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ePOCT+ and the medAL-; suite; : development of an electronic clinical decision support algorithm and digital platform for pediatric outpatients in low- and middle-income countries

Tan, R. and Cobuccio, L. and Beynon, F. and Levine, G. A. and Vaezipour, N. and Luwanda, L. B. and Mangu, C. and Vonlanthen, A. and De Santis, O. and Salim, N. and Manji, K. and Naburi, H. and Chirande, L. and Matata, L. and Bulongeleje, M. and Moshiro, R. and Miheso, A. and Arimi, P. and Ndiaye, O. and Faye, M. and Thiongane, A. and Awasthi, S. and Sharma, K. and Kumar, G. and Van De Maat, J. and Kulinkina, A. and Rwandarwacu, V. and Dusengumuremyi, T. and Nkuranga, J. B. and Rusingiza, E. and Tuyisenge, L. and Hartley, M. A. and Faivre, V. and Thabard, J. and Keitel, K. and D'Acremont, V.. (2023) ePOCT+ and the medAL-; suite; : development of an electronic clinical decision support algorithm and digital platform for pediatric outpatients in low- and middle-income countries. PLOS Digit Health, 2. e0000170.

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Abstract

Electronic clinical decision support algorithms (CDSAs) have been developed to address high childhood mortality and inappropriate antibiotic prescription by helping clinicians adhere to guidelines. Previously identified challenges of CDSAs include their limited scope, usability, and outdated clinical content. To address these challenges we developed ePOCT+, a CDSA for the care of pediatric outpatients in low- and middle-income settings, and the medical algorithm suite (medAL-suite), a software for the creation and execution of CDSAs. Following the principles of digital development, we aim to describe the process and lessons learnt from the development of ePOCT+ and the medAL-suite. In particular, this work outlines the systematic integrative development process in the design and implementation of these tools required to meet the needs of clinicians to improve uptake and quality of care. We considered the feasibility, acceptability and reliability of clinical signs and symptoms, as well as the diagnostic and prognostic performance of predictors. To assure clinical validity, and appropriateness for the country of implementation the algorithm underwent numerous reviews by clinical experts and health authorities from the implementing countries. The digitalization process involved the creation of medAL-creator, a digital platform which allows clinicians without IT programming skills to easily create the algorithms, and medAL-reader the mobile health (mHealth) application used by clinicians during the consultation. Extensive feasibility tests were done with feedback from end-users of multiple countries to improve the clinical algorithm and medAL-reader software. We hope that the development framework used for developing ePOCT+ will help support the development of other CDSAs, and that the open-source medAL-suite will enable others to easily and independently implement them. Further clinical validation studies are underway in Tanzania, Rwanda, Kenya, Senegal, and India.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Swiss Centre for International Health (SCIH) > Digital Health Unit (Raab)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Medicine (MED) > Clinical Research (Reither)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Medicine (MED) > Clinical Statistics and Data Management (Glass)
UniBasel Contributors:Tan, Rainer and Cobuccio, Ludovico and Beynon, Fenella and Levine, Gillian and Vaezipour, Nina and Kumar, Gaurav and Kulinkina, Alexandra and Keitel, Kristina and D'Acremont, Valérie
Item Type:Article, refereed
Article Subtype:Research Article
ISSN:2767-3170 (Electronic)2767-3170 (Linking)
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
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Last Modified:06 Mar 2023 09:35
Deposited On:06 Mar 2023 09:35

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