Evaluation of Standard and Mobile Health–Supported Clinical Diagnostic Tools for Assessing Dehydration in Patients with Diarrhea in Rural Bangladesh
| Autor: | Al Fazal Khan, Saadiyah Bilal, Lars Meisner, Yokabed Ashenafi, Shivani Teegala, Mahfuj Alam, Adam C. Levine, Saad Al Amin, Eric J. Nelson, Nur H. Alam |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Diarrhea Male Rural Population medicine.medical_specialty Adolescent 030231 tropical medicine Population MEDLINE Nurses World Health Organization 03 medical and health sciences 0302 clinical medicine Virology Humans Medicine In patient Prospective Studies 030212 general & internal medicine Dehydration Child Prospective cohort study education mHealth Reliability (statistics) Observer Variation Bangladesh education.field_of_study business.industry Infant Middle Aged medicine.disease Hospitals Telemedicine Infectious Diseases ROC Curve Child Preschool Acute Disease Emergency medicine Female Parasitology Smartphone Erratum medicine.symptom business Algorithms |
| Zdroj: | The American Journal of Tropical Medicine and Hygiene |
| ISSN: | 1476-1645 0002-9637 |
| DOI: | 10.4269/ajtmh.17-0648 |
| Popis: | Diarrhea remains a leading cause of morbidity and mortality in patients worldwide. The objective of this study was to determine the relative inter-rater reliability and usability of standard and Mobile health (mHealth)-supported World Health Organization (WHO) algorithms for dehydration assessment in patients with acute diarrhea in a rural, low-income country hospital. Two nurses blinded to each other's examinations assessed dehydration status on patients soon after hospital arrival using either the standard WHO algorithm printed on a laminated card or an mHealth-supported WHO algorithm downloaded onto a smartphone. The assignment of assessment tool was based on odd or even enrollment date. The inter-rater reliability for dehydration assessment between the two nurses was calculated using Cohen's K statistic for each study group. A total of 496 patients ( 5 years N = 147) were enrolled in the study; 132 (27%) had some or severe dehydration, and 364 (73%) had no dehydration on arrival. Cohen's K statistic demonstrated greater reliability for the mHealth-supported dehydration assessment (0.59) compared with the standard assessment (0.50) in the overall population (P < 0.0001), as well as in the pediatric (0.43 versus 0.37, P < 0.0001) and adult (0.79 versus 0.57, P < 0.0001) populations individually. This is the first study to show that mHealth can improve the reliability of nursing dehydration assessment in patients with acute diarrhea and the first to report on the reliability of the WHO algorithm in adult patients specifically. Future studies should focus on the impact of mHealth-supported dehydration assessment on patient-centered outcomes and examine its reliability in different settings worldwide. |
| Databáze: | OpenAIRE |
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