Background The outbreak of COVID-19 has caused a continuing global pandemic. Hospitals are integral to the control and prevention of COVID-19; however, they are facing numerous challenges during the epidemic. Objective Our study aimed to introduce the practical experience of the design and implementation of a web-based COVID-19 service platform at a tertiary hospital in China as well as the preliminary results of the implementation. Methods The web-based COVID-19 service platform was deployed within the health care system of the Guangdong Second Provincial General Hospital and Internet Hospital; the function of the platform was to provide web-based medical services for both members of the public and lay health care workers. The focal functions of this system included automated COVID-19 screening, related symptom monitoring, web-based consultation, and psychological support; it also served as a COVID-19 knowledge hub. The design and process of each function are introduced. The usage data for the platform service were collected and are represented by three periods: the pre-epidemic period (December 22, 2019, to January 22, 2020, 32 days), the controlled period (January 23 to March 31, 2020, 69 days), and the postepidemic period (April 1 to June 30, 2020, 91 days). Results By the end of June 2020, 96,642 people had used the automated COVID-19 screening and symptom monitoring systems 161,884 and 7,795,194 times, respectively. The number of general web-based consultation services per day increased from 30 visits in the pre-epidemic period to 122 visits during the controlled period, then dropped to 73 visits in the postepidemic period. The psychological counseling program served 636 clients during the epidemic period. For people who used the automated COVID-19 screening service, 160,916 (99.40%) of the total users were classified in the no risk category. 464 (0.29%) of the people were categorized as medium to high risk, and 12 people (0.01%) were recommended for further COVID-19 testing and treatment. Among the 96,642 individuals who used the COVID-19 related symptoms monitoring service, 6696 (6.93%) were symptomatic at some point during the monitoring period. Fever was the most frequently reported symptom, with 2684/6696 symptomatic people (40.1%) having had this symptom. Cough and sore throat were also relatively frequently reported by the 6696 symptomatic users (1657 people, 24.7%, and 1622 people, 24.2%, respectively). Conclusions The web-based COVID-19 service platform implemented at a tertiary hospital in China is exhibited to be a role model for using digital health technologies to respond to the COVID-19 pandemic. The digital solutions of automated COVID-19 screening, daily symptom monitoring, web-based care, and knowledge propagation have plausible acceptability and feasibility for complementing offline hospital services and facilitating disease control and prevention.
ObjectivesHyperuricaemia has been reported to be significantly associated with risk of obesity. However, previous studies on the association between serum uric acid (SUA) and body mass index (BMI) yielded conflicting results. The present study examined the relationship between SUA and obesity among Chinese adults.MethodsData were collected at Guangdong Second Provincial General Hospital in Guangzhou City, China, between January 2010 and December 2018. Participants with ≥2 medical check-up times were included in our analyses. Physical examinations and laboratory measurement variables were obtained from the medical check-up system. The high SUA level group was classified as participants with hyperuricaemia, and obesity was defined as BMI ≥28 kg/m2. Logistic regression model was performed for data at baseline. For all participants, generalised estimation equation (GEE) model was used to assess the association between SUA and obesity, where the data were repeatedly measured over the 9-year study period. Subgroup analyses were performed by gender and age group. We calculated the cut-off values for SUA of obesity using the receiver operating characteristic curves (ROC) technique.ResultsA total of 15 959 participants (10 023 men and 5936 women) were included in this study, with an average age of 37.38 years (SD: 13.27) and average SUA of 367.05 μmol/L (SD: 97.97) at baseline, respectively. Finally, 1078 participants developed obesity over the 9-year period. The prevalence of obesity was approximately 14.2% for high SUA level. In logistic regression analysis at baseline, we observed a positive association between SUA and risk of obesity: OR=1.84 (95% CI: 1.77 to 1.90) for per-SD increase in SUA. Considering repeated measures over 9 year for all participants in the GEE model, the per-SD OR was 1.85 (95% CI: 1.77 to 1.91) for SUA and the increased risk of obesity were greater for men (OR=1.45) and elderly participants (OR=1.01). In subgroup analyses by gender and age, we observed significant associations between SUA and obesity with higher risk in women (OR=2.35) and young participants (OR=1.87) when compared with men (OR=1.70) and elderly participants (OR=1.48). The SUA cut-off points for risk of obesity using ROC curves were approximately consistent with the international standard.ConclusionsOur study observed higher SUA level was associated with increased risk of obesity. More high-quality research is needed to further support these findings.
With the rapid development of AI techniques, Computer-aided Diagnosis has attracted much attention and has been successfully deployed in many applications of health care and medical diagnosis. For some specific tasks, the learning-based system can compare with or even outperform human experts' performance. The impressive performance owes to the excellent expressiveness and scalability of the neural networks, although the models' intuition usually can not be represented explicitly. Interpretability is, however, very important, even the same as the diagnosis precision, for computer-aided diagnosis. To fill this gap, our approach is intuitive to detect pneumonia interpretably. We first build a large dataset of community-acquired pneumonia consisting of 35389 cases (distinguished from nosocomial pneumonia) based on actual medical records. Second, we train a prediction model with the chest X-ray images in our dataset, capable of precisely detecting pneumonia. Third, we propose an intuitive approach to combine neural networks with an explainable model such as the Bayesian Network. The experiment result shows that our proposal further improves the performance by using multi-source data and provides intuitive explanations for the diagnosis results.INDEX TERMS Pneumonia, Computer-aided diagnosis, medical image analysis, interpretive medicalassisted diagnosis, large-scale annotated X-ray image dataset.
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