Table 1

Overview of metrics and considerations for use

Data ItemsExamplesIssues
Setting
FacilityPrehospital
Facility (rural vs urban)
Different levels of data will be appropriate based on facility and the research capacity
PersonnelLevel of training
Proportion of providers across each levels of training
Large variability and must be thoroughly reported to ensure understanding and generalisability of findings
EquipmentCT scan, sterile equipment, basic disposable items, for example, catheters, fluids, medicationsSupply chain limitations and sustainability of access
Demographics
Country demographicsAge and sex distinctions with generally younger populations with larger burdens of patients living with minimal resourcesDemographic and risk transitions are poorly understood in LMICs and need to be well documented
ComorbiditiesConcurrence of infectious disease with non-infectious ones (eg, burdens of anaemia in injured patients)
Chronic diseases often unrecognised in LMIC
Difficulty to assess and categorise for existence and overlap
Processes
Prehospital care
ED
Admission as inpatient
Need for ICU
Discharge
ED length of stay
ED disposition
Inpatient length of stay
ICU availability and usage
Lack of clear definitions across physical structures and within single facilities
Laboratory testing
Point of care testing
Blood counts
TuberculosiB or HIV tests
ECG
Ultrasound
Availability of tests and types
Documentation of results
Interventions for treatmentsAntimicrobials
Haemodynamic and respiratory support
Availability of equipment
Implementation costs
Implementation
Quality assurance
Uptake of and compliance with care algorithmsDifficult to maintain sustainability without resource
Need for simple evaluation points
Outcomes
Mortality
Cause of death
ED based (initial treatment <24 hours)
In-hospital mortality and 30/60/90-day mortality
ED based outcomes not commonly collected
Posthospital follow-up difficult and resource intensive
Post-discharge function and morbidityQuality of life and functionality assessmentsDifficult to collect
Cultural appropriateness
Provider acceptabilityDate from surveys, interviews, focus groups.Poor uptake resulting in lack of representativeness and inaccuracy
Uncommonly done in LMICs
CostingFees incurred, lengths of stay, ICU usage, treatmentsVariability in costs across settings
  • ED, emergency department; ICU, intensive care unit; LMICs, low-income and middle-income countries.