Electronic Clinical Decision Support Tools: Strategies to Improve the Management of Lower Respiratory Tract Infections in Low-Resource Settings
Lower respiratory tract infection (LRTI) is a common reason for hospitalization and antibacterial use globally. There is considerable overlap in the clinical presentation of bacterial and viral LRTIs. Low- or middle-income countries (LMICs) face the dual challenge of appropriately targeting antibacterials for bacterial LRTI while reducing inappropriate antibacterials for viral LRTI. We propose a framework by which an electronic clinical decision support tool (eCDST) for diagnosing LRTI and reducing unnecessary antibacterial use may be developed, validated, and prospectively evaluated in an LMIC. The developed tool would be data driven, low-cost, feasible in the local setting, adaptable based on resource availability, and updated in real time, with prospective assessment to identify its clinical impact. We draw upon our team's recent experience developing an eCDST for LRTI management in Sri Lanka. Publicly sharing such processes and data is valuable, such that we can collectively improve clinical care in LMICs and other settings.
Authors
- Dhammika Palangasinghe
- Christopher W. Woods (ORCID: https://orcid.org/0000-0001-7240-2453)
- Maria D. Iglesias-Ussel (ORCID: https://orcid.org/0000-0002-3679-9681)
- Champica K. Bodinayake (ORCID: https://orcid.org/0000-0003-1339-1883)
- Madureka Premamali (ORCID: https://orcid.org/0000-0001-5488-8293)
- Truls Østbye (ORCID: https://orcid.org/0000-0002-0662-7440)
- John A. Gallis (ORCID: https://orcid.org/0000-0003-1921-8424)
- Eric B. Laber (ORCID: https://orcid.org/0000-0003-2640-7696)
- James S. Ngocho (ORCID: https://orcid.org/0000-0001-6242-9863)
- Susanna Naggie (ORCID: https://orcid.org/0000-0001-7721-6975)
- L. Gayani Tillekeratne (ORCID: https://orcid.org/0000-0001-6012-7271)
- Stefany Olague
- Hrishikesh Chakraborty (ORCID: https://orcid.org/0000-0001-9078-845X)
- Melissa H. Watt (ORCID: https://orcid.org/0000-0003-1317-3536)
- Evan R. Myers (ORCID: https://orcid.org/0000-0002-9053-9864)
- Ruvini Kurukulasooriya (ORCID: https://orcid.org/0000-0002-9783-4313)
- Armstrong Obale (ORCID: https://orcid.org/0009-0006-5804-5377)
- Warsha De Soyza
- Thilini Wickramatunga
- Kate Sanborn
- Jayani Gamage
- Ajith Nagahawatte (ORCID: https://orcid.org/0000-0001-6481-0203)
Institutions
- University of Ruhuna (LK)
- Duke University (US)
- University of Utah (US)
- Clinical Research Institute (US)
- Kilimanjaro Christian Medical Centre (TZ)
Publication Details
- Journal
- American Journal of Tropical Medicine and Hygiene
- Published
- 2024-10-08
- DOI
- https://doi.org/10.4269/ajtmh.24-0126
- Citations
- 2
- Primary Topic
- Mobile Health and mHealth Applications
- Type
- article
- Field-Weighted Citation Impact
- 1.70
Funders
- National Institute of Allergy and Infectious Diseases