REDCAP is an electronic data capture system that allows collection, storage, and analysis.  This tool permits us to perform clinical trials, cohorts, case control studies, among others. Redcap has features such as surveys, multi-language tools, calculated values and piping to optimize these tasks. Piping allows users to insert previously recorded data into instruments, emails, and other locations (1).
Data is uploaded to RedCap in two ways: it can be manually introduced from electronic medical records with prior informed consent or through patients answer surveys.  Uploading data from medical records to Redcap implies additional effort which becomes a obstacle if there is not enough personal generating work overload.  In order to improve efficiency in this task,  we searched for alternatives tools for collecting data from patients while optimizing data processing in the electronic health record.

We search for ways we could integrate the available tools of Redcap, like surveys and piping to enter in real time the data of the urodynamics carried out in our service to our database. In this way, at the end of the procedure, we could have a structured report with all the information that was documented, which can be included in the patient's medical record and sent to his doctor. To achieve this, we review the current criteria from the International Continence Society for a urodynamic study (2). We organized the information we wanted to include for both clinical practice and research projects. Therefore, we include basic demographic and clinical data about the patient like age, weight, size, pathologic antecedents, and reason for the procedure. Also, we add scales validated in our language that objectify urinary tract symptoms and their impact on the quality of life, like the International Consultation on Incontinence Questionnaire (ICIQ), Quality of life (QOL), and the International Prostate Symptom Score (IPSS) (3). We developed a script of the survey performed to patients in conjunction with the urologists of the service following the recommendations of the ICS. Integrating all this information, we designed a draft structured report for the urodynamic study,  using branching logic by gathering all the information collected from the patient's admission until the end of the procedure.

Then, we developed A redcap database with prior authorization from the institution's research and ethics committee.  The database was designed with three sections. The first section consists of the patient's admission data, where gender, age, and the procedure (Uroflowmetry, urodynamics, or video-urodynamics) are recorded. We standardized the general information collected in this survey for all patients undergoing procedures in our service. In this section, we had the support of the nursing team, which allowed the reduction of time needed to collect information such as background information or pre-study examinations.  The second section are surveys with standardized scales, personalized according to the gender and age of the patients, which evaluate the urinary tract symptoms of the patient and their impact on the quality of life.  These scales are sent to the patients' e-mail addresses with their prior authorization. In this way, the patients fill out the scales autonomously on their mobile devices. If they lack a mobile device, we provide tablets so they can fill them out.  In the last section, Redcap generates an organized summary of the information collected so far for the urologist in charge of urodynamics. Then, the urologist completes the clinical history. The background questions are automatically customized according to the sex of the patient (for example, only women are asked about pregnancy history, and only men are asked about prostate surgery history). To achieve this, we use the function of redcap branching logic. This function allows you to show or hide text or variables only when certain conditions are met, generating less overloaded and more personalized text (1).

Once the urodynamic study begins, the data from the procedure is filled in real-time by the urologist in charge of the procedure. It contains multiple-choice and open-ended variables, allowing for a personalized description of each procedure performed.  This survey follows the structure of the urodynamic study, starting with uroflowmetry, then cystometry, and ending with the flow-pressure study. Finally, when all the information in the procedure is completed, we wrote a structured report which included the variables previously mentioned using the pipping feature. With the use of branching logic, these reports were different depending on the procedure performed, and the information varied whether the procedure had been performed on a man or a woman and whether it had included electromyography or not, among other things. We offer a follow-up option to patients by e-mail to identify future complications associated with the procedure prematurely.  Multiple tests were performed with the doctors and corrections were made until the final report was completed.

We created the database and implemented it in our urology department. Figure 1 illustrates the data collection process, the structured report with pipping, and the completed report.  We make corrections on an ongoing basis to improve the final report.

The designed database is currently used in the day-to-day running of our service, obtaining data in real-time and generating reports for patients.

RedCap is a powerful data collection platform, but so far, we have limited ourselves for data storage. The use of advanced redcap tools like pipping, branching logic, and surveys allows expanding its possibilities. With the support and feedback of our urology department, we developed structured reports that can be included in the clinical history, achieving several benefits for our service and our medical staff:  We optimize the acquisition of information for future research in urology, decreasing the workload on the research group in tasks such as data collection. We standardized urodynamic reports, which are now based on ICS recommendations. These recommendations can be updated through Redcap as needed, to generate a report that is at the forefront of medical advances. This development for the collection of urodynamic data in real-time generates a precedent for the generation of tools using artificial intelligence that allow the analysis of the results at the time of performing a urodynamic study.  Finally, we digitalize patient surveys and admission information, generating an environmental impact. In future work, we will share the impact of this new toll on our urology department and the work we performed with the data collected.

Harris PA, Taylor R, Minor BL, Elliott V, Fernandez M, O’Neal L, et al. The REDCap consortium: Building an international community of software platform partners. Vol. 95, Journal of Biomedical Informatics. Academic Press Inc.; 2019.
The 2023 compilation of the International Continence Society Standardisations, Consensus statements, Educational modules, Terminology and Fundamentals documents, with the International Consultation on Incontinence algorithms Vienna, Austria.
Abdelmoteleb H, Kamel MI, Hashim H. The association between the ICIQ-LUTS and the ICIQ-bladder diary in assessing LUTS. Neurourol Urodyn. 2017 Aug 1;36(6):1601–6.