Tampere University Research Articles

A retrospective study of accuracy and usefulness of electrophysiological exercise tests

ObjectivesThis study aimed to determine the usefulness of electrophysiological exercise tests. The significance of slightly abnormal exercise tests was also examined.MethodsWe identified all the patients who had undergone exercise testing between February 2007 to June 2022 in Tampere University Hospital, Finland. Their medical records after diagnostic workup and exercise test reports were reviewed. A binary logistic regression was performed to evaluate the association between positive test result in short exercise test, long exercise test, or short exercise test with cooling and genetically confirmed skeletal muscle channelopathy or myotonic disorder.ResultsWe identified 256 patients. 27 patients were diagnosed with nondystrophic myotonia, periodic paralysis, myotonic dystrophy type 1, myotonic dystrophy type 2, or other specified myopathy. 14 patients were suspected to have a skeletal muscle channelopathy, but pathogenic variants could not be identified. The remaining 215 patients were diagnosed with other conditions than skeletal muscle channelopathy or myotonic disorder. The combined sensitivity of exercise tests was 59.3% and specificity 99.1%. Abnormal exercise test result was associated with increased risk of skeletal muscle channelopathy or myotonic disorder (OR 164.3, 95% CI 28.3–954.6, p < 0.001).ConclusionsElectrophysiological exercise test is not optimal to exclude skeletal muscle channelopathy. It may be useful if a skeletal muscle channelopathy is suspected and genetic testing is negative or indeterminate and further evidence is required. Slightly abnormal exercise test results are possible in various conditions and result from different aetiologies. There is a demand for neurophysiological studies with higher sensitivity to detect skeletal muscle channelopathies.

Opponent’s statement of Erkki-Jussi Nylén’s doctoral dissertation

This is the opponent’s statement of Erkki-Jussi Nylén’s doctoral dissertation "Theorizing Ideological Steering: The journey of the circular economy". The doctoral thesis defence took place in Tampere University in 22.9.2023. The Lectio Praecursoria from the doctoral thesis defence by Erkki-Jussi Nylén is published in the same issue and can be accessed at: https://doi.org/10.30663/ay.138654.

Migrating 120,000 Legacy Publications from Several Systems into a Current Research Information System Using Advanced Data Wrangling Techniques

This article describes a complex CRIS (current research information system) implementation project involving the migration of around 120,000 legacy publication records from three different systems. The project, undertaken by Tampere University, encountered several challenges in data diversity, data quality, and resource allocation. To handle the extensive and heterogenous dataset, innovative approaches such as machine learning techniques and various data wrangling tools were used to process data, correct errors, and merge information from different sources. Despite significant delays and unforeseen obstacles, the project was ultimately successful in achieving its goals. The project served as a valuable learning experience, highlighting the importance of data quality and standardized practices, and the need for dedicated resources in handling complex data migration projects in research organizations. This study stands out for its comprehensive documentation of the data wrangling and migration process, which has been less explored in the context of CRIS literature.

P-suPAR may reflect the inflammatory response after pancreatic surgery

BackgroundSeveral different scoring systems have been developed to predict post-pancreatectomy complications. Currently used inflammatory markers are of only limited value in predicting complications after pancreatic surgery. Plasma soluble urokinase plasminogen activator receptor (P-suPAR) is a prognostic biomarker associated with different inflammatory conditions. The aim of this study was to investigate P-suPAR levels before and after pancreatic surgery. MethodsOne hundred and seventy-six patients evaluated for pancreatic surgery due to suspected malignant or premalignant lesion were recruited for this study at Tampere University Hospital between 2016 and 2021. P-suPAR was analyzed before the planned operation and on postoperative days (PODs) one and three. ResultsOne hundred and thirty-three patients [median age 67 (range 33–84) years, 50 % male] underwent a pancreatic surgery procedure. Compared to preoperative values [median 3.7 (IQR 3.1–4.7) ng/mL], P-suPAR was significantly lower on PODs 1 [3.2 (2.5–3.9) ng/mL; p < 0.001] and 3 [3.2 (2.7–4.1) ng/mL; p < 0.001]. P-suPAR on POD 1 was significantly lower in patients with postoperative pancreatic fistula (POPF) [2.6 (2.1–3.4) ng/mL] than in patients with no POPF [3.2 (2.6–3.8) ng/mL; p = 0.007]. Similar decreases in P-suPAR values were seen in patients with postoperative acute pancreatitis (POAP) and surgical site infection (SSI). ConclusionsAfter pancreatic surgery, P-suPAR level on POD 1 is significantly lower in patients with POPF, POAP or SSI. P-suPAR is decreased after pancreatic resection in all patients. This type of postoperative P-suPAR profile has not previously been described, and may reflect the compensatory anti-inflammatory reaction following the initial systemic inflammatory reaction caused by surgical trauma.

Comprehensive institution-wide adoption of an ePRO treatment symptom reporting solution.

567 Background: A cloud-based bidirectional app (ePRO) communicating real-time patient-reported cancer treatment symptom(s)/severity and clinical care team (CCT) recommendation(s) can lessen treatment burden. Previous studies have focused on a single diagnosis or treatment modality, but not institution-wide, multi-modal use. Methods: Tampere University Hospital oncology patients (Pt; n=1,873) receiving radiotherapy (RT), systemic therapy (chemo-, immune-, or hormone therapy; ST) or both (RT+ST) modalities with active ePRO accounts between 2015-2021 were asked to complete an app-based treatment-specific questionnaire administered regularly. It was also available ad hoc. Items assessed overall distress (11-point scale; 0=none,10=Worst Possible), physical function (ECOG-based), and treatment symptoms (CTCAE-based; v5). Prespecified responses were programmed to alert the CCT, which in turn, provided customized, app-based recommendations. All data were analyzed descriptively. Results: Pts were predominantly female and middle-aged. The two most common cancer types were breast and prostate; each of the others comprised &lt;5% of the sample and were grouped into “other”. Most received RT+ST (concurrent or sequential). Mean time on active treatment ranged from 4.2 to 11.4 months. The response rate ranged from 82.2% to 87.3%. The most common symptoms were fatigue and pain, with almost a quarter of Pts reporting severe pain. Higher severity levels were reported by patients receiving any ST (Table 1). Conclusions: Pt’s high engagement rate with the app demonstrates that a single, actionable solution can be successfully employed across the continuity of care, despite varying regimens and schedules, and is a behavioral indicator of its value.[Table: see text]

445 The differences of urban and rural out-of-hospital cardiac arrests in Tampere University Hospital area, Finland

445 The differences of urban and rural out-of-hospital cardiac arrests in Tampere University Hospital area, Finland

213 System development of Emergency Medical Service and improved bystander activity have enhanced outcome for the out-of-hospital cardiac arrest in Tampere University Hospital area, Finland

213 System development of Emergency Medical Service and improved bystander activity have enhanced outcome for the out-of-hospital cardiac arrest in Tampere University Hospital area, Finland

Therapy Efficacy of Idiopathic Ventricular Extrasystoles: A Real Life Study

Background. Ventricular extrasystoles (VESs) are common and often harmless in a healthy heart, but they can significantly affect the quality of life. If changes in lifestyle and antiarrhythmic medication are not enough, invasive and often curative catheter ablation can be considered. Better understanding of the conformation of VESs with a 12-lead ECG, as well as their precise localization, have increased their treatment with catheter ablation. Our goal was to determine whether the anatomical site of VES had an effect on procedure success. We also analyzed the safety of the procedure and patient-related factors affecting the results. Materials and Methods. In this retrospective study, we analyzed the medical records of 63 consecutive patients with multiple idiopathic VESs treated by catheter ablation at Heart Hospital, Tampere University Hospital, during 2017 and 2018. Patients with structural heart disease were excluded. Ablation success was estimated with two endpoints, primary and follow-up success. Results. The majority of the patients received treatment on the right ventricular outflow tract (66.7%), others on the left ventricle (17.5%), or the aortic cusp (9.5%). The site of origin remained unknown in four procedures (6.3% of patients). Primary success was observed in 48 procedures (76.2%). During the follow-up period of three months, the procedure was successful in 70.3% of the cases. The anatomical site of VES had no significant effect on either primary or follow-up success. Those with a successful follow-up result had a lower body mass index (BMI = 26.4) than those who had an unsuccessful result (BMI = 28.7; p = 0.069 ); this did not reach statistical significance, potentially due to the small study population size. Complications were observed in three patients (4.5%). All of them were related to the catheter insertion site. Conclusions. For a symptomatic patient, catheter ablation is an effective and often fully curative treatment. The success rate was similar regardless of the site of VESs. This suggests that catheter ablation should also be assessed early on for other cases besides classic right ventricular outflow tract VESs. A high BMI was the only factor associated with a poor procedure success rate. The procedure itself is safe, and adverse effects are rare. The radiation dose is also low partly due to the current magnetic navigation method.

Problems Experienced by Health Care Professionals with Do not Attempt Resuscitation (DNAR) Orders - A Qualitative Study.

A 'Do Not Attempt Resuscitation' (DNAR) order is one of the most important yet difficult medical decisions. Despite the recent European guidelines, health care professionals (HCPs) in general perceive challenges in making a DNAR order. We aimed to evaluate the types of problems related to DNAR order making. A link to a web-based multiple-choice questionnaire including open-ended questions was sent by e-mail to all physicians and nurses working in the Tampere University Hospital special responsibility area covering a catchment area of 900,000 Finns. The questionnaire covered issues on DNAR order making, its meaning and documentation. Here we report the analysis of the open-ended questions, examined based on the Ottawa Decision Support Framework with expanded individual decisional needs categories. Qualitative data describing respondents' opinions (N=648) regarding problems related to DNAR order decision making were analysed using Atlas.ti 23.12 software. In total, 599 statements (phrases) dealing with inadequate advice, information, emotional support, and instrumental help were identified. Our results show that HCPs experience lack of support in DNAR decision making on multiple levels. Digital decision-making support integrated into electronic patient records (EPR) to assure timely and clearly visible DNAR orders could be beneficial.

Preface

It is with great honor to present the proceeding of the International Interdisciplinary Conference on Human Factors, Design and Education for Sustainability (ICoHDES) held in Parahyangan Catholic University (UNPAR) Bandung-Indonesia, 14 - 15th of August 2023. The conference is co-supported by the Erasmus+ Capacity Building for Higher Education (CBHE) project called IN2FOOD: Resolving Societal Challenge: Interdisciplinary Approach Towards Fostering Collaborative Innovation in Food Waste Management, Reference Number: 618717-EPP-12020-1-ID-EPPKA2-CBHE-JP.This proceeding consists 7 reviewed articles which best suited to be published in the scope for IOP Proceeding Series: Earth and Environmental Sciences (EES). Other articles presented in the conference are submitted for a special edition in an Indonesian accredited journal. We are hopeful that the conference and its publications will bring impactful results to the society, bringing together a network of people to resolve sustainability issues through collaborative innovation.We would like to extend our deepest gratitude to distinguished keynote speakers, namely: Prof. Elina Närvänen (Tampere University, Finland), Prof. Lieven de Marez (Ghent University, Belgium), Dr. (cand)., Anna de Visser-Amundson (Hoteschool The Hague, the Netherlands), Dr. Thedy Yogasara (Parahyangan Catholic University, Indonesia) and Dr. Pius Sugeng Prasetyo (Parahyangan Catholic University, Indonesia). Lastly, we would like to express our gratitude to all participants, our organizing and scientific committee for their relentless supports ensuring the success of this conference.Best regards,Carles Sitompul (Conference Chair and Editor)Clara Theresia (Editor)List of Steering Committee, Organizing Committte and Scientific Committee are available in this pdf.

Finnish children who needed long-term home respiratory support had severe sleep-disordered breathing and complex medical backgrounds.

No studies have described long-term paediatric home respiratory support in Nordic countries. We examined the clinical characteristics and long-term outcomes of paediatric patients who received continuous positive airway pressure, non-invasive-positive-pressure ventilation and invasive ventilation from a multidisciplinary home respiratory support team. Retrospective tertiary-level data were collected between 1 January 2010 and 31 December 2020 in Tampere University Hospital. These comprised patient demographics, treatment course and polysomnography-confirmed sleep-disordered breathing (SDB). There were 93 patients (63.4% boys). The median age at treatment initiation was 8.4 (range 0.11-16.9) years. The patients had: neuromuscular disease (16.1%), central nervous system disease (14.0%), developmental disabilities and congenital syndrome (29.0%), lung-airway conditions (11.8%), craniofacial syndrome (15.1%) and severe obesity (14.0%). More than two-thirds had severe SDB (66.7%) and the most common one was obstructive sleep apnoea in 66.7%. We found that 92.5% received long-term therapy for more than 3 months and the mean treatment duration was 3.3 ± 2.7 years. A non-invasive mask interface was used in 94.7% of cases and 5.3% needed tracheostomy ventilation. More than a quarter (26.7%) achieved disease resolution during the study period. Most children who needed long-term home respiratory support had complex conditions and severe, persistent SDB.

Sociodemographic factors affecting glycaemic control in Finnish paediatric patients with type 1 diabetes.

Socioeconomic problems may present significant challenges when trying to reach optimal glycaemic control in paediatric patients with type 1 diabetes. We examined sociodemographic factors affecting metabolic control in patients in one of the biggest paediatric diabetes clinics in Finland. One hundred ninety-one children (age 2-15 years; median 11 years; 47% female) with type 1 diabetes and their families were recruited during outpatient visits in the paediatric diabetes clinic of Tampere University Hospital, Finland. The participants completed a questionnaire on the family's sociodemographic background. The child's glycaemic control was assessed by both glycosylated haemoglobin (HbA1c) and time in range (TIR). Risk factors for poor (HbA1c ≥75 mmol/mol; TIR <40%) and optimal (HbA1c <53 mmol/mol; TIR ≥70%) metabolic control were searched using logistic regression analyses. Living in a nuclear family, male gender, younger age and a school assistant for diabetes management were associated with the simultaneous presence of both indicators of optimal metabolic control. Poor glycaemic control, as estimated by HbA1c, was associated with lower parental education and the child's older age. Parental smoking and the child's older age were associated with poor TIR. This study confirms the importance of sociodemographic factors in care of Finnish paediatric patients with type 1 diabetes. Sociodemographic status markers of the family could be used as triggers to alert paediatric diabetes teams to offer more tailored care to families with new-onset type 1 diabetes mellitus.

No place to go? Older people reconsidering the meaning of social spaces in the context of the COVID-19 pandemic

Under COVID-19 restrictions, older people were advised to avoid social contact and to self-isolate at home. The situation forced them to reconsider their everyday social spaces such as home and leisure time places. This study approached the meaning of social spaces for older people by examining how older people positioned themselves in relation to social spaces during the pandemic. The data were drawn from the Ageing and social well-being (SoWell) research project at Tampere University, Finland, and they consisted of phone interviews collected during the summer of 2020 with 31 older persons aged 64–96 years. The data were analysed using the frameworks of positioning analysis and environmental positioning. Results showed the positions of older people being manifold, flexible and even contradictory. Within home, the participants portrayed themselves as restricted due to limited social contact, but also as able to adapt to and content being alone. Virtual spaces were depicted as spaces for younger and healthy persons, and the participants themselves as sceptical technology users not satisfied with technology-mediated interaction. Within an assisted living facility, the participants described themselves as sensible and responsible persons who wanted to follow the facility's pandemic-related rules but also as independent persons having nothing to do with these rules. In the spaces outside the home, the participants portrayed themselves as persons who followed pandemic instructions but also as persons who were not required to follow the instructions because they could use their own judgement. These self-positions shed light on the social needs of older people in the spaces of their everyday lives. Our results provide useful insights for policy makers and professionals working with older people and will help to promote spaces of living, care and everyday life that can enhance and maintain social interaction and well-being both in times of change and in more stable times.

The clinical course and outcomes of non-aneurysmal subarachnoid hemorrhages in a single-center retrospective study

BackgroundNon-aneurysmal subarachnoid hemorrhages (SAHs) are thought to have a benign clinical course compared to aneurysmal SAHs. The aim of this study is to report the clinical course and outcomes of non-aneurysmal SAHs in a large single-center study.MethodsThe patients with non-aneurysmal SAHs were screened from Tampere University Hospital from 2005 to 2020. The clinical data were collected from the patient’s medical records and from the imaging studies. The primary interest was the neurological outcome assessed by dichotomized GOS at 2 months. Multivariable logistic regression was used to study the factors associated with unfavorable outcome.ResultsWe found 216 non-aneurysmal SAHs in 214 patients (2 patients with > 1 bleed). Ninety-seven percent of patients with a typical perimesencephalic bleeding pattern SAH (PSAH) (75/77) had a favorable outcome, while 86% of patients with non-perimesencephalic SAH (NPSAH) had a favorable outcome (84/98). In a multivariable logistic regression analysis, loss of consciousness (LOC) (aOR 214.67, 95% CI 17.62–2615.89) and Fisher grade 4 bleeding pattern (aOR 23.32, 95% CI 1.40–387.98) were associated with increased risk for unfavorable outcome (GOS 1–3). Vasospasm was seen in 20% of non-aneurysmal SAH patients, hydrocephalus in 17%, and 13% needed ventriculostomy.ConclusionsNon-aneurysmal SAH seems to have a good prognosis for majority of patients, especially for patients with a PSAH. Non-aneurysmal SAH patients are however affected by vasospasm and hydrocephalus and have similar risk factors for poor outcome as patients with aneurysmal SAH. This suggests that it is the severity of the bleed rather than the etiology that associates with poor outcome.

Experimental and numerical investigation of reduced web section connections in fire

AbstractThis paper presents the details and analysis of a fire test conducted on a reduced web section (RWS) connection for steel framed construction. The test was completed in the fire laboratory at Tampere University in order to assess how these connections, usually selected and designed for their seismic performance, behave under fire conditions. RWS connections were first devised for fixed joints in steel framed buildings, with a view to moving the plastic hinge away from the column face during an extreme event such as an earthquake, thus improving the ductility of the structure. Until now, there was very little known of their behaviour under fire conditions. Accordingly, the current paper provides a detailed description and analysis of the fire test on a RWS connection, during which the arrangement lasted for around 16 minutes of standard fire exposure. It also describes the development of a numerical model, which is validated against the test data. The purpose of the model is to enable a more thorough examination of the various parameters and variables that may exist in a real structure, subjected to a real fire.

Emergency department crowding increases 10-day mortality for non-critical patients: a retrospective observational study

The current evidence suggests that higher levels of crowding in the Emergency Department (ED) have a negative impact on patient outcomes, including mortality. However, only limited data are available about the association between crowding and mortality, especially for patients discharged from the ED. The primary objective of this study was to establish the association between ED crowding and overall 10-day mortality for non-critical patients. The secondary objective was to perform a subgroup analysis of mortality risk separately for both admitted and discharged patients. An observational single-centre retrospective study was conducted in the Tampere University Hospital ED from January 2018 to February 2020. The ED Occupancy Ratio (EDOR) was used to describe the level of crowding and it was calculated both at patient’s arrival and at the maximum point during the stay in the ED. Age, gender, Emergency Medical Service transport, triage acuity, and shift were considered as confounding factors in the analyses. A total of 103,196 ED visits were included. The overall 10-day mortality rate was 1.0% (n = 1022). After controlling for confounding factors, the highest quartile of crowding was identified as an independent risk factor for 10-day mortality. The results were essentially similar whether using the EDOR at arrival (OR 1.31, 95% CI 1.07–1.61, p = 0.009) or the maximum EDOR (OR 1.27, 95% CI 1.04–1.56, p = 0.020). A more precise, mortality-associated threshold of crowding was identified at EDOR 0.9. The subgroup analysis did not yield any statistically significant findings. The risk for 10-day mortality increased among non-critical ED patients treated during the highest EDOR quartile.

Validation of the Finnish version of the food allergy quality of life questionnaire-parent form (F-FAQLQ-PF).

Specific questionnaires about food allergy and health-related quality of life (HRQoL) have been developed and validated in several languages, but not Finnish. We aimed to validate the Finnish Food Allergy Quality of Life Questionnaire-Parent Form (FAQLQ-PF) for children under age 13 years. The original FAQLQ-PF and Food Allergy Independent Measure (FAIM) were translated into Finnish per World Health Organisation guidelines and tested by 72 parents of children under age 13 years with suspected severe peanut or tree nut allergy who were recruited at Allergy Centre in Tampere University Hospital in Tampere, Finland. We calculated the construct validity of the questionnaire by calculating the coefficients between the two measures and used Cronbach's alpha to establish the internal consistency. The FAQLQ-PF showed strong correlations with domain structure and internal consistency, based on Spearman's correlations (rho) for the HRQoL questions, FAIM questions and FAIM mean values. The total questionnaire score correlated significantly with the mean FAIM (rho = 0.95, p < 0.001) and individual FAIM questions. The FAQLQ-PF and domains had good or excellent internal consistency (Cronbach's alpha >0.70). The Finnish FAQLQ-PF demonstrated good construct validity and excellent internal consistency for measuring food allergy HRQoL in children under age 13 years.

Systematic analysis of adverse incident reports revealed the need for improvements in the neonatal unit.

The aims were to characterise adverse incident reports and recommendations to avoid the reoccurrence of adverse incidents and detect a possible increase in incidents outside of office hours and on vacation season. Analysis of adverse incidents reported at the neonatal intensive care unit of Tampere University Hospital in Finland between 2013 and 2020. Analysis of 925 fully processed adverse incident reports revealed that 36.3% of the reports were related to medication, fluid management and blood products, and 34.8% of these were administering errors. Nurses reported 828 (89.5%) adverse incidents and physicians reported 37 (4.0%). Near misses constituted 35.3% of nurses' and 21.6% of physicians' reports. There were significantly more adverse incident reports on day shifts, on Thursdays and, Saturdays and in June, November and December than at other times. The interventions recommended were to inform the staff or other parties after 673 (72.7%) reports and to recommend improvements after 56 (6.0%) reports. Analysis of adverse incident reports can reveal the need for improvements in existing protocols in the neonatal intensive care unit.

Thyroid function test variability and cardiovascular morbidity in hyperthyroidism.

The variability of thyroid function tests (TFTs) during antithyroid drug (ATD) therapy and its association with adverse health outcomes have not been previously studied. The aim of this study was to evaluate the association of TFT variability and cardiovascular morbidity during ATD therapy. Retrospective cohort study. Hyperthyroid patients (n = 394) treated with ATD therapy at Tampere University Hospital between March 2016 and December 2018 were followed up for a median time of 1.5 years (interquartile range 0.8-2.0). The coefficients of variation (CVs) of the follow-up thyroid-stimulating hormone (TSH), free thyroxine (fT4) and free triiodothyronine (fT3) measurements were determined. The associations of TFT variability and baseline clinical factors with cardiovascular disease (CVD) -associated hospital visits were assessed with logistic regression analyses. In the multivariable analyses, age (odds ratio [OR]: 1.06, 95% confidence interval [CI]: 1.03-1.09), male gender (OR: 2.33, 95% CI: 1.03-5.28) and fT4-CV (OR: 1.02, 95% CI: 1.01-1.04) were independent risk factors for cardiovascular morbidity, whereas baseline positive thyrotropin receptor antibodies (TRAbs) were associated with lower cardiovascular morbidity (OR: 0.29, 95% CI: 0.14-0.61). When the patients with baseline TRAb positivity were studied separately, fT4-CV was associated with cardiovascular morbidity (OR: 1.03, 95% CI: 1.00-1.05). During ATD therapy, fT4 variability is associated with an increased cardiovascular morbidity. Although positive TRAbs are associated with a lower cardiovascular morbidity compared with hyperthyroidism with negative autoantibodies, the variability of fT4 is associated with cardiovascular morbidity also in patients with positive TRAbs.

User-Initiated Symptom Assessment With an Electronic Symptom Checker: Protocol for a Mixed Methods Validation Study.

The national Omaolo digital social welfare and health care service of Finland provides a symptom checker, Omaolo, which is a medical device (based on Duodecim Clinical Decision Support EBMEDS software) with a CE marking (risk class IIa), manufactured by the government-owned DigiFinland Oy. Users of this service can perform their triage by using the questions in the symptom checker. By completing the symptom checker, the user receives a recommendation for action and a service assessment with appropriate guidance regarding their health problems on the basis of a selected specific symptom in the symptom checker. This allows users to be provided with appropriate health care services, regardless of time and place. This study describes the protocol for the mixed methods validation process of the symptom checker available in Omaolo digital services. This is a mixed methods study using quantitative and qualitative methods, which will be part of the clinical validation process that takes place in primary health care centers in Finland. Each organization provides a space where the study and the nurse triage can be done in order to include an unscreened target population of users. The primary health care units provide walk-in model services, where no prior phone call or contact is required. For the validation of the Omaolo symptom checker, case vignettes will be incorporated to supplement the triage accuracy of rare and acute cases that cannot be tested extensively in real-life settings. Vignettes are produced from a variety of clinical sources, and they test the symptom checker in different triage levels by using 1 standardized patient case example. This study plan underwent an ethics review by the regional permission, which was requested from each organization participating in the research, and an ethics committee statement was requested and granted from Pirkanmaa hospital district's ethics committee, which is in accordance with the University of Tampere's regulations. Of 964 clinical user-filled symptom checker assessments, 877 cases were fully completed with a triage result, and therefore, they met the requirements for clinical validation studies. The goal for sufficient data has been reached for most of the chief symptoms. Data collection was completed in September 2019, and the first feasibility and patient experience results were published by the end of 2020. Case vignettes have been identified and are to be completed before further testing the symptom checker. The analysis and reporting are estimated to be finalized in 2024. The primary goals of this multimethod electronic symptom checker study are to assess safety and to provide crucial information regarding the accuracy and usability of the Omaolo electronic symptom checker. To our knowledge, this will be the first study to include real-life clinical cases along with case vignettes. DERR1-10.2196/41423.