ClinicalTrials.gg
CompletedNCT07257705OASESUpdated Feb 24, 2026

Pilot Trial of a Clinical Decision-Support App for Managing Emergencies Among Clinicians in a Rural Ugandan Hospital

An interventional study of OASES App in Diarrhea Infectious, Seizures and Emergency Care, sponsored by University of Milano Bicocca. Completed at 1 site in Uganda. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-02-24.

Sponsored by University of Milano Bicocca · Not applicable, Interventional, and Health services research

Phase
Not applicable
Study type
Interventional
Enrollment
15
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This study is testing a new mobile application called the OASES App, developed by the University of Milano-Bicocca. The App is designed to help frontline clinicians (nurses, clinical officers, and nursing assistants) provide faster and more accurate emergency care for patients with life-threatening conditions such as severe diarrhea, breathing difficulties, and seizures.

The OASES App guides clinicians step by step through internationally recognized emergency care guidelines, including triage, diagnosis, and treatment recommendations. It is intended to be used offline on a tablet, making it suitable for rural hospitals with limited resources.

This is a pilot study to understand whether the App improves the way clinicians manage simulated emergency cases compared to standard practice. About 16 clinicians at Dr. Ambrosoli Memorial Hospital, Kalongo, Uganda will take part in structured simulation exercises using realistic patient scenarios. Each participant will manage cases with and without the App, so that the two approaches can be compared.

The main goal is to evaluate whether the App helps clinicians follow evidence-based guidelines more consistently. Other goals include measuring accuracy of triage, diagnosis, and treatment decisions, as well as the time needed to complete cases and clinicians' perceptions of usability, trust, and feasibility.

No real patients will be involved in this study. All scenarios are simulations conducted in a safe, controlled environment. The results will help refine the App and inform the design of a larger study in the future.

Read the detailed description

Emergency conditions such as severe diarrhea, dyspnea, and seizures remain major causes of morbidity and mortality in low- and middle-income countries. Despite the availability of World Health Organization (WHO) and national guidelines, adherence to evidence-based emergency practices is often suboptimal in rural health facilities. Common challenges include limited training, high workload, and lack of decision-support resources.

The Organization for the Advancement and Support of Emergency Systems (OASES) App was developed in 2025 by the University of Milano-Bicocca as part of a quality improvement collaboration with Dr. Ambrosoli Memorial Hospital, Kalongo, Uganda. The App digitizes validated emergency care algorithms derived from WHO frameworks and Ugandan clinical guidelines. It incorporates the Interagency Integrated Triage Tool (IITT) and provides structured pathways for the management of diarrhea, dyspnea, and seizures in both adults and children. Designed for offline use on Android tablets, the App offers step-by-step decision support for frontline clinicians while also collecting structured clinical data.

This pilot trial uses a randomized, stratified crossover simulation design to evaluate the effectiveness, usability, and feasibility of the OASES App before clinical deployment. Approximately 16 outpatient department (OPD) clinicians at Dr. Ambrosoli Memorial Hospital (including nurses, clinical officers, and nursing assistants) will participate. Each clinician will complete a total of 12 standardized emergency case scenarios, divided into two sessions: one using the OASES App and one using standard practice without the App. To minimize learning effects, sessions will be separated by at least a three-day washout period.

The case scenarios are adapted from WHO training materials (such as Basic Emergency Care and Emergency Triage Assessment and Treatment guidelines) and reflect typical emergency presentations seen in the hospital's OPD. Each participant will manage six scenarios per study arm (two diarrhea, two dyspnea, two seizures), designed in matched pairs for comparability. Scenarios are facilitated by trained researchers and scored against gold-standard checklists derived from WHO and Ugandan guidelines.

The primary objective of the study is to assess whether use of the OASES App improves clinicians' adherence to evidence-based management steps during simulated emergencies. Secondary objectives include assessing triage accuracy, diagnostic accuracy, appropriateness of disposition decisions, completeness of history-taking and physical examination (process quality), time required to complete cases, and clinician perceptions of usability, trust, and feasibility.

The trial involves no real patients; all activities are conducted in controlled, simulation-based environments. Risks to participants are minimal and mainly related to potential discomfort in being assessed. Benefits include the opportunity to practice emergency scenarios and become familiar with digital decision-support tools.

Data are collected electronically using Kobo Toolbox, with facilitator checklists, participant responses, and structured usability surveys. Responses are scored independently by two blinded assessors, with discrepancies resolved by consensus or third-party adjudication. Data will be analyzed using mixed-effects models appropriate for a crossover design.

Findings from this pilot trial will provide preliminary evidence on the effectiveness and acceptability of the OASES App among frontline clinicians in a rural African hospital. Results will inform refinement of the App, guide study procedures, and support the design of a larger powered trial. At a broader level, the study aims to contribute to the evidence base for digital health solutions to strengthen emergency and acute care in resource-limited settings.

02

Conditions studied

  • Diarrhea Infectious
  • Seizures
  • Emergency Care
  • Clinical Decision Support Systems
  • Rural Health
  • Dyspnea

Keywords

  • OASES App
  • Clinical Decision Support Systems
  • Emergency Care
  • Simulation Trial
03

In context

Dysentery

44 studies on the registry are indexed under Dysentery; 6 are open to participants now.

This study's enrollment of 15 is below the median of 163 across 38 interventional studies indexed under Dysentery.

Browse Dysentery studies →

Lead sponsor

University of Milano Bicocca is the lead sponsor of 126 studies on the registry; 47 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Nurses, clinical officers, or nursing assistants currently employed in the outpatient department (OPD) of Dr. Ambrosoli Memorial Hospital.
  • Age ≥18 years.
  • Willing and able to provide written .
  • Available to participate in both simulation sessions.

Exclusion criteria

Exclusion Criteria:

  • Individuals unable or unwilling to participate in both scheduled simulation sessions.
  • Individuals not currently employed in the OPD of Dr. Ambrosoli Memorial Hospital.
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

05

Study design

Phase
Not applicable
Primary purpose
Health services research
Allocation
Randomized
Intervention model
Crossover assignment
Masking
Single (Outcomes assessor)
Enrollment
15 participants (actual)

Study arms

  • Experimental
    OASES App-Assisted Emergency Care

    Participants will use the OASES tablet-based clinical decision-support system to manage simulated emergency cases of diarrhea, dyspnea, and seizures. The App incorporates the WHO Interagency Integrated Triage Tool (IITT) and evidence-based algorithms from WHO and Ugandan guidelines. It provides real-time guidance for triage, diagnosis, and treatment steps, while also collecting structured data. Before use, participants receive a short orientation to the App but no formal training.

    Other: OASES App

  • No intervention
    Standard Practice Emergency Care

    Participants will manage the same simulated emergency cases of diarrhea, dyspnea, and seizures without the OASES App, using their usual knowledge, clinical experience, and available resources. Standard reference materials, including paper-based WHO Interagency Integrated Triage Tool (IITT) and Uganda Clinical Guidelines, are accessible. This arm reflects routine practice in the outpatient department of Dr. Ambrosoli Memorial Hospital.

Interventions

  • OtherOASES App

    The OASES App is a tablet-based digital clinical decision-support system (CDSS) developed in 2025 by the University of Milano-Bicocca. The App digitizes validated WHO- and Uganda guideline-based triage and emergency care algorithms, including the Interagency Integrated Triage Tool (IITT) and condition-specific pathways for diarrhea, dyspnea, and seizures in both adults and children. It provides step-by-step guidance for frontline clinicians during emergency case management and simultaneously collects structured clinical data. The App is designed for offline use in rural hospitals with limited infrastructure. In this trial, participants receive a brief orientation but no formal training before using the App during simulation scenarios.

    Also known as: Organization for the Advancement and Support of Emergency Systems App, OASES Clinical Decision-Support App

06

What researchers measure

Primary outcomes

  1. Guideline-Adherent Management of Simulated Emergency Cases

    Proportion of pre-specified, evidence-based diagnostic and treatment actions (critical management steps) correctly performed by participants during simulated scenarios of diarrhea, dyspnea, and seizures. Performance will be scored against gold-standard checklists derived from WHO and Uganda clinical guidelines by two independent blinded assessors. The outcome is expressed as a proportion (0-1) of guideline-consistent critical management actions completed.

    Time frame: Immediately after completion of each simulation scenario

Secondary outcomes

  1. Triage Accuracy

    Correct assignment of patients to Interagency Integrated Triage Tool (IITT) categories (Emergency/Red, Urgent/Yellow, Non-urgent/Green), compared to case-specific gold standards. Scoring performed by two blinded assessors.

    Time frame: Immediately after completion of each simulation scenario

  2. Disposition Appropriateness

    Correctness of the decision to admit or discharge patients, compared to gold-standard expected dispositions derived from WHO and Ugandan guidelines. Scoring by two blinded assessors.

    Time frame: Immediately after completion of each simulation scenario

  3. Diagnostic Accuracy

    Accuracy of working impression (initial stage) and final diagnosis (post-investigation stage), compared with case-specific gold-standard diagnoses. Scoring by two blinded assessors.

    Time frame: Immediately after completion of each simulation scenario

  4. Guideline-Adherent Evaluation (Process Quality)

    Proportion of critical history and examination items elicited by clinicians during simulated cases, compared with case-specific lists from WHO guidelines. Scored by facilitators using structured checklists.

    Time frame: Immediately after completion of each simulation scenario

  5. Time to Case Completion

    Duration in minutes required by participants to complete each simulated case, measured by facilitators during simulation sessions.

    Time frame: Immediately after completion of each simulation scenario

  6. System Usability Scale (SUS) Score

    Usability of the OASES App measured by the validated 10-item System Usability Scale (SUS), completed by participants after simulation sessions involving the App. The scale ranges from 0 to 100, where higher scores indicate better usability.

    Time frame: Immediately after completion of the OASES App simulation session

  7. Perceived Usefulness, Trust, Satisfaction, and Feasibility

    Clinicians' perceptions of the OASES App assessed through structured 5-point Likert-scale survey items (1 = strongly disagree to 5 = strongly agree), adapted from Technology Acceptance Model and related frameworks, and short qualitative debriefs.

    Time frame: Immediately after completion of the OASES App simulation session

07

Study locations

1 site
  • Dr. Ambrosoli Memorial Hospital Kalongo
    Kalongo, Agago District 47, Uganda
08

References and documents

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

Individual participant data

Plan to share: No — This pilot study collects simulation-based performance data from a small number of clinicians. Because the dataset is small and involves individual-level performance in a professional setting, sharing could pose confidentiality risks despite de-identification. Aggregate results will be provided, but individual-level data will not be shared.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Feb 24, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07257705
Responsible party
Michele Bombelli (Associate Professor, School of Medicine and Surgery, University of Milano-Bicocca, University of Milano Bicocca) — Principal investigator
First posted
Dec 2, 2025
Start date
Feb 6, 2026
Primary completion
Feb 14, 2026
Completion
Feb 14, 2026
Last update
Feb 24, 2026

Study contacts

Michele Bombelli, MD
principal investigator · University of Milano Bicocca

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Feb 2026. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion