Relative ORs (95% CI) estimating the effect of PAR use and time on documentation of clinical sign indicator and symptoms
| Indicator | Indicator performance at baseline (%) (first 3 months) | OR (95% CI) documentation period 2 (9–18 months) | OR (95% CI) documentation period 3 (19–25 months) | OR (95% CI) PAR used | OR (95% CI) PAR used Period 2 (9–18 months) | OR (95% CI) PAR used Period 3 (19–25 months) | ICC |
| Simple documentation indicators | |||||||
| Passive feedback indicators | |||||||
| Central cyanosis | 88.1 | 0.90 (0.87 to 0.93) | 0.95 (0.92 to 0.97) | 1.06 (1.05 to 1.07) | 1.05 (1.04 to 1.06) | 1.04 (1.03 to 1.05) | 0.16 |
| Pallor | 89.9 | 0.82 (0.78 to 0.86) | 0.92 (0.89 to 0.96) | 1.04 (1.03 to 1.05) | 1.05 (1.04 to 1.06) | 1.05 (1.04 to 1.07) | 0.15 |
| Indrawing | 79.3 | 0.97 (0.94 to 1.01) | 1.04 (1.02 to 1.06) | 1.12 (1.11 to 1.13) | 1.04 (1.02 to 1.06) | 0.98 (0.94 to 1.01) | 0.17 |
| Grunting | 76 | 1.04 (1.02 to 1.07) | 1.09 (1.08 to 1.11) | 1.14 (1.13 to 1.15) | 0.99 (0.95 to 1.03) | 0.85 (0.79 to 0.92) | 0.18 |
| Acidotic breathing | 73.7 | 1.07 (1.05 to 1.09) | 1.12 (1.10 to 1.13) | 1.15 (1.14 to 1.16) | 0.98 (0.92 to 1.02) | 0.82 (0.74 to 0.89) | 0.19 |
| No feedback indicators | |||||||
| Jaundice | 92 | 0.86 (0.82 to 0.89) | 0.93 (0.90 to 0.96) | 1.03 (1.02 to 1.04) | 1.05 (1.04 to 1.06) | 1.03 (1.02 to 1.04) | 0.15 |
| Wheeze | 83.7 | 0.96 (0.93 to 0.98) | 1.00 (0.97 to 1.02) | 1.09 (1.08 to 1.10) | 1.04 (1.03 to 1.06) | 1.03 (1.01 to 1.04) | 0.16 |
| Lymph nodes >1 cm | 62.2 | 1.05 (1.01 to 1.08) | 1.16 (1.13 to 1.18) | 1.23 (1.22 to 1.25) | 1.11 (1.08 to 1.14) | 0.99 (0.93 to 1.04) | 0.17 |
| Wrist/rib signs for rickets | 51.1 | 1.24 (1.19 to 1.27) | 1.35 (1.34 to 1.36) | 1.36 (1.35 to 1.38) | 0.95 (0.85 to 1.05) | 0.41 (0.33 to 0.50) | 0.19 |
| Thrush | 60.9 | 1.15 (1.13 to 1.18) | 1.22 (1.24 to 1.25) | 1.24 (1.23 to 1.26) | 1.01 (0.95 to 1.06) | 0.68 (0.59 to 0.77) | 0.18 |
| Crackles | 84.4 | 0.94 (0.91 to 0.97) | 0.99 (0.96 to 1.01) | 1.10 (1.09 to 1.11) | 1.05 (1.04 to 1.07) | 1.04 (1.02 to 1.05) | 0.16 |
| Stridor | 66.8 | 1.10 (1.08 to 1.11) | 1.16 (1.15 to 1.17) | 1.17 (1.18 to 1.19) | 1.07 (1.05 to 1.09) | 0.72 (0.65 to 0.77) | 0.19 |
| Difficult documentation indicators | |||||||
| Active feedback indicators | |||||||
| MUAC/WHZ | 26.7 | 1.64 (1.50 to 1.18) | 1.83 (1.74 to 1.90) | 1.81 (1.75 to 1.91) | 0.18 | ||
| Respiratory rate | 70.3 | 0.89 (0.83 to 0.94) | 0.82 (0.75 to 0.89) | 1.14 (1.12 to 1.15) | 1.16 (1.13 to 1.19) | 1.21 (1.18 to 1.23) | 0.17 |
| Passive feedback indicators | |||||||
| AVPU | 87.4 | 0.95 (0.92 to 0.97) | 0.97 (0.94 to 0.99) | 1.07 (1.06 to 1.08) | 1.05 (1.04 to 1.06) | 1.05 (1.04 to 1.06) | 0.16 |
| Capillary refill | 61.1 | 1.13 (1.08 to 1.17) | 1.24 (1.22 to 1.26) | 1.29 (1.28 to 1.30) | 1.04 (0.97 to 1.10) | 0.86 (0.77 to 0.93) | 0.17 |
| Skin pinch | 71.2 | 1.04 (1.01 to 1.07) | 1.13 (1.25 to 1.14) | 1.18 (1.17 to 1.19) | 1.04 (1.01 to 1.07) | 0.87 (0.81 to 0.93) | 0.17 |
| Ability to drink | 71.9 | 1.04 (1.01 to 1.06) | 1.12 (1.11 to 1.14) | 1.17 (1.16 to 1.18) | 1.03 (0.98 to 1.06) | 0.86 (0.79 to 0.92) | 0.15 |
| No feedback indicators | |||||||
| Pulse rate | 52.7 | 0.87 (0.78 to 0.97) | 0.75 (0.64 to 0.86) | 1.19 (1.15 to 1.23) | 1.26 (1.18 to 1.34) | 1.42 (1.33 to 1.49) | 0.16 |
| Temperature | 81.5 | 0.95 (0.92 to 0.99) | 0.89 (0.84 to 0.94) | 1.11 (1.10 to 1.13) | 1.07 (1.05 to 1.09) | 1.10 (1.08 to 1.12) | 0.16 |
AVPU, alert, verbal response, pain response, unresponsive; ICC, intracluster correlation coefficient; MUAC/WHZ, mid-upper arm circumference/weight for height z-score; PAR, paediatric admission record.