The First National Remote Emergency System for Malignant Hyperthermia (MH-NRES) in China: Protocol for the Design, Development, and Evaluation of a WeChat Applet

Hong Yu; Lingcan Tan; Yi Teng; Zhao Xu; Kun Xiao; Jin Yin; Yunxia Zuo; Tao Zhu; Xiaoqian Deng

doi:10.2196/37084

The First National Remote Emergency System for Malignant Hyperthermia (MH-NRES) in China: Protocol for the Design, Development, and Evaluation of a WeChat Applet

JMIR Res Protoc. 2022 Jun 10;11(6):e37084. doi: 10.2196/37084.

Authors

Hong Yu¹, Lingcan Tan¹, Yi Teng¹, Zhao Xu¹, Kun Xiao², Jin Yin³, Yunxia Zuo¹, Tao Zhu¹, Xiaoqian Deng¹

Affiliations

¹ Department of Anesthesiology, Sichuan University West China Hospital, Chengdu, China.
² School of Information and Software Engineering, University of Electronic Science and Technology of China, Chengdu, China.
³ West China Biomedical Big Data Center, Sichuan University West China Hospital, Chengdu, China.

PMID: 35687418
PMCID: PMC9233253
DOI: 10.2196/37084

Abstract

Background: Malignant hyperthermia (MH) is a rare life-threatening anesthetic emergency. With respect to the high fatality rate, difficulty in early recognition, and the lack of disease-specific drug (ie, dantrolene) in China, more effort is needed to strengthen early diagnosis and effective treatment of MH emergencies. Nowadays, mobile health (mHealth) apps are changing the way of medical practice; they can serve as an accessible tool to help anesthesiologists deal with MH crises. However, no related mHealth-based emergency system is available currently.

Objective: The aim of this study is to outline the protocol for the development of a WeChat applet used to design a National Remote Emergency System for Malignant Hyperthermia (MH-NRES) in China, as well as the protocol for the evaluation of the user experience and perception of the system.

Methods: The system adopts the client-server architecture, with a custom user interface operating as clients and the back-end system operating as the server. The client-side software was developed using uni-app technology with Vue.js-based framework, which consists of 6 modules: Quick Diagnosis, Dantrolene Mobilization, Instruction on Dantrolene Use, MH Treatment, Recovery Period Treatment, and DNA Test and Biopsy. The back-end system was developed based on the Spring framework. The system will be evaluated by administrating a modified user version of the Mobile App Rating Scale. Pilot testing will be conducted in Sichuan Province, China, and a subsequent evaluation on a national scale is planned.

Results: The theoretical framework design of this system was completed in August 2021. The development of the system was completed in February 2022, and the refinement is currently ongoing. Pilot testing after the implementation of the system in Sichuan Province is planned to take 2 months, and the subsequent evaluation on a national scale is planned to take 2 months.

Conclusions: We have described a novel approach using the WeChat applet to develop the MH-NRES. Findings from the usability testing process in the current study may lead to refinements and is expected to suggest that this system is both feasible and welcomed by anesthesiologists. Depending on the availability of research funding, this system will be extended nationally across China.

International registered report identifier (irrid): PRR1-10.2196/37084.

Keywords: China; Chinese; WeChat; WeChat applet; anesthesia; anesthesiologist; anesthesiology; anesthetic; applet; calling app; dantrolene; development; diagnosis; diagnostic service; digital health; emergency; evaluation; health app; hyperthermia; mHealth; malignant hyperthermia; messaging app; mobile health; national remote emergency system; perception; uni-app; user experience.

©Hong Yu, Lingcan Tan, Yi Teng, Zhao Xu, Kun Xiao, Jin Yin, Yunxia Zuo, Tao Zhu, Xiaoqian Deng. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 10.06.2022.