Observational studyBMJ open2016
Respiratory rate and pulse oximetry derived information as predictors of hospital admission in young children in Bangladesh: a prospective observational study.
Observational study in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03750747 (Assessing the Feasibility and Effectiveness of Introducing Pulse Oximetry in IMCI Services to Manage Acute Respiratory Infections at First Level Health Facilities of Bangladesh), which is not on this map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Assessing the Feasibility and Effectiveness of Introducing Pulse Oximetry in IMCI Services to Manage Acute Respiratory Infections at First Level Health Facilities of Bangladesh
Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The effects of mobile health on emergency care in low- and middle-income countries: A systematic review and narrative synthesis.Journal of global health · 2021Pooled it
- A cluster-randomized trial of water, sanitation, handwashing and nutritional interventions on stress and epigenetic programming.Nature communications · 2024Trial
- Wound Image Quality From a Mobile Health Tool for Home-Based Chronic Wound Management With Real-Time Quality Feedback: Randomized Feasibility Study.JMIR mHealth and uHealth · 2021Trial
- Trial
- The Measurement of Vital Signs in Pediatric Patients by Lifelight Software in Comparison to the Standard of Care: Protocol for the VISION-Junior Observational Study.JMIR research protocols · 2025Observational
- Information Based Similarity Analysis of Oxygen Saturation Recordings to Detect Pulmonary Hypertension in Preterm Infants.Biomedical signal processing and control · 2023Article
- Article
- Reduced oxygen saturation entropy is associated with poor prognosis in critically ill patients with sepsis.Physiological reports · 2022Article
- Using self-supervised feature learning to improve the use of pulse oximeter signals to predict paediatric hospitalization.Wellcome open research · 2021Article
- The PRECISE (PREgnancy Care Integrating translational Science, Everywhere) Network's first protocol: deep phenotyping in three sub-Saharan African countries.Reproductive health · 2020Article
- The prevalence of hypoxemia among pediatric and adult patients presenting to healthcare facilities in low- and middle-income countries: protocol for a systematic review and meta-analysis.Systematic reviews · 2020Article
- Wearable Finger Pulse Oximetry for Continuous Oxygen Saturation Measurements During Daily Home Routines of Patients With Chronic Obstructive Pulmonary Disease (COPD) Over One Week: Observational Study.JMIR mHealth and uHealth · 2019Observational
- Derivation and internal validation of a data-driven prediction model to guide frontline health workers in triaging children under-five in Nairobi, Kenya.Wellcome open research · 2019Article
- Observational
- Validation of Instantaneous Respiratory Rate Using Reflectance PPG from Different Body Positions.Sensors (Basel, Switzerland) · 2018Article
- Pattern Analysis of Oxygen Saturation Variability in Healthy Individuals: Entropy of Pulse Oximetry Signals Carries Information about Mean Oxygen Saturation.Frontiers in physiology · 2017Article
Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveHypoxaemia is a strong predictor of mortality in children. Early detection of deteriorating condition is vital to timely intervention. We hypothesise that measures of pulse oximetry dynamics may identify children requiring hospitalisation. Our aim was to develop a predictive tool using only objective data derived from pulse oximetry and observed respiratory rate to identify children at increased risk of hospital admission.
settingTertiary-level hospital emergency department in Bangladesh.
participantsChildren under 5 years (n=3374) presenting at the facility (October 2012-April 2013) without documented chronic diseases were recruited. 1-minute segments of pulse oximetry (photoplethysmogram (PPG), blood oxygen saturation (SpO2) and heart rate (HR)) and respiratory rate were collected with a mobile app. PRIMARY OUTCOME: The need for hospitalisation based on expert physician review and follow-up.
methodsPulse rate variability (PRV) using pulse peak intervals of the PPG signal and features extracted from the SpO2 signal, all derived from pulse oximetry recordings, were studied. A univariate age-adjusted logistic regression was applied to evaluate differences between admitted and non-admitted children. A multivariate logistic regression model was developed using a stepwise selection of predictors and was internally validated using bootstrapping.
resultsChildren admitted to hospital showed significantly (p<0.01) decreased PRV and higher SpO2 variability compared to non-admitted children. The strongest predictors of hospitalisation were reduced PRV-power in the low frequency band (OR associated with a 0.01 unit increase, 0.93; 95% CI 0.89 to 0.98), greater time spent below an SpO2 of 98% and 94% (OR associated with 10 s increase, 1.4; 95% CI 1.3 to 1.4 and 1.5; 95% CI 1.4 to 1.6, respectively), high respiratory rate, high HR, low SpO2, young age and male sex. These variables provided a bootstrap-corrected AUC of the receiver operating characteristic of 0.76.
conclusionsObjective measurements, easily obtained using a mobile device in low-resource settings, can predict the need for hospitalisation. External validation will be required before clinical adoption.
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