Smartphone app for neonatal heart rate assessment: an observational study
Background Heart rate (HR) assessment is crucial in neonatal resuscitation, but pulse oximetry (PO) and electrocardiography (ECG) are rarely accessible in low-resource to middle-resource settings. This study evaluated a free-of-charge smartphone application, NeoTap, which records HR with a screen-ta...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2020-02-01
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| Series: | BMJ Paediatrics Open |
| Online Access: | https://bmjpaedsopen.bmj.com/content/4/1/e000688.full |
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| author | Francesco Cavallin Nicolas J Pejovic Josaphat Byamugisha Tobias Alfvén Thorkild Tylleskär Susanna Myrnerts Höök Clare Lubulwa Jolly Nankunda |
| author_facet | Francesco Cavallin Nicolas J Pejovic Josaphat Byamugisha Tobias Alfvén Thorkild Tylleskär Susanna Myrnerts Höök Clare Lubulwa Jolly Nankunda |
| author_sort | Francesco Cavallin |
| collection | DOAJ |
| description | Background Heart rate (HR) assessment is crucial in neonatal resuscitation, but pulse oximetry (PO) and electrocardiography (ECG) are rarely accessible in low-resource to middle-resource settings. This study evaluated a free-of-charge smartphone application, NeoTap, which records HR with a screen-tapping method bypassing mental arithmetic calculations.Methods This observational study was carried out during three time periods between May 2015 and January 2019 in Uganda in three phases. In phase 1, a metronome rate (n=180) was recorded by low-end users (midwives) using NeoTap. In phase 2, HR (n=69) in breathing neonates was recorded by high-end users (paediatricians) using NeoTap versus PO. In phase 3, HR (n=235) in non-breathing neonates was recorded by low-end users using NeoTap versus ECG.Results In high-end users the mean difference was 3 beats per minute (bpm) higher with NeoTap versus PO (95% agreement limits −14 to 19 bpm), with acquisition time of 5 seconds. In low-end users, the mean difference was 6 bpm lower with NeoTap versus metronome (95% agreement limits −26 to 14 bpm) and 3 bpm higher with NeoTap versus ECG in non-breathing neonates (95% agreement limits −48 to 53 bpm), with acquisition time of 2.7 seconds. The agreement between NeoTap and ECG was good in the HR categories of 60–99 bpm and ≥100 bpm; HR <60 bpm had few measurements (kappa index 0.71, 95% CI 0.63 to 0.79).Conclusion HR could be accurately and rapidly assessed using a smartphone application in breathing neonates in a low-resource setting. Clinical assessment by low-end users was less accurate with wider CI but still adds clinically important information in non-breathing neonates. The authors suggest low-end users may benefit from auscultation-focused training. More research is needed to evaluate its feasibility in clinical use. |
| format | Article |
| id | doaj-art-0abfa7b1fe4a4c498bfda5ea6111e84a |
| institution | Kabale University |
| issn | 2399-9772 |
| language | English |
| publishDate | 2020-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Paediatrics Open |
| spelling | doaj-art-0abfa7b1fe4a4c498bfda5ea6111e84a2024-12-01T01:35:09ZengBMJ Publishing GroupBMJ Paediatrics Open2399-97722020-02-014110.1136/bmjpo-2020-000688Smartphone app for neonatal heart rate assessment: an observational studyFrancesco Cavallin0Nicolas J Pejovic1Josaphat Byamugisha2Tobias Alfvén3Thorkild Tylleskär4Susanna Myrnerts Höök5Clare Lubulwa6Jolly Nankunda7Independent Statistician, Solagna, ItalySachs` Children and Youth Hospital, Stockholm, Sweden9 Obstetrics and Gynecology, Mulago National Referral Hospital, Kampala, UgandaDepartment of Global Public Health, Karolinska Institutet, Stockholm, SwedenCentre for International Health, Department of Global Public Health and Primary Care, Universitetet i Bergen, Bergen, NorwaySachs’ Children and Youth Hospital, Stockholm, Sweden6 Department of Pediatrics and Child Health, Mulago National Referral Hospital, Kampala, Uganda9 Paediatrics and Child Health, Makerere University, Kampala, UgandaBackground Heart rate (HR) assessment is crucial in neonatal resuscitation, but pulse oximetry (PO) and electrocardiography (ECG) are rarely accessible in low-resource to middle-resource settings. This study evaluated a free-of-charge smartphone application, NeoTap, which records HR with a screen-tapping method bypassing mental arithmetic calculations.Methods This observational study was carried out during three time periods between May 2015 and January 2019 in Uganda in three phases. In phase 1, a metronome rate (n=180) was recorded by low-end users (midwives) using NeoTap. In phase 2, HR (n=69) in breathing neonates was recorded by high-end users (paediatricians) using NeoTap versus PO. In phase 3, HR (n=235) in non-breathing neonates was recorded by low-end users using NeoTap versus ECG.Results In high-end users the mean difference was 3 beats per minute (bpm) higher with NeoTap versus PO (95% agreement limits −14 to 19 bpm), with acquisition time of 5 seconds. In low-end users, the mean difference was 6 bpm lower with NeoTap versus metronome (95% agreement limits −26 to 14 bpm) and 3 bpm higher with NeoTap versus ECG in non-breathing neonates (95% agreement limits −48 to 53 bpm), with acquisition time of 2.7 seconds. The agreement between NeoTap and ECG was good in the HR categories of 60–99 bpm and ≥100 bpm; HR <60 bpm had few measurements (kappa index 0.71, 95% CI 0.63 to 0.79).Conclusion HR could be accurately and rapidly assessed using a smartphone application in breathing neonates in a low-resource setting. Clinical assessment by low-end users was less accurate with wider CI but still adds clinically important information in non-breathing neonates. The authors suggest low-end users may benefit from auscultation-focused training. More research is needed to evaluate its feasibility in clinical use.https://bmjpaedsopen.bmj.com/content/4/1/e000688.full |
| spellingShingle | Francesco Cavallin Nicolas J Pejovic Josaphat Byamugisha Tobias Alfvén Thorkild Tylleskär Susanna Myrnerts Höök Clare Lubulwa Jolly Nankunda Smartphone app for neonatal heart rate assessment: an observational study BMJ Paediatrics Open |
| title | Smartphone app for neonatal heart rate assessment: an observational study |
| title_full | Smartphone app for neonatal heart rate assessment: an observational study |
| title_fullStr | Smartphone app for neonatal heart rate assessment: an observational study |
| title_full_unstemmed | Smartphone app for neonatal heart rate assessment: an observational study |
| title_short | Smartphone app for neonatal heart rate assessment: an observational study |
| title_sort | smartphone app for neonatal heart rate assessment an observational study |
| url | https://bmjpaedsopen.bmj.com/content/4/1/e000688.full |
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