Global Medical Resources High quality medical information summaries, extracted from ZIMS medical records entered by member institutions Funded by IMLS award #: MG-30-14-0039-14

ZIMS Updates! This PowerPoint is up-to-date as of: November 12th 2018 ZIMS is developed in an “agile” method This means that it is updated every two weeks, sometimes with additional releases in between! Use the link below to see if there have been any updates to this topic since the date above: http://training.species360.org/updates/

Medical Resources These resources provide the same type of information that could be obtained by contacting a colleague and asking about their experience with a vaccine, their preferred anesthetic drug combination or the most common medical problems within a specific taxonomic group. It is just done here on a larger scale, with these resources summarizing information from millions of medical records, about thousands of different species, that were submitted by hundreds of colleagues.

Resources are Global The information presented in Medical Resources is extracted from records entered by our international membership All resource output is designed to be anonymous, protecting the privacy of medical information recorded by our member institutions

Resources are Global The Resource outputs are manually validated, but with millions of medical records in ZIMS, a full review of all the resources is not possible. Please read the disclaimer in the header of each resource to properly interpret the data. The total number of records and the total number of animals represented are indicated in that statistics page for each resource.

Resource Access Access to the medical resources is controlled by your ZIMS Role. Permission to search and view these features will be granted by your local or medical administrator. If you do not have access to the resources, contact your local or medical admin or support@species360.org

Resource Access The Medical Resources are accessed from the Start Menu Start > Medical > Medical Resources Or Start > Global Resources > Medical Resources

Sources of the Data Anesthesia Summaries Drug Usage Extracts Anesthesia records in ZIMS (see 2007) Drug Usage Extracts Prescription records in ZIMS (see 2004) Test Results Samples, Tests & Results records in ZIMS (see 2006) Search by Test Expected Test Results Mortality and Morbidity Analysis Most Common Clinical Issues Diagnosis records in ZIMS (see 2003) Relevant Death Information analysis Husbandry death records Search by Diagnosis

Anesthesia Summaries Extracted from ZIMS anesthesia records A species level summary of the injectable drug combinations and dosages (mg/kg) used by member institutions to anesthetize collection animals Displays up to 5 different drug protocols (drug combinations) for each species, that are ranked using a combination of total usage and recent usage Provides frequency of reported anesthetic complications and recovery information to assist with risk assessment for each protocol

Anesthesia Summaries Search/Filter options: Taxonomy (includes taxonomy below) Drug Used (only display protocols containing the specified drug)

Anesthesia Summaries Additional Search/Filter options: The overall summary protocols displayed for a species can be refined by selecting additional filter options within the “Filter Anesthesia Summaries” panel above the report (panel may be collapsed) Protocols will be recalculated based on specific filter options selected by the user (e.g., use only anesthesia events rated as good or excellent)

Anesthesia Summaries Report options: Underlined data and histogram icons indicates that additional information is available when you ‘hover over’ the item Reports can be exported to Excel and PDF

Drug Usage Extracts A genus or species level summary of drug and vaccine usage information that has been extracted from ZIMS prescription records This is anecdotal data, not pharmacokinetic data Not a drug or vaccine recommendation!!! Not an indication of treatment effectiveness!!! But still valuable for clinical reference.

Drug Usage Extracts Search/Filter options: Taxonomy (including taxonomy below) Drug Category (e.g., antibiotics) Drug Name (e.g., Enrofloxacin)

Drug Usage Extracts Drug usage data are grouped by taxonomy, active ingredient, route of administration and frequency of dosing Report options: Underlined data and histogram icons indicate that additional data is available when you ‘hover over’ the item Reports can be exported to Excel and PDF Provided within each drug usage grouping are dosage, treatment duration, adverse reaction and early termination information

Test Results Until now, the only test result information available to users was in the form of the Global Reference Intervals. The strict criteria required to calculate a valid reference interval meant that most of the test results in ZIMS were unavailable to users This new, anonymous reporting function allows users access to some of the other results in ZIMS Multiple filters to allow selection of specific data sets Can search by a specific Test or review all Expected Test Results for a taxonomy.

Test Results – Search by Test Example: Need to know the serum copper levels found in Addra Gazelle? This reporting tool will show you the existing global results in ZIMS (9 values as of 1 Jan 2018) Can export the report to various formats Use “Export for raw Excel” button to get the result values in a format that makes additional manipulation and calculation much easier

Test Results – Search by Test There are multiple filters available Scope of the search can be changed There is the ability to view in graph form

Test Results – Expected Test Results Reference calculations from 10 million test results on healthy patients in over 1000 species global reference intervals basic statistics for small data sets If Test field is left blank the results will display all the expected tests results calculated from the ZIMS database for the species

Test Results – Expected Test Results You have the ability to further filter and refine your results There are tabs for Hematology, Chemistry/Fluid Analysis and Endocrinology/ Reproduction

Mortality and Morbidity Analysis This Resource has three independent tools: Most common clinical issues Relevant death information analysis Search by Diagnosis

Most Common Clinical Issues Each page in the resource is a grid listing the most common clinical issues for a species, along with duration data for each clinical issue The number of historical (resolved) cases and active cases (as of the date the resource was calculated) are shown Based on information extracted from the diagnosis records entered by member institutions. Search by taxonomy only

Most Common Clinical Issues Report options: Underlined data and histogram icons indicates that additional information is available when you ‘hover over’ the item Reports can be exported to Excel and PDF Both a Grid View (default) and a Graphical View are available Graphical View Grid View

Relevant Death Information Performs real-time analysis on the Relevant Death Information associated with the husbandry death records Data scope filters include: Taxonomy: group data at any taxonomic level Geography: Global, Continent or User’s Institution Accessioned Types (Individual, Group, etc.) Date range Example: RDI analysis for Mammalia at My institution over the last 10 years

Relevant Death Information Analysis output is an interactive bar graph that starts at the highest analysis level (lowest data resolution)

Relevant Death Information If the label for a bar is underlined, then clicking on the label or the bar opens a new graph showing the finer resolution data that was used to create the previous bar. Each level has a “back” button to return to the previous analysis level

Search by Diagnosis Medical Resources>Morbidity & Mortality Analysis>Search by diagnosis This report searches for local diagnoses that contain specific medical terms Your data set can be filtered by Taxonomy, Diagnosis type (clinical or pathology), Confidence level and Onset date. Multiple medical terms can be placed in the same search field and they are joined by implicit ‘OR’ logic Multiple search fields are joined by ‘AND’ logic

Search by Diagnosis This search request will be interpreted as: search for diagnoses containing the medical term “wound” or “bite injury” or “Wound (laceration)” or “puncture wound” search for diagnoses containing any one of the terms in the first search field AND any one of the terms in the second search field Producing this list of diagnoses that match the search criteria

Search by Diagnosis Using Term Groups to make searching easier Term groups are lists of related, but separate, medical terms Example: a term group could be the list of all the types of neoplasia (cancer) in the medical term dictionary Term groups are created through the Term Dictionary When you type into the search field, the list produced will including matching Term Groups; these groups are indicated by a count of terms included Neoplasia (group of 162 terms) is Term Group created by Species360 that contains a list of terms for specific types of neoplasia Neoplasia is a single global medical term for the generic disease process Searching using a Term Group is exactly the same as typing in each term in the list into the search field, but it is easier to choose just the term group Example: to search your entire collection for every diagnosis specifying a type of neoplasia, use the existing Species360 term group Neoplasia combined with Taxonomy = Animalia

THANK YOU! Institute of Museum and Library Services (IMLS) Thanks to a grant from IMLS, Species360 was able to generate these Medical Resources, providing unique metrics on medical care for thousands of exotic species to our member institutions.