Improving School-based Physical Fitness Testing Real World Evidence Through Domain Analysis Modeling

The transformation of real-world data (RWD) to real-world evidence (RWE) in exercise and physical activity (PA) research and clinical practice, often obtained under field conditions, is challenging. Key roadblocks include disharmony in terminology, in the recording and curation of PA data, and in communication with relevant stakeholders. Our approach is to create a Domain Analysis Model (DAM) focused on school based physical fitness testing (SB-PFT) with the standards development organization Health Level Seven (HL7). Using the DAM to accelerate the evolution of RWE from RWD, we hope to standardize terminology, improve the quality of SB-PFT data, and streamline data collection and exchange between schools, clinical settings, state and local programs, and parents and children. PURPOSE: To provide a harmonized heuristic of terminology and data flow associated with SB-PFT, which is mandated in public schools in the 5th, 7th, and 9th grades in 16 states, by employing an academic health center-community collaboration to facilitate interoperability across a wide range of conditions; enhance communication of data; and identify and address health disparities. METHODS: The DAM approach, previously used for CPET DAM, requires substantial commitment and resources. We have convened bi-monthly with key stakeholders and content experts consisting of standards developers, school personnel, health department officials, exercise scientists, and clinicians to systematically address definitions; field protocols; data formats; communication with students, parents, school personnel; and incorporation of PFT data to address the crisis of poor PA in children. RESULTS: Although more work is required, we have achieved consensus on the data elements in Table 1. CONCLUSION: This promising work of standardization will enable quality reporting of information, facilitate sharing, provide opportunities to address health disparities, and enhance analytics quality for RWE.