scholarly journals Diagnostic Accuracy of Web-Based COVID-19 Symptom Checkers: Comparison Study (Preprint)

2020 ◽  
Author(s):  
Nicolas Munsch ◽  
Alistair Martin ◽  
Stefanie Gruarin ◽  
Jama Nateqi ◽  
Isselmou Abdarahmane ◽  
...  

BACKGROUND A large number of web-based COVID-19 symptom checkers and chatbots have been developed; however, anecdotal evidence suggests that their conclusions are highly variable. To our knowledge, no study has evaluated the accuracy of COVID-19 symptom checkers in a statistically rigorous manner. OBJECTIVE The aim of this study is to evaluate and compare the diagnostic accuracies of web-based COVID-19 symptom checkers. METHODS We identified 10 web-based COVID-19 symptom checkers, all of which were included in the study. We evaluated the COVID-19 symptom checkers by assessing 50 COVID-19 case reports alongside 410 non–COVID-19 control cases. A bootstrapping method was used to counter the unbalanced sample sizes and obtain confidence intervals (CIs). Results are reported as sensitivity, specificity, F1 score, and Matthews correlation coefficient (MCC). RESULTS The classification task between COVID-19–positive and COVID-19–negative for “high risk” cases among the 460 test cases yielded (sorted by F1 score): Symptoma (F1=0.92, MCC=0.85), Infermedica (F1=0.80, MCC=0.61), US Centers for Disease Control and Prevention (CDC) (F1=0.71, MCC=0.30), Babylon (F1=0.70, MCC=0.29), Cleveland Clinic (F1=0.40, MCC=0.07), Providence (F1=0.40, MCC=0.05), Apple (F1=0.29, MCC=-0.10), Docyet (F1=0.27, MCC=0.29), Ada (F1=0.24, MCC=0.27) and Your.MD (F1=0.24, MCC=0.27). For “high risk” and “medium risk” combined the performance was: Symptoma (F1=0.91, MCC=0.83) Infermedica (F1=0.80, MCC=0.61), Cleveland Clinic (F1=0.76, MCC=0.47), Providence (F1=0.75, MCC=0.45), Your.MD (F1=0.72, MCC=0.33), CDC (F1=0.71, MCC=0.30), Babylon (F1=0.70, MCC=0.29), Apple (F1=0.70, MCC=0.25), Ada (F1=0.42, MCC=0.03), and Docyet (F1=0.27, MCC=0.29). CONCLUSIONS We found that the number of correctly assessed COVID-19 and control cases varies considerably between symptom checkers, with different symptom checkers showing different strengths with respect to sensitivity and specificity. A good balance between sensitivity and specificity was only achieved by two symptom checkers.

10.2196/21299 ◽  
2020 ◽  
Vol 22 (10) ◽  
pp. e21299
Author(s):  
Nicolas Munsch ◽  
Alistair Martin ◽  
Stefanie Gruarin ◽  
Jama Nateqi ◽  
Isselmou Abdarahmane ◽  
...  

Background A large number of web-based COVID-19 symptom checkers and chatbots have been developed; however, anecdotal evidence suggests that their conclusions are highly variable. To our knowledge, no study has evaluated the accuracy of COVID-19 symptom checkers in a statistically rigorous manner. Objective The aim of this study is to evaluate and compare the diagnostic accuracies of web-based COVID-19 symptom checkers. Methods We identified 10 web-based COVID-19 symptom checkers, all of which were included in the study. We evaluated the COVID-19 symptom checkers by assessing 50 COVID-19 case reports alongside 410 non–COVID-19 control cases. A bootstrapping method was used to counter the unbalanced sample sizes and obtain confidence intervals (CIs). Results are reported as sensitivity, specificity, F1 score, and Matthews correlation coefficient (MCC). Results The classification task between COVID-19–positive and COVID-19–negative for “high risk” cases among the 460 test cases yielded (sorted by F1 score): Symptoma (F1=0.92, MCC=0.85), Infermedica (F1=0.80, MCC=0.61), US Centers for Disease Control and Prevention (CDC) (F1=0.71, MCC=0.30), Babylon (F1=0.70, MCC=0.29), Cleveland Clinic (F1=0.40, MCC=0.07), Providence (F1=0.40, MCC=0.05), Apple (F1=0.29, MCC=-0.10), Docyet (F1=0.27, MCC=0.29), Ada (F1=0.24, MCC=0.27) and Your.MD (F1=0.24, MCC=0.27). For “high risk” and “medium risk” combined the performance was: Symptoma (F1=0.91, MCC=0.83) Infermedica (F1=0.80, MCC=0.61), Cleveland Clinic (F1=0.76, MCC=0.47), Providence (F1=0.75, MCC=0.45), Your.MD (F1=0.72, MCC=0.33), CDC (F1=0.71, MCC=0.30), Babylon (F1=0.70, MCC=0.29), Apple (F1=0.70, MCC=0.25), Ada (F1=0.42, MCC=0.03), and Docyet (F1=0.27, MCC=0.29). Conclusions We found that the number of correctly assessed COVID-19 and control cases varies considerably between symptom checkers, with different symptom checkers showing different strengths with respect to sensitivity and specificity. A good balance between sensitivity and specificity was only achieved by two symptom checkers.


2019 ◽  
Author(s):  
Jia Liu ◽  
Zhe Wang ◽  
Dingyong Sun ◽  
Xiying Wang

UNSTRUCTURED The HIV epidemic imposes a heavy burden on societal development. Presently, the protection of susceptible populations is the most feasible method for eliminating the spread of HIV. Governments and other relevant industries are actively attempting to solve the problem. In view of the unavailability of biological vaccines, the best measures that can currently be applied are identification of HIV-infected persons and provision of treatment and behavioral intervention. This paper proposes a HIV digital vaccine strategy based on blockchain technology. In the proposed strategy, a decentralized surveillance network is jointly constructed using HIV high-risk individuals as application nodes and accredited testing agencies as authentication nodes. Following testing at the authentication nodes, the results are uploaded to the blockchain, which results in HIV high-risk individuals being able to determine the HIV infection status of each other in a convenient, anonymous, and credible manner. This reduces the occurrence of high-risk sexual behavior and effectively protects susceptible populations. The proposed strategy is a promising solution to prevent the spread of HIV. The performance of the decentralized surveillance network may lead to the restructuring of current government-funded infectious disease prevention and control modes that are centered on centers for disease control and prevention and hospitals to introduce revolutionary changes in public health systems globally.


Author(s):  
Eliza Lai-Yi Wong ◽  
Kin-Fai Ho ◽  
Dong Dong ◽  
Annie Wai-Ling Cheung ◽  
Peter Sen-Yung Yau ◽  
...  

Background: Standard precautions prevent the spread of infections in healthcare settings. Incompliance with infection control guidelines of healthcare workers (HCWs) may increase their risk of exposure to infectious disease, especially under pandemics. The purpose of this study was to assess the level of compliance with the infection prevention and control practices among HCWs in different healthcare settings and its relationship with their views on workplace infection control measures during the COVID-19 pandemic. Methods: Nurses in Hong Kong were invited to respond to a cross-sectional online survey, in which their views on workplace infection and prevention policy, compliance with standard precautions and self-reported health during pandemics were collected. Results: The respondents were dissatisfied with workplace infection and prevention policy in terms of comprehensiveness (62%), clarity (64%), timeliness (63%), and transparency (60%). For the protective behavior, the respondents did not fully comply with the standard precautions when they were involved in medical care. Their compliance was relatively low when having proper patient handling (54%) and performing invasive procedures (46%). A multivariate analysis model proved that the level of compliance of the standard precautions was positively associated with the satisfaction on infection control and prevention policy among high risk group (0.020; 95% CI: 0.005–0.036), while older respondents had higher level of compliance among the inpatient and outpatient groups (coefficient range: 0.065–0.076). The higher level of compliance was also significantly associated with working in designated team and having chronic condition of the respondents among high-risk and inpatient groups. Conclusions: Standard precautions are the most important elements to reduce cross-transmission among HCWs and patients while the satisfaction on infection control and prevention policy would increase the compliance among the high-risk group. An overall suboptimal compliance and poor views on the infection prevention and control guidelines is a warning signal to healthcare system especially during pandemics.


2019 ◽  
Vol 8 (12) ◽  
pp. 2152 ◽  
Author(s):  
Sanna Syrjäläinen ◽  
Ulvi Kahraman Gursoy ◽  
Mervi Gursoy ◽  
Pirkko Pussinen ◽  
Milla Pietiäinen ◽  
...  

Systemic low-grade inflammation is associated with obesity. Our aim was to examine the association between obesity and salivary biomarkers of periodontitis. Salivary interleukin (IL)-1-receptor antagonist (IL-1Ra), IL-6, IL-8, IL-10, and tumor necrosis factor (TNF)-α concentrations were measured from 287 non-diabetic obese (body mass index (BMI) of >35 kg/m2) individuals and 293 normal-weight (BMI of 18.5–25 kg/m2) controls. Periodontal status was defined according to a diagnostic cumulative risk score (CRS) to calculate the risk of having periodontitis (CRS I, low risk; CRS II, medium risk; CRS III, high risk). In the whole population, and especially in smokers, higher IL-8 and lower IL-10 concentrations were detected in the obese group compared to the control group, while in non-smoking participants, the obese and control groups did not differ. IL-1Ra and IL-8 concentrations were higher in those with medium or high risk (CRS II and CRS III, p < 0.001) of periodontitis, whereas IL-10 and TNF-α concentrations were lower when compared to those with low risk (CRS I). In multivariate models adjusted for periodontal status, obesity did not associate with any salivary cytokine concentration. In conclusion, salivary cytokine biomarkers are not independently associated with obesity and concentrations are dependent on periodontal status.


2021 ◽  
Vol 9 ◽  
Author(s):  
Walid A. Al-Qerem ◽  
Anan S. Jarab

Background: The Coronavirus disease 2019 (COVID-19) pandemic is a major threat to public health and has had a significant impact on all aspects of life. An effective vaccine is the most anticipated resolution. This study aims to evaluate Jordanian intent to be vaccinated.Methods: This is a cross-sectional web-based study. Sample characteristics were gathered, and the participants were classified according to the degree of COVID-19 risk based on the categories of the Centers for Disease Control and Prevention (CDC). Participants' KAP toward COVID-19 were assessed, and two scores were calculated: knowledge score and practice score. The association between different sample characteristics and these scores was identified using binary logistical regressions. The participants' vaccination intention was evaluated and multinomial logistic regression was applied to identify the predictors of vaccination intention. Finally, the reasons behind the participants' vaccination refusal/hesitation were determined and categorized into different groups.Results: 1,144 participants were enrolled in the study (females = 66.5%). 30.4% of the participants were at high risk of COVID-19 complications, and 27.5% were at medium risk. Overall, participants' knowledge of COVID-19 symptoms, transmission methods, protective measures, and availability of cure were high (median of knowledge score = 17 out of 21). High protective practices were followed by many participants (median of practice score = 7 out of 10). 3.7% of participants were infected, and 6.4% suspected they were infected with the COVID-19 virus. 36.8% of the participants answered “No” when asked if they would take the vaccine once it becomes available, and 26.4% answered, “Not sure.” The main reasons for the participants' vaccination refusal or hesitancy were concerns regarding the use of vaccines and a lack of trust in them.Conclusion: Participants reported high refusal/hesitancy. Several barriers were identified, and efforts should be intensified to overcome these barriers.


2021 ◽  
Vol 8 ◽  
Author(s):  
Giorgio Prouse ◽  
Ludovica Ettorre ◽  
Francesco Mongelli ◽  
Daniela Demundo ◽  
Jos C. van den Berg ◽  
...  

Background: Severe acute respiratory syndrome from coronavirus-2 (SARS-CoV-2) has been associated with an increased risk of venous thromboembolism (VTE). Different anticoagulation protocols have been applied in several studies in the absence of clear evidence. A reliable deep venous thrombosis (DVT) indicator in critical patients with SARS-CoV-2 could guide the anticoagulation treatment; however, it has not yet been identified, and clinical applicability of the most common markers is debatable. The aim of our study was to determine the actual incidence of DVT in critically ill SARS-CoV-2 patients and to find a reliable tool to identify patients who might benefit from therapeutic-intensity anticoagulation.Methods: From March 1, 2020 to May 31, 2020, all patients admitted to the intensive care unit (ICU) for SARS-CoV-2 at Ospedale Regionale di Locarno, Locarno, Switzerland, were prospectively enrolled and screened daily with ultrasound for DVT. Following international consensus, a higher-intensity thromboprophylaxis was administered to all patients who were not at increased risk for bleeding. Sepsis-induced coagulopathy (SIC) and sequential organ failure assessment (SOFA) scores were calculated and time-to-DVT event in a COX proportional-hazard regression model was performed. A receiver operating characteristic (ROC) curve was used to determine sensitivity and specificity and the Youden's Index to establish the best threshold.Results: A total of 96 patients were enrolled. Deep venous thrombosis was detected in 37% of patients. Sepsis-induced coagulopathy and SOFA scores were both correlated to DVT. A SIC score of 1 vs. ≥2 showed a close association with DVT, with sensitivity, specificity, and positive and negative predictive values of 90.0, 48.1, and 49.1, and 89.7%, respectively. Most significantly though, a SOFA score of 1 or 2 points was shown to be the most accurate value in predicting the absence of DVT, indicating no need for therapeutic-intensity anticoagulation. Its sensitivity, specificity, and positive and negative predictive values were 87.9, 100, and 100, and 93.7%, respectively. The D-dimer test showed lower sensitivity and specificity whereas platelet count and aPTT were not found to be correlated to DVT.Conclusions: Patients with SOFA scores of 1 or 2 are at low risk of developing DVT and do not require therapeutic-intensity anticoagulation. Conversely, patients with scores ≥3 are at high risk of developing DVT.


2020 ◽  
Vol 15 (10) ◽  
pp. 673-681
Author(s):  
Jing-Jing Guo ◽  
Yan-Hua Yu ◽  
Xue-Ying Ma ◽  
Ya-Nan Liu ◽  
Qian Fang ◽  
...  

Aim: The outbreak of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) has had serious repercussions worldwide. This study was aimed to evaluate the accuracy of a new kit for detection of SARS-CoV-2 compared with similar detection kit. Materials & methods: A total of 500 subjects were included and tested with both the new test and control kits. Clinical diagnosis results were taken as the reference standard. Results: Compared with clinical diagnosis, the sensitivity of the test kit was 82.64%, specificity was 98.45% and total coincidence rate was 90.80%. The total coincidence rate, sensitivity and specificity between control kit and clinical diagnosis were 89.20%, 78.10% and 99.61%, respectively. Conclusions: The new kit was comparable to the similar detection kit for detection of SARS-CoV-2 in sensitivity, specificity and total coincidence rate.


2020 ◽  
Vol 24 (103) ◽  
pp. 35-40
Author(s):  
Marcela López Bravo ◽  
Román María del Cisne ◽  
Eliana Mejia Suarez ◽  
Luis Ordoñez Mullo

Las muertes violentas en Ecuador representan una problemática social importante, en este trabajo hemos aplicado una metodología de estudio observacional, retrospectiva, transversal, no experimental, la población fue conformada por el total de personas fallecidas que fueron registradas por el Instituto de ciencias forenses y criminalística, y la muestra se consideró las muertes por lesiones producidas por armas de fuego y explosivos desde enero del 2017 a diciembre del 2019, obteniendo como resultados que el 100% de muertes de esta modalidad fueron catalogadas como muertes violentas y a todos ellos se les realizó autopsia , más del 80% de las víctimas fueron de sexo masculino, el rango de edad con mayor cantidad de víctimas oscila entre los 36 y 64 años de edad, las lesiones mortales por armas de fuego fueron en su mayoría dirigidas a cavidades craneal y toraco-abdominal, mientras que por explosivos las lesiones fueron generalizadas provocando muerte instantánea. Palabras Clave: lesiones, muertes, armas de fuego, explosivos. Referencias [1]UNODC, «Global study on homicide.,» 2013. [2]UNODC, «United Nations Office on Drugs and Crime,» World Drug Report, 2019. [3]C. M. Á. Velasco y G. J. Pontón, «Lesiones con armas de fuego: sobrevivir a las balas en Ecuador.,» Estado & comunes, revista de políticas y problemas públicos, vol. 1 (10), 2020. [4]J. P. Pinto, «Más que plomo,» Perfil Criminológico, vol. 17, 2015. [5]G. J. González Pérez, M. G. Vega López, C. E. Cabrera Pivaral, A. Vega López y A. Muñoz de la Torre, «Mortalidad por homicidios en México: tendencias, variaciones socio-geográficas y factores asociados,» Ciência & Saúde Coletiva, vol. 17, pp. 3195-3208, 2012. [6]J. Cavazos, J. Palacios, F. Reyna, N. Álvarez, L. Alatorres y G. Muñoz, «Epidemiología de las lesiones por proyectil de arma de fuego en el Hospital Universitario “Dr. José Eleuterio González” de la,» Cirugía y Cirujanos, vol. 85, pp. 41-48, 2017. [7]O. S. Castro, La muerte violenta. inspeccion ocular y cuerpo del delito., LA LEY., 2004. [8] M. Zurbarán, F. Calle y R. Restrepo, «Descripción de lesiones por explosivos: revisión de la literatura, reporte de caso y propuesta de nueva clasificación.,» vol. 1(2), pp. Case reports, 1(2), 1-68., 2015. [9]National Center for Injury Prevention and Control, «Explosions and Blast injuries: A primer for Clinicians.,» Atlanta: Centers for Disease Control and Prevention, 2006. [10]P. Pasquier, B. Lenoir, y B. Debien, «Blast y lesiones por explosión.,» EMC-Anestesia-Reanimación,, vol. 40 (1), pp. 1-12., 2014. [11]M. Carnicero y M. Baigorri, «Muerte por explosión: cuestiones y sistemática médico-forenses.,» Cuadmed. forense, pp. 39-52, 2002.


VASA ◽  
2015 ◽  
Vol 44 (2) ◽  
pp. 106-114 ◽  
Author(s):  
Adem Adar ◽  
Hakan Erkan ◽  
Tayyar Gokdeniz ◽  
Aysegul Karadeniz ◽  
Ismail G. Cavusoglu ◽  
...  

Background: We aimed to investigate the association between aortic arch and coronary artery calcification (CAC). We postulated that low‐ and high‐risk CAC scores could be predicted with the evaluation of standard chest radiography for aortic arch calcification (AAC). Patients and methods: Consecutive patients who were referred for a multidetector computerized tomography (MDCT) examination were enrolled prospectively. All patients were scanned using a commercially available 64‐slice MDCT scanner for the evaluation of CAC score. A four‐point grading scale (0, 1, 2 and 3) was used to evaluate AAC on the standard posterior‐anterior chest radiography images. Results: The study group consisted of 248 patients. Median age of the study group was 52 (IQR: 10) years, and 165 (67 %) were male. AAC grades (r = 0.676, p < 0.0001) and age (r = 0.518, p < 0.0001) were significantly and positively correlated with CAC score. Presence of AAC was independently associated with the presence of CAC (OR: 11.20, 95 % CI 4.25 to 29.52). An AAC grade of ≥ 2 was the strongest independent predictor of a high‐risk CAC score (OR: 27.42, 95 % CI 6.09 to 123.52). Receiver operating characteristics curve analysis yielded a strong predictive ability of AAC grades for a CAC score of ≥ 100 (AUC = 0.892, P < 0.0001), and ≥ 400 (AUC = 0.894, P < 0.0001). Absence of AAC had a sensitivity, specificity and accuracy of 90 %, 84 % and 89 %, respectively, for a CAC score of < 100. An AAC grade of ≥ 2 predicted a CAC score of ≥400 with a sensitivity, specificity and accuracy of 68 %, 98 % and 95 %, respectively. Conclusions: AAC is a strong and independent predictor of CAC. The discriminative performance of AAC is high in detecting patients with low‐ and high‐risk CAC scores.


Sensi Journal ◽  
2020 ◽  
Vol 6 (2) ◽  
pp. 236-246
Author(s):  
Ilamsyah Ilamsyah ◽  
Yulianto Yulianto ◽  
Tri Vita Febriani

The right and appropriate system of receiving and transferring goods is needed by the company. In the process of receiving and transferring goods from the central warehouse to the branch warehouse at PDAM Tirta Kerta Raharja, Tangerang Regency, which is currently done manually is still ineffective and inaccurate because the Head of Subdivision uses receipt documents, namely PPBP and mutation of goods, namely MPPW in the form of paper as a submission media. The Head of Subdivision enters the data of receipt and mutation of goods manually and requires a relatively long time because at the time of demand for the transfer of goods the Head of Subdivision must check the inventory of goods in the central warehouse first. Therefore, it is necessary to hold a design of information systems for the receipt and transfer of goods from the central warehouse to a web-based branch warehouse that is already database so that it is more effective, efficient and accurate. With the web-based system of receiving and transferring goods that are already datatabed, it can facilitate the Head of Subdivision in inputing data on the receipt and transfer of goods and control of stock inventory so that the Sub Head of Subdivision can do it periodically to make it more effective, efficient and accurate. The method of data collection is done by observing, interviewing and studying literature from various previous studies, while the system analysis method uses the Waterfall method which aims to solve a problem and uses design methods with visual modeling that is object oriented with UML while programming using PHP and MySQL as a database.


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