Trauma Follow-Up Prediction (Project 2: Aim 2)
Injury Traumatic, Injuries
About this trial
This is an interventional prevention trial for Injury Traumatic focused on measuring Cameroon, Sub-Sahara Africa, mHealth, Machine learning, Injury, Trauma, Mobile phone, SuperLearner
Eligibility Criteria
Inclusion Criteria:
Trauma Registry (CTR): Patients satisfying the following inclusion criteria will be included in the registry:
- Patients with acute traumatic injury i.e. within 2 weeks of presentation for care.
- Trauma patients who are formally admitted to the hospital as in-patients.
- Trauma patients who die upon arriving to the Emergency Departments or while admitted in the hospital.
- Trauma patients who are transferred to other health facilities.
- Trauma patients with indications for hospital admission (based on physicians' assessments) but leave against medical advice
- Trauma patients who are kept under observation in the Emergency Department for over 24 hours
Standard mHealth Triage Tool Eligibility: The mHealth triage tool will be administered to the subset of patients included in the trauma registry who are admitted then discharged home after treatment.
Optimized version of the mHealth screening tool (intervention) Eligibility: The optimized version of mHealth screening tool will be administered to the subset of patients included in the trauma registry who are admitted then discharged home after treatment.
Exclusion Criteria:
- Trauma Registry Exclusion criteria: Patients will not be excluded based on age, gender, race, or nationality. If patients or their surrogate decision-maker do not give consent to participation, those patients will be excluded.
According to the World Health Organization (WHO) injury definition, the following will be excluded from the definition of "injury": "Whereas the above definition of an injury includes drowning (lack of oxygen), hypothermia (lack of heat), strangulation (lack of oxygen), decompression sickness or "the bends" (excess nitrogen compounds) and poisonings (by toxic substances), it does NOT include conditions that result from continual stress, such as carpal tunnel syndrome, chronic back pain and poisoning due to infections. Mental disorders and chronic disability, although these may be eventual consequences of physical injury, are also excluded by the above definition." Although included in the WHO definition, poisonings will be excluded from the CTR as these have been extremely rare events in the CTR to date and are not typically included in trauma registries in most other contexts.
Patients who are not formally admitted and discharged within 24 hours from the Emergency Ward will be excluded.
Sites / Locations
Arms of the Study
Arm 1
Arm 2
No Intervention
Experimental
Standard mHealth screening tool
Optimized version of the mHealth screening tool (intervention) using the machine learning approach
This is a tested standard phone screening tool which determines the need for in-person follow-up after a patient has been discharge. Consenting trauma patients will be contacted via mobile phone at 0.5, 1, 3, and 6 months post-discharge by a research assistant to complete the screening which will guide whether or not the patient should seek follow-up care based on the number of flagged responses to ≥1 question on the 7-item screening survey.
This arm will receive an improvement to the mHealth triage tool using a machine learning approach. Patients will be called using the optimized tool at outcome timepoints (3 months, 6months and 12months). At each call, research assistants will complete the GOSE survey and the mHealth triage tool, entering call outcomes and patient responses directly into the mHealth system. If follow-up care is indicated, the research assistant will share that information with the patient and offer to schedule an appointment.