleli'ation of various operations, such as loading data, building indexes and evaluating !ueries. Although data may be stored in a distributed fashion, the distribution is governed solely by performance considerations. (arallel databases improve processing and input/output speeds by using multiple )(*s and dis#s in parallel. )entrali'ed and client+server database systems are not powerful enough to handle such applications. In parallel processing, many operations are performed simultaneously, as opposed to serial processing, in which the computational steps are performed se!uentially http://www.it.bton.ac.u#/staff/lp,,/)-,.//)-,./0edical1-ys.html An expert system is software that attempts to provide an answer to a problem, or clarify uncertainties where normally one or more human experts would need to be consulted. 2xpert systems are most common in a specific problem domain, and is a traditional application and/or subfield of artificial intelligence. A wide variety of methods can be used to simulate the performance of the expert however common to most or all are 34 the creation of a so+called 5#nowledgebase5 which uses some #nowledge representation

formalism to capture the -ub6ect 0atter 2xpert%s 7-024 #nowledge and ,4 a process of gathering that #nowledge from the -02 and codifying it according to the formalism, which is called #nowledge engineering. 2xpert systems may or may not have learning components but a third common element is that once the system is developed it is proven by being placed in the same real world problem solving situation as the human -02, typically as an aid to human wor#ers or a supplement to some information system.

Advantages and disadvantages

Advantages:

(rovides consistent answers for repetitive decisions, processes and tas#s 8olds and maintains significant levels of information 2ncourages organi'ations to clarify the logic of their decision+ma#ing 9ever 5forgets5 to as# a !uestion, as a human might )an wor# round the cloc# )an be used by the user more fre!uently A multi+user expert system can serve more users at a time

Disadvantages:

:ac#s common sense needed in some decision ma#ing )annot ma#e creative responses as human expert would in unusual circumstances Domain experts not always able to explain their logic and reasoning 2rrors may occur in the #nowledge base, and lead to wrong decisions )annot adapt to changing environments, unless #nowledge base is changed

Challenges
People in the medical field have difficult decisions to make and have certain challenges to face: they may have to decide who gets treated first and who gets sent home - the "triage" situation GP's have to decide whether to visit a patient or leave them until surgery their knowledge may be out of date decision makers in emergency situations may not have access to test results before having to decide on treatment they may have fallen into "diagnostic habits" they typically have limited time to read journals or go to conferences they may have no experience of a particular rare condition and therefore not recognise it or not know how to deal with it the specialists whom an a doctor might like to consult may be in different part of country or world a treatment may cost so much they hesitate to suggest it

they may be unsure about their diagnosis and want to check it with someone more experienced they may be under time pressure they may not be aware of modern drugs drug interactions guidelines on drug usage contra-indications

MYCIN: medical diagnosis using production rules

!"#$% was the first well known medical expert system developed by &hortliffe at &tanford 'niversity to help doctors not expert in antimicrobial drugs prescribe such drugs for blood infections( !"#$% has three sub-systems: #onsultation system )xplanation &ystem *ule +c,uisition system

Background
-asic medical tasks when prescribing drugs for blood infections:

3. is the patient suffering from an infection. /-'0 bacteria occur normally1 and
samples can be contaminated2

,. what3s the organism. .. which drugs are appropriate. /some drugs too toxic for safe use1 no single ;. <.

anitbiotic is generally effective2 which one/s2 to select. lab tests - ,uickly for morphology staining characteristics1 later /45-56 hrs2 for full identification1 later still /7 - 4 days for sensitivity to antimicrobial agents2

0o consider when prescribing treatment: possible type of microbe age weight and sex of patient kidney function likely effectiveness of antimicrobial agents oral intravenous intramuscular administration dosage

Problems that occur with drug prescription

non-expert doctors don3t go through this process - prescribe habitual choice overprescription /e(g( for viral illnesses2 estimated at time at 78-48 times necessary wastes money can make for resistant strains of organisms

1. Mycin s Consultation !ystem

- works out possible organisms and suggests treatments

"ule base
rules stored as premise -action pairs premises are conjunctions and disjunctions of conditions conditions normally evaluate to 0rue or 9alse with some certainty factor on the evidence( *ules also have certainty factors( #ombined to form new certainty factors certainty factor - degree of belief attached to information actions are either conclusions /e(g( microbe is type :2 or instruction /e(g( remove drug from list of possibles2

)xample rule /in doctorese pseudo-;$&P2: IF 1) the stain of the organism is gramneg and 2) the morphology of the organism is rod and 3) the aerobicity of the organism is aerobic THEN there is strongly suggestive evidence (0.8) that the class of the organism is enterobacteriaceae

!tatic and dynamic data structures

Static data structures 0hese store medical knowledge not suitable for storage as inferential rules: includes lists of organisms knowledge tables with features of bacteria types list sof parameters Parameters < features of patients bacterial cultures drugs= Parameters can be ">% /e(g( 9)-*$;)2 single value /e(g( $?)%0$0" - if it3s salmonella it can3t be another organism as well2 or multi-value /e(g( $%9)#0 - patient can have more than one infection2 Parameter properties ):P)#0 range of possible values

P*@!P0 )nglish sentence to elicit reponse ;+-?+0+ can be known for certain from ;ab data ;@@A+B)+? lists rules mentioning the parameter in their premise /e(g( a rule might need to know whether or not a patient is febrile2 'P?+0)?--" lists rules mentioning the parameter in their action /i(e( they may draw a conclusion about the value of the parameter such as the $?)%0$0" parameter2 Dynamic data structures store information about the evolving case - the patient details possible diagnoses rules consulted: )xample piece of dynamic data: 0o evaluate the premise of the rule mentioned above: ($AND (SAME ORGANISM-1 GRAM GRAMNEG) (SAME ORGANISM-1 MORPH ROD) (SAME ORGANISM-1 AIR AEROBIC)) from following data ORGANISM-1 GRAM = (GRAMNEG 1.0) MORPH = (ROD 0.8) (COCCUS 0.2) AIR = (AEROBIC 0.6) (FACUL 0.4) 0otal value of whole expression is lowest certainty value < 8(C #onclusion is therefore: (CONCLUDE ORGANISM-1 is enterobacteriaceae 0.48 ( = 0.6 (CF of premise) x 0.8 (CF of rule)) /$n disjunctive premise total value of whole expression is highest certainty value2

Control structure
!"#$% first attempts to create a "patient context" containing information about the case then tries to compile a list of therapies for the context( $t uses a backward chaining mechanism reasoning back friom the goals it want sto prove to the data it has rather than vice versa( 0he overall goal is "compile a list of therapies"( Duestions can be prompted by the invocation of rules to find out necessary data to avoid unnecessary ,uestions(

#. $he %&planation !ystem

!"#$% can answer ,uestions about B@E a conclusion was reached and EB" a ,uestion was asked either after a consultation or while it is going on( $t does this by manipulating its record of the rules it invoked the goal it was trying to achieve the information it was trying to discover( #an also answer general ,uestions /e(g( what would you prescribe for organism :.2 by consulting its static data structures(

'. $he "ule (c)uisition !ystem

)xperts can enter new rules or edit existing rules( 0he system automatically adds the new rule to the ;@@A+B)+? list for all parameters mentioned in its premise and to the 'P?+0)?--" list of all paramters mentioned in its action(

%*aluation o+ MYCIN
$nitial evaluation: five experts agreed with F4G of its recommendations over 7H cases $n later experiment !"#$%3s performance was rated against senior and on-senior doctors:

!ource !"#$% 9aculty 7 9aculty 4 9ellow 9aculty I +ctual therapy 9aculty 5 *esident 9aculty H &tudent

"ating H4 H8 56 56 5C 5C 55 IC I5 45

( $ypical Consultation !ession

7( Patient $nformation 72 Patient3s name

PT538 42 +ge 34 years I2 &ex Male

Diagnosis C2 Please enter results of pending cultures in table: &$0) #';0'*)J ?+0) ):+!$%)? CSF 1234 30.1 YES 782 ?o you suspect P0HI6 may have an infection at a site from which you have not obtained specimens. No 7H2 Bas P0HI6 recently had objective evidence of abnormal neurologic signs /e(g( seiKures coma2 documented by physician. Yes 0he #&9 culture will be considered to be associated with meningitis( Cause 7F2 ?oes P0HI6 have an abnormal chest x-ray. %o 762 Bas P0HI6 been exposed to any contagious diseases recently. %o 4F2 Please enter #&9 findings in table: E-# GP!% Protein #&9glucose Periph-glucose 100 99 280 5 UNKNOWN IH2 $s meningitis a hospital-ac,uired infection.

Yes IL2 is P0HI6 a burns patient. Yes $ have found evidence /*';)H5H *';)HHF2that treatment should cover for e-coli causing meningitis $ have found evidence /*';)H5H *';)HHF *';)HF62that treatment should cover for pseudomaonas aeruginosa causing meningitis $ have found evidence /*';)H5H *';)HHF *';)HF62that treatment should cover for Alebsiella pneumoniae causing meningitis $ have found evidence /*';)H8F2that treatment should cover for ?iplococcuspneumoniae causing meningitis

Treatment $t is important to cover for the following infection/s2 and associated organism/s2: !eningitis Mitem 7Ne-coli Mitem 4Npseudomaonas aeruginosa Mitem INAlebsiella pneumoniae Mitem 5N?iplococcus-pneumoniae 572 ?oes P0HI6 have a clinically significant allergic reaction to any antimicrobial agent. No 5I2 P0HI63s weight in kilograms: F8 *ecommendation 7 !y preferred therapy is as follows: $n order to cover for items M7 4 I 5N give the following in combination:

72 +!P$#$;;$% ?ose I(Hg ,5h $O 42 G)%0+!"#$% ?ose 77L mg ,6h $O &ince high concentration of penicilllins can inactivate aminoglycosides do not mix these two antibiotics in the same $O bottle(