ArticleJMIR mHealth and uHealth2020
Syndromic Surveillance Insights from a Symptom Assessment App Before and During COVID-19 Measures in Germany and the United Kingdom: Results From Repeated Cross-Sectional Analyses.
Article in JMIR mHealth and uHealth, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed.
- Impact of a Symptom Checker App on Patient-Physician Interaction Among Self-Referred Walk-In Patients in the Emergency Department: Multicenter, Parallel-Group, Randomized, Controlled Trial.Journal of medical Internet research · 2025Trial
- Comparison of Four Active SARS-CoV-2 Surveillance Strategies in Representative Population Sample Points: Two-Factor Factorial Randomized Controlled Trial.JMIR public health and surveillance · 2023Trial
- Changes to Public Health Surveillance Methods Due to the COVID-19 Pandemic: Scoping Review.JMIR public health and surveillance · 2024Article
- Pandemetrics: systematically assessing, monitoring, and controlling the evolution of a pandemic.Quality & quantity · 2023Article
- Detecting early signals of COVID-19 outbreaks in 2020 in small areas by monitoring healthcare utilisation databases: first lessons learned from the Italian Alert_CoV project.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2023Article
- The Use of a Self-triage Tool to Predict COVID-19 Cases and Hospitalizations in the State of Georgia.The western journal of emergency medicine · 2022Article
- Triage Accuracy of Symptom Checker Apps: 5-Year Follow-up Evaluation.Journal of medical Internet research · 2022Article
- Chatbot use cases in the Covid-19 public health response.Journal of the American Medical Informatics Association : JAMIA · 2022Article
- Novel Methods in the Surveillance of Influenza-Like Illness in Germany Using Data From a Symptom Assessment App (Ada): Observational Case Study.JMIR public health and surveillance · 2021Article
- Participatory Surveillance of COVID-19 in Lesotho via Weekly Calls: Protocol for Cell Phone Data Collection.JMIR research protocols · 2021Article
- [Epidemiological approaches to address key research questions on COVID-19-an overview].Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2021Review
- Participatory COVID-19 Surveillance Tool in Rural Appalachia : Real-Time Disease Monitoring and Regional Response.Public health reports (Washington, D.C. : 1974) · 2021Article
- Attitudes of General Practitioners Toward Prescription of Mobile Health Apps: Qualitative Study.JMIR mHealth and uHealth · 2021Article
- Performance of national COVID-19 'symptom checkers': a comparative case simulation study.BMJ health & care informatics · 2021Article
- Article
- Feasibility of using a mobile App to monitor and report COVID-19 related symptoms and people's movements in Uganda.PloS one · 2021Article
- App-based symptom tracking to optimize SARS-CoV-2 testing strategy using machine learning.PloS one · 2021Article
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4 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundUnprecedented lockdown measures have been introduced in countries worldwide to mitigate the spread and consequences of COVID-19. Although attention has been focused on the effects of these measures on epidemiological indicators relating directly to the infection, there is increased recognition of their broader health implications. However, assessing these implications in real time is a challenge, due to the limitations of existing syndromic surveillance data and tools.
objectiveThe aim of this study is to explore the added value of mobile phone app-based symptom assessment tools as real-time health insight providers to inform public health policy makers.
methodsA comparative and descriptive analysis of the proportion of all self-reported symptoms entered by users during an assessment within the Ada app in Germany and the United Kingdom was conducted between two periods, namely before and after the implementation of "Phase One" COVID-19 measures. Additional analyses were performed to explore the association between symptom trends and seasonality, and symptom trends and weather. Differences in the proportion of unique symptoms between the periods were analyzed using a Pearson chi-square test and reported as log2 fold changes.
resultsOverall, 48,300-54,900 symptomatic users reported 140,500-170,400 symptoms during the Baseline and Measures periods in Germany. Overall, 34,200-37,400 symptomatic users in the United Kingdom reported 112,100-131,900 symptoms during the Baseline and Measures periods. The majority of symptomatic users were female (Germany: 68,600/103,200, 66.52%; United Kingdom: 51,200/71,600, 72.74%). The majority were aged 10-29 years (Germany: 68,500/100,000, 68.45%; United Kingdom: 50,900/68,800, 73.91%), and about one-quarter were aged 30-59 years (Germany: 26,200/100,000, 26.15%; United Kingdom: 14,900/68,800, 21.65%). Overall, 103 symptoms were reported either more or less frequently (with statistically significant differences) during the Measures period as compared to the Baseline period, and 34 of these were reported in both countries. The following mental health symptoms (log2 fold change, P value) were reported less often during the Measures period: inability to manage constant stress and demands at work (-1.07, P<.001), memory difficulty (-0.56, P<.001), depressed mood (-0.42, P<.001), and impaired concentration (-0.46, P<.001). Diminished sense of taste (2.26, P<.001) and hyposmia (2.20, P<.001) were reported more frequently during the Measures period. None of the 34 symptoms were found to be different between the same dates in 2019. In total, 14 of the 34 symptoms had statistically significant associations with weather variables.
conclusionsSymptom assessment apps have an important role to play in facilitating improved understanding of the implications of public health policies such as COVID-19 lockdown measures. Not only do they provide the means to complement and cross-validate hypotheses based on data collected through more traditional channels, they can also generate novel insights through a real-time syndromic surveillance system.
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