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，儿童死亡人数比艾滋病、疟疾和麻疹加起来还要多。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并发症和死亡风险最高的肺炎患儿。该项目旨在利用现有技术的创新应用，将更准确的呼吸频率、氧饱和度和临床症状测量结合起来，形成更有用的肺炎诊断算法。我们试图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地区的卫生保健提供者。该工具将包括基于手机的以下三个组件的集成：1。一种基于世界卫生组织赞助的儿童疾病综合管理方案的分步诊断和治疗算法，通过咳嗽和发烧等综合症状来识别患有肺炎的儿童。2. 一种在协议内操作的呼吸计，以更准确地计算每分钟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，并根据病情的严重程度和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，这种生物测量和症状评估的结合将导致更准确的肺炎诊断，并提供严重程度的可量化指示。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。

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.