PROTEMPA: A Method for Specifying and Identifying Temporal Sequences in Retrospective Data for Patient Selection

Abstract

Objective: To specify and identify disease and patient care processes represented by temporal patterns in clinical events and observations, and retrieve patient populations containing those patterns from clinical data repositories, in support of clinical research, outcomes studies, and quality assurance. Design: A data processing method called PROTEMPA (Process-oriented Temporal Analysis) was developed for defining and detecting clinically relevant temporal and mathematical patterns in retrospective data. PROTEMPA provides for portability across data sources, "pluggable" data processing environments, and the creation of libraries of pattern definitions and data processing algorithms. Measurements: A proof-of-concept implementation of PROTEMPA in Java was evaluated against standard SQL queries for its ability to identify patients from a large clinical data repository who show the features of HELLP syndrome, and categorize those patients by disease severity and progression based on time sequence characteristics in their clinical laboratory test results. Results were verified by manual case review. Results: The proof-of-concept implementation was more accurate than SQL in identifying patients with HELLP and correctly assigned severity and disease progression categories, which was not possible using SQL only. Conclusions: PROTEMPA supports the identification and categorization of patients with complex disease based on the characteristics of and relationships between time sequences in multiple data types. Identifying patient populations who share these types of patterns may be useful when patient features of interest do not have standard codes, are poorly-expressed in coding schemes, may be inaccurately or incompletely coded, or are not represented explicitly as data values. © 2007 J Am Med Inform Assoc.