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Mixed-method evaluation of an online forward triage tool within the COVID-19 pandemic

Applicant Sauter Thomas
Number 196615
Funding scheme Special Call on Coronaviruses
Research institution Universitäres Notfallzentrum Inselspital Universitätsspital Bern
Institution of higher education University of Berne - BE
Main discipline Internal Medicine
Start/End 01.06.2020 - 31.05.2022
Approved amount 99'906.00
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All Disciplines (3)

Discipline
Internal Medicine
Methods of Epidemiology and Preventive Medicine
Public Health and Health Services

Keywords (5)

patient flow; COVID_19; decision support; symptom checker; qualitative methods

Lay Summary (German)

Lead
Online Triage-Tools können während einer Pandemie helfen, unsicheren Patienten und Aerzten Informationen zur Verfügung zu stellen und Hinweis zum Ablauf (Notwendigkeit, Zeitpunkt oder Ort) der weiteren Abklärungen bieten. Auswirkungen und Nutzen von solchen Tools sind bis jetzt wenig untersucht.
Lay summary

Inhalt und Ziele des Forschungsprojekts

Das Gesamtziel der Studie besteht darin, die Auswirkungen und den Nutzen eines Online Triage Tools in Epidemie- oder Pandemiesituationen zu untersuchen. Hierfür werden wir eine Studie durchführen mit qualitativen und quantitativen Studienanteilen. Im quantitativen Teil unserer Studie werden wir die Nutzer des Online Triage-Tools und die Einflüsse des Triage Tools auf ihre Entscheidung untersuchen. Im qualitativen Schritt werden wir eine repräsentative Gruppe von Nutzer (Ärzte und Patienten) sowie Behördenvertreter befragen, um die Hintergründe sowie Einflussfaktoren auf Anwendung und Nutzung besser zu verstehen.

Wissenschaftlicher und gesellschaftlicher Kontext des Forschungsprojekts

Der gegenwärtige Ausbruch des neuartigen Coronavirus SARS-CoV2 kann lange Zeit andauern und birgt die Gefahr, die Kapazität der Gesundheitssysteme zu übersteigen und zu Unsicherheit in der Öffentlichkeit und im Gesundheitswesen zu führen. Ein Online-Triage Tool kann Entscheidungshilfen liefern, Konsultationen vermeiden und damit ein vermeidbares Infektionsrisiko reduzieren und Daten zum Verstehen und Monitoren der Entwicklung der Infektionen für die Behörden liefern. Die sichere und sinnvolle Anwendung dieser Tools, zu welcher unsere Studie beitragen will, kann für diese und zukünftige Gesundheitsnotfallsituationen wichtig sein.


Direct link to Lay Summary Last update: 20.05.2020

Responsible applicant and co-applicants

Employees

Name Institute

Project partner

Associated projects

Number Title Start Funding scheme
192842 Schweizer Kongress für Telenotfallmedizin und Digital Health 01.01.2020 Scientific Exchanges
197398 lOw-dose CT cOmPared to Lung UltraSonography vs standard care for the diagnosis of pneumonia in the elderly: a multicentre randomized controlled study (OCTOPLUS) 01.04.2021 Project funding
187284 The digital diagnostician: how information technology affects medical diagnoses 01.04.2020 NRP 77 Digital Transformation
173081 DETECT - Dizziness Evaluation Tool for Emergent Clinical Triage 01.06.2017 Project funding

Abstract

The overall purpose of the study is to estimate the effects and assess the utility of an online forward triage tool (OFTT) in epidemic or pandemic situations. We propose a mixed-method sequential explanatory study of the utility and effects of an OFFT for COVID-19 in Switzerland.The current outbreak of the novel Coronavirus termed SARS-CoV2 will likely last for several more month at least and will most likely outrun the capacity of most health systems internationally. Governments worldwide respond with frequently changing policies and guidelines, resulting in uncertainty among the public and health care providers alike. Next to caring for the sick, the health system is thus currently burdened with a large number of persons seeking information, testing and reassurance. When presenting in person, these people put themselves at risk of cross infection and further burden the health systems capacities.In response to this situation, we developed an online forward triage tool (OFTT) to i) screen and reduce the number of people presenting themselves for testing on site that do not fulfil current testing criteria and direct them to the appropriate level of care, ii) provide a reliable and up to date source of information about testing and reporting criteria to both, the public and health professionals, and iii) monitor temporal and regional patterns in testing recommendations and provide authorities with data on the effects of changes in testing criteria and guidelines. Many other providers have set up similar tools. However, it is not clear whether users of an OFTT actually follow the recommendations given and what factors affect their decisions. In addition, it is unknown whether the recommendations given, although based on the most current FOPH testing criteria, are in fact correct. Arguably, the use of an OFTT is only defensible if users have better or at least similar outcomes than non-users. Furthermore, it is unknown whether OFTT appeal to all population groups. For example, the elderly may be less inclined to use online tools to guide their decision making. Likewise, education or socio-economic status may affect whether users turn to an OFTT and to what extend they rely on the tools recommendation. In addition, it is unknown how far people’s use of OFTTs is affected by media coverage of a pandemic or epidemic.We propose a mixed-method sequential explanatory study of the utility of the OFTT and the outcomes of using such a tool. Based on large data sets already collected at both, the first OFTT for COVID-19, and the currently largest real-world testing site in Switzerland, we will conduct a survey of users who provided contact details for research purposes. Results of this survey will inform qualitative data collection. In addition, at the synthesis level, quantitative findings will be understood and explained with the aid of qualitative results. Insights gained will be used in the adaptation of existing OFTTs. Findings from this research will result in rapid implementation and the improvement of existing OFTTs with regard to i) user groups reached and not reached, ii) improved adherence to recommendations, iii) easing the burden on the health care system and iv) their ability to inform authorities about the effect of changing testing recommendations.
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