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Import and Export

Systole supports importing data from Breeze CPET software, BreezeSuite MedGraphics SQL Server, and its own .pedal format, and exports to REDCap CSV and .pedal files.

Importing Data

Single File Import (Records tab)

From the Records sub-tab bar, click Import and select one or more files. Supported formats:

When importing a file, Systole:

1. Parses all CPET fields from the file (including PFT and breath-by-breath, if v5.0 .pedal)
2. Matches the patient by MRN — exact matches auto-link, fuzzy matches (name mismatch) go to the Review queue
3. Checks for duplicate tests (by GUID or patient + date of service)
4. Saves the test to the database and opens it in the Exercise tab
5. If the test has BxB data but no summary values, automatically computes Rest/AT/Peak summaries using the site default averaging method

MedGraphics Direct Import (Records tab)

If a MedGraphics SQL Server connection has been configured (Settings → MedGraphics Connection), a MedGraphics button appears on the Records sub-tab bar between Import and + New Test. Click it to:

1. Open the MedGraphics test picker modal — shows recent tests from the configured site(s)
2. Find the test you want using one of:
   • Search by MRN — exact-match lookup that ignores leading-zero / padding differences (so 45496181 and 045496181 both match)
   • Search by name — free-text last/first tokens (e.g. smith, smith, j, john smith); case-insensitive contains-match across PatientFirstName and PatientLastName, multi-token AND, top 50 results sorted by visit date
   • Show Recent — restores the default view (last N tests across configured site(s))
3. Select one or more tests with the checkboxes
4. Click Import Selected

Systole pulls the test directly from MedGraphics and saves it to the local database, including any breath-by-breath data. Tests imported this way default to Preliminary status and Review duplicate handling. Summary values (Rest / AT / Peak) are auto-computed from the BxB data when the source record doesn't already have them.

When you import a single test and it imports cleanly, the picker closes and the test opens straight in the Exercise tab — no extra click, no hunting for it in Records. If you import several tests at once (or any are queued for review, skipped, or error out), the picker shows a results summary instead and you close it when you're done.

The picker's Status column tells you, at a glance, whether each listed test is already in your local database:

• New — not yet imported
• In database — already imported, with breath-by-breath data
• No BxB — already imported, but missing breath-by-breath data (can be backfilled — see below)

Follow-up: prior tests and missing breath-by-breath data

After you import a recent test, Systole scans that patient's full MedGraphics history and — if there's anything worth adding — opens a follow-up dialog offering two checklists:

• Prior tests not in your database — older visits for the same patient that haven't been imported. Selected tests are imported as Historical status (so they're available for trend comparison but excluded from REDCap export by default).
• Existing tests missing breath-by-breath data — tests already in your database without BxB. Selected tests have their BxB retrieved from MedGraphics and merged in, without disturbing clinical values or verification status. This works on verified tests too: the breaths are added, the verified values stay as they are, and the timing is held until an amendment (see Verified tests in a bulk import). A record that MedGraphics returns with no breath data is skipped and reported — the local test is never overwritten.

Every item is checked by default; uncheck anything you don't want, then click Import Selected (or Skip to dismiss). The dialog doesn't appear when the patient has no additional tests to offer.

Find Prior Tests in MedGraphics (Patient modal / Report tab)

You can trigger the same scan directly, without first importing a recent test:

• Patient modal — when editing an existing patient (Records → Patients → Edit Patient, or the Edit Patient button on a loaded test), click Find Prior Tests in MedGraphics in the modal footer (Electron only, when MedGraphics is configured).
• Report tab — the Historical Test Comparison section has a Find Prior Tests in MedGraphics button whenever a patient is loaded and MedGraphics is configured.

Either button searches BreezeSuite for the patient (by MRN, falling back to name) and opens the follow-up dialog described above. Use this to backfill a known patient's historical visits or retrieve missing breath-by-breath data without re-typing their MRN. If nothing new is found, a brief message says so; the trend charts refresh automatically after any import.

Bulk Import (Data Management tab)

For importing many tests at once (e.g., migrating from a legacy database):

1. Go to the Data Management tab → Bulk Import section
2. Click Select Files, Select Folder, or MedGraphics (desktop app, when configured)
3. Configure import options:

Verified tests in a bulk import

A verified test's values change only through an amendment, one test at a time, with a reason. Bulk import never does that for you:

• Merge Mode onto a verified test with no breath-by-breath data adds the breaths and nothing else. Summary, AT and PFT values stay exactly as verified — blanks included, since a blank AT may be the reader's decision. The file's timing and AT time are held until you amend the test and click Fill Missing or Recompute from BxB.
• A verified test that already has breath-by-breath data, or Duplicate Handling = Overwrite on a verified test, sends the file to the Review queue instead. Nothing is changed.
• Importing as Verified saves each test exactly as the file has it; no summary is calculated from its breath data.

The results box reports Breath data added to verified tests and Verified tests sent to Review, so neither happens silently.

In depth: Bulk Import in Depth covers every merge rule, what happens to verified tests, and a situation-by-situation reference table.

4. Optionally click Dry Run first: it runs the whole import with these settings, lists what would happen to each file, and then undoes it — nothing is saved, and your file selection is kept.
5. Click Start Import. Systole processes files sequentially, displaying a progress bar.
6. After import, results show:
   • Total tests imported
   • Patients created or matched
   • Items sent to the Review queue (if any)
   • Merges that found nothing new to add, and anything done to or withheld from verified tests

Recalculate Summaries from Breath Data (Data Management tab)

Recalculates Rest / AT / Peak from breath-by-breath data for many tests already in the database — Recompute from BxB for each one. Choose Preliminary and/or Historical, click Preview to see every test and value that would change (nothing is changed), then Recalculate N tests. Verified and amended tests are never included; each test keeps its own averaging method, and Breeze-averaged data is not averaged again. Details: Bulk Import in Depth → Recalculate summaries.

Resolving Review Items

If bulk import flags ambiguous matches or duplicates, they appear in the Records Review sub-tab. For each item:

• Patient match conflicts — The imported test's MRN or name partially matches an existing patient. Options:

  • Link to the existing patient
  • New Patient to create a separate record
  • Skip to discard the import

• Duplicate tests — The imported test appears to be a repeat of an existing test (same patient, same date). Options:

  • Overwrite the existing test with the imported data. If the existing test is verified, this is an amendment: Systole explains what will change and asks for a reason, which is recorded in the test's history
  • Skip to keep the existing test

  Merge (add breath-by-breath and PFT data without overwriting clinical values) is offered when you Link a patient-match item that turns out to be a duplicate of an existing test, rather than as a button on the duplicate row. To merge a whole folder, use Merge Mode in Bulk Import instead.

Click the expand arrow on any review item to see a side-by-side comparison of the imported data and the existing record.

When the name is spelled differently

The most common patient match conflict is a spelling variant — the same MRN and date of birth, one letter off in the name. Clicking Link asks which spelling is current before it merges; the one you don't choose is kept as a searchable alias, so neither is lost. Cancelling the dialog leaves the item in the queue rather than merging it.

Full walkthrough, including what happens to a patient's already-verified tests: Patient Records → Choosing which spelling is correct.

The same prompt appears outside bulk import — if you save or download a test that isn't yet linked to a patient, Systole looks for a match and shows the Similar Patients Found dialog. Choosing Link there runs the identical name check, and cancelling returns you to the patient list instead of completing the save.

Exporting Data

.pedal File Export

From the Data Management tab, click Download .pedal to export the currently loaded test. The .pedal file contains:

• Patient demographics
• All observed CPET values and derived metrics
• Exercise prescription (if created)
• Clinical report narratives and selected normative reference
• Test metadata (source, dates, status)

.pedal files can be shared with other Systole sites or re-imported later. They serve as a complete, self-contained record of a single exercise test.

Version selection on export is automatic:

• v5.0 is written when the test has breath-by-breath or PFT data (adds bxb and pft top-level sections).
• v4.0 is written when the test has only summary CPET data (no BxB).
• v3.0 is no longer written but is still accepted on import for backward compatibility with legacy archives.

REDCap CSV Export

Following the export process end to end? See Exporting to REDCap — Step by Step for the prerequisites-first walkthrough (Site ID, protocol mappings, the export → confirm handshake, and troubleshooting). The sections below are the field-level reference.

The REDCap export generates a CSV formatted for direct upload to your PEDAL Network Data Registry REDCap project. The PEDAL registry is a single flat form (est_data_rptevents): one CSV row is one exercise test, and each row carries that test's patient demographics repeated alongside its CPET values. There are no separate patient/test arms.

Choosing what to export

Use the quick-select buttons at the top of the export dialog to build your selection, then refine it by ticking individual patients or tests in the table:

Status gates — three categories of test status are gated independently:

Verified tests always export. The two checkboxes are independent — you can include historical without preliminary/amended, or vice versa, or both. Your choices persist between sessions, so a site mid-migration can leave Include historical tests on without re-checking it on every export. Tests subject to the unverified gate show a yellow Unverified pill in the export table; historical tests show a purple Historical pill.

Record ID format

Each row's REDCap record_id is SITE-PEDALID-VISIT (e.g. 396-4567-1):

• SITE — your site's assigned numeric PEDAL Site ID (configured in Settings)
• PEDALID — the patient's PEDAL Patient number
• VISIT — the visit number for that test (patients with multiple tests get -1, -2, …)

The row also carries patient_id (SITE-PEDALID, the per-patient key) and site_code (the numeric site ID alone). These are generated automatically — you never type them.

Confirming an upload

Downloading the CSV marks the included records as pending (not yet confirmed). After you have successfully imported the CSV into REDCap, reopen the export dialog and click Confirm in the banner at the top; this promotes the pending records to exported so future Unexported selections skip them. If a REDCap import failed, click Reject instead to return the records to unexported. Starting a new export while a batch is still pending prompts you to confirm the previous one first.

Exported tests show a green indicator in the Records Tests table.

Superseded records (re-linked tests)

If you reassign an already-exported test to a different patient (see Patient Records → Admin Mode), its old REDCap record can no longer be reached — a CSV import cannot delete a REDCap record. Systole handles this automatically: your next export includes a superseded-record row that flags the old record_id (with record_status = 2, Superseded) so your PEDAL registry coordinator can find and remove the orphaned record. These rows are counted in the pending banner as superseded records and follow the same Confirm/Reject flow. You don't create them by hand — reassigning a confirmed-exported test queues one, and a toast tells you when it happens.

After export

• The downloaded CSV can be uploaded directly to REDCap via its data import tool.
• Out-of-range values are flagged by REDCap on import but do not block it; Systole also flags them (a soft amber warning) at data-entry time so typos are caught at the source.

Site ID and Protocol Mapping Requirements

Two configurations on the Data Management tab gate REDCap export:

• Site ID must be set in the Site Configuration section. Without it, REDCap record IDs cannot be generated and export is blocked.
• Protocol mappings must exist for every protocol used in the tests being exported. REDCap requires numeric codes rather than free-text names. Map your lab's protocol names in the Protocol Mappings section. Unmapped protocols prevent export and are highlighted in red.

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