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Site Configuration

Site-level configuration is split between two tabs:

• Settings tab — Application Mode, license key, normative defaults, BxB averaging, database management, troubleshooting log, software updates, auto-backup, MedGraphics connection, developer options.
• Data Management tab → Site Configuration / Protocol Mappings sections — PEDAL Site ID, MRN digit length, and Breeze → REDCap protocol code mappings.

This split exists because Site ID and Protocol Mappings are tightly coupled to the REDCap export workflow that lives on the Data Management tab.

Application Mode (Settings tab)

The first section of the Settings tab. Systole maintains two completely separate databases:

Switching mode triggers a confirmation and restarts Systole. Your data is preserved in both databases — switching does not move or merge records.

In Demo mode a Reset Demo Data button appears. Clicking it deletes all changes you made to demo data and restores the bundled seed on the next launch. This button is hidden in Clinical mode.

A persistent informational banner at the top of the app indicates when you are in Demo mode, with a "Switch to Clinical Mode" link that jumps to this Settings section.

PEDAL Site ID (Data Management tab → Site Configuration)

Your PEDAL Site ID is assigned by the PEDAL coordinating center and identifies your institution in the PEDAL REDCap database. Enter it under Data Management → Site Configuration → PEDAL Site ID and click Save Site ID.

The Site ID becomes the prefix for all REDCap record IDs, which take the form SITE-PEDALID-VISIT. For example, with Site ID 396, a patient's PEDAL number 4567, and visit 1, the REDCap record ID is 396-4567-1.

This must be configured before any REDCap exports.

MRN Digit Length (Data Management tab → Site Configuration)

Some institutions use zero-padded MRNs (e.g., 045496181 — 9 digits). Older records or data from external systems may lack the leading zeros (45496181). Set the MRN Digit Length in the Site Configuration section to automatically pad shorter MRNs with leading zeros during import and patient matching.

• 0 (default) — No normalization; MRNs are matched as-is
• 9 — Common for Epic sites; 45496181 is stored and matched as 045496181

When set, padding is applied when:

• Creating or updating a patient
• Matching imported tests to existing patients
• Looking up patients by MRN

Existing records are not retroactively padded — only new imports and edits are affected. When normalization is active, lookups also fall back to a stripped-zero comparison so legacy unpadded data still matches.

Click Save in the MRN field row to apply changes.

Protocol Mappings (Data Management tab → Protocol Mappings)

Exercise protocols in Breeze (and other CPET software) are stored as free-text names (e.g., "Godfrey Cycle 10W/min"). REDCap requires these to be translated to numeric codes. The protocol mapping table handles this translation.

Setting Up Mappings

1. Automatic detection — Click Scan Database to find all unique protocol names in your imported tests
2. Manual entry — Click + Add Mapping to add a protocol that hasn't been imported yet
3. For each protocol, set the modality (cycle/treadmill) and REDCap protocol code from the PEDAL data dictionary

Unmapped protocols are highlighted in red and will be flagged during REDCap export.

Default Normative References (Settings tab)

Controls which prediction equation is applied by default when a test does not have an explicitly selected reference. Organized by age group and modality.

The table is fully editable: click the dropdown in any cell to change the equation. Click Edit Age Groups to adjust the age boundaries. Click Reset to Defaults to restore the original configuration.

A typical configuration:

Defaults are resolved at display time — changing the default immediately affects any preliminary or amended test without an explicit selection. Verified tests are not affected: when a test is verified, whichever reference was displayed at that moment is snapshotted into the test record, so the verified clinical interpretation can't drift if the site default is changed later. To change the reference on a verified test, the user must Amend it first.

Default BxB Averaging Method (Settings tab)

Controls the averaging method used when computing summary values from breath-by-breath data for new tests. Default is 30-second rolling.

Options: 10s, 15s, 20s, 30s, 8-breath mean, Middle 5 of 7, Raw (no averaging).

Individual tests can override this on the BxB tab using the averaging speed buttons and Apply Changes to Test.

Changing the default does not change existing tests by itself. When preliminary tests would be affected, an Apply to N preliminary tests button appears here to re-average them with the new default. To recalculate historical tests too, or to see every change before it is made, use Data Management → Recalculate Summaries from Breath Data (details).

License (Settings tab)

Systole is licensed per site. Paste the key supplied by the coordinating center into License Key and click Verify & Apply; the status badge changes to Licensed.

• Verification happens entirely on this computer — no internet connection is used, at any point.
• Without a valid key the status reads Not licensed and a countdown runs. An amber banner appears at the top of the window; when the grace period ends, creating tests, importing, and exporting are disabled. Data already in the database stays readable and nothing is deleted.
• The key is stored on the machine, not in the database — it does not travel with an exported or imported database. Re-enter it after moving to a new machine.
• Remove License clears the stored key (rarely needed).

Database Management (Settings tab)

• Export Database — Downloads a complete backup of the SQLite database as a .db file
• Import Database — Loads a previously exported .db file, replacing all current data. A confirmation dialog shows the current patient/test counts before proceeding.

Use this for backup and restore when moving between machines or recovering from data loss. Note: Import affects the database for the current mode only — importing while in Demo mode replaces demo.db, not pedal.db.

Auto-Backup (Settings tab, desktop app)

Available in the Systole desktop application:

Click Backup Now to create an immediate backup.

Retention Strategy

The keep-last budget is split evenly between recent and daily history:

• Recent half — the most recent interval backups (granular coverage of the last few hours)
• Daily half — one backup per day for prior days (longer-term coverage)

For example, with Keep last = 20 and Interval = 30 min:

• 10 most recent backups (~last 5 hours of work)
• 10 daily backups (one per day, keeping the latest backup from each day)

Days with no backups (weekends, days off) are skipped — the daily slots stretch back as far as needed to fill the budget.

MedGraphics Connection (Settings tab, desktop app)

Configures direct read-only connection to a BreezeSuite MedGraphics SQL Server database. Once configured, Systole adds MedGraphics import buttons on the Records sub-tab bar and on the Data Management bulk import section. See Import and Export for the import workflow.

Click Test Connection to validate, then Save to persist. The MedGraphics import buttons appear after a successful save.

Until a connection is saved and tested, this panel is informational-only; the import buttons stay hidden.

Troubleshooting — Diagnostic Log (Settings tab, desktop app)

Systole keeps a rolling record of what the application did — startup, database activity, imports, exports, and any error it hit. If something misbehaves, this file is what makes the cause findable.

• Open Log Folder (Settings tab → Troubleshooting) reveals the log; the full path is shown beneath the button. It lives alongside the database, in the application's data folder. The same entry point is on the Help menu (Open Diagnostic Log Folder).
• Two files are kept: systole.log (current) and systole.log.1 (previous). Each is capped at 2 MB, so the log never grows without bound.
• Nothing is transmitted anywhere. The file is written and read locally, and is only shared if you attach it to a bug report yourself.

Before sending a log, open it and read it. Error messages sometimes quote the value that caused them, so a log can contain patient identifiers. Remove anything identifying, or describe the problem without the file, if in doubt.

If the application window ever closes unexpectedly, Systole shows a message naming this log path. Your data is in the database and is not lost — restart the app and attach the log to the report.

Software Updates (Settings tab, desktop app)

Systole checks the releases page for a newer version about once a day and shows a green banner at the top of the window when one is available. It never downloads or installs anything on its own — updates are installed by hand from the releases page.

• Check for Updates Now runs an immediate check, bypassing the once-a-day limit. Use it when you have been told a release is out and don't want to wait. The line beneath the button shows the running version and when the last check happened, read from local settings — opening Settings never makes a network call by itself.
• Download appears beside it when a newer version is found, and opens the releases page in your browser. Clicking Download in the banner hides the banner for that session only; if you don't actually install, you are reminded again at the next launch. Installing the update clears the banner for good.
• Receive beta builds opts this machine into pre-release versions. Leave it unchecked at clinical sites — a stable install is never offered a beta, so publishing a test build for one site can't prompt the others. Beta builds are for testing and are not for clinical use.
• If the update server can't be reached, the status line says so rather than reporting that you are up to date.

Developer Options (Settings tab)

• Show Debug tab — Enables the Debug tab in the navigation bar. The Debug tab shows the raw PatientDataStore state, BxB data samples, 9-panel draft state, and an event log. Useful for troubleshooting data issues.

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