Development and evaluation of a mobile application trauma registry for use in low- and middle-income countries

Abstract

Introduction Trauma registries are a means for improving trauma care in low- and middle-income countries, though a number of challenges for the sustainability of these trauma registries exist. Mobile health applications represent a promising technology for low- and middle-income country trauma registries. The development, implementation and evaluation of a mobile application trauma registry for use at the Mbarara Regional Referral Hospital, Uganda is demonstrated. Methods A paper-based trauma registry was implemented at the Mbarara Regional Referral Hospital. Based on feedback from local stakeholders, this was developed into an open-source mobile application version of the trauma registry. The mobile application was evaluated by 17 healthcare workers using a modified Unified Theory of Acceptance and Use of Technology questionnaire and qualitative analysis. Results Unified Theory of Acceptance and Use of Technology scores showed the majority of participants responding positively to the major constructs of Performance Expectancy, Effort Expectancy, Social Influence and Facilitating Conditions, with mean Likert scores (out of 7) of 6.41 (±1.43), 6.25 (±1.41), 5.44 (±1.43) and 5.32 (±1.99), respectively. There was also a young average user age (29.1 years). Qualitative analysis identified response themes of ease of use, efficiency and potential for future research and clinical use; users also suggested expansion of the type of platforms the application was available on. Conclusion Though a number of challenges exist for sustaining trauma registries in low- and middle-income countries, substantial involvement of local stakeholders and responsiveness to feedback should be used to facilitate the use of these technologies in developing countries. This study demonstrates a potential methodology for developing and evaluating trauma registry technologies for use in low- and middle-income countries.

The Kampala Trauma Score: A 20-year track record

“…The most frequently mentioned reason for using the KTS for injury severity scoring is that it effectively predicts in-hospital mortality 15–17,21–40 . Several publications mentioned that the KTS compares well with other major scores 11,25,26,28,31,32,38,40–42 .…”

“…The most frequently mentioned reason for using the KTS for injury severity scoring is that it effectively predicts in-hospital mortality 15–17,21–40 . Several publications mentioned that the KTS compares well with other major scores 11,25,26,28,31,32,38,40–42 . Another reason for using the KTS is its ability to calculate an ISS for both adults and children, which is important in regions where there are no pediatric specific hospitals 11,14,31,32,38 .…”

“…However, a few mentioned the reduced time needed for data collection or the relative ease of calculation. One article highlighted that the score does not require expensive prognostic equipment like computed tomography scanners 40 …”

“…Eight publications mention that the KTS is a simple score to calculate 11,14,41–46 . Seven publications discussed its minimal data requirements as a benefit of the score 15,17,21,40,43,47 …”

“…Suitability of the score for resource scarce environments was mentioned by 29 of the publications 11,15,16,21–30,37,40,41,43–45,47–56 . Most articles did not elaborate on this.…”