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Anticipating the future: prognostic tools as a complementary strategy to improve care for patients with febrile illnesses in resource-limited settings
- Source :
- BMJ Global Health, BMJ Global Health, Vol 6, Iss 7 (2021)
- Publication Year :
- 2021
- Publisher :
- BMJ Publishing Group, 2021.
-
Abstract
- In low-income and middle-income countries, most patients with febrile illnesses present to peripheral levels of the health system where diagnostic capacity is very limited. In these contexts, accurate risk stratification can be particularly impactful, helping to guide allocation of scarce resources to ensure timely and tailored care. However, reporting of prognostic research is often imprecise and few prognostic tests or algorithms are translated into clinical practice.Here, we review the often-conflated concepts of prognosis and diagnosis, with a focus on patients with febrile illnesses. Drawing on a recent global stakeholder consultation, we apply these concepts to propose three use-cases for prognostic tools in the management of febrile illnesses in resource-limited settings: (1) guiding referrals from the community to higher-level care; (2) informing resource allocation for patients admitted to hospital and (3) identifying patients who may benefit from closer follow-up post-hospital discharge. We explore the practical implications for new technologies and reflect on the challenges and knowledge gaps that must be addressed before this approach could be incorporated into routine care settings.Our intention is that these use-cases, alongside other recent initiatives, will help to promote a harmonised yet contextualised approach for prognostic research in febrile illness. We argue that this is especially important given the heterogeneous settings in which care is often provided for patients with febrile illnesses living in low-income and middle-income countries.
- Subjects :
- Medicine (General)
medicine.medical_specialty
Emerging technologies
media_common.quotation_subject
030231 tropical medicine
Infectious and parasitic diseases
RC109-216
diagnostics and tools
diseases
Scarcity
03 medical and health sciences
R5-920
0302 clinical medicine
Medicine
Humans
030212 general & internal medicine
infections
Intensive care medicine
disorders
Practical implications
media_common
injuries
Practice
business.industry
Health Policy
Public Health, Environmental and Occupational Health
Febrile illness
Prognosis
Clinical Practice
Hospitalization
Resource allocation
business
Limited resources
health systems
Stakeholder consultation
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- BMJ Global Health, BMJ Global Health, Vol 6, Iss 7 (2021)
- Accession number :
- edsair.doi.dedup.....b396f99337de6388413c00683fbefa1d