Smartphone ultrasonography to improve diagnosis and treatment of life-threatening injuries for trauma patients in Cameroon

项目摘要/摘要 诊断成像是创伤评估的标准部分，但获得成像的机会往往极其有限。 在低收入和中等收入国家，大多数伤害死亡发生在这些国家。喀麦隆的创伤死亡率是 高于周边国家。失血性休克的诊断失败与死亡有关 喀麦隆创伤登记处和国家创伤质量改进委员会的分析 可预防死亡的主要根本原因。目前，喀麦隆只有不到一半的创伤患者接受 诊断成像。开发由提供商执行的基于智能手机的超声检查(SBU)程序 因为创伤可以增加诊断机会，促进对伤害的及时诊断和治疗，但只有在 在喀麦隆的情况下是可行和有效的。这项研究的长期目标是减少 在喀麦隆，与伤病相关的负担。这项研究的总体目标是将诊断能力扩展到 有利于及时诊断伤害，减轻伤害负担。研究假设是实施一种 提供者执行的SBU计划是扩大获得诊断成像的一种可行而有效的方法 为喀麦隆的创伤患者准备的。为了达到这一目标，这项研究将追求三个具体目标 R21阶段：1)评估SBU短期和中期技能培训课程的教育效果 和喀麦隆创伤提供者的知识获取；2)评估提供者的可行性-- 在喀麦隆进行SBU试点；3)评估喀麦隆创伤中SBU试点的可接受性 利益相关者。如果达到R21过渡里程碑，R33阶段将实现三个具体目标：1) 评估提供者进行的SBU对创伤患者诊断的准确性；2)评估 提供者执行SBU计划，以扩大创伤诊断能力；3)测试之间的关联 SBU计划的实施和创伤结果。验证SBU是一种可行和有效的方法 扩大诊断能力将消除促使创伤护理的主要障碍，并提供关键目标 以减少伤害对这一人群的有害影响。学习方法中嵌入的是培训 喀麦隆临床医生参与卫生系统研究和加强移动健康能力，这将 支持卫生部门的开发和研究。标准化的SBU培训和实施 议定书可以迅速扩大，以便在整个喀麦隆更广泛地实施，并在其他国家得到验证 LMIC环境。

Project Summary/Abstract Diagnostic imaging is a standard part of trauma assessment, but access to imaging is often extremely limited in low and middle-income countries, where most injury deaths occur. Trauma death rates in Cameroon are higher than surrounding countries. Failure to diagnose hemorrhagic shock has been implicated in death analysis of the Cameroon Trauma Registry and by the National Trauma Quality Improvement Committee as a key root cause of preventable deaths. Currently, fewer than half of trauma patients in Cameroon receive diagnostic imaging. Development of a provider-performed smartphone-based ultrasonography (SBU) program for trauma could increase diagnostic access and facilitate timely diagnosis and treatment of injuries but only if it is feasible and effective for the Cameroonian context. The long-term goal of this research is to reduce the burden associated with injury in Cameroon. This study’s overall objective is to expand diagnostic capacity to facilitate timely diagnosis of injury and reduce injury burden. The study hypothesis is that implementation of a provider-performed SBU program is a feasible and effective method of expanding access to diagnostic imaging for trauma patients in Cameroon. To accomplish the objective, this study will pursue three specific aims for the R21 phase: 1) Evaluate the educational efficacy of a SBU training curriculum in short- and medium-term skill and knowledge acquisition among Cameroonian trauma providers; 2) Evaluate the feasibility of a provider- performed SBU pilot in Cameroon; 3) Assess the acceptability of an SBU pilot among Cameroonian trauma stakeholders. If the R21 transition milestones are met, the R33 phase will pursue three specific aims: 1) Assess diagnostic accuracy of provider-performed SBU on trauma patients; 2) Evaluate the effectiveness of a provider-performed SBU program in expanding diagnostic capacity for trauma; 3) Test associations between SBU program implementation and trauma outcomes. Validating SBU as a feasible and effective method to expand diagnostic capacity will remove a major roadblock to prompt trauma care and provide a critical target for reducing the detrimental impact of injury on this population. Embedded in the study approach is the training of clinicians in health systems research and strengthening of mHEALTH capacity in Cameroon which will support development and research across health sectors. A standardized SBU training and implementation protocol could be rapidly scaled-up for wider implementation throughout Cameroon and validated in other LMIC contexts.