Lessons Learned from Implementing a Rapid Test of a Technology Device in
                        a Tertiary Hospital in Uganda

Byakika-Kibwika, Pauline; M, Muwonge; Watts, William; Kange, Justine; Watts, Raleigh

doi:10.1016/j.aogh.2015.12.009

Cited by 3 publications

(2 citation statements)

References 6 publications

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“…A review of the current literature shows that only four studies have evaluated any form of wireless wearable technology in LMIC settings: one pilot study (conducted by two of this study’s authors) evaluating the use of a wearable device in patients with suspected Ebola virus disease in Sierra Leone; and three studies in Uganda—two in a maternity ward and one in a general medical ward. 20,26,32,33 While no prior studies have evaluated wireless wearable devices for pediatric monitoring in an LMIC setting, the findings of this study urge further investigation of these devices in pediatric patients who constitute a large burden of critically ill patients in LMICs. A recent study among pediatric inpatients admitted to district-level hospitals in Kenya found that the frequency of vital sign measurements was far lower than the stated goal benchmark of three sets of vital sign measurements in a 24-h period.…”

Section: Discussionmentioning

confidence: 91%

Validation of a wearable biosensor device for vital sign monitoring in septic emergency department patients in Rwanda

et al. 2019

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Objective: Critical care capabilities needed for the management of septic patients, such as continuous vital sign monitoring, are largely unavailable in most emergency departments (EDs) in low-and middle-income country (LMIC) settings. This study aimed to assess the feasibility and accuracy of using a wireless wearable biosensor device for continuous vital sign monitoring in ED patients with suspected sepsis in an LMIC setting. Methods: This was a prospective observational study of pediatric (!2 mon) and adult patients with suspected sepsis at the Kigali University Teaching Hospital ED. Heart rate, respiratory rate and temperature measurements were continuously recorded using a wearable biosensor device for the duration of the patients' ED course and compared to intermittent manually collected vital signs. Results: A total of 42 patients had sufficient data for analysis. Mean duration of monitoring was 32.8 h per patient. Biosensor measurements were strongly correlated with manual measurements for heart rate (r ¼ 0.87, p < 0.001) and respiratory rate (r ¼ 0.75, p < 0.001), although were less strong for temperature (r ¼ 0.61, p < 0.001). Mean (SD) differences between biosensor and manual measurements were 1.2 (11.4) beats/min, 2.5 (5.5) breaths/min and 1.4 (1.0) C. Technical or practical feasibility issues occurred in 12 patients (28.6%) although were minor and included biosensor detachment, connectivity problems, removal for a radiologic study or exam, and patient/parent desire to remove the device. Conclusions: Wearable biosensor devices can be feasibly implemented and provide accurate continuous heart rate and respiratory rate monitoring in acutely ill pediatric and adult ED patients with sepsis in an LMIC setting.

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Section: Discussionmentioning

confidence: 91%

Validation of a wearable biosensor device for vital sign monitoring in septic emergency department patients in Rwanda

et al. 2019

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“…The accuracy of the EarlySense device was confirmed in a study population of high-risk adult surgical patients and in a small feasibility series with a paediatric and adult patient population in a sleep laboratory and intensive care unit setting. 21 22 Other studies of monitoring technologies have been conducted in low-resource settings [23][24][25][26] ; however, research conducted in neonates has largely been limited to studies in high-resource settings. Well-established methods for HR and RR monitoring exist, but limitations including inaccuracy, invasiveness, timeconsuming application and high cost have prompted development of novel technologies.…”

Section: Global Child Healthmentioning

confidence: 99%

Evaluation of a contactless neonatal physiological monitor in Nairobi, Kenya

Wang¹,

Macharia

Ochieng

et al. 2021

Arch Dis Child

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BackgroundGlobally, 2.5 million neonates died in 2018, accounting for 46% of under-5 deaths. Multiparameter continuous physiological monitoring (MCPM) of neonates allows for early detection and treatment of life-threatening health problems. However, neonatal monitoring technology is largely unavailable in low-resource settings.MethodsIn four evaluation rounds, we prospectively compared the accuracy of the EarlySense under-mattress device to the Masimo Rad-97 pulse CO-oximeter with capnography reference device for heart rate (HR) and respiratory rate (RR) measurements in neonates in Kenya. EarlySense algorithm optimisations were made between evaluation rounds. In each evaluation round, we compared 200 randomly selected epochs of data using Bland-Altman plots and generated Clarke error grids with zones of 20% to aid in clinical interpretation.ResultsBetween 9 July 2019 and 8 January 2020, we collected 280 hours of MCPM data from 76 enrolled neonates. At the final evaluation round, the EarlySense MCPM device demonstrated a bias of −0.8 beats/minute for HR and 1.6 breaths/minute for RR, and normalised spread between the 95% upper and lower limits of agreement of 6.2% for HR and 27.3% for RR. Agreement between the two MCPM devices met the a priori–defined threshold of 30%. The Clarke error grids showed that all observations for HR and 197/200 for RR were within a 20% difference.ConclusionOur research indicates that there is acceptable agreement between the EarlySense and Masimo MCPM devices in the context of large within-subject variability; however, further studies establishing cost-effectiveness and clinical effectiveness are needed before large-scale implementation of the EarlySense MCPM device in neonates.Trial registration numberNCT03920761.

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Use of fitness trackers in patient-centred healthcare research: a systematic review (Preprint)

Khetrapal¹,

Ang²,

Chau³

et al. 2019

Preprint

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BACKGROUND Fitness trackers are increasingly popular consumer electronic devices which provide a rich source of precise individual health data, and are increasingly used in healthcare research. OBJECTIVE This systematic review aims to provide an overview of all patient-centred research studies that used fitness trackers. METHODS MEDLINE and Web of Science databases (up to May 2019) were searched for manuscripts reporting the results of original research using fitness trackers and recruiting patients with any/all medical conditions are included: a total of 63 studies using 41 different models of fitness trackers. Search results were reviewed by two appraisers independently in accordance with the PRISMA statement. Relevant risk-of-bias assessments were performed in all prospective studies. RESULTS Study sizes varied, with a median recruitment of 45 patients (IQR 29-147). Twenty-three randomised controlled trials (RCTs) were identified, of which nine recruited patients with metabolic syndrome or associated conditions with the aim of lifestyle modification. The RCTs did not agree in their conclusions regarding the benefit of using fitness trackers for lifestyle modification. In the remaining 40 studies, 6 were prospective case-control studies, and the remainder were a mix of cohort (21), cross-sectional (8), qualitative (3) and retrospective (2) studies. Fitbit was the commonest device manufacturer, with 27 (42.9%) studies using their products. CONCLUSIONS This review demonstrates the exponential rise of fitness trackers being used in healthcare studies over the last five years, which is likely to continue as fitness trackers and smart-watches offer new healthcare features. Studies reported in this review are of variable quality, and more robust studies to examine the place of fitness trackers in healthcare are necessary – and urgently needed – as their potential to provide objective clinical context is undeniable. CLINICALTRIAL PROSPERO REGISTRATION: CRD42018098993

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Lessons Learned from Implementing a Rapid Test of a Technology Device in a Tertiary Hospital in Uganda

Abstract: A rapid study of innovative technology can be successful at a hospital in a resource-limited setting.

Cited by 3 publications

References 6 publications

Validation of a wearable biosensor device for vital sign monitoring in septic emergency department patients in Rwanda

Validation of a wearable biosensor device for vital sign monitoring in septic emergency department patients in Rwanda

Evaluation of a contactless neonatal physiological monitor in Nairobi, Kenya

Use of fitness trackers in patient-centred healthcare research: a systematic review (Preprint)

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