Usability and acceptability of an automated respiratory rate counter to assess childhood pneumonia in Nepal

Källander, Karin; Ward, Charlotte; Smith, Helen; Bhattarai, Radheshyam; Kc, Ashish; Timsina, Deepak; Lamichhane, Bikash; Maurel, Alice; Shrestha, Prabhakar; Baral, Sushil; McWhorter, Cindy; LaBarre, Paul; Cola, Monica Anna de; Baker, K. Scott

doi:10.1111/apa.15108

Cited by 10 publications

(12 citation statements)

References 17 publications

(32 reference statements)

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“…Performance of automated RR counting with ChARM was similar to the one of the Masimo Rad G pulse oximeter, with a mean difference of −1.1 breath per minute, wide 95% CI limits of agreement (−19.6-17.4 breaths/min), a kappa-statistic of 0.65 and a positive percent agreement of 81.5% [20]. Moreover, usability studies have shown that it also performed slowly with a mean performance time of more than three minutes [17,19] and the important limitation that breathing rates often increased after its application around the child's chest due to agitation [18].…”

Section: Discussionmentioning

confidence: 80%

“…Therefore, UNICEF launched the acute respiratory infection diagnostic aid (ARIDA) project and determined the target product profile of an automated RR counter [13]. Recently, two automated RR counters, i.e., a photoplethysmography-based (Masimo Rad G) [14][15][16] and accelerometer-based (Philips ChARM) [17][18][19][20] device have been evaluated in a low-resource setting. These studies revealed variable accuracy and some usability issues, such as slow performance and measurement failure [14][15][16][17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

“…Recently, two automated RR counters, i.e., a photoplethysmography-based (Masimo Rad G) [14][15][16] and accelerometer-based (Philips ChARM) [17][18][19][20] device have been evaluated in a low-resource setting. These studies revealed variable accuracy and some usability issues, such as slow performance and measurement failure [14][15][16][17][18][19][20]. However, for a full evaluation of the value of these two methods to detect fast breathing as a clinical danger sign, field studies should specifically address children with severe febrile illness in a low resource setting.…”

Section: Introductionmentioning

confidence: 99%

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Performance of Automated Point-of-Care Respiratory Rate Counting versus Manual Counting in Children under Five Admitted with Severe Febrile Illness to Kisantu Hospital, DR Congo

Tack

Vita²,

Mbaki³

et al. 2021

Diagnostics

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To improve the early recognition of danger signs in children with severe febrile illness in low resource settings, WHO promotes automated respiratory rate (RR) counting, but its performance is unknown in this population. Therefore, we prospectively evaluated the field performance of automated point-of-care plethysmography-based RR counting in hospitalized children with severe febrile illness (<5 years) in DR Congo. A trained research nurse simultaneously counted the RR manually (comparative method) and automatically with the Masimo Rad G pulse oximeter. Valid paired RR measurements were obtained in 202 (83.1%) children, among whom 43.1% (87/202) had fast breathing according to WHO criteria based on manual counting. Automated counting frequently underestimated the RR (median difference of −1 breath/minute; p2.5–p97.5 limits of agreement: −34–6), particularly at higher RR. This resulted in a failure to detect fast breathing in 24.1% (21/87) of fast breathing children (positive percent agreement: 75.9%), which was not explained by clinical characteristics (p > 0.05). Children without fast breathing were mostly correctly classified (negative percent agreement: 98.3%). In conclusion, in the present setting the automated RR counter performed insufficiently to facilitate the early recognition of danger signs in children with severe febrile illness, given wide limits of agreement and a too low positive percent agreement.

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Section: Discussionmentioning

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Performance of Automated Point-of-Care Respiratory Rate Counting versus Manual Counting in Children under Five Admitted with Severe Febrile Illness to Kisantu Hospital, DR Congo

Tack

Vita²,

Mbaki³

et al. 2021

Diagnostics

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“… 21 Other authors have used automatic respiratory rate counters; however, they are not universally available and require cost-effectiveness studies. 22 23 It has also been previously shown that the sensitivity and specificity of caregivers is insufficient to recognise tachypnoea and signs of respiratory distress in respiratory diseases and pneumonia. 24 …”

Section: Discussionmentioning

confidence: 99%

Use of the ReSVinet Scale for parents and healthcare workers in a paediatric emergency service: a prospective study

Camacho-Cruz

Briñez

Álvarez

et al. 2021

bmjpo

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IntroductionMost scales for acute respiratory infection (ARI) are limited to healthcare worker (HCW) use for clinical decision-making. The Respiratory Syncytial Virus network (ReSVinet) Scale offers a version for parents that could potentially help as an early warning system.ObjectiveTo determine whether or not the ReSVinet Scale for ARI in infants can be reliably used by HCWs and parents in an emergency service.MethodsA prospective study was done of infants with ARI who were admitted to a paediatric emergency room to assess the ReSVinet Scale when used by faculty (paediatric doctor-professors), residents (doctors doing their first specialty in paediatrics) and parents. Spearman’s correlation and a weighted kappa coefficient were used to measure interobserver agreement. Internal consistency was also tested by Cronbach’s alpha test.ResultsOverall, 188 patients, 58% male, were enrolled. A Spearman’s correlation of 0.92 for faculty and resident scoring and 0.64 for faculty or resident and parent scoring was found. The weighted kappa coefficients were 0.78 for faculty versus residents, 0.41 for faculty versus parents, and 0.41 for residents versus parents. Cronbach’s alpha test was 0.67 for faculty, 0.62 for residents and 0.69 for parents.ConclusionThere was good correlation in the ReSVinet scores between health professionals when used in the paediatric emergency area. Agreement between parents and health professionals was found to be more variable. Future studies should focus on finding ways to improve its reliability when used by parents before the scale is used in the emergency room.

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“…The usability and acceptability of this device have been tested in a study in Ethiopia 15 and Nepal. 16…”

Section: Introductionmentioning

confidence: 99%

Developing a video expert panel as a reference standard to evaluate respiratory rate counting in paediatric pneumonia diagnosis: protocol for a cross-sectional study

Khan

Ahmed

Chowdhury

et al. 2022

Preprint

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Introduction: Manual counting of respiratory rate (RR) in children is challenging for health workers and can result in misdiagnosis of pneumonia. Some novel RR counting devices automate the counting of RR and classification of fast breathing. The absence of an appropriate reference standard to evaluate the performance of these devices is a challenge. If good quality videos could be captured, with RR interpretation from these videos systematically conducted by an expert panel, it could act as a reference standard. This study is designed to develop a video expert panel (VEP) as a reference standard to evaluate RR counting for identifying pneumonia in children. Methods and analysis: Using a cross-sectional design, we will enrol children aged 0-59 months presenting with suspected pneumonia at different levels of health facilities in Dhaka and Sylhet, Bangladesh. We will video record a physician/health worker counting RR manually and also using an automated RR counter (ChARM) from each child. We will establish a standard operating procedure for capturing quality videos, make a set of reference videos, and train and standardise the VEP members using the reference videos. After that, we will assess the performance of the VEP as a reference standard to evaluate RR counting. We will calculate the mean difference and proportions of agreement within 2 breaths per minute and create Bland-Altman plots with limits of agreement between VEP members. Ethics and dissemination: The study protocol was approved by the National Research Ethics Committee of Bangladesh Medical Research Council (BMRC), Bangladesh (registration number: 39315022021) and Edinburgh Medical School Research Ethics Committee (EMREC), Edinburgh, UK (REC Reference: 21-EMREC-040). Dissemination of the study findings will be through conference presentations and publications in peer-reviewed scientific journals.

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Usability and acceptability of an automated respiratory rate counter to assess childhood pneumonia in Nepal

Abstract: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Cited by 10 publications

References 17 publications

Performance of Automated Point-of-Care Respiratory Rate Counting versus Manual Counting in Children under Five Admitted with Severe Febrile Illness to Kisantu Hospital, DR Congo

Performance of Automated Point-of-Care Respiratory Rate Counting versus Manual Counting in Children under Five Admitted with Severe Febrile Illness to Kisantu Hospital, DR Congo

Use of the ReSVinet Scale for parents and healthcare workers in a paediatric emergency service: a prospective study

Developing a video expert panel as a reference standard to evaluate respiratory rate counting in paediatric pneumonia diagnosis: protocol for a cross-sectional study

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