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OpenSDE is a free, open source electronic medical record system developed by Department of medical informatics, Erasmus University Rotterdam as of March 2003[1,2].


The purpose of OpenSDE is to support structured data entry in different settings as in patient care or research. For patient care narrative text works well and for research coded data is preferred. However, for clinicians to enter data in two different ways would be additional work and cumbersome. OpenSDE was created from a patient care perspective aiming to utilize the data collected for research (3). It is based on a specific domain that defines the content of that domain while maintaining the structure.


The root to guide the model is the hierarchical structure of medical knowledge: each concept is described by other concepts. For example: examination of heart is described by percussion of heart and auscultation of heart, auscultation of heart is described by heart sounds and possibly a cardiac murmur, a cardiac murmur is described by its phase in the heart cycle, its loudness, its location, its propagation etc. This model uses a methodology called Row Modeling in which one column contains all of the attributes and the other column contains the values for those attributes to allow for data flexibility while maintaining structure.


.OpenSDE includes a thesaurus of concepts and a tree to represent this concept hierarchy. Each node in the tree represents a medical concept in a unique context, which is further described by its branching nodes. The depth of the tree reflects the granularity. OpenSDE also includes a translator that allows translation of terms from the language in which the tree was modeled to another language. Additionally, an OpenSDE domain model represents the semantics for data collected with OpenSDE. Such a domain model is a generative model,i.e. it is the combination of terms in a path to a node that represents the meaning of a node. Therefore, concepts may appear in more than one path (‘severity’ in context of ‘chest pain’ or in context of ‘cough’). Hence, a single concept does not represent the meaning of a node.

Data Entry interfaces that are created from these concept models can be altered by clinicians.

OpenSDE is open source written in Delphi and is used in different various domians such as neurology, radiology, immunology, and pediatrics (1).


  1. Los RK, van Ginneken AM, de Wilde M, van der Lei J. OpenSDE: Row modeling applied to generic structured data entry. JAMIA 2004; 11 (2):162-5
  2. Min Z, Baofen D, Weeber M, van Ginneken AM.Mapping OpenSDE domain models to SNOMED CT. Applied to the domain of cardiovascular disease.Methods Inf Med. 2006;45(1):4-9
  3. Los, R. van Giinneken, A. van der Lei, J. OpenSDE: A strategy for expressive and flexible structured data entry. International Journal of Medical Informatics. 2005;74:481-490
  4. OpenSDE.