By Gio Wiederhold (auth.)
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The availability and usage of these systems is increasing, since they provide good database capabilities at a lower installation cost than locally developed research support systems. C FUTURE USE OF DATABASES IN HEALTH CARE There seems little doubt that usage of the various types of databases cited above will continue to grow, even though the number of successful database 27 operations is still quite small. In many current systems the breadth of usage and the degree of medical interaction is much less than was hoped for.
1. 26 Clinical databases may take many forms, but since in general a cause and effect relationship is to be explored, we will need to collect patient data that represent at least both events. The event which is the cause should precede the event which shows the effect by some interval of time. If the interval is short, a single patient observation may suffice. When data are abstracted from the medical record, the past history is available from the patient record and can be combined with outcome variables into a single record.
The Academy of Dermatology has now published SNODERM with codes specific to dermatology in these six dimensions (AAOD, 1978). The topic of codes is a major field of research in itself, and we will have to forego further exposition here. The actual encoding of clinical observations for computer entry can be carried out in a variety of ways. 1. 26 Clinical databases may take many forms, but since in general a cause and effect relationship is to be explored, we will need to collect patient data that represent at least both events.