Centro de Investigaciones Clínicas (CIC), Fundación Valle del Lili, Cali, Colombia.
Grupo de Investigación i2T, Universidad Icesi, Cali, Colombia.
PLoS One. 2020 May 29;15(5):e0233269. doi: 10.1371/journal.pone.0233269. eCollection 2020.
Vector-borne diseases are a public health problem in Colombia, where dengue virus infection is hyperendemic. The introduction of other arboviruses, such as chikungunya and Zika in the last three years, has aggravated the situation. Mobile health (mHealth) offers new strategies for strengthening health care and surveillance systems promoting the collection, delivery, and access of health information to professionals, researchers, and patients. Assessing mobile application performance has been a challenge in low- and middle-income countries due to the difficulty of implementing these technologies in different clinical settings. In this study, we evaluate the usability and acceptability of a mobile application, FeverDX, as a support tool in the management of patients with febrile syndrome and suspected arboviruses infection by general practitioners from Colombia.
A pilot implementation study was conducted to evaluate the usability and acceptability of FeverDX using the modified version of the Mobile Application Rating Scale (uMARS). The evaluation form included 25 questions regarding quantity and quality of information, engagement, functionality, aesthetics, impact, and acceptability by healthcare workers. Each item uses a 5-point scale (1-Inadequate, 2-Poor, 3-Acceptable, 4-Good, 5-Excellent). A global score was obtained for the evaluation form test by determining the median scores of each subsection. A descriptive statistical analysis of the data obtained was performed.
Between December 2016 and January 2017, a total of 20 general practitioners from the Emergency room and hospitalization areas evaluated FeverDX. Less than half (9/20) of the evaluators had a comprehensive knowledge of the Colombian Ministry of Health's guidelines for the diagnosis and management of arboviruses, and evaluators partially (4/9) or completely (5/9) agreed that the content of the application follows the management guidelines. On uMARS scale, FeverDX excelled regarding impact (median 5; IQR = 5-5), functionality (median 5; IQR = 4.8-5), and information and scientific basis (median 4; IQR = 4-4). FeverDX scored well regarding user feedback (median 4; IQR = 4-4.5), design and aesthetics (median 4; IQR = 4-4.3), and subjective assessment of quality (median 4.5; IQR = 4.3-4.8).
FeverDX, a mobile application, is a novel mHealth strategy to strengthen care processes and facilitate the detection and reporting of notifiable surveillance diseases. It could improve adherence to clinical practice guidelines for the management and prevention of prevalent diseases as arboviruses in healthcare settings. Although this pilot study used a small sample size, FeverDx performed adequately in a simulated emergency consultation. Further implementation studies are needed to increase the reliability of mHealth technologies in different scenarios.
虫媒传染病是哥伦比亚的一个公共卫生问题，登革热病毒感染呈高度流行状态。在过去的三年中，寨卡病毒和基孔肯雅热等其他虫媒病毒的引入使情况更加恶化。移动医疗（mHealth）为加强医疗保健和监测系统提供了新的策略，促进了专业人员、研究人员和患者获取、传递和利用健康信息。在中低收入国家，评估移动应用程序的性能一直是一个挑战，因为在不同的临床环境中实施这些技术存在困难。在这项研究中，我们评估了 FeverDX 移动应用程序作为哥伦比亚全科医生管理发热综合征和疑似虫媒病毒感染患者的支持工具的可用性和可接受性。
采用改良版移动应用程序评分量表（uMARS）对 FeverDX 的可用性和可接受性进行了试点实施研究。评估表包含 25 个问题，涉及信息的数量和质量、参与度、功能、美观、影响以及医护人员的可接受性。每个项目使用 5 分制（1-不足，2-差，3-可接受，4-好，5-优秀）。通过确定每个子部分的中位数得分，获得评估表测试的整体评分。对获得的数据进行描述性统计分析。
2016 年 12 月至 2017 年 1 月期间，共有 20 名来自急诊室和住院区的全科医生评估了 FeverDX。评估者中不到一半（9/20）全面了解哥伦比亚卫生部关于虫媒病毒诊断和管理的指南，评估者部分（4/9）或完全（5/9）同意应用程序的内容符合管理指南。在 uMARS 量表上，FeverDX 在影响（中位数 5；IQR=5-5）、功能（中位数 5；IQR=4.8-5）和信息与科学依据（中位数 4；IQR=4-4）方面表现出色。FeverDX 在用户反馈（中位数 4；IQR=4-4.5）、设计和美学（中位数 4；IQR=4-4.3）以及主观质量评估（中位数 4.5；IQR=4.3-4.8）方面得分也很高。
FeverDX 是一种移动应用程序，是加强护理流程和促进可报告监测疾病检测和报告的新的移动医疗策略。它可以提高医疗保健环境中常见疾病（如虫媒病毒）管理和预防方面对临床实践指南的依从性。尽管这项试点研究使用了小样本量，但 FeverDx 在模拟急诊咨询中表现良好。需要进一步开展实施研究，以提高移动医疗技术在不同场景中的可靠性。
