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4. Common data elements for predictors of pediatric sepsis: A framework to standardize data collection

Author

Mawji, Alishah, Li, Edmond, Chandna, Arjun, Kortz, Teresa, Akech, Samuel, Wiens, Matthew O, Kissoon, Niranjan, and Ansermino, Mark

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Health Sciences, Infectious Diseases, Pediatric, Clinical Research, Sepsis, Hematology, Algorithms, Child, Common Data Elements, Delphi Technique, Early Diagnosis, Humans, Mobile Applications, Triage, General Science & Technology
Abstract

BackgroundStandardized collection of predictors of pediatric sepsis has enormous potential to increase data compatibility across research studies. The Pediatric Sepsis Predictor Standardization Working Group collaborated to define common data elements for pediatric sepsis predictors at the point of triage to serve as a standardized framework for data collection in resource-limited settings.MethodsA preliminary list of pediatric sepsis predictor variables was compiled through a systematic literature review and examination of global guideline documents. A 5-round modified Delphi that involved independent voting and active group discussions was conducted to select, standardize, and prioritize predictors. Considerations included the perceived predictive value of the candidate predictor at the point of triage, intra- and inter-rater measurement reliability, and the amount of time and material resources required to reliably collect the predictor in resource-limited settings.ResultsWe generated 116 common data elements for implementation in future studies. Each common data element includes a standardized prompt, suggested response values, and prioritization as tier 1 (essential), tier 2 (important), or tier 3 (exploratory). Branching logic was added to the predictors list to facilitate the design of efficient data collection methods, such as low-cost electronic case report forms on a mobile application. The set of common data elements are freely available on the Pediatric Sepsis CoLab Dataverse and a web-based feedback survey is available through the Pediatric Sepsis CoLab. Updated iterations will continuously be released based on feedback from the pediatric sepsis research community and emergence of new information.ConclusionRoutine use of the common data elements in future studies can allow data sharing between studies and contribute to development of powerful risk prediction algorithms. These algorithms may then be used to support clinical decision making at triage in resource-limited settings. Continued collaboration, engagement, and feedback from the pediatric sepsis research community will be important to ensure the common data elements remain applicable across a broad range of geographical and sociocultural settings.

Published
2021

7. Features and Frequency of Use of Electronic Health Records in Primary Care Across 20 Countries: A Cross-Sectional Study

Author

Kerr, Gabriele K., primary, Kulshreshtha, Niharika, additional, Greenfield, Geva, additional, Li, Edmond, additional, Beaney, Thomas, additional, Hayhoe, Benedict WJ, additional, Car, Josip, additional, Clavería, Ana, additional, Collins, Claire, additional, Espitia, Sandra Milena, additional, Fernandez, Maria Jose, additional, Gusso, Gustavo, additional, Hoedebecke, Kyle, additional, Hoffman, Robert D., additional, Irving, Greg, additional, Jimenez, Geronimo, additional, Laranjo, Liliana, additional, Lazić, Vanja, additional, Lingner, Heidrun, additional, Memarian, Ensieh, additional, Nessler, Katarzyna, additional, O'Neill, Braden Gregory, additional, Petek, Davorina, additional, Serafini, Alice, additional, Ungan, Mehmet, additional, Majeed, Azeem, additional, and Neves, Ana Luisa, additional

Published
2024
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9. Strengths, Weaknesses, Opportunities, and Threats Analysis of the Use of Digital Health Technologies in Primary Health Care in the Sub-Saharan African Region: Qualitative Study

Author

O'Brien, Niki, primary, Li, Edmond, additional, Chaibva, Cynthia N, additional, Gomez Bravo, Raquel, additional, Kovacevic, Lana, additional, Kwame Ayisi-Boateng, Nana, additional, Lounsbury, Olivia, additional, Nwabufo, Ngnedjou Francoise F, additional, Senkyire, Ephraim Kumi, additional, Serafini, Alice, additional, Surafel Abay, Eleleta, additional, van de Vijver, Steven, additional, Wanjala, Mercy, additional, Wangari, Marie-Claire, additional, Moosa, Shabir, additional, and Neves, Ana Luisa, additional

Published
2023
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14. Digital maturity and its determinants in General Practice: A cross-sectional study in 20 countries

Author

Teixeira, Fábia, primary, Li, Edmond, additional, Laranjo, Liliana, additional, Collins, Claire, additional, Irving, Greg, additional, Fernandez, Maria Jose, additional, Car, Josip, additional, Ungan, Mehmet, additional, Petek, Davorina, additional, Hoffman, Robert, additional, Majeed, Azeem, additional, Nessler, Katarzyna, additional, Lingner, Heidrun, additional, Jimenez, Geronimo, additional, Darzi, Ara, additional, Jácome, Cristina, additional, and Neves, Ana Luísa, additional

Published
2023
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16. Strengths, Weaknesses, Opportunities, and Threats Analysis of the Use of Digital Health Technologies in Primary Health Care in the Sub-Saharan African Region: Qualitative Study (Preprint)

Author

O'Brien, Niki, primary, Li, Edmond, additional, Chaibva, Cynthia N, additional, Gomez Bravo, Raquel, additional, Kovacevic, Lana, additional, Kwame Ayisi-Boateng, Nana, additional, Lounsbury, Olivia, additional, Nwabufo, Ngnedjou Francoise F, additional, Senkyire, Ephraim Kumi, additional, Serafini, Alice, additional, Surafel Abay, Eleleta, additional, van de Vijver, Steven, additional, Wanjala, Mercy, additional, Wangari, Marie-Claire, additional, Moosa, Shabir, additional, and Neves, Ana Luisa, additional

Published
2022
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19. Digital maturity and its determinants in General Practice: a cross-sectional study in 20 countries

Author

Teixeira, Fábia, primary, Li, Edmond, additional, Laranjo, Liliana, additional, Collins, Claire, additional, Irving, Greg, additional, Fernandez, Maria Jose, additional, Car, Josip, additional, Ungan, Mehmet, additional, Petek, Davorina, additional, Hoffman, Robert, additional, Majeed, Azeem, additional, Nessler, Katarzyna, additional, Lingner, Heidrun, additional, Jimenez, Geronimo, additional, Darzi, Ara, additional, Jácome, Cristina, additional, and Neves, Ana Luísa, additional

Published
2022
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20. General practitioners’ perceptions of using virtual primary care during the COVID-19 pandemic: An international cross-sectional survey study

Author

Li, Edmond, primary, Tsopra, Rosy, additional, Jimenez, Geronimo, additional, Serafini, Alice, additional, Gusso, Gustavo, additional, Lingner, Heidrun, additional, Fernandez, Maria Jose, additional, Irving, Greg, additional, Petek, Davorina, additional, Hoffman, Robert, additional, Lazic, Vanja, additional, Memarian, Ensieh, additional, Koskela, Tuomas, additional, Collins, Claire, additional, Espitia, Sandra Milena, additional, Clavería, Ana, additional, Nessler, Katarzyna, additional, O’Neill, Braden Gregory, additional, Hoedebecke, Kyle, additional, Ungan, Mehmet, additional, Laranjo, Liliana, additional, Ghafur, Saira, additional, Fontana, Gianluca, additional, Majeed, Azeem, additional, Car, Josip, additional, Darzi, Ara, additional, and Neves, Ana Luisa, additional

Published
2022
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22. Benefits and Challenges of Using Virtual Primary Care During the COVID-19 Pandemic: An International Cross-sectional Survey Study (Preprint)

Author

Li, Edmond, primary, Tsopra, Rosy, additional, Jimenez, Geronimo, additional, Serafini, Alice, additional, Gusso, Gustavo, additional, Lingner, Heidrun, additional, Fernandez, Maria Jose, additional, Irving, Greg, additional, Petek, Davorina, additional, Hoffman, Robert, additional, Lazic, Vanja, additional, Memarian, Ensieh, additional, Koskela, Tuomas H, additional, Collins, Claire, additional, Espitia, Sandra Milena, additional, Clavería, Ana, additional, Nessler, Katarzyna, additional, O’Neill, Braden Gregory, additional, Hoedebecke, Kyle, additional, Ungan, Mehmet, additional, Laranjo, Liliana, additional, Ghafur, Saira, additional, Fontana, Gianluca, additional, Majeed, Azeem, additional, Car, Josip, additional, Darzi, Ara, additional, and Neves, Ana Luísa, additional

Published
2021
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23. Evaluating the Impact of COVID-19 on the Adoption of Virtual Care in General Practice in 20 Countries (inSIGHT): Protocol and Rationale Study

Author

Neves, Ana Luísa, primary, Li, Edmond, additional, Serafini, Alice, additional, Jimenez, Geronimo, additional, Lingner, Heidrun, additional, Koskela, Tuomas H, additional, Hoffman, Robert D, additional, Collins, Claire, additional, Petek, Davorina, additional, Claveria, Ana, additional, Tsopra, Rosy, additional, Irving, Greg, additional, Gusso, Gustavo, additional, O’Neill, Braden Gregory, additional, Hoedebecke, Kyle, additional, Espitia, Sandra Milena, additional, Ungan, Mehmet, additional, Nessler, Katarzyna, additional, Lazic, Vanja, additional, Laranjo, Liliana, additional, Memarian, Ensieh, additional, Fernandez, Maria Jose, additional, Ghafur, Saira, additional, Fontana, Gianluca, additional, Majeed, Azeem, additional, Car, Josip, additional, and Darzi, Ara, additional

Published
2021
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24. Benefits and Challenges of Using Virtual Primary Care During the COVID-19 Pandemic: From Key Lessons to a Framework for Implementation

Author

Li, Edmond, primary, Tsopra, Rosy, additional, Gimenez, Geronimo Larrain, additional, Serafini, Alice, additional, Gusso, Gustavo, additional, Lingner, Heidrun, additional, Fernandez, Maria Jose, additional, Irving, Greg, additional, Petek, Davorina, additional, Hoffman, Robert, additional, Lazic, Vanja, additional, Ensieh, Memarian, additional, Koskela, Tuomas, additional, Collins, Claire, additional, Espitia, Sandra Milena, additional, Clavería, Ana, additional, Nessler, Katarzyna, additional, O’Neill, Braden Gregory, additional, Hoedebecke, Kyle, additional, Ungan, Mehmet, additional, Laranjo, Liliana, additional, Ghafur, Saira, additional, Fontana, Gianluca, additional, Majeed, Azeem, additional, Car, Josip, additional, Darzi, Ara, additional, and Neves, Ana Luisa, additional

Published
2021
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26. Evaluating the impact of COVID-19 on the adoption of virtual care in general practice in 20 countries (inSIGHT): rationale and study protocol (Preprint)

Author

Neves, Ana Luísa, primary, Li, Edmond, additional, Serafini, Alice, additional, Gimenez, Geronimo Larrain, additional, Lingner, Heidrun, additional, Koskela, Tuomas, additional, Hoffman, Robert D, additional, Collins, Claire, additional, Petek, Davorina, additional, Claveria, Ana, additional, Tsopra, Rosy, additional, Irving, Greg, additional, Gusso, Gustavo, additional, O’Neill, Braden Gregory, additional, Hoedebecke, Kyle, additional, Espitia, Sandra Milena, additional, Ungan, Mehmet, additional, Nessler, Katarzyna, additional, Lazic, Vanja, additional, Laranjo, Liliana, additional, Ensieh, Memarian, additional, Fernandez, Maria Jose, additional, Ghafur, Saira, additional, Fontana, Gianluca, additional, Majeed, Azeem, additional, Car, Josip, additional, and Darzi, Ara, additional

Published
2021
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35. Additional file 3 of Smart triage: triage and management of sepsis in children using the point-of-care Pediatric Rapid Sepsis Trigger (PRST) tool

Author

Mawji, Alishah, Li, Edmond, Komugisha, Clare, Akech, Samuel, Dunsmuir, Dustin, Wiens, Matthew O., Niranjan Kissoon, Kenya-Mugisha, Nathan, Tagoola, Abner, Kimutai, David, Bone, Jeffrey N., Dumont, Guy, and J. Mark Ansermino

Subjects
InformationSystems_GENERAL, ComputingMilieux_THECOMPUTINGPROFESSION, GeneralLiterature_INTRODUCTORYANDSURVEY, Data_FILES, 3. Good health
Abstract

Additional file 3. Healthcare Worker Satisfaction Survey.

36. Additional file 3 of Smart triage: triage and management of sepsis in children using the point-of-care Pediatric Rapid Sepsis Trigger (PRST) tool

Author

Mawji, Alishah, Li, Edmond, Komugisha, Clare, Akech, Samuel, Dunsmuir, Dustin, Wiens, Matthew O., Niranjan Kissoon, Kenya-Mugisha, Nathan, Tagoola, Abner, Kimutai, David, Bone, Jeffrey N., Dumont, Guy, and J. Mark Ansermino

Subjects
InformationSystems_GENERAL, ComputingMilieux_THECOMPUTINGPROFESSION, GeneralLiterature_INTRODUCTORYANDSURVEY, Data_FILES, 3. Good health
Abstract

Additional file 3. Healthcare Worker Satisfaction Survey.

37. Additional file 1 of Smart triage: triage and management of sepsis in children using the point-of-care Pediatric Rapid Sepsis Trigger (PRST) tool

Author

Mawji, Alishah, Li, Edmond, Komugisha, Clare, Akech, Samuel, Dunsmuir, Dustin, Wiens, Matthew O., Niranjan Kissoon, Kenya-Mugisha, Nathan, Tagoola, Abner, Kimutai, David, Bone, Jeffrey N., Dumont, Guy, and J. Mark Ansermino

Subjects
TheoryofComputation_MISCELLANEOUS, Data_FILES, ComputingMilieux_PERSONALCOMPUTING, Data_CODINGANDINFORMATIONTHEORY, 3. Good health
Abstract

Additional file 1. Smart Triage Data Dictionary.

38. Smart triage: triage and management of sepsis in children using the point-of-care Pediatric Rapid Sepsis Trigger (PRST) tool

Author

Mawji, Alishah, Li, Edmond, Komugisha, Clare, Akech, Samuel, Dunsmuir, Dustin, Wiens, Matthew O, Kissoon, Niranjan, Kenya-Mugisha, Nathan, Tagoola, Abner, Kimutai, David, Bone, Jeffrey N, Dumont, Guy, and Ansermino, J. M

Subjects
3. Good health
Abstract

Background: Sepsis is the leading cause of death and disability in children. Every hour of delay in treatment is associated with an escalating risk of morbidity and mortality. The burden of sepsis is greatest in low- and middle-income countries where timely treatment may not occur due to delays in diagnosis and prioritization of critically ill children. To circumvent these challenges, we propose the development and clinical evaluation of a digital triage tool that will identify high risk children and reduce time to treatment. We will also implement and clinically validate a Radio-Frequency Identification system to automate tracking of patients. The mobile platform (mobile device and dashboard) and automated patient tracking system will create a low cost, highly scalable solution for critically ill children, including those with sepsis. Methods: This is pre-post intervention study consisting of three phases. Phase I will be a baseline period where data is collected on key predictors and outcomes before implementation of the digital triage tool. In Phase I, there will be no changes to healthcare delivery processes in place at the study hospitals. Phase II will involve model derivation, technology development, and usability testing. Phase III will be the intervention period where data is collected on key predictors and outcomes after implementation of the digital triage tool. The primary outcome, time to treatment initiation, will be compared to assess effectiveness of the digital health intervention. Discussion: Smart technology has the potential to overcome the barrier of limited clinical expertise in the identification of the child at risk. This mobile health platform, with sensors and data-driven applications, will provide real-time individualized risk prediction to rapidly triage patients and facilitate timely access to life-saving treatments for children in low- and middle-income countries, where specialists are not regularly available and deaths from sepsis are common. Trial registration: Clinical Trials.gov Identifier: NCT04304235, Registered 11 March 2020.

40. Additional file 1 of Smart triage: triage and management of sepsis in children using the point-of-care Pediatric Rapid Sepsis Trigger (PRST) tool

Author

Mawji, Alishah, Li, Edmond, Komugisha, Clare, Akech, Samuel, Dunsmuir, Dustin, Wiens, Matthew O., Niranjan Kissoon, Kenya-Mugisha, Nathan, Tagoola, Abner, Kimutai, David, Bone, Jeffrey N., Dumont, Guy, and J. Mark Ansermino

Subjects
TheoryofComputation_MISCELLANEOUS, Data_FILES, ComputingMilieux_PERSONALCOMPUTING, Data_CODINGANDINFORMATIONTHEORY, 3. Good health
Abstract

Additional file 1. Smart Triage Data Dictionary.

42. Validating a framework to guide the implementation of high-quality virtual primary care: an international eDelphi study protocol.

Author

Carvalho JM, Li E, Hayhoe B, Beaney T, Majeed A, Greenfield G, and Neves AL

Subjects
Humans, Delphi Technique, Consensus, London, Primary Health Care, General Practitioners
Abstract

Background: There is an urgent need to support primary care organisations in implementing safe and high-quality virtual consultations. We have previously performed qualitative research to capture the views of 1600 primary care physicians across 20 countries on the main benefits and challenges of using virtual consultations. Subsequently, a prototype of a framework to guide the implementation of high-quality virtual primary care was developed., Aim: To explore general practitioners' perspectives on the appropriateness and relevance of each component of the framework's prototype, to further refine it and optimise its practical use in primary care facilities., Methods and Analysis: Participants will be primary care physicians with active experience providing virtual care, recruited through convenience and snowball sampling. This study will use a systematic and iterative online Delphi research approach (eDelphi), with a minimum of three rounds. A pre-round will be used to circulate items for initial feedback and adjustment. In subsequent rounds, participants will be asked to rate the relevance of the framework's components. Consensus will be defined as >70% of participants agreeing/strongly agreeing or disagreeing/strongly disagreeing with a component. Data will be collected using structured online questionnaires. The primary outcome of the study will be a list of the essential components to be incorporated in the final version of the framework., Ethics and Dissemination: The study has received ethical approval conceded by the Imperial College London Science, Engineering and Technology Research Ethics Committee (SETREC) (reference no .6559176/2023). Anonymous results will be made available to the public, academic organisations and policymakers., Competing Interests: Competing interests: BH is an employee of eConsult Health Ltd, a provider of electronic consultations for NHS primary, secondary and urgent/emergency care. Other authors have no conflicts of interest to disclose., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Published
2023
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