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This design concept has its roots in the TrialDB project that was started in Yale University in 1990s

TrialDB is a customizable Web-based clinical trials database system used for the storage and management of clinical data designed and maintained at the Yale Center for Medical Informatics. It relies on a rich data library that contains information about individual data elements (parameters, typically clinical facts about patients) and their higher-order grouping. The library is used to generate case report forms (CRF) as Web pages, and records both information used to interactively validate the contents of the CRF as well as specify how individual elements in the CRF are presented to the user. The forms support validation of individual elements based on data type, range, and non-empty checks, as well as arbitrarily complex validation across the elements in a form (or across more than one form). They support skip logic, where certain elements are dynamically enabled or disabled based upon the values of previously entered elements. Access to a number of controlled vocabularies (e.g., ICD-10, DSM-IV, the Cerner/Multum Drug Lexicon, the NCI Common Toxicity Criteria) during data entry is also supported.

It can manage an arbitrary number of studies, with no limits on the number of patients per study or the number of parameters that are tracked in each study. It does all of this without the need to modify the database structure repeatedly each time you capture parameters for a new clinical domain.

TrialDB Publications:

TrialDB: A Web-based Clinical Study Data Management System. AMIA 2003 Open Source Expo

Achieving Evolvable Web-Database Bioscience Applications Using the EAV/CR Framework: Recent Advances