instruction: has patient 78221 been given any diagnosis until 4 years ago?
response: SELECT COUNT(*) > 0 FROM diagnoses_icd WHERE diagnoses_icd.hadm_id IN (SELECT admissions.hadm_id FROM admissions WHERE admissions.subject_id = 78221) AND DATETIME(diagnoses_icd.charttime) <= DATETIME(CURRENT_TIME(), '-4 year')