ePOCT+ and the medAL-suite: Development of an electronic clinical decision support algorithm and digital platform for pediatric outpatients in low- and middle-income countries

• DOI: 10.1371/journal.pdig.0000170
• Publication Date: 2023-01-19T18:23:12Z
• Authors: Rainer Tan; Ludovico Cobuccio; Fenella Beynon; Gillian A. Levine; Nina Vaezipour; Lameck Bonaventur...; Chacha Mangu; Alan Vonlanthen; Olga De Santis; Nahya Salim; Karim Manji; Helga Naburi; Lulu Chirande; Lena Matata; Method Bulongeleje; Robert Moshiro; Andolo Miheso; Peter Arimi; Ousmane Ndiaye; Moctar Faye; Aliou Thiongane; Shally Awasthi; Kovid Sharma; Gaurav Kumar; Josephine Van De ...; Alexandra Kulinkina; Victor Rwandarwacu; Théophile Dusengu...; John Baptist Nkur...; Emmanuel Rusingiza; Lisine Tuyisenge; Mary-Anne Hartley; Vincent Faivre; Julien Thabard; Kristina Keitel; Valérie D’Acremont
• Keywords: Medal; mHealth

Electronic clinical decision support algorithms (CDSAs) have been developed to address high childhood mortality and inappropriate antibiotic prescription by helping clinicians adhere guidelines. Previously identified challenges of CDSAs include their limited scope, usability, outdated content. To these we ePOCT+, a CDSA for the care pediatric outpatients in low- middle-income settings, medical algorithm suite (medAL-suite), software creation execution CDSAs. Following principles digital development, aim describe process lessons learnt from development ePOCT+ medAL-suite. In particular, this work outlines systematic integrative design implementation tools required meet needs improve uptake quality care. We considered feasibility, acceptability reliability signs symptoms, as well diagnostic prognostic performance predictors. assure validity, appropriateness country underwent numerous reviews experts health authorities implementing countries. The digitalization involved medAL-creator, platform which allows without IT programming skills easily create algorithms, medAL-reader mobile (mHealth) application used during consultation. Extensive feasibility tests were done with feedback end-users multiple countries software. hope that framework developing will help other CDSAs, open-source medAL-suite enable others independently implement them. Further validation studies are underway Tanzania, Rwanda, Kenya, Senegal, India.