In this case (medical informatics), then a document oriented database
like CouchDB (as Marnen pointed out already) may be the best solution.

On Jul 31, 10:43 am, Andrew Pace <andrewpp...@gmail.com> wrote:
> Also consider the demands of a very very rapidly changing field, like
> medical informatics.  In this area, many prefer the flexibility of a
> key/value system because adding columns constantly would be a
> nightmare.  Think off adding columns for every new lab test, imaging
> type, procedure, etc.  This is where a system like this is extremely
> helpful.
>
> Another addition that can sometimes be helpful is to add an additional
> column that holds a "datatype" that represents a traditional database
> constraint.  This allows for easy programmatic testing against this
> datatype before the data enters the database.  Obviously this requires
> some programming work up-front, but this can be exceedingly useful
> once it is built.  Again, flexibility is the key here.
>
> Some links:
>
> http://ycmi.med.yale.edu/nadkarni/eav_CR_contents.htmhttp://www.cdc.gov/nedss/DataModels/index.htmlhttp://www.research.ibm.com/journal/sj/461/eggebraaten.html
>
> Andrew
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