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BMC Medical Informatics and Decision Making
Published in: BMC Medical Informatics and Decision Making 1/2017

Open Access 01-12-2017 | Research article

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

Authors: Ricardo Sánchez-de-Madariaga, Adolfo Muñoz, Raimundo Lozano-Rubí, Pablo Serrano-Balazote, Antonio L. Castro, Oscar Moreno, Mario Pascual

Published in: BMC Medical Informatics and Decision Making | Issue 1/2017

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Abstract

Background

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.

Methods

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.

Results

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.

Conclusion

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.
Appendix
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Metadata
Title
Examining database persistence of ISO/EN 13606 standardized electronic health record extracts: relational vs. NoSQL approaches
Authors
Ricardo Sánchez-de-Madariaga
Adolfo Muñoz
Raimundo Lozano-Rubí
Pablo Serrano-Balazote
Antonio L. Castro
Oscar Moreno
Mario Pascual
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Medical Informatics and Decision Making / Issue 1/2017
Electronic ISSN: 1472-6947
DOI
https://doi.org/10.1186/s12911-017-0515-4

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