HEART RESERVE | Current expanded follow-up instructions | October 16, 2026

ENDURING COMPANION
Use host/expanded/followup-assessment.csv: nine reserved clinical cases, three per completed module. Use host/program/followup-survey.csv for four unscored implementation/barrier questions. These are optional, consented 60-day follow-up, not a completion or certificate requirement. The reference player does not send surveys.

LIVE PROGRAM
Host/program/assessment-import.csv retains 27 live-bank items: nine pre, nine post and nine follow-up. Live S-prefixed and enduring E-prefixed items adapt the same bank. The three enduring modules have nine pre and nine parallel post items in host/expanded/assessment-import.csv. Import each bank only into its intended format. Do not import old HR5/F1/F3/F5 or TR1-TR3 foundation variants into this edition.

ANALYSIS AND EXPOSURE
The primary endpoint is first-pre to first-post change on three matched concepts within each module or live session, using parallel case variants. These forms are not psychometrically equated. Preserve first attempts and report retries separately. Report retained competence at 60 days separately from immediate learning and self-reported practice.

Use followup-activity-map.csv for the live/enduring concept mapping. Record source_item_id, prior_item_exposure and response_id. If the same follow-up case applies to overlapping activities at the same time, collect it once and link the response; do not count it as an independent second observation. If a case is repeated at another time, flag prior exposure. Do not add activity samples together as unique people.

Report delivered and bounced invitations, unique responders, response/completion by module, missing items, eligible encounters, reported actions and barriers. Include No eligible encounter in denominator reporting. Scored case responses and unscored self-report answers have separate denominators. Follow-up does not prove verified clinical performance or patient benefit. Independent clinical and provider approval remain pending.