Blaya Joaquín A, Cohen Ted, Rodríguez Pablo, Kim Jihoon, Fraser Hamish S F
Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA, USA.
Int J Infect Dis. 2009 May;13(3):410-8. doi: 10.1016/j.ijid.2008.09.015. Epub 2008 Dec 18.
To evaluate the effectiveness of a personal digital assistant (PDA)-based system for collecting tuberculosis test results and to compare this new system to the previous paper-based system. The PDA- and paper-based systems were evaluated based on processing times, frequency of errors, and number of work-hours expended by data collectors.
We conducted a cluster randomized controlled trial in 93 health establishments in Peru. Baseline data were collected for 19 months. Districts (n=4) were then randomly assigned to intervention (PDA) or control (paper) groups, and further data were collected for 6 months. Comparisons were made between intervention and control districts and within-districts before and after the introduction of the intervention.
The PDA-based system had a significant effect on processing times (p<0.001) and errors (p=0.005). In the between-districts comparison, the median processing time for cultures was reduced from 23 to 8 days and for smears was reduced from 25 to 12 days. In that comparison, the proportion of cultures with delays >90 days was reduced from 9.2% to 0.1% and the number of errors was decreased by 57.1%. The intervention reduced the work-hours necessary to process results by 70% and was preferred by all users.
A well-designed PDA-based system to collect data from institutions over a large, resource-poor area can significantly reduce delays, errors, and person-hours spent processing data.
评估基于个人数字助理(PDA)的系统收集结核病检测结果的有效性,并将这一新系统与之前的纸质系统进行比较。基于PDA的系统和纸质系统根据处理时间、错误频率以及数据收集者花费的工作小时数进行评估。
我们在秘鲁的93个医疗机构中进行了一项整群随机对照试验。收集了19个月的基线数据。然后将地区(n = 4)随机分配到干预组(PDA)或对照组(纸质),并进一步收集了6个月的数据。在干预组和对照组之间以及引入干预前后在组内进行了比较。
基于PDA的系统对处理时间(p < 0.001)和错误(p = 0.005)有显著影响。在地区间比较中,培养物的中位处理时间从23天减少到8天,涂片的中位处理时间从25天减少到12天。在该比较中,延迟>90天的培养物比例从9.2%降至0.1%,错误数量减少了约57.1%。干预使处理结果所需的工作小时数减少了70%,并且受到所有用户的青睐。
一个精心设计的基于PDA的系统,用于从资源匮乏的大面积地区的机构收集数据,可以显著减少延迟、错误以及处理数据所花费的工时。