Public Health - Santé Publique
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Public Health - Santé Publique
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An artificial intelligence system for predicting the deterioration of COVID-19 patients in the emergency department

An artificial intelligence system for predicting the deterioration of COVID-19 patients in the emergency department | Public Health - Santé Publique | Scoop.it

During the coronavirus disease 2019 (COVID-19) pandemic, rapid and accurate triage of patients at the emergency department is critical to inform decision-making.


 


We propose a data-driven approach for automatic prediction of deterioration risk using a deep neural network that learns from chest X-ray images and a gradient boosting model that learns from routine clinical variables.


 


Our AI prognosis system, trained using data from 3661 patients, achieves an area under the receiver operating characteristic curve (AUC) of 0.786 (95% CI: 0.745–0.830) when predicting deterioration within 96 hours.


 


The deep neural network extracts informative areas of chest X-ray images to assist clinicians in interpreting the predictions and performs comparably to two radiologists in a reader study. In order to verify performance in a real clinical setting, we silently deployed a preliminary version of the deep neural network at New York University Langone Health during the first wave of the pandemic, which produced accurate predictions in real-time.


 


 


In summary, our findings demonstrate the potential of the proposed system for assisting front-line physicians in the triage of COVID-19 patients.


 


read the open article at https://www.nature.com/articles/s41746-021-00453-0


 

Lire l'article complet sur : www.nature.com


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Case-Initiated COVID-19 Contact Tracing Using Anonymous Notifications

Case-Initiated COVID-19 Contact Tracing Using Anonymous Notifications | Public Health - Santé Publique | Scoop.it

We discuss the concept of a participatory digital contact notification approach to assist tracing of contacts who are exposed to confirmed cases of coronavirus disease (COVID-19);


 


The core functionality of our concept is to provide a usable, labor-saving tool for contact tracing by confirmed cases themselves


 


the approach is simple and affordable for countries with limited access to health care resources and advanced technology.


 


The proposed tool serves as a supplemental contract tracing approach to counteract the shortage of health care staff while providing privacy protection for both cases and contacts.



  • This tool can be deployed on the internet or as a plugin for a smartphone app.

  • Confirmed cases with COVID-19 can use this tool to provide contact information (either email addresses or mobile phone numbers) of close contacts.

  • The system will then automatically send a message to the contacts informing them of their contact status, what this status means, the actions that should follow (eg, self-quarantine, respiratory hygiene/cough etiquette), and advice for receiving early care if they develop symptoms.

  • The name of the sender of the notification message by email or mobile phone can be anonymous or not.

  • The message received by the contact contains no disease information but contains a security code for the contact to log on the platform to retrieve the information.


 

Conclusion

The successful application of this tool relies heavily on public social responsibility and credibility, and it remains to be seen if the public would adopt such a tool and what mechanisms are required to prevent misuse.


 


This is a simple tool that does not require complicated computer techniques despite strict user privacy protection design with respect to countries and regions. Additionally, this tool can help avoid coercive surveillance, facilitate the allocation of health resources, and prioritize clinical service for patients with COVID-19. Information obtained from the platform can also increase our understanding of the epidemiology of COVID-19.


 


read this concept paper at https://mhealth.jmir.org/2020/6/e20369


 


 

Lire l'article complet sur : mhealth.jmir.org


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Capturing COVID-19–Like Symptoms at Scale Using Banner Ads on an Online News Platform

Capturing COVID-19–Like Symptoms at Scale Using Banner Ads on an Online News Platform | Public Health - Santé Publique | Scoop.it

Identifying new COVID-19 cases is challenging. Not every suspected case undergoes testing, because testing kits and other equipment are limited in many parts of the world. Yet populations increasingly use the internet to manage both home and work life during the pandemic, giving researchers mediated connections to millions of people sheltering in place.



Objective: The goal of this study was to assess the feasibility of using an online news platform to recruit volunteers willing to report COVID-19–like symptoms and behaviors.


 



Methods: An online epidemiologic survey captured COVID-19–related symptoms and behaviors from individuals recruited through banner ads offered through Microsoft News. Respondents indicated whether they were experiencing symptoms, whether they received COVID-19 testing, and whether they traveled outside of their local area.



Results: A total of 87,322 respondents completed the survey across a 3-week span at the end of April 2020, with 54.3% of the responses from the United States and 32.0% from Japan. Of the total respondents, 19,631 (22.3%) reported at least one symptom associated with COVID-19. Nearly two-fifths of these respondents (39.1%) reported more than one COVID-19–like symptom. Individuals who reported being tested for COVID-19 were significantly more likely to report symptoms (47.7% vs 21.5%; P<.001). Symptom reporting rates positively correlated with per capita COVID-19 testing rates (R2=0.26; P<.001). Respondents were geographically diverse, with all states and most ZIP Codes represented. More than half of the respondents from both countries were older than 50 years of age.



Conclusions: News platforms can be used to quickly recruit study participants, enabling collection of infectious disease symptoms at scale and with populations that are older than those found through social media platforms. Such platforms could enable epidemiologists and researchers to quickly assess trends in emerging infections potentially before at-risk populations present to clinics and hospitals for testing and/or treatment.


 


source: Credit to Regenstrief Institute


 


read the entire study here : https://www.jmir.org/2021/5/e24742


 

Lire l'article complet sur : www.jmir.org


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nrip's curator insight, May 29, 2021 4:31 AM

Wow! Online news tools can be a useful strategy to reach a broad and diverse population during emerging outbreaks. This provides a quick and easy way to capture data on what is happening in the community at large rather than people hospitalized with the disease.

 

The beauty of this approach is that it offers access to a wide audience, many of whom might not be captured in other data gathering methods. Make no mistake, this is not useful when used in a silo. Its amazing if this is used as a step one tool to bring in participation to more involved mHealth tools for surveying.

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Introduction of mobile health tools to support COVID-19 training and surveillance in Ogun State Nigeria

Introduction of mobile health tools to support COVID-19 training and surveillance in Ogun State Nigeria | Public Health - Santé Publique | Scoop.it

Mobile health (mhealth) tools delivered through wireless technology are emerging as effective strategies for



  • delivering quality training,

  • ensuring rapid clinical decision making and

  • monitoring implementation of simple and effective interventions in under-resourced settings.


 


We share our early experience of development and deployment of the InStrat COVID-19 health worker training application (App) based on the MediXcel Lite #mHealth platform by Plus91 technologies in Ogun state, Western Nigeria where the country's first case was reported.


 


This App was designed to



  • directly provide frontline health workers with accurate and up-to-date information about COVID-19;

  • enable them to quickly identify, screen and manage COVID-19 suspects;

  • provide guidance on specimen collection techniques and safety measures to observe within wards and quarantine centres dealing with COVID-19.


 


The App was deployed in 271 primary health care facilities in Ogun State and a total of 311 health workers were trained. Of the 123 health workers who completed knowledge pre-and post-tests, their average test score improved from 47.5(±9.4) % to 73.1(±10.0) %, P < 0.0001 after using the tutorial.


 


Rapid adoption and uptake were driven largely by public-private sector involvement as well as certification with reported satisfaction levels of over 95%.


 


Challenges encountered included a lack of universal availability of android phones for frontline health workers, lack of internet access in remote areas and a need to incentivize the workers.


 


The timely deployment of this App targeting primary health care workers, mostly in hard-to-reach areas, obviated the need for conventional didactic training with potential of savings in training costs and time and could be applied to similar contexts.


 


This novel use of mobile health training to shore up training of front line health workers in a resource-limited setting during a pandemic has applicability to similar contexts.


 


 

Lire l'article complet sur : www.researchgate.net


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nrip's curator insight, March 4, 2021 5:38 AM

This novel use of mobile health training to shore up training of front line health workers in a resource-limited setting during a pandemic has applicability to similar contexts. The MediXcel Lite platform is primarily built to help develop and deploy a wide variety of mobile and web solutions which are tailored towards data collections, data management, AI powered decision making , training and contact tracing. Contact me or visit https://www.plus91.in to discuss further

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Automated Travel History Extraction From Clinical Notes for Informing the Detection of Emergent Infectious Disease Events

Automated Travel History Extraction From Clinical Notes for Informing the Detection of Emergent Infectious Disease Events | Public Health - Santé Publique | Scoop.it

Patient travel history can be crucial in evaluating evolving infectious disease events. Such information can be challenging to acquire in electronic health records, as it is often available only in unstructured text.



Objective: This study aims to assess the feasibility of annotating and automatically extracting travel history mentions from unstructured clinical documents in the Department of Veterans Affairs across disparate health care facilities and among millions of patients. Information about travel exposure augments existing surveillance applications for increased preparedness in responding quickly to public health threats.



Methods: Clinical documents related to arboviral disease were annotated following selection using a semiautomated bootstrapping process. Using annotated instances as training data, models were developed to extract from unstructured clinical text any mention of affirmed travel locations outside of the continental United States. Automated text processing models were evaluated, involving machine learning and neural language models for extraction accuracy.



Results: Among 4584 annotated instances, 2659 (58%) contained an affirmed mention of travel history, while 347 (7.6%) were negated. Interannotator agreement resulted in a document-level Cohen kappa of 0.776. Automated text processing accuracy (F1 85.6, 95% CI 82.5-87.9) and computational burden were acceptable such that the system can provide a rapid screen for public health events.



Conclusions: Automated extraction of patient travel history from clinical documents is feasible for enhanced passive surveillance public health systems.


 


Without such a system, it would usually be necessary to manually review charts to identify recent travel or lack of travel, use an electronic health record that enforces travel history documentation, or ignore this potential source of information altogether.


 


The development of this tool was initially motivated by emergent arboviral diseases. More recently, this system was used in the early phases of response to COVID-19 in the United States, although its utility was limited to a relatively brief window due to the rapid domestic spread of the virus.


 


Such systems may aid future efforts to prevent and contain the spread of infectious diseases.


 


read the study at https://publichealth.jmir.org/2021/3/e26719


 

Lire l'article complet sur : publichealth.jmir.org


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nrip's curator insight, June 15, 2021 11:26 PM

Information about travel exposure augments existing surveillance applications for increased preparedness in responding quickly to public health threats. Using algorithms and/or learning models to extract travel related information from EHR's is not a novel concept but it has come into the spotlight(like most of digital health) in the past 18 months.

 

We should be adding short travel related questionnaires in patient intake forms going forward. The symptoms which trigger this sort of an intake form for a particular patient can change with time, month to month preferably, and be governed by a multi regional , multi national approach. What do you think?

 

 

 

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Acceptability of App-Based Contact Tracing for COVID-19

Acceptability of App-Based Contact Tracing for COVID-19 | Public Health - Santé Publique | Scoop.it

The COVID-19 pandemic is the greatest public health crisis of the last 100 years. Countries have responded with various levels of lockdown to save lives and stop health systems from being overwhelmed. At the same time, lockdowns entail large socioeconomic costs.

 

One exit strategy under consideration is a mobile phone app that traces the close contacts of those infected with COVID-19.

 

Recent research has demonstrated the theoretical effectiveness of this solution in different disease settings. However, concerns have been raised about such apps because of the potential privacy implications. This could limit the acceptability of app-based contact tracing in the general population. As the effectiveness of this approach increases strongly with app uptake, it is crucial to understand public support for this intervention.

 

Objective: The objective of this study is to investigate the user

acceptability of a contact-tracing app in five countries hit by the pandemic.


Methods: We conducted a largescale, multicountry study (N=5995) to measure public support for the digital contact tracing of COVID-19 infections.

 

We ran anonymous online surveys in France, Germany, Italy, the United Kingdom, and the United States and measured intentions to use a contact-tracing app across different installation regimes (voluntary installation vs automatic installation by mobile phone providers) and studied how these intentions vary across individuals and countries.


Results: We found strong support for the app under both regimes, in all countries, across all subgroups of the population, and irrespective of regional-level COVID-19 mortality rates.

We investigated the main factors that may hinder or facilitate uptake and found that concerns about cybersecurity and privacy, together with a lack of trust in the government, are the main barriers to adoption.


Conclusions:

 

Epidemiological evidence shows that app-based contact tracing can suppress the spread of COVID-19 if a high enough proportion of the population uses the app and that it can still reduce the number of infections if uptake is moderate. Our findings show that the willingness to install the app is very high. The available evidence suggests that app-based contact tracing may be a viable approach to control the diffusion of COVID-19.

 

read the study at https://mhealth.jmir.org/2020/8/e19857

 

Lire l'article complet sur : mhealth.jmir.org


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nrip's curator insight, June 12, 2021 5:34 AM

A lot of research and anecdotal evidence shows that mHealth/Mobile App based contact tracing can suppress the spread of COVID-19 if a high enough proportion of the population uses the app. 

that it can still reduce the number of infections if uptake is moderate is interesting to note.

 

 

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AI algorithm that can detect the presence of COVID-19 disease in Chest X Rays

AI algorithm that can detect the presence of COVID-19 disease in Chest X Rays | Public Health - Santé Publique | Scoop.it

“ATMAN AI”, an Artificial Intelligence algorithm that can detect the presence of COVID-19 disease in Chest X Rays, has been developed to combat COVID fatalities involving lung. ATMAN AI is used for chest X-ray screening as a triaging tool in Covid-19 diagnosis, a method for rapid identification and assessment of lung involvement. This is a joint effort of the DRDO Centre for Artificial Intelligence and Robotics (CAIR), 5C Network & HCG Academics. This will be utilized by online diagnostic startup 5C Network with support of HCG Academics across India.


 


Triaging COVID suspect patients using X Ray is fast, cost effective and efficient. It can be a very useful tool especially in smaller towns in India owing to lack of easy access to CT scans there.


 


This will also reduce the existing burden on radiologists and make CT machines which are being used for COVID be used for other diseases and illness owing to overload for CT scans.


 


The novel feature namely “Believable AI” along with existing ResNet models have improved the accuracy of the software and being a machine learning tool, the accuracy will improve continually.


 


Chest X-Rays of RT-PCR positive hospitalized patients in various stages of disease involvement were retrospectively analysed using Deep Learning & Convolutional Neural Network models by an indigenously developed deep learning application by CAIR-DRDO for COVID -19 screening using digital chest X-Rays. The algorithm showed an accuracy of 96.73%.


 


 read more at http://indiaai.gov.in/news/drdo-cair-5g-network-and-hcg-academics-develop-atman-ai


 


 

Lire l'article complet sur : indiaai.gov.in


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nrip's curator insight, May 12, 2021 12:47 AM

Utilizing algorithms for chest X-ray is an effective triaging tool. Once perfected these can accessible by people in remote areas. Thus offering significant improvements in the care process as encountered in rural and remote areas.

 

Similar methods are being used/experimented on by a variety of labs and digital health companies, for predominant respiratory diseases.

 

Plus91 has developed similar technology for different Pneumonia and TB.

 

nrip's curator insight, May 12, 2021 3:17 AM

Utilizing algorithms for chest X-ray is an effective triaging tool. Once perfected these can accessible by people in remote areas. Thus offering significant improvements in the care process as encountered in rural and remote areas.

 

Similar methods are being used/experimented on by a variety of labs and digital health companies, for predominant respiratory diseases.

 

Plus91 has developed similar technology for different Pneumonia and TB.