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      Applications of digital health for public health responses to COVID-19: a systematic scoping review of artificial intelligence, telehealth and related technologies

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          Abstract

          The coronavirus disease 2019 (COVID-19) pandemic has overwhelmed healthcare services, faced with the twin challenges in acutely meeting the medical needs of patients with COVID-19 while continuing essential services for non-COVID-19 illnesses. The need to re-invent, re-organize and transform healthcare and co-ordinate clinical services at a population level is urgent as countries that controlled initial outbreaks start to experience resurgences. A wide range of digital health solutions have been proposed, although the extent of successful real-world applications of these technologies is unclear. This study aims to review applications of artificial intelligence (AI), telehealth, and other relevant digital health solutions for public health responses in the healthcare operating environment amidst the COVID-19 pandemic. A systematic scoping review was performed to identify potentially relevant reports. Key findings include a large body of evidence for various clinical and operational applications of telehealth (40.1%, n = 99/247). Although a large quantity of reports investigated applications of artificial intelligence (AI) (44.9%, n = 111/247) and big data analytics (36.0%, n = 89/247), weaknesses in study design limit generalizability and translation, highlighting the need for more pragmatic real-world investigations. There were also few descriptions of applications for the internet of things (IoT) (2.0%, n = 5/247), digital platforms for communication (DC) (10.9%, 27/247), digital solutions for data management (DM) (1.6%, n = 4/247), and digital structural screening (DS) (8.9%, n = 22/247); representing gaps and opportunities for digital public health. Finally, the performance of digital health technology for operational applications related to population surveillance and points of entry have not been adequately evaluated.

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          Most cited references40

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          COVID-19 and mental health: A review of the existing literature

          Highlights • Subsyndromal mental health concerns are a common response to the COVID-19 outbreak. • These responses affect both the general public and healthcare workers. • Depressive and anxiety symptoms have been reported in 16–28% of subjects screened. • Novel methods of consultation, such as online services, can be helpful for these patients. • There is a need for further long-term research in this area, especially from other countries
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            High-performance medicine: the convergence of human and artificial intelligence

            Eric Topol (2019)
            The use of artificial intelligence, and the deep-learning subtype in particular, has been enabled by the use of labeled big data, along with markedly enhanced computing power and cloud storage, across all sectors. In medicine, this is beginning to have an impact at three levels: for clinicians, predominantly via rapid, accurate image interpretation; for health systems, by improving workflow and the potential for reducing medical errors; and for patients, by enabling them to process their own data to promote health. The current limitations, including bias, privacy and security, and lack of transparency, along with the future directions of these applications will be discussed in this article. Over time, marked improvements in accuracy, productivity, and workflow will likely be actualized, but whether that will be used to improve the patient-doctor relationship or facilitate its erosion remains to be seen.
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              Real-time tracking of self-reported symptoms to predict potential COVID-19

              A total of 2,618,862 participants reported their potential symptoms of COVID-19 on a smartphone-based app. Among the 18,401 who had undergone a SARS-CoV-2 test, the proportion of participants who reported loss of smell and taste was higher in those with a positive test result (4,668 of 7,178 individuals; 65.03%) than in those with a negative test result (2,436 of 11,223 participants; 21.71%) (odds ratio = 6.74; 95% confidence interval = 6.31–7.21). A model combining symptoms to predict probable infection was applied to the data from all app users who reported symptoms (805,753) and predicted that 140,312 (17.42%) participants are likely to have COVID-19.
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                Author and article information

                Contributors
                wong.tien.yin@singhealth.com.sg
                Journal
                NPJ Digit Med
                NPJ Digit Med
                NPJ Digital Medicine
                Nature Publishing Group UK (London )
                2398-6352
                26 February 2021
                26 February 2021
                2021
                : 4
                : 40
                Affiliations
                [1 ]GRID grid.419272.b, ISNI 0000 0000 9960 1711, Singapore Eye Research Institute (SERI), , Singapore National Eye Center (SNEC), ; Singapore, Singapore
                [2 ]GRID grid.4280.e, ISNI 0000 0001 2180 6431, Yong Loo Lin School of Medicine, , National University of Singapore (NUS), ; Singapore, Singapore
                [3 ]GRID grid.428397.3, ISNI 0000 0004 0385 0924, Duke-NUS Medical School, ; Singapore, Singapore
                Author information
                http://orcid.org/0000-0002-8502-2334
                http://orcid.org/0000-0002-8448-1264
                Article
                412
                10.1038/s41746-021-00412-9
                7910557
                33637833
                cdd57901-41f6-46d6-838b-e2d348d5b6df
                © The Author(s) 2021

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 7 October 2020
                : 15 January 2021
                Categories
                Review Article
                Custom metadata
                © The Author(s) 2021

                infectious diseases,public health
                infectious diseases, public health

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