How to Make COVID-19 Contact Tracing Apps work: Insights from Behavioral Economics (Preprint)

2021 ◽  
Author(s):  
Ian Ayres ◽  
Alessandro Romano ◽  
Chiara Sotis
Keyword(s):  
Phase I ◽  
Phase Ii ◽  
Network Effects ◽  
Risky Behaviors ◽  
Contact Tracing ◽  
Risk Compensation ◽  
Main Function ◽  
Double Blind ◽  
Compensation Theory ◽  
Pros And Cons

BACKGROUND Due to network effects, Contact Tracing Apps (CTAs) are only effective if many people download them. However, the response to CTAs has been tepid. For example, in France less than 2 million people (roughly 3% of the population) downloaded the CTA. Consequently, CTAs need to be fundamentally rethought to increase their effectiveness. OBJECTIVE This study aimed to show that CTAs can still play a key role in containing the pandemic, provided that they take into account insights from behavioral sciences. Moreover, we study whether emphasizing the virtues of CTA to induce people to download them makes app users engage in more risky behaviors (risk compensation theory) and whether feedback on a user’s behavior affects future behaviors. METHODS We perform a double-blind online experiment (n=1500) divided in two phases. In Phase I respondents are randomly assigned to one of three different groups: Pros of the app, Pros and Cons of the app and Control I. Respondents in the Pros group were shown information on the advantages of CTAs. Participants in the Pros and Cons group were shown information on both the advantages and the problems that characterize CTAs. Last, respondents in the Control I group were not given any information on CTAs. All participants are then asked how worried they are about the pandemic, how likely they are to download the app, and on how they intend to behave (e.g. attend small and large gathering, wear a mask, etc.). A week later we carried out Phase II. Participants in Phase II were randomly assigned to different in-app notifications in which they were informed on how much risk they were taking compared to the average user. We then ask participants their intentions for future behaviors to investigate whether these notifications were effective in making respondents more prudent. RESULTS All 1500 participants completed phase I of the experiment, whereas 1303 (86.9%) completed also phase 2. The main findings are: i) informing people on the pros of the app make them less worried about the pandemic (p=.004), ii) informing people about both the pros and the cons of the app makes them more likely to download the app (p=.07); iii) carefully devised in-app notification induce people to state that they will: attend less large gatherings (p= .05) and less small gatherings (p= .001), see less people at risk (p=.004), that they stay more at home (p=.006) and wear more often the mask (p=.09). We do not find support for the risk-compensation theory. CONCLUSIONS we suggest that CTAs should be re-framed as Behavioral Feedback Apps (BFAs). The main function of BFAs would be providing users with information on how to minimize the risk of contracting COVID-19, e.g. to provide information on how crowded a store is likely to be at a given time of the day. Moreover, the BFA could have a rating system that allows users to flag stores that do not respect safety norms, such as mandating customers to wear a mask or not respecting social distancing. These functions can inform the behavior of app users, thus playing a key role in containing the spread of the virus even if a small percentage of people download the BFA. While effective contact tracing is impossible when only 3% of the population downloads the app, less risk taking by small portions of the population can produce large benefits. BFAs can be programmed so that users can also activate a tracing function akin to the one currently carried out by CTAs. Making contact tracing an ancillary, opt-in function might facilitate a wider acceptance of BFAs.

scholarly journals Focusing on the Treatment of COVID-19: A Comprehensive Analysis of 226 Trials Registered on Clinicaltrials.gov and ChiCTR

2021 ◽  
Author(s):  
Jincai Guo ◽  
Hui Xie ◽  
Hao Wu
Keyword(s):  
Clinical Trials ◽  
Chinese Medicine ◽  
Phase I ◽  
Phase Ii ◽  
Western Medicine ◽  
Phase Iii ◽  
Phase Ii Trials ◽  
Double Blind ◽  
Intervention Measures ◽  
Chinese Medicine Treatment

Abstract Background: The purpose of this study is to analyze the registered clinical trials of COVID-19, and to provide a reference for the clinical treatment of COVID-19. Methods: Chinese ClinicalTrial Registry (ChiCTR) and Clinicaltrials.gov databases were searched for clinical trials of COVID-19, which were registered from inception to February 29, 2020, to screen out the clinical trials on the treatment of COVID-19, and the research units and regions, sample size, study types, study stages, and intervention measures were analyzed. Results: There were 226 clinical trials on COVID-19 in the 2 databases, and all of them were registered by research units in China. The top five registered areas were Hubei, Beijing, Shanghai, Guangdong, and Zhejiang. The study type was as follows: interventional study (207, 91.6%) and observational study (18, 8.0%). Clinical trial staging was as follows: exploratory studies/preliminary trials (91, 40.3%), phase I trials (4, 1.8%), phase II trials (12, 5.3%), phase III trials (12, 5.3%), phase IV trials (47, 20.8%), phase I/II trials (2, 0.9%), phase II/III trials (5, 2.2%), and other trials (57, 25.2%). Intervention measures were as follows: there were 143 (63.3%) trials of western medicine treatment, 50 (22.1%) trials of Chinese medicine treatment, and 21 (9.3%) trials of integrated Chinese medicine treatment and western medicine treatment. Conclusion: Researchers have registered a large number of clinical trials in a short time. The number of existing patients of COVID-19 is not enough to support hundreds of clinical trials. There is a lack of multicenter, randomized, double-blind, placebo-controlled trials.

P4555Efficacy and safety of valsartan in children aged 1–5 years with hypertension, with or without chronic kidney disease: A 6-week randomised, multicentre, double-blind study followed by open-label phase

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Bapatla ◽  
A Jankauskiene ◽  
D Drozdz ◽  
A Wasilewska ◽  
R De Paula Bernardes ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Phase I ◽  
Phase Ii ◽  
Dose Response ◽  
Dose Group ◽  
Organ Damage ◽  
Open Label ◽  
Double Blind ◽  
Dose Dependent

Abstract Background Hypertension is a leading cause of disability and mortality worldwide. In the paediatric population, hypertension and chronic kidney disease (CKD) have raised significant health concern due to the risk of target organ damage similar to that seen in adults. Management of hypertension may therefore prevent decline in renal function and progression of CKD to end organ damage. Currently, there are no angiotensin receptor blockers approved in EU for hypertensive children younger than 6 years. Purpose To evaluate a dose-dependent reduction in mean systolic blood pressure (MSBP), safety and tolerability of two doses of valsartan (VAL) solution (0.25 mg/kg/day and 4 mg/kg/day) in children aged 1–5 years with hypertension with or without CKD. Methods This study comprised of a randomised multicentre double-blind (DB) double-dummy phase I (6-weeks) followed by an open-label (OL) titration phase II (20-weeks). In phase I, patients with history of hypertension were randomised 1:1 to receive VAL (0.25 or 4 mg/kg/day). Patients received VAL 1 mg/kg/day, optionally titrated to 2 mg/kg/day to 4 mg/kg/day based on BP response in phase II. Results Of the 127 randomised patients, 120 completed phase I, and 114 (55 CKD; 59 non-CKD) phase II. Baseline characteristics and demographics were comparable between treatment groups, and within the CKD and non-CKD subgroups. In the DB phase, a clinically and statistically significant reduction was observed in MSBP at week 6 in the VAL 4 mg/kg group (8.5 mmHg) compared with the VAL 0.25 mg/kg group (4.1 mmHg, respectively; P=0.0157; baseline 113.3 mmHg vs. 116.0 mmHg, respectively). A positive dose-response relationship (i.e. slope for dose per body weight, mg/kg) was observed in MSBP reduction between the VAL 0.25 mg/kg and VAL 4.0 mg/kg group (P=0.0012). In CKD patients, there was a significant reduction in MSBP from baseline to week 6 in the VAL 4 mg/kg group (9.2 mmHg) compared with the VAL 0.25 mg/kg group (1.2 mmHg; P=0.0096). MSBP reduction in non-CKD group was numerically larger with higher dose (7.8 mmHg vs 6.9 mmHg) but difference was not statistically significant (P=0.6531). Incidence of adverse events (AEs) was lower with VAL 4 mg/kg (41.9%) vs VAL 0.25 mg/kg (51.6%); similar in the CKD (48.4%) and non-CKD (45.3%) subgroups and not dose dependent. The most common AE was respiratory tract infection (5.6%). Serious AEs occurred in 3.2% patients with similar incidence in each dose group. Discontinuation due to AEs was 1.6%, all in VAL 0.25 mg/kg group. One patient in low dose and 2 in high dose group had potassium values >5.5 mEq/L. Incidence of AEs in OL phase was 76.7% with pyrexia being most frequent (16.7%). Conclusion Valsartan produced clinically relevant reductions in BP with a statistically significant dose response in children aged 1–5 years with hypertension, with or without CKD. Long-term efficacy was maintained and was generally well tolerated.

scholarly journals Drug exposure and clinical effect of transdermal mirtazapine in healthy young cats: a pilot study

2016 ◽  
Vol 19 (10) ◽  
pp. 998-1006 ◽  
Author(s):  
Kellyi K Benson ◽  
Lara B Zajic ◽  
Paula K Morgan ◽  
Sarah R Brown ◽  
Ryan J Hansen ◽  
...  
Keyword(s):  
Phase I ◽  
Phase Ii ◽  
Drug Exposure ◽  
Clinical Effect ◽  
Area Under The Curve ◽  
Clinical Effects ◽  
Food Ingestion ◽  
Serum Samples ◽  
Double Blind ◽  
At Home

Objectives The objective of this study was to measure drug exposure and clinical effects after administration of transdermal mirtazapine (TMZ) in healthy cats. Methods Phase I: seven healthy research cats received (1) 3.75 mg and 7.5 mg TMZ once aurally with 48 h serum sampling (serum samples were obtained via the jugular catheter at 0, 0.5, 1, 2, 5, 9, 12, 24, 36 and 48 h); (2) 7.5 mg TMZ and placebo daily aurally for 6 days then 48 h serum sampling; (3) 1.88 mg mirtazapine orally once with serum sampling at 1, 4 and 8 h. Phase II: 20 client-owned cats were enrolled in a randomized, double-blind, placebo-controlled, three-way crossover clinical effect study. Treatments consisted of 6 days of aural 7.5 mg TMZ or placebo gel at home, and 1.88 mg mirtazapine orally once in the clinic. Owners documented appetite, rate of food ingestion, begging activity and vocalization daily at home. On day 6, food consumed, activity and vocalization were documented in hospital, and trough and peak serum mirtazapine levels were obtained. Serum mirtazapine and gel concentrations were measured using liquid chromatography/tandem mass spectrometry. Results Phase I: administration of TMZ achieved measureable serum mirtazapine concentrations. Area under the curve0–48 of multidose 7.5 mg TMZ was significantly higher than single-dose 1.88 mg oral mirtazapine (OMZ) ( P = 0.02). Phase II: client-owned cats administered TMZ had a significant increase in appetite ( P = 0.003), rate of food ingestion ( P = 0.002), activity ( P = 0.002), begging ( P = 0.002) and vocalization ( P = 0.002) at home. In hospital there was a significant increase in food ingested with both TMZ and OMZ compared with placebo ( P <0.05). Gel concentrations ranged from 87%–119% of target dose. Conclusions and relevance TMZ 7.5 mg daily achieves measureable serum concentrations and produces significant appetite stimulation despite variance in compounded gel concentrations, but side effects denote a lower dose is indicated.

Acute Rhodiola Rosea Intake Can Improve Endurance Exercise Performance

2004 ◽  
Vol 14 (3) ◽  
pp. 298-307 ◽  
Author(s):  
Katrien De Bock ◽  
Bert O. Eijnde ◽  
Monique Ramaekers ◽  
Peter Hespel
Keyword(s):  
Reaction Time ◽  
Phase I ◽  
Exercise Capacity ◽  
Phase Ii ◽  
Endurance Exercise ◽  
Limb Movement ◽  
Rhodiola Rosea ◽  
Controlled Study ◽  
Double Blind ◽  
Double Blind Placebo

Purpose:The purpose of this study was to investigate the effect of acute and 4-week Rhodiola rosea intake on physical capacity, muscle strength, speed of limb movement, reaction time, and attention.Methods:PHASE I: A double blind placebo-controlled randomized study (n = 24) was performed, consisting of 2 sessions (2 days per session). Day 1: One hour after acute Rhodiola rosea intake (R, 200-mg Rhodiola rosea extract containing 3% rosavin + 1% salidroside plus 500 mg starch) or placebo (P, 700 mg starch) speed of limb movement (plate tapping test), aural and visual reaction time, and the ability to sustain attention (Fepsy Vigilance test) were assessed. Day 2: Following the same intake procedure as on day 1, maximal isometric knee-extension torque and endurance exercise capacity were tested. Following a 5-day washout period, the experimental procedure was repeated, with the treatment regimens being switched between groups (session 2). PHASE II: A double blind placebo-controlled study (n = 12) was performed. Subjects underwent sessions 3 and 4, identical to Phase I, separated by a 4-week R/P intake, during which subjects ingested 200 mg R/P per day.Results:PHASE I: Compared with P, acute R intake in Phase I increased 0 < -05) time to exhaustion from 16.8 ± 0.7 min to 17.2 ± 0.8 min. Accordingly, VO2peak (p < .05) and VCO2peak(p< .05) increased during R compared to P from 50.9 ± 1.8 ml • min-1 • kg−1 to 52.9 ± 2.7 ml • min-1 • kg"’ (VO2peak) and from 60.0 ± 2.3 ml • min-1 • kg-’ to 63.5 ± 2.7 ml • min-1 kg-1 (VCO2peak). Pulmonary ventilation (p = .07) tended to increase more during R than during P(P: 115.9±7.7L/min; R: 124.8 ± 7.7 L/min). All other parameters remained unchanged. PHASE II: Four-week R intake did not alter any of the variables measured.Conclusion:Acute Rhodiola rosea intake can improve endurance exercise capacity in young healthy volunteers. This response was not altered by prior daily 4-week Rhodiola intake.

scholarly journals How to Make COVID-19 Contact Tracing Apps work: Insights From Behavioral Economics

2020 ◽  
Author(s):  
Ian Ayres ◽  
Alessandro Romano ◽  
Chiara Sotis
Keyword(s):  
Behavioral Economics ◽  
Risk Taking ◽  
Network Effects ◽  
Behavioral Science ◽  
Rating System ◽  
Contact Tracing ◽  
Main Function ◽  
Effective Contact ◽  
The One ◽  
Behavioral Feedback

Due to network effects, Contact Tracing Apps (CTAs) are only effective if many people download them. However, the response to CTAs has been tepid. For example, in France less than 2 million people (roughly 3% of the population) downloaded the CTA. Against this background, we carry out an online experiment to show that CTAs can still play a key role in containing the spread of COVID-19, provided that they are re-conceptualized to account for insights from behavioral science. We start by showing that carefully devised in-app notifications are effective in inducing prudent behavior like wearing a mask or staying home. In particular, people that are notified that they are taking too much risk and could become a superspreader engage in more prudent behavior. Building on this result, we suggest that CTAs should be re-framed as Behavioral Feedback Apps (BFAs). The main function of BFAs would be providing users with information on how to minimize the risk of contracting COVID-19, like how crowded a store is likely to be. Moreover, the BFA could have a rating system that allows users to flag stores that do not respect safety norms like wearing masks. These functions can inform the behavior of app users, thus playing a key role in containing the spread of the virus even if a small percentage of people download the BFA. While effective contact tracing is impossible when only 3% of the population downloads the app, less risk taking by small portions of the population can produce large benefits. BFAs can be programmed so that users can also activate a tracing function akin to the one currently carried out by CTAs. Making contact tracing an ancillary, opt-in function might facilitate a wider acceptance of BFAs.

884: Phase I, Double-Blind, Placebo-Controlled Study in Healthy Male Subjects to Investigate the Safety, Tolerability, and Pharmacokinetics of DA-8159

2004 ◽  
Vol 171 (4S) ◽  
pp. 234-234 ◽  
Author(s):  
Harin Padma-Nathan ◽  
Jae Seung Pacik ◽  
Byoung Ok Ahn ◽  
Kyung Koo Kang ◽  
Mi Young Bahng ◽  
...  
Keyword(s):  
Phase I ◽  
Controlled Study ◽  
Healthy Male ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Male Subjects

Bewegungstherapie und körperliche Aktivität bei Patienten mit Herzinsuffizienz

Praxis ◽  
2018 ◽  
Vol 107 (17-18) ◽  
pp. 951-958 ◽  
Author(s):  
Matthias Wilhelm
Keyword(s):  
Phase I ◽  
Phase Ii ◽  
Körperliche Aktivität ◽  
Phase Iii

Zusammenfassung. Herzinsuffizienz ist ein klinisches Syndrom mit unterschiedlichen Ätiologien und Phänotypen. Die überwachte Bewegungstherapie und individuelle körperliche Aktivität ist bei allen Formen eine Klasse-IA-Empfehlung in aktuellen Leitlinien. Eine Bewegungstherapie kann unmittelbar nach Stabilisierung einer akuten Herzinsuffizienz im Spital begonnen werden (Phase I). Sie kann nach Entlassung in einem stationären oder ambulanten Präventions- und Rehabilitationsprogramm fortgesetzt werden (Phase II). Typische Elemente sind Ausdauer-, Kraft- und Atemtraining. Die Kosten werden von der Krankenversicherung für drei bis sechs Monate übernommen. In erfahrenen Zentren können auch Patienten mit implantierten Defibrillatoren oder linksventrikulären Unterstützungssystemen trainieren. Wichtiges Ziel der Phase II ist neben muskulärer Rekonditionierung auch die Steigerung der Gesundheitskompetenz, um die Langzeit-Adhärenz bezüglich körperlicher Aktivität zu verbessern. In Phase III bieten Herzgruppen Unterstützung.

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