Table 1.
General Scope | |||
Characteristics | Minimal requirements | Optimal requirements | Comments |
Intended use | The toolkit, composed of an electronic clinical decision support algorithm(s) and POC diagnostic tests, is intended to increase evidence-based treatment decisions by capturing diagnostic test results, patient clinical data (eg, exposures, signs including vital signs) and context-specific data (eg, disease incidence, seasonality) to provide treatment and care recommendations | ||
Target population | The algorithm shall define the target population Inclusion and exclusion criteria are used at the encounter to enrol the patient |
The system can be modular, that is, composed of discrete algorithms, such that one can be used for a specific population based on predefined criteria | |
Setting (level of implementation in the healthcare system) | Defined by the algorithm | The system can be modular, that is, composed of discrete algorithms, such that one can be used for a specific healthcare setting based on the infrastructure, workforce knowledge and skills, and POC tools available | |
Targeted end user | Defined by the algorithm | The end user shall have the required training/skills to use the app appropriately | |
Scope of toolkit components | |||
Algorithm access | The electronic clinical decision support algorithm is accessible through an app downloaded on compatible target devices | The app can be a web app, a native app or a hybrid app | |
Algorithm content | Built on:
|
*See FDA’s SaMD clinical evaluation for guidance20 | |
Algorithm treatment recommendations | Therapeutic recommendations shall be compliant with national treatment guidelines and national EML, and support antimicrobial stewardship | Same as minimal, and evidence-based medicine to support optimal treatment recommendations | Recommendations support the appropriate selection, dosage and duration of antimicrobial and any other kind of treatment and management, causing the least harm to the patient |
Compatible POC tools | POCs or other relevant medical devices prompted for use by the app shall be locally relevant, that is, recommended by EDL or relevant national equivalent or country programme | Same as minimal, plus emerging diagnostic tools and medical devices relevant to the algorithm and implementation setting | |
Regulated toolkit components | POC diagnostic tests and medical devices are regulatory approved and compliant with local regulations | Same as minimal, and if the software is a medical device the app shall also have regulatory approval | |
Compatible devices | The app is compatible with any device, including:
|
Computers are included as it may be necessary for health facility supervisors to access data collected at the facility level to make informed decisions (ie, restocking medical supplies) | |
Compatible operating systems | OS agnostic | Same as minimal |
EDL, Essential Diagnostics List; EML, Essential Medicines List; FDA, Food and Drug Administration; OS, operating system; POC, point-of-care; SaMD, software as a medical device.