Examining database persistence of ISO/EN 13606 standardized electronic health record extracts : relational vs. NoSQL approaches
Sánchez-de-Madariaga, Ricardo (Instituto de Salud Carlos III)
Muñoz, Adolfo (Instituto de Salud Carlos III)
Lozano-Rubí, Raimundo (Universitat Autònoma de Barcelona. Departament de Ciències de la Computació)
Serrano-Balazote, Pablo (Hospital Universitario 12 de Octubre (Madrid))
Castro, Antonio L. (Instituto de Salud Carlos III)
Moreno, Oscar (Instituto de Salud Carlos III)
Pascual, Mario (Instituto de Salud Carlos III)

Data:	2017
Resum:	The 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. One 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. Relational 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. Non-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.
Ajuts:	Instituto de Salud Carlos III PI12/00508 Instituto de Salud Carlos III PI15CIII/00003 Instituto de Salud Carlos III PI12/01476 Instituto de Salud Carlos III PI15CIII/00010 Instituto de Salud Carlos III PI12/01558 Instituto de Salud Carlos III PI12/01399 Instituto de Salud Carlos III PI15/00321 Instituto de Salud Carlos III PI15/00831
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	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
Publicat a:	BMC Medical Informatics and Decision Making, Vol. 17 (August 2017) , art. 123, ISSN 1472-6947

DOI: 10.1186/s12911-017-0515-4
PMID: 28821246

14 p, 981.8 KB

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