Matara

Researchers are evaluating an electronic clinical decision support tool eCDST designed to help diagnose and treat lower respiratory tract infections LRTI in patients aged 14 years and older at three hospitals in Southern Sri Lanka. This open-label, stepped-wedge, cluster-randomized trial aims to compare clinical outcomes and antibacterial prescribing between patients managed with the eCDST and those receiving usual care. The study will enroll 765 patients and monitor them over 30 days to assess the impact of the tool on treatment decisions and patient health. Participants are grouped by hospital wards that switch from usual care to the eCDST at intervals of 3 to 6 months until all wards use the intervention. Clinicians in the intervention arm use the eCDST on mobile phones to receive diagnostic plans and treatment recommendations, including point-of-care testing conducted by clinical or trained research staff. Usual care participants receive standard diagnostic testing and treatment at clinician discretion. Final decisions on antimicrobial prescriptions remain with the treating doctors. During the study, participants are followed for 30 days after enrollment to record clinical outcomes and antibacterial use, with a maximum antibacterial prescription duration of 14 days. Researchers will monitor various outcomes including adverse events related to withholding antibacterials, duration of antibacterial use, hospital readmissions, ventilator use, ICU admissions, oxygen supplementation, and physician adherence to eCDST recommendations. Assessments include clinical monitoring and routine diagnostic tests according to each treatment arm.