Cell Phone Based Protocols for Diagnosis and Management of Childhood Pneumonia

基于手机的儿童肺炎诊断和管理方案

• 批准号: 8460042
• 负责人: Amy Ginsburg
• 金额: $ 10.51万
• 依托单位: PATH
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-04-16 至 2015-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8460042
• 关键词: Accounting; Acquired Immunodeficiency Syndrome; Address; Adherence; Age; Algorithms; Antibiotics; Authorization documentation; Biometry; Biotechnology; Caring; Cause of Death; Cellular Phone; Cessation of life; Child; Childhood; Clinic; Clinical; Clinical assessments; Communities; Computer software; Coughing; Development; Devices; Diagnosis; Diagnostic; Engineering; Enrollment; Ethics Committees; Fever; Fingers; Funding; Glosso-Sterandryl; Goals; Gold; Government Officials; Guidelines; Health; Health Personnel; Health care facility; Hypoxemia; India; Instruction; International; Interview; Laboratories; Lead; Malaria; Measles; Measurement; Measures; Methods; Neonatal; Nurse Midwives; Outcome; Oxygen; Paper; Participant; Patients; Pharmaceutical Preparations; Phase; Physiologic pulse; Pilot Projects; Pneumonia; Protocols documentation; Research; Resources; Respiration; Risk; Role; Severities; Severity of illness; Symptoms; Technology; Telephone; Testing; Thoracic Radiography; Training; Trust; Universities; Washington; Weight; Work; Workplace; World Health Organization; base; cohort; computer science; design; diagnostic accuracy; digital; dosage; high risk; improved; innovation; member; respiratory; satisfaction; social; software development; standard care; standard of care; tool; usability; user-friendly

DESCRIPTION (provided by applicant): Pneumonia is the leading cause of death in children, accounting for more childhood deaths than AIDS, malaria, and measles combined. Almost all these deaths are preventable if pneumonia is diagnosed and treated correctly. However, the current approach, using paper-based protocols that rely on a clinician's ability to count respiratory rate, has proven inadequate in addressing this problem. Recent evidence has suggested that cell phone-based algorithms can improve adherence to diagnostic and treatment guidelines for pneumonia. Furthermore, studies have shown that algorithms based on respiratory rate alone do not adequately identify children with pneumonia at the highest risk of complications and death. This proposed project aims to use an innovative application of existing technology to combine more accurate measures of respiratory rate, oxygen saturation, and clinical symptoms into a more useful diagnostic algorithm for pneumonia. We seek to improve diagnosis accuracy and management of childhood pneumonia through the development of a cell phone-based tool that will assist health care providers in low-resource settings. This tool will include the cell phone-based integration of the following three components: 1. A step-by-step diagnosis and treatment algorithm grounded in the World Health Organization- sponsored Integrated Management of Childhood Illness protocol to identify children with pneumonia using a combination of symptoms, such as cough and fever. 2. A respirometer that operates within the protocol to more accurately count the number of breaths per minute and guide diagnostic decisions. 3. A pulse oximeter to measure oxygen saturation when applicable and provide clinical support and patient management decisions based on the severity of the condition and the risks associated with hypoxemia. We believe that this combination of biometric measurements and symptom assessment will lead to more accurate diagnosis of pneumonia and provide a quantifiable indication of severity. The algorithm will factor in these measures and recommend appropriate treatment, including drug choice and dosage based on age, weight, and severity of illness.

描述(申请人提供)：肺炎是儿童死亡的主要原因，儿童死亡人数超过艾滋病、疟疾和麻疹的总和。如果肺炎得到正确诊断和治疗，几乎所有这些死亡都是可以预防的。然而，目前的方法，使用基于纸质的方案，依赖于临床医生计算呼吸频率的能力，已被证明不足以解决这一问题。最近的证据表明，基于手机的算法可以提高对肺炎诊断和治疗指南的遵守程度。此外，研究表明，仅基于呼吸频率的算法不能充分识别患有肺炎的儿童，这些儿童的并发症和死亡风险最高。这个拟议的项目旨在利用现有技术的创新应用，将更准确的呼吸频率、血氧饱和度和临床症状的测量结合到更有用的肺炎诊断算法中。我们寻求通过开发一种基于手机的工具来提高儿童肺炎的诊断准确性和管理水平，该工具将在资源匮乏的情况下帮助卫生保健提供者。这一工具将包括以手机为基础的以下三个组成部分的整合：1.以世界卫生组织发起的儿童疾病综合管理议定书为基础的循序渐进的诊断和治疗算法，利用咳嗽和发烧等症状的组合来识别患有肺炎的儿童。2.呼吸仪，在协议内运行，以更准确地计算每分钟的呼吸次数，并指导诊断决定。3.脉搏血氧仪，在适用时测量血氧饱和度，并根据病情的严重程度和与低氧血症相关的风险提供临床支持和病人管理决策。我们相信，这种生物测量和症状评估的结合将导致对肺炎的更准确诊断，并提供可量化的严重程度指示。该算法将考虑这些措施并推荐适当的治疗，包括基于年龄、体重和疾病严重程度的药物选择和剂量。