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      Digital contact tracing technology in the COVID-19 pandemic: a systematic review

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          Abstract

          Introduction

          The COVID-19 pandemic prompted public health teams across the world to emphasize case identification, contact tracing, and isolation in outbreak management strategies. Contact tracing was advanced by global access to mobile phones to develop and implement digital contact tracing (DCT) technology with the objective of increasing the rate of contact tracing while reducing the resources required.

          Purpose

          This study aimed to describe the DCT technology used during the COVID-19 pandemic across the world, and to identify differences and similarities between characteristics and uses.

          Methods

          This review followed the PRISMA (2020) guidelines for systematic reviews. Literature searches were conducted using Embase, MEDLINE, and PubMed and were restricted to English studies published between 2019 to 2023. Studies were excluded if they did not report findings for DCT during COVID-19, did not provide data for technology characteristics or outcomes, or were a study design listed for exclusion.

          Results

          Sixty one studies were included in the review producing results for 147 digital contact tracing technologies across 83 countries. The majority of digital contact tracing (DCT) technologies are government-owned (75.6%), primarily developed for COVID-19 tracing (96.4%). Bluetooth is the most favored technology (70%) used in their development, followed by GPS (30%) and QR codes (22%). Applications are the preferred platform (90.9%), with a few using applets (6.3%) and wearable devices (1.4%). Only 2 DCT technologies have achieved over 100 million downloads or uses (3.1%). Most DCTs fall into the 1–9.99 million downloads range (27.7%) and 10,000–99,999 downloads (20%). The majority of DCTs are voluntarily used by the population (63.6%), while 27.3% are mandated for use.

          Conclusions

          Digital contact tracing technologies were developed and implemented globally as a strategy in emergency outbreak management to reduce the spread of disease. This review describes the use of DCT across the world by identifying key features and characteristics that will serve as a lesson learned for improvement of existing DCT technologies for other emergency response outbreak management.

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          Most cited references71

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          The PRISMA 2020 statement: an updated guideline for reporting systematic reviews

          The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, published in 2009, was designed to help systematic reviewers transparently report why the review was done, what the authors did, and what they found. Over the past decade, advances in systematic review methodology and terminology have necessitated an update to the guideline. The PRISMA 2020 statement replaces the 2009 statement and includes new reporting guidance that reflects advances in methods to identify, select, appraise, and synthesise studies. The structure and presentation of the items have been modified to facilitate implementation. In this article, we present the PRISMA 2020 27-item checklist, an expanded checklist that details reporting recommendations for each item, the PRISMA 2020 abstract checklist, and the revised flow diagrams for original and updated reviews.
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            Digital technologies in the public-health response to COVID-19

            Digital technologies are being harnessed to support the public-health response to COVID-19 worldwide, including population surveillance, case identification, contact tracing and evaluation of interventions on the basis of mobility data and communication with the public. These rapid responses leverage billions of mobile phones, large online datasets, connected devices, relatively low-cost computing resources and advances in machine learning and natural language processing. This Review aims to capture the breadth of digital innovations for the public-health response to COVID-19 worldwide and their limitations, and barriers to their implementation, including legal, ethical and privacy barriers, as well as organizational and workforce barriers. The future of public health is likely to become increasingly digital, and we review the need for the alignment of international strategies for the regulation, evaluation and use of digital technologies to strengthen pandemic management, and future preparedness for COVID-19 and other infectious diseases.
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              Adoption of Digital Technologies in Health Care During the COVID-19 Pandemic: Systematic Review of Early Scientific Literature

              Background The COVID-19 pandemic is favoring digital transitions in many industries and in society as a whole. Health care organizations have responded to the first phase of the pandemic by rapidly adopting digital solutions and advanced technology tools. Objective The aim of this review is to describe the digital solutions that have been reported in the early scientific literature to mitigate the impact of COVID-19 on individuals and health systems. Methods We conducted a systematic review of early COVID-19–related literature (from January 1 to April 30, 2020) by searching MEDLINE and medRxiv with appropriate terms to find relevant literature on the use of digital technologies in response to the pandemic. We extracted study characteristics such as the paper title, journal, and publication date, and we categorized the retrieved papers by the type of technology and patient needs addressed. We built a scoring rubric by cross-classifying the patient needs with the type of technology. We also extracted information and classified each technology reported by the selected articles according to health care system target, grade of innovation, and scalability to other geographical areas. Results The search identified 269 articles, of which 124 full-text articles were assessed and included in the review after screening. Most of the selected articles addressed the use of digital technologies for diagnosis, surveillance, and prevention. We report that most of these digital solutions and innovative technologies have been proposed for the diagnosis of COVID-19. In particular, within the reviewed articles, we identified numerous suggestions on the use of artificial intelligence (AI)–powered tools for the diagnosis and screening of COVID-19. Digital technologies are also useful for prevention and surveillance measures, such as contact-tracing apps and monitoring of internet searches and social media usage. Fewer scientific contributions address the use of digital technologies for lifestyle empowerment or patient engagement. Conclusions In the field of diagnosis, digital solutions that integrate with traditional methods, such as AI-based diagnostic algorithms based both on imaging and clinical data, appear to be promising. For surveillance, digital apps have already proven their effectiveness; however, problems related to privacy and usability remain. For other patient needs, several solutions have been proposed, such as telemedicine or telehealth tools. These tools have long been available, but this historical moment may actually be favoring their definitive large-scale adoption. It is worth taking advantage of the impetus provided by the crisis; it is also important to keep track of the digital solutions currently being proposed to implement best practices and models of care in future and to adopt at least some of the solutions proposed in the scientific literature, especially in national health systems, which have proved to be particularly resistant to the digital transition in recent years.
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                Author and article information

                Journal
                Health and Technology
                Health Technol.
                Springer Science and Business Media LLC
                2190-7188
                2190-7196
                May 04 2024
                Article
                10.1007/s12553-024-00857-4
                42646925-7ce0-4b07-b0f6-333cbe0a1930
                © 2024

                https://creativecommons.org/licenses/by/4.0

                https://creativecommons.org/licenses/by/4.0

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