Examining database persistence of ISO/EN 13606 standardized electronic health record extracts: relational vs. NoSQL approaches

BMC Medical Informatics and Decision Making

Research Article

Pablo Serrano-Balazote¹  Raimundo Lozano-Rubí²  Ricardo Sánchez-de-Madariaga³  Antonio L. Castro³  Oscar Moreno³  Mario Pascual³  Adolfo Muñoz³ 

[1]Doce de Octubre University Hospital, Madrid, Spain

[2]Medical Informatics, Hospital Clínic, Unit of Medical Informatics, University of Barcelona, Barcelona, Spain

[3]Department of Computer Science, Autonomous Univerity of Barcelona, Barcelona, Spain

[4]Telemedicine and Information Society Department, Health Institute “Carlos III” (ISCIII), c/Sinesio Delgado, 4 –, 28029, Madrid, Spain

关键词: Relational database;    NoSQL database;    Normalized medical information;    ISO/EN 13606 standard;    Electronic health record extract;    Algorithmic complexity;    Primary use;    Clinical practice;    Secondary research use;    Document-based task;   

DOI  :  10.1186/s12911-017-0515-4

 received in 2016-10-13, accepted in 2017-07-31,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe objective of this research is to compare the relational and non-relational (NoSQL) database systems approaches in order to store, recover, query and persist standardized medical information in the form of ISO/EN 13606 normalized Electronic Health Record XML extracts, both in isolation and concurrently. NoSQL database systems have recently attracted much attention, but few studies in the literature address their direct comparison with relational databases when applied to build the persistence layer of a standardized medical information system.MethodsOne relational and two NoSQL databases (one document-based and one native XML database) of three different sizes have been created in order to evaluate and compare the response times (algorithmic complexity) of six different complexity growing queries, which have been performed on them. Similar appropriate results available in the literature have also been considered.ResultsRelational and non-relational NoSQL database systems show almost linear algorithmic complexity query execution. However, they show very different linear slopes, the former being much steeper than the two latter. Document-based NoSQL databases perform better in concurrency than in isolation, and also better than relational databases in concurrency.ConclusionNon-relational NoSQL databases seem to be more appropriate than standard relational SQL databases when database size is extremely high (secondary use, research applications). Document-based NoSQL databases perform in general better than native XML NoSQL databases. EHR extracts visualization and edition are also document-based tasks more appropriate to NoSQL database systems. However, the appropriate database solution much depends on each particular situation and specific problem.

【 授权许可】

CC BY   
© The Author(s). 2017