A novel approach to improve patient care and diarrheal disease research using mobile technology

描述(申请人提供)：腹泻病是全球5岁以下儿童死亡的第二大原因。我们对腹泻疾病霍乱特别感兴趣，因为这种疾病对高危人群具有破坏性影响，而且出现了利用移动技术克服我们在霍乱领域数十年来面临的基本临床和科学挑战的机会。尽管进行了有效的治疗并在提供者教育方面取得了进展，但霍乱病例死亡率仍然很高。传统方法已经无法克服障碍，为患者提供及时的护理机会，并在家庭一级充分了解疾病。随着在霍乱相关发病率和死亡率较高的地区出现高手机普及率，我们感到有了新的干预机会。我们的研究挑战是采取一种非传统的方法来开发一个系统，使用移动技术来识别病例，改善获得护理的机会，并在疾病状态的早期确定微生物区系的特征。该应用程序的具体目标是(I)开发一个系统，利用移动技术检测霍乱患者的早期疾病，(Ii)验证检测系统和临床影响 该系统与对照组进行了中断的时间序列研究，以及(Iii)表征了霍乱粪便在疾病早期状态下的微生物区系。这些目标将产生以下交付成果：我们将首次展示移动技术可以用来识别和提供ORS给疾病早期的腹泻病患者。我们将展示移动技术可以被用来降低入院病例的发生率和严重性。最后，我们将首次使用现代技术来确定霍乱粪便的特征，这可能会影响我们对疾病进展和传播相关因素的基本理解。

DESCRIPTION (provided by applicant): Diarrheal disease is the second leading cause of death among children under 5 years of age globally. We are specifically interested in the diarrheal disease cholera because of the devastating impact the disease has on at-risk populations and an emerging opportunity to leverage mobile technology to overcome fundamental clinical and scientific challenges we have faced for decades in the cholera field. Despite effective treatments and advances in provider education, cholera case fatality rates remain high. Conventional methods have been unable to overcome barriers to provide patients timely access to care and fully understand the disease at the level of the household. With the emergence of high rates of cell phone penetration in areas with significant cholera associated morbidity and mortality, we feel there are new opportunities for intervention. Our research challenge is to take an unconventional approach to develop a system using mobile technology to identify cases, improve access to care, and characterize the microbial flora early in the disease state. The application's specific aims are (i) develop a system to detect cholera patients early in disease using mobile technology, (ii) validate the detection system and clinical impact of the system in an interrupted time series study with a control group, and (iii) characterize the microbial flora of cholera stool during the early disease state. These aims will generate the following deliverables: We will show for the first time that mobile technology can be used to identify and provide ORS to diarrheal disease patients early in disease. We will show that mobile technology can be leveraged to decrease the incidence and severity of cases admitted to the hospital. Lastly, we will implement the system to characterize cholera stool using modern techniques early in disease for the first time, which may impact our fundamental understanding of correlates to disease progression and transmission.