Medical decision support: experience with implementing the Arden Syntax at the Columbia-Presbyterian Medical Center. Academic Article uri icon


MeSH Major

  • Artificial Intelligence
  • Decision Making, Computer-Assisted
  • Decision Support Techniques
  • Programming Languages


  • We began implementation of a medical decision support system (MDSS) at the Columbia-Presbyterian Medical Center (CPMC) using the Arden Syntax in 1992. The Clinical Event Monitor which executes the Medical Logic Modules (MLMs) runs on a mainframe computer. Data are stored in a relational database and accessed via PL/I programs known as Data Access Modules (DAMs). Currently we have 18 clinical, 12 research and 10 administrative MLMs. On average, the clinical MLMs generate 50357 simple interpretations of laboratory data and 1080 alerts each month. The number of alerts actually read varies by subject of the MLM from 32.4% to 73.5%. Most simple interpretations are not read at all. A significant problem of MLMs is maintenance, and changes in laboratory testing and message output can impair MLM execution significantly. We are now using relational database technology and coded MLM output to study the process outcome of our MDSS.

publication date

  • December 1995



  • Academic Article



  • eng

PubMed Central ID

  • PMC2579077

PubMed ID

  • 8563259

Additional Document Info

start page

  • 169

end page

  • 73