PNDI Research and Technical Specifications: FHIR R4 Implementation Guide, RWE Pipeline, Research Transcript Coding Manual, and Terminology Mapping for the Patient Narrative Distortion Index

Research and technical specification package for the Patient Narrative Distortion Index (PNDI). Contains three documents: (1) PNDI FHIR R4 Implementation Guide and RWE Pipeline Specification — FHIR R4 resource profiles, CodeSystem definitions, LOINC candidate mappings, SNOMED CT nearest matches, OMOP-CDM v5.4 integration, Python reference implementation, SQL analysis templates for unit dashboard and equity analysis, and dbt model hierarchy; (2) PNDI Research Transcript Coding Manual — operational definitions, behavioural anchors, coding procedures, inter-rater reliability protocol, and data recording sheet for applying PNDI to clinical encounter transcripts in research settings; (3) PNDI Terminology Mapping — LOINC and SNOMED CT cross-reference for all five PNDI domains, interim local code system, and terminology submission roadmap. All domain definitions verified against the published manuscript. Companion resource to: Gupta YK. The Patient Narrative Distortion Index (PNDI): A Framework to Detect Narrative Loss as a Hidden Driver of Diagnostic Error. Diagnosis. 2026. doi:10.1515/dx-2026-0086