Evidence map›Paper›PMID 29020976›Full record

Trial reportTrials2017

The added value of a mobile application of Community Case Management on referral, re-consultation and hospitalization rates of children aged under 5 years in two districts in Northern Malawi: study protocol for a pragmatic, stepped-wedge cluster-randomized controlled trial.

Victoria Hardy, Yvonne O'Connor, Ciara Heavin, Nikolaos Mastellos, Tammy Tran, John O'Donoghue, Annette L Fitzpatrick, Nicole Ide, Tsung-Shu Joseph Wu, Griphin Baxter Chirambo and 5 more

Registry-linked trialOpen access · goldAbstract readMulticenter StudyPragmatic Clinical TrialRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Trials, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02763345 (The Added Value of a Mobile Application of Community Case Management on Under-5 Referral, Re-consultation and Hospitalization Rates in Malawi), which is not on this map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
11.3field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

NCT02763345 nacompletednot on this map

The Added Value of a Mobile Application of Community Case Management on Under-5 Referral, Re-consultation and Hospitalization Rates in Malawi: a Pragmatic Stepped-wedge Cluster Randomized Trial

TypeinterventionalSponsorUniversity of WashingtonRan2016 to 2017Enrolled6,995ConditionsInfectious DiseasesArmsSupporting LIFE electronic Community Case Management, Standard care
3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 35 citations in OpenAlex.

  1. Trial
  2. Article
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  4. Review
  5. Review
  6. Article
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  11. Evaluating mobile solutions of integrated Community Case Management (iCCM): Making the final connection.Malawi medical journal : the journal of Medical Association of Malawi · 2017
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 7 institutions in 5 countries.

Victoria HardyDepartment of Family Medicine, University of Washington, Seattle, WA, 98195-4696, USA. vhardy4@uw.edu.
Yvonne O'ConnorHealth Information Systems Research Centre, Cork University Business School, University College Cork, Cork, Ireland.
Ciara HeavinHealth Information Systems Research Centre, Cork University Business School, University College Cork, Cork, Ireland.
Nikolaos MastellosGlobal eHealth Unit, Department of Primary Care and Public Health, Imperial College London, London, UK.
Tammy TranGlobal eHealth Unit, Department of Primary Care and Public Health, Imperial College London, London, UK.
John O'DonoghueGlobal eHealth Unit, Department of Primary Care and Public Health, Imperial College London, London, UK.
Annette L FitzpatrickDepartment of Family Medicine, University of Washington, Seattle, WA, 98195-4696, USA.
Nicole IdeDepartment of Family Medicine, University of Washington, Seattle, WA, 98195-4696, USA.
Tsung-Shu Joseph WuDepartment of Global Health, University of Washington, Seattle, WA, USA.
Griphin Baxter ChiramboFaculty of Health Sciences, Mzuzu University, Luwinga, Mzuzu, Malawi.
Adamson S MuulaDepartment of Public Health, School of Public Health and Family Medicine, College of Medicine, Cork, Malawi.
Moffat NyirendaLondon School of Hygiene and Tropical Medicine, Keppel St, London, UK.
Sven CarlssonDepartment of Informatics, Lund Universitet, School of Economics and Management, Lund, Sweden.
Bo AnderssonDepartment of Informatics, Lund Universitet, School of Economics and Management, Lund, Sweden.
Matthew ThompsonDepartment of Family Medicine, University of Washington, Seattle, WA, 98195-4696, USA.
Imperial College London · GBSeattle University · USLund University · SEMzuzu University · MWUniversity College Cork · IEUniversity of London · GBUniversity of Washington · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is evidence to suggest that frontline community health workers in Malawi are under-referring children to higher-level facilities. Integrating a digitized version of paper-based methods of Community Case Management (CCM) could strengthen delivery, increasing urgent referral rates and preventing unnecessary re-consultations and hospital admissions. This trial aims to evaluate the added value of the Supporting LIFE electronic Community Case Management Application (SL eCCM App) compared to paper-based CCM on urgent referral, re-consultation and hospitalization rates, in two districts in Northern Malawi. METHODS/

designThis is a pragmatic, stepped-wedge cluster-randomized trial assessing the added value of the SL eCCM App on urgent referral, re-consultation and hospitalization rates of children aged 2 months and older to up to 5 years, within 7 days of the index visit. One hundred and two health surveillance assistants (HSAs) were stratified into six clusters based on geographical location, and clusters randomized to the timing of crossover to the intervention using simple, computer-generated randomization. Training workshops were conducted prior to the control (paper-CCM) and intervention (paper-CCM + SL eCCM App) in assigned clusters. Neither participants nor study personnel were blinded to allocation. Outcome measures were determined by abstraction of clinical data from patient records 2 weeks after recruitment. A nested qualitative study explored perceptions of adherence to urgent referral recommendations and a cost evaluation determined the financial and time-related costs to caregivers of subsequent health care utilization. The trial was conducted between July 2016 and February 2017. DISCUSSION: This is the first large-scale trial evaluating the value of adding a mobile application of CCM to the assessment of children aged under 5 years. The trial will generate evidence on the potential use of mobile health for CCM in Malawi, and more widely in other low- and middle-income countries.

trial registrationClinicalTrials.gov, ID: NCT02763345 . Registered on 3 May 2016.

Indexed as

Mobile ApplicationsAttitude of Health PersonnelCase ManagementChild Health ServicesChild, PreschoolClinical ProtocolsCommunity Health WorkersCost-Benefit AnalysisDelivery of Health Care, IntegratedFemaleHealth Care CostsHealth Knowledge, Attitudes, PracticeHealth ResourcesHospitalizationHumansInfantChild healthCommunity health workersInfectious diseasesIntegrated management for childhood illness (IMCI)MalawimHealth

Identifiers

PMID29020976
PMCPMC5637321
OpenAlexW2760971273

What OpenQuestion holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.