Conceptual Inferencing for Real-time Clinical Decision Support Using Hierarchical Queries in a Relational Database Management System

Abstract Clinical inferencing requires computing the full transitive closure across source and target concept relationships, which has been expensive and difficult to do using relational database management systems (RDBMS). Use of SQL-99 recursive queries has been proposed, but suggested query optimization techniques have serious limitations, including the possibility of allowing only strict single hierarchies. We have successfully used Oracle hierarchical queries for polyhierarchical inferencing with good application performance.