Cell Phone Based Protocols for Diagnosis and Management of Childhood Pneumonia

描述（由申请人提供）：肺炎是儿童死亡的主要原因，比艾滋病、疟疾和麻疹的总和还要多。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，使用基于纸张的协议，依赖于临床医生的能力来计算呼吸率，已被证明不足以解决这个问题。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依从性。此外，研究表明，仅基于呼吸频率的算法无法充分识别并发症和死亡风险最高的肺炎儿童。该拟议项目旨在使用现有技术的创新应用，将呼吸率、氧饱和度和临床症状的更准确测量值联合收割机组合成更有用的肺炎诊断算法。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，该工具将帮助资源匮乏环境中的卫生保健提供者。这个工具将包括基于手机的以下三个组成部分的整合：1.一种基于世界卫生组织赞助的儿童疾病综合管理协议的分步诊断和治疗算法，用于使用咳嗽和发烧等症状的组合来识别肺炎儿童。2.在协议内运行的呼吸计，可更准确地计算每分钟的呼吸次数并指导诊断决策。3.脉搏血氧仪，用于测量血氧饱和度（如适用），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患者管理决策。我们相信，生物特征测量和症状评估的这种结合将有助于更准确地诊断肺炎，并提供可量化的严重程度指标。该算法将考虑这些措施，并建议适当的治疗，包括根据年龄，体重和疾病严重程度选择药物和剂量。 公共卫生相关性：肺炎是儿童死亡的主要原因，比艾滋病、疟疾和麻疹的总和还要多。该项目旨在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，该工具将帮助资源匮乏环境中的卫生保健提供者。

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. PUBLIC HEALTH RELEVANCE: Pneumonia is the leading cause of death in children, accounting for more childhood deaths than AIDS, malaria, and measles combined. This project seeks 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.