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Metadata-driven Software Systems in Biomedicine: Designing Systems that can adapt to Changing Knowledge (Health Informatics) [Hardcover]

Prakash M. Nadkarni
4.5 out of 5 stars  See all reviews (2 customer reviews)

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Book Description

May 29, 2011 1848829183 978-0857295095 2011

While the use of database technology is ubiquitous throughout IT (and health IT in particular), it is not generally appreciated that, as a database increases in scope, certain designs are far superior to others. In biomedical domains, new knowledge is being generated continually, and the databases that must support areas such as clinical care and research must also be able to evolve while requiring minimal or no logical / physical redesign. Appropriately designed metadata, and software designed to utilize it effectively, can provide significant insulation against change.

Many of the larger EMR or clinical research database vendors have realized this, but their designs are proprietary and not described in the literature. Consequently, numerous misconceptions abound among individuals who have not had to work with large-scale biomedical systems, and graduates of a health or bioinformatics program may find that they need to unlearn what they were taught in database and software design classes in order to work productively with such systems. A working knowledge of such systems is also important for individuals who are not primarily software developers, such as health informaticians, medical information officers and data analysts. This book is, in a sense, intended to prepare all of the above individuals for the real world.

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From the Back Cover

To build good systems, one needs both good development skills as well as a thorough knowledge of the problem one is trying to solve. Knowledge of software history – what has worked and what hasn’t – also helps in these types of detailed projects. Metadata-Driven Software Systems in Biomedicine lays down some of the foundations and provides a knowledge-base to assist this process.
The technical portion of the book consists of database schemas and working code that provide non-trivial examples for the practitioner who is conversant with software development and wishes to employ the approaches described in the book.  Eight of the ten chapters include case studies, while the book also includes extensible designs in biomedical applications: electronic medical records, clinical study data management systems, laboratory research support systems, ontologies, and production-rule subsystems. This book is therefore ideal for individuals who have to interact with large biomedical database systems in an information-technology or informatician capacity, build interfaces to such systems or design new systems themselves.

Product Details

  • Series: Health Informatics
  • Hardcover: 336 pages
  • Publisher: Springer; 2011 edition (May 29, 2011)
  • Language: English
  • ISBN-10: 1848829183
  • ISBN-13: 978-0857295095
  • ASIN: 0857295098
  • Product Dimensions: 9.1 x 6.3 x 1.2 inches
  • Shipping Weight: 1.6 pounds (View shipping rates and policies)
  • Average Customer Review: 4.5 out of 5 stars  See all reviews (2 customer reviews)
  • Amazon Best Sellers Rank: #2,941,120 in Books (See Top 100 in Books)

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Most Helpful Customer Reviews
Format:Hardcover|Verified Purchase
Back in the 1990s I learned much of what I now know about relational database design when I worked with Prakash Nadkarni at Yale. Already in my first quick read of this book I have picked up several important points to consider about designing any non-trivial biomedical database application. And his understated wit shines through on every page.

If your underlying data model is not designed correctly from the start, no amount of "user-friendly" software layered on top will conceal the problem. Read and heed the advice in this book, and you can avoid much pain. Also you should hit vendors over the head when they ignore the principles that Prakash lays out.
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5.0 out of 5 stars Required Reading for Medical Informaticists February 10, 2012
I have followed Dr. Nadkarni's work for over a decade, and I've been very impressed by his trailblazing in metadata-driven EAV systems and databases. My own work has been heavily-influenced by his publications. Unfortunately, his ideas and practical data management approaches have not gained more traction in the Health IT community. Hopefully this excellent book will help to remedy that situation.

This is possibly the only comprehensive book on the subject of metadata-driven systems in healthcare, but it is very high quality. It is a highly readable, entertaining, comprehensive and practical introduction to building complex systems for healthcare data management. The first person writing style is refreshing, and draws the reader in. The text is punctuated with amusing brutally-honest assessments about certain suboptimal technologies and approaches that are prevalent in healthcare informatics.

In my opinion, this book, with supplemental materials and assignments, should form the basis for required coursework in all medical informatics programs. Prerequisites would include basic courses in programming, database design, clinical thought, statistics and the like. Since the book leans heavily on Windows and database technology, a familiarity with SQL and Microsoft Access query design and programming will be very helpful. Ideally, readers should also have at least several months of practical experience using a few EMR systems. This is a book to be studied and applied in practice while building new systems. Dr. Nadkarni's open source TrialDB software and documentation ( are also very useful for playing with a working product.

On the downside, there are a few first-edition typos, and the binding on my copy broke after a few weeks.

Highly recommended.
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