The utility of mobile telephone-recorded videos as adjuncts to the diagnosis of seizures and paroxysmal events in children with suspected epileptic seizures

Background. Epilepsy is often diagnosed through clinical description, but inter-observer interpretations can be diverse and misleading. Objective. To assess the utility of smartphone videos in the diagnosis of paediatric epilepsy.Methods. The literature was reviewed for evidence to support the use of smartphone videos, inclusive of advantages, ethical practice and potential disadvantages. An existing adult-based quality of video (QOV) scoring tool was adapted for use in children. A pilot study used convenience sampling of videos from 25 patients, which were reviewed to assess the viability of the adapted QOV tool against the subsequent diagnosis for the patients with videos. The referral mechanism of the videos was reviewed for the source and consent processes followed. Results. A total of 14 studies were identified. Methodologies varied; only three focused on videos of children, and QOV was formally scored in three. Studies found that smartphone videos of good quality assisted the differentiation of epilepsy from non-epileptic events, especially with accompanying history and with more experienced clinicians. The ethics and risks of circulation of smartphone videos were briefly considered in a minority of the reports. The pilot study found that the adapted QOV tool correlated with videos of moderate and high quality and subsequent diagnostic closure.Conclusions. Data relating to the role of smartphone video of events in children is lacking, especially from low- and middle-income settings. Guidelines for caregivers to acquire good-quality videos are not part of routine practice. The ethical implications of transfer of sensitive material have not been adequately addressed for this group. Prospective multicentre studies are needed to formally assess the viability of the adapted QOV tool for paediatric videos.

Blood donor app usage behaviour and perceptions: Considerations for a blood donation app

Background: South Africa often experiences critically low blood stock levels, making it vulnerable to blood shortages for everyday use and during times of crisis. There are over 3.5 billion smartphone users worldwide and, during 2019, app downloads were estimated at 204 billion. Considering that at least 51% of South Africans own a smartphone that can access the Internet and apps, it is clear that blood donation organisations in South Africa could benefit from engaging with the public through a mobile app. Objectives: This article aimed to determine whether South African blood donors' app usage behaviour and perceptions were conducive to introduce a blood donation app, and what these behaviours and perceptions could reveal, to support South African Blood Donation Organisations in their recruitment and engagement endeavours. Method: The research problem discussed in this article sought to highlight the app usage behaviour of blood donors, and their perceptions about a proposed blood donation app. Forming part of a larger sequential mixed-methods study, the data presented in this article were gathered through a quantitative online questionnaire involving 2154 South Africans respondents. Results: The findings revealed that the majority of respondents owned a smart device and that they used apps falling within the 'Communication' category. Of the respondents, 41% believed that a blood donation app will encourage younger South Africans to donate blood more regularly, whilst 25% of respondents were of the opinion that an app will motivate all South Africans to donate blood more often. Conclusion: The value of this research lies in the insight gained into the behaviour and perceptions of South African blood donors, which can inform the conceptualisation and design of a blood donation app, thereby improving its efficacy and subsequently supporting the strategy of employing such a technology to increase blood donation.

Cervical precancerous lesions at the Tchibanga Regional Hospital and the University Hospital in Gabon in 2018: smartphone as a screening tool for diagnosis

Background: Cervical precancerous lesions are disorders that can induce discoloration changes. Their detection is difficult in remote areas in the absence of adequate equipment. The objectives were to evaluate Smartphone performance in diagnosing cervical precancerous lesions in Tchibanga, Gabon. Methods: It was an interventional cross-sectional study to evaluate the validity and reliability of the smartphone as a tool for diagnosing atypical changes in the cervix. Study period was between July 1, 2017, to February 28, 2018, at the Tchibanga Regional Hospital (CHRT) and the University Hospital (CHU). The variability between examiners was determined according to Cohen's Kappa formula. The Gold standard test was the cytology. Results: Compared to the examiner -1, the examiner - 2 found a high percentage of inflammations as atypical transformations: 15.3% versus 9%. With regard to smartphonic impressions, the examiner-1 found the normal impressions almost equal to that of the examiner-2, 72.9% versus 72.2%. The concordance between positive smartphonic impressions was 93.8% and 95.5% between negative smartphonic impressions, with k = 0.86. Conclusion: In view of the above, the concordance between positive and negative smart phonic impressions was 93.8 and 95.5% with k = 0.86. The performance parameters being good, there is a need to use the smartphone as a tool for the diagnosis of precancerous lesions

Orthopaedic referrals using a smartphone app: uptake, response times and outcome

Background. It is well established that South Africa (SA) suffers an immense burden of violence and injuries. The responsibility of providing care for these injuries falls mainly on public health services, resulting in overloading of the health system. Prior to a recent intervention, the large burden had been exacerbated by limitations in the traditional referral system that highlighted the need for a better referral system. Vula's smartphone app was introduced at Tygerberg Hospital in August 2016. This study evaluated the uptake, response times and outcomes using this app.Objectives. The main objectives of the study were to describe: (i) the number of referrals; (ii) referral response times; (iii) referring facilities; and (iv) referral outcomes. Secondary objectives were to: (i) evaluate whether the referral outcome pathway was appropriate; and (ii) assess professional conduct and evidence of upskilling.Methods. This retrospective, descriptive study investigated Vula app referrals to the Division of Orthopaedic Surgery at Tygerberg Hospital between 1 August 2016 and 31 March 2017. Vula was advertised to key facilities in the hospital's referral network. All referrals to the division during the study period were systematically included in the analysis of operational outcomes, although some were excluded from the subsequent referral outcome analysis. Operational outcomes included the number of referrals, referring facilities and referral response times. Referral outcome analysis included the clinical diagnosis, referral pathway, whether the referral was used for upskilling and whether it was conducted in a professional manner.Results. A total of 2 275 referrals from 39 different facilities were received during the study period from 238 individual users; 50% of referrals received a response within 11 minutes, while a small percentage received no response. Clinical and demographic characteristics of 1 985 patients included in the referral outcome analysis indicated that the majority of trauma and emergency referrals involved males, with closed fractures being the most frequent clinical presentation. Although the most common referral outcome was immediate transfer, one-third of the patients were treated at the referring hospital with advice only.Conclusions. The large volume of orthopaedic referrals received through the Vula app suggests that Vula represents a successful alternative to traditional referral methods. Referrals managed by advice only could suggest that Vula facilitates some relief for the overburdened trauma services. Future research could further explore Vula's role in strengthening the public health system, including interventions for high-volume referral areas and upskilling of referring health workers