Evidence map›Paper›PMID 38191203›Full record

ArticleBMJ paediatrics open2024

Development and evaluation of a clinical guideline for a paediatric telemedicine service in a low-resource setting.

Molly B Klarman, Xiaofei Chi, Youseline Cajusma, Katelyn E Flaherty, Anne Carine Capois, Michel Daryl Vladimir Dofiné, Lerby Exantus, Jason Friesen, Valery Madsen Beau de Rochars, Torben Becker and 3 more

Registry-linked trialOpen access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ paediatrics open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03943654 (Novel Approach to Improve Patient Care and Diarrheal Disease Research Using Mobile Technology), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
4.7field-weighted citation impact, top 6% 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.

NCT03943654 completednot on this map

Novel Approach to Improve Patient Care and Diarrheal Disease Research Using Mobile Technology

TypeobservationalSponsorUniversity of FloridaRan2019 to 2021Enrolled391ConditionsAcute Diarrhea, Acute Respiratory Infection, Acute Febrile IllnessArmsMotoMeds Healthline- illness assessment and treatment recommendation for non-emergent cases by telephone
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 7 citations in OpenAlex.

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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

13 authors at 3 institutions in 2 countries.

Molly B Klarman *Department of Pediatrics, University of Florida, Gainesville, Florida, USA.ORCID 0000-0003-4846-507X
Xiaofei Chi *Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, Florida, USA.
Youseline CajusmaDepartment of Pediatrics, University of Florida, Gainesville, Florida, USA.
Katelyn E FlahertyDepartments of Emergency Medicine and Environmental and Global Health, University of Florida, Gainesville, Florida, USA.
Anne Carine CapoisDepartment of Pediatrics, University of Florida, Gainesville, Florida, USA.
Michel Daryl Vladimir DofinéDepartment of Pediatrics, University of Florida, Gainesville, Florida, USA.
Lerby ExantusFaculté de Médecine et de Pharmacie, Université d'État d'Haiti, Port-au-Prince, Haiti.
Jason FriesenTrek Medics International, Washington, DC, USA.
Valery Madsen Beau de RocharsDepartment of Health Services Research, Management and Policy, University of Florida, Gainesville, Florida, USA.
Torben BeckerDepartment of Emergency Medicine, University of Florida, Gainesville, Florida, USA.
Chantale BarilFaculté de Médecine et de Pharmacie, Université d'État d'Haiti, Port-au-Prince, Haiti.
Matthew J GurkaDepartments of Pediatrics and Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, Florida, USA.
Eric J NelsonDepartments of Pediatrics and Environmental and Global Health, University of Florida, Gainesville, Florida, USA eric.nelson@ufl.edu.ORCID 0000-0003-2649-2624
University of Florida · USUniversity of Florida Health · USUniversity of Haiti · HT

Funding

A novel approach to improve patient care and diarrheal disease research using mobile technologyDP5OD019893 · OD · UNIVERSITY OF FLORIDA · PI NELSON, ERIC JORGE · 2014 to 2018
$1.9M
NIH HHS DP5 OD019893
6 · The paper itself

Abstract

objectiveTo develop and evaluate a guideline for a paediatric telemedicine and medication delivery service (TMDS).

methodsA clinical guideline for paediatric telemedicine was derived from the World Health (WHO) Organization

resultsA total of 391 cases were enrolled. Among the 320 cases with paired examinations, no general WHO danger signs were identified during in-person examinations; 5 cases (2%) required hospital referral due to problem-specific danger signs or other reasons for escalation. Cohen's kappa for the virtual designation of mild cases was 0.78 (95% CI: 0.69 to 0.87). The sensitivity and specificity of a virtually reported fever were 91% (95% CI: 87% to 96%) and 69% (95% CI: 62% to 76%), respectively; the sensitivity and specificity of virtually reported 'fast breathing' were 47% (95% CI: 21% to 72%) and 89% (95% CI: 85% to 94%), respectively. Kappa for 'no' and 'some' dehydration indicated moderate congruence between virtual and in-person examinations (0.69; 95% CI: 0.41 to 0.98). At 10 days, 273 (95%) of the 287 cases reached by phone were better/recovered.

conclusionCritical components of the virtual examination (triage, danger signs and dehydration assessment) performed well despite varied performance among the problem-specific components. The study and associated resources represents formative steps towards an evidence-based paediatric telemedicine guideline built on WHO clinical principles. In-person examinations for select cases were important to address limitations with virtual examinations and identify cases for escalation. TRIAL REGISTRATION NUMBER: NCT03943654.

Indexed as

Call CentersTelemedicineChildDehydrationHumansProspective StudiesResource-Limited SettingsHealth services research

Identifiers

PMID38191203
PMCPMC10806461
OpenAlexW4390699439

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

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.