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www.coronabambini.ch:瑞士儿科 COVID-19 检测在线决策支持工具的开发和使用:一项横断面分析。

www.coronabambini.ch: Development and usage of an online decision support tool for paediatric COVID-19-testing in Switzerland: a cross-sectional analysis.

机构信息

Department of Pediatrics, Division of Pediatric Emergency Medicine, Inselspital University Hospital, Bern, Switzerland

Emergency Telemedicine, University of Bern, Bern, Switzerland.

出版信息

BMJ Open. 2023 Mar 16;13(3):e063820. doi: 10.1136/bmjopen-2022-063820.

Abstract

OBJECTIVES

To describe the development and usage of www.coronabambini.ch as an example of a paediatric electronic public health application and to explore its potential and limitations in providing information on disease epidemiology and public health policy implementation.

DESIGN

We developed and maintained a non-commercial online decision support tool, www.coronabambini.ch, to translate the Swiss Federal Office of Public Health (FOPH) paediatric (age 0-18 years) COVID-19 guidelines around testing and school/daycare attendance for caregivers, teachers and healthcare personnel. We analysed the online decision tool as well as a voluntary follow-up survey from October 2020 to September 2021 to explore its potential as a surveillance tool for public health policy and epidemiology.

PARTICIPANTS

68 269 users accessed and 52 726 filled out the complete online decision tool. 3% (1399/52 726) filled out a voluntary follow-up. 92% (18 797/20 330) of users were parents.

RESULTS

Certain dynamics of the pandemic and changes in testing strategies were reflected in the data captured by www.coronabambini.ch, for example, in terms of disease epidemiology, gastrointestinal symptoms were reported more frequently in younger age groups (13% (3308/26 180) in children 0-5 years vs 9% (3934/42 089) in children ≥6 years, χ=184, p≤0.001). As a reflection of public health policy, the proportion of users consulting the tool for a positive contact without symptoms in children 6-12 years increased from 4% (1415/32 215) to 6% (636/9872) after the FOPH loosened testing criteria in this age group, χ=69, p≤0.001. Adherence to the recommendation was generally high (84% (1131/1352)) but differed by the type of recommendation: 89% (344/385) for 'stay at home and observe', 75% (232/310) for 'school attendance'.

CONCLUSIONS

Usage of www.coronabambini.ch was generally high in areas where it was developed and promoted. Certain patterns in epidemiology and adherence to public health policy could be depicted but selection bias was difficult to measure showing the potential and challenges of digital decision support as public health tools.

摘要

目的

以儿科电子公共卫生应用程序为例,描述 www.coronabambini.ch 的开发和使用情况,并探讨其在提供疾病流行病学和公共卫生政策实施信息方面的潜力和局限性。

设计

我们开发并维护了一个非商业性的在线决策支持工具 www.coronabambini.ch,用于翻译瑞士联邦公共卫生办公室(FOPH)针对 0-18 岁儿童的 COVID-19 检测和学校/日托出勤率指南,供护理人员、教师和医疗保健人员使用。我们分析了在线决策工具以及 2020 年 10 月至 2021 年 9 月的自愿随访调查,以探讨其作为公共卫生政策和流行病学监测工具的潜力。

参与者

68269 名用户访问了该网站,52726 名用户完整填写了在线决策工具。3%(1399/52726)的用户填写了自愿随访。92%(18797/20330)的用户是家长。

结果

www.coronabambini.ch 所捕获的数据反映了大流行的某些动态和检测策略的变化,例如在疾病流行病学方面,胃肠道症状在年龄较小的儿童中更为常见(0-5 岁儿童为 13%(3308/26180),≥6 岁儿童为 9%(3934/42089),χ=184,p≤0.001)。作为公共卫生政策的反映,在 FOPH 放宽该年龄段的检测标准后,6-12 岁有症状接触者咨询该工具的用户比例从 4%(1415/32215)增加到 6%(636/9872),χ=69,p≤0.001。建议的遵守率总体较高(84%(1131/1352)),但因建议类型而异:89%(344/385)为“居家观察”,75%(232/310)为“上学”。

结论

在开发和推广该工具的地区,www.coronabambini.ch 的使用率普遍较高。可以描绘出流行病学的某些模式和对公共卫生政策的遵守情况,但很难衡量选择偏差,这显示了数字决策支持作为公共卫生工具的潜力和挑战。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4fdd/10030280/7e8cac52ffdf/bmjopen-2022-063820f01.jpg

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