{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T08:24:55Z","timestamp":1787041495363,"version":"build-2736575974"},"reference-count":70,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T00:00:00Z","timestamp":1785024000000},"content-version":"vor","delay-in-days":25,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["TR002004"],"award-info":[{"award-number":["TR002004"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["TR004927"],"award-info":[{"award-number":["TR004927"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Learning Health Systems"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Unique challenges of data quality, standardization, and interoperability face non\u2010traditional sources of real world data (RWD), those outside of the common RWD source, the electronic health record (EHR). The experience of our clinical, research, and community group in addressing the endangered school\u2010based physical fitness testing (SB\u2010PFT) data set may be useful as a paradigm for a variety of nontraditional instances of health\u2010related RWD. Until recently, SB\u2010PFT was mandated annually within public schools in ~60% of U.S. children and adolescents representing one of the most robust and inclusive data sets available in youth. When implemented rigorously, SB\u2010PFT produced data that improved pediatric health and student learning. Driven by perceived and real gaps in data quality, inconsistent and insensitive school\u2010site implementation, and uneven evidence for health\u2010relevance, calls for revamping (and, in some cases, ending) school testing are growing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>To preserve and enhance this unique resource, SB\u2010PFT must incorporate emerging science and technology. We describe here the rationale, structure, and process involved in our building an HL7\u2010associated Domain Analysis Model for SB\u2010PFT. Our team consisted of clinicians, exercise scientists, school personnel, publish health officials, parents and students. The structure of the DAM was facilitated by data standard experts and skilled Unified Modeling Language professionals. Administrative support was rendered by our institution's NIH\u2010funded Clinical Translational Science Award.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The DAM will serve as a necessary first step in integrating Fast Healthcare Interoperability Resources (FHIR) and Learning Health Systems (LHS) models essential to realize the full potential of SB\u2010PFT data in advancing child health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The experience presented here can serve as a roadmap for addressing critical issues of data standardization and RWE generation in nontraditional instances of RWD. The DAM can be deployed in SB\u2010PFT data exchange in real world settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lrh2.70108","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T05:35:25Z","timestamp":1785130525000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pathways to Real World Evidence From the Real World of\u00a0School\u2010Based Physical Fitness Testing (\n                    <scp>SB<\/scp>\n                    \u2010\n                    <scp>PFT<\/scp>\n                    )"],"prefix":"10.1002","volume":"10","author":[{"given":"Anita","family":"Walden","sequence":"first","affiliation":[{"name":"Department of Genetics University of North Carolina School of Medicine  Chapel Hill North Carolina 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University of California at Irvine  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Schneider","sequence":"additional","affiliation":[{"name":"Institute for Clinical and Translational Science, School of Public Health, University of California at Irvine  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allyson","family":"Reeds","sequence":"additional","affiliation":[{"name":"Orange County Department of Education  Orange County California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AbdulMalik","family":"Shakir","sequence":"additional","affiliation":[{"name":"Shakir Consulting  LaVerne California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1736-775X","authenticated-orcid":false,"given":"Dan M.","family":"Cooper","sequence":"additional","affiliation":[{"name":"Department of Pediatrics School of Medicine, Institute for Clinical and Translational Science, University of California at Irvine  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,26]]},"reference":[{"key":"e_1_2_16_2_1","unstructured":"Health Level Seven International \u201cDomain Analysis Model Specifications and Requirements: Canonical Definition \u201d2017 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