Diagnosis of epileptic seizures by community health workers using a mobile app: A comparison with physicians and a neurologist

Patterson, Victor; Samant, Shruti; Singh, Mamta Bhushan; Jain, Priya; Agavane, Vaibhav; Jain, Yogesh

doi:10.1016/j.seizure.2017.12.006

Cited by 31 publications

(40 citation statements)

References 21 publications

(27 reference statements)

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“…Alguns aplicativos são recomendados por especialistas com fundamentação científica, por exemplo, os que auxiliam na coleta de dados e na análise de eletrocardiogramas (NYOTOWIDJOJO; ERICKSON; LEE, 2016); e os que identificam ataques epiléticos (PATTERSON et al, 2018). Porém, existem autores que questionam os métodos de prognósticos e diagnósticos determinado por leigos através de aplicativos móveis, principalmente por que a maioria não explicita as limitações do diagnóstico (possíveis erros ou intervalos de confiança), apresentam conclusões generalizadas (ao contrário de uma medicina individualizada), e concluem sem uma indicação ou sugestão de que o usuário deve procurar um médico e posteriormente protocolos consolidados laboratoriais, para uma maior precisão do diagnóstico (LUPTON; JUTEL, 2015).…”

Section: Introductionunclassified

Pré-diagnóstico da esquistossomose no semiárido: régua antropométrica e aplicativo colaborativo

et al. 2019

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A esquistossomose é uma doença tropical negligenciada pertencente ao grupo das infecções helmínticas, causada pelo parasita do gênero Schistosoma, que tem afetado pessoas em todo o mundo. No Brasil, cem milhões de casos foram registrados nos últimos trinta e sete anos. Os objetivos desta dissertação foram detectar uma zona pré-diagnóstica para esquistossomose na relação entre o índice de massa corporal e a circunferência abdominal de indivíduos suspeitos de terem essa doença e propor uma ferramenta e um aplicativo colaborativo que terá também um uso educacional. Os procedimentos metodológicos seguiram seis passos: i) a alimentação do banco de dados; ii) a modelagem estatística; iii) a sistematização da árvore de decisão diagnóstica pelas variáveis; iv) a construção de uma régua antropométrica e de um aplicativo colaborativo; v) a aplicação das ferramentas construídas; e, vi) a análise quali-quantitativa. As ferramentas construídas participaram de maneira eficiente para o pré-diagnóstico da esquistossomose, com a redução da passagem de pacientes da fase aguda para fases crônica e pós-crônica, contribuindo com o paciente, no sentido de qualidade e no tempo do tratamento, e com a redução de gastos pelo sistema público de saúde. O mesmo foi relatado para as atividades de ensino e aprendizagem, a utilização das ferramentas por docentes e agentes de saúde em seus ambientes de laboro pôde apresentar de forma lúdica a aplicação da árvore de decisão para o pré-diagnóstico da doença em questão, a resultar na apropriação do conteúdo e da práxis pelo aprendiz.

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Section: Introductionunclassified

Pré-diagnóstico da esquistossomose no semiárido: régua antropométrica e aplicativo colaborativo

et al. 2019

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“…It should be transferable to other LMICs. [13]. The sensitivity of this app was 92% and 86% in two previous https://doi.…”

mentioning

confidence: 75%

“…The algorithm underlying the app uses a Bayesian approach and was developed in a Nepalese population [10] and validated in India and Nepal [11]. This app, presented on a tablet computer, can be used easily by computer-naïve NPHWs [12] and, when compared to the diagnosis of a neurologist, can generate similar agreement to that of local doctors studies [11,13]with specificities of 100% and 33%. More importantly its misdiagnosis rate was 8% compared with 25% for the tool designed in South Asia by Anand et al [14].…”

Section: Introductionmentioning

confidence: 99%

Epilepsy field workers, a smartphone application and telephone telemedicine: Safe and effective epilepsy care in rural Nepal

Rajbhandari

Joshi

Malakar

et al. 2019

Seizure

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A B S T R A C TPurpose: Most people with epilepsy live in low-or middle-income countries (LMICs) where there are relatively few doctors. Over 50% of people with epilepsy in these countries are untreated so other models of care are needed. In this report we evaluate a novel model of care. Methods: We trained four residents of Myagdi, a rural district in Nepal as epilepsy field workers (EFWs). They provided epilepsy awareness to their communities. When they identified someone with possible epilepsy they used a smartphone application (app) to determine the probability score for an episode being epileptic and contacted an epilepsy specialist by phone. If the specialist thought treatment was indicated this was arranged by the EFW. We recorded mortality, change of diagnosis at face-to-face consultation and drug-related events as measures of safety. Seizure frequency and general wellbeing were also recorded, and a questionnaire was devised to measure satisfaction. Results: 112 patients with app scores suggesting epileptic seizures were identified and managed in 18 months, of whom 15 had provoked seizures. Forty-three percent of epilepsy patients were untreated. At follow-up one had died of a cause other than epilepsy. Diagnostic agreement at face-to-face assessment was 93%. Overall 5% had side-effects of medication. Seizures were stopped in 33% and reduced in 57%. Ninety-six percent of patients preferred this service to travelling to other doctors. Conclusion: This novel service met all criteria of safety and was effective in reducing frequency of seizures. Patients preferred it to conventional services. It should be transferable to other LMICs. [13]. The sensitivity of this app was 92% and 86% in two previous https://doi.

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“…Other think-out-of-box attemps include a specifically-designed game for Vegus Nerve Stimulation (VNS) education [32]. In an exciting study aimed to facilitate diagnosis of epilepsy in community by non-professional local caregivers using an App, researchers revealed a roughly equal specificity for correct diagnosis to physicians [37]. These new attempts expanded the traditional concept of epilepsy control and fulfilled different levels of needs for PWEs, even for caregivers.…”

Section: Self-management Of Epilepsymentioning

confidence: 99%

Epilepsy control during an epidemic: emerging approaches and a new management framework

Deng

Zhu

Lin

et al. 2020

Acta Epileptologica

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Epidemics are a big threat to world health. The ongoing pandemic of corona virus disease 2019 (COVID-19) has caused a series of challenges to public health. One such challenge is the management of chronic diseases such as epilepsy during an epidemic event. Studies on this topic are rather limited and the related medical practice is full of uncertainty. Here we review recent development of potential approaches for epilepsy control during an epidemic and propose a new three-level management framework to address these challenges.

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Diagnosis of epileptic seizures by community health workers using a mobile app: A comparison with physicians and a neurologist

Cited by 31 publications

References 21 publications

Pré-diagnóstico da esquistossomose no semiárido: régua antropométrica e aplicativo colaborativo

Pré-diagnóstico da esquistossomose no semiárido: régua antropométrica e aplicativo colaborativo

Epilepsy field workers, a smartphone application and telephone telemedicine: Safe and effective epilepsy care in rural Nepal

Epilepsy control during an epidemic: emerging approaches and a new management framework

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