Background Effective contact tracing is labor intensive and time sensitive during the COVID-19 pandemic, but also essential in the absence of effective treatment and vaccines. Singapore launched the first Bluetooth-based contact tracing app—TraceTogether—in March 2020 to augment Singapore’s contact tracing capabilities. Objective This study aims to compare the performance of the contact tracing app—TraceTogether—with that of a wearable tag-based real-time locating system (RTLS) and to validate them against the electronic medical records at the National Centre for Infectious Diseases (NCID), the national referral center for COVID-19 screening. Methods All patients and physicians in the NCID screening center were issued RTLS tags (CADI Scientific) for contact tracing. In total, 18 physicians were deployed to the NCID screening center from May 10 to May 20, 2020. The physicians activated the TraceTogether app (version 1.6; GovTech) on their smartphones during shifts and urged their patients to use the app. We compared patient contacts identified by TraceTogether and those identified by RTLS tags within the NCID vicinity during physicians’ 10-day posting. We also validated both digital contact tracing tools by verifying the physician-patient contacts with the electronic medical records of 156 patients who attended the NCID screening center over a 24-hour time frame within the study period. Results RTLS tags had a high sensitivity of 95.3% for detecting patient contacts identified either by the system or TraceTogether while TraceTogether had an overall sensitivity of 6.5% and performed significantly better on Android phones than iPhones (Android: 9.7%, iPhone: 2.7%; P<.001). When validated against the electronic medical records, RTLS tags had a sensitivity of 96.9% and specificity of 83.1%, while TraceTogether only detected 2 patient contacts with physicians who did not attend to them. Conclusions TraceTogether had a much lower sensitivity than RTLS tags for identifying patient contacts in a clinical setting. Although the tag-based RTLS performed well for contact tracing in a clinical setting, its implementation in the community would be more challenging than TraceTogether. Given the uncertainty of the adoption and capabilities of contact tracing apps, policy makers should be cautioned against overreliance on such apps for contact tracing. Nonetheless, leveraging technology to augment conventional manual contact tracing is a necessary move for returning some normalcy to life during the long haul of the COVID-19 pandemic.
Laparoscopic radical nephrectomy is a safe and efficacious treatment option for clinically localized renal cell carcinoma. The intermediate-term oncological outcome appears favourable.
BACKGROUND Effective contact tracing is labor- and time-intensive during the coronavirus disease 2019 (COVID-19) pandemic, but essential in the absence of effective treatment and vaccines. Singapore launched the first Bluetooth-based contact tracing app— “TraceTogether” in March 2020 to augment its contact tracing capabilities. OBJECTIVE This study aimed to compare the performance of the contact tracing app—“TraceTogether” with a wearable tag-based Real-Time Locating System and validate them against the Electronic Medical Records at the National Center for Infectious Disease (NCID), the national referral center for COVID-19 screening. METHODS All patients and physicians in NCID’s screening center were issued with RTLS tags for contact tracing. Eighteen physicians deployed to NCID’s screening center from May 10–19, 2020 activated the “TraceTogether” app on their smartphones during shifts and urged patients to whom they medically attended to use the app. We compared patient contacts identified by “TraceTogether” and tag-based RTLS within NCID’s vicinity during the physicians’ 10-day posting. We further validated both digital contact tracing tools by verifying the physician-patient contacts with the EMR of 156 patients who attended at NCID’s screening center over a 24-hr time frame within the study period. RESULTS RTLS had a high sensitivity of 95.3% in detecting all patient contacts identified either by the system or “TraceTogether” while “TraceTogether” had an overall sensitivity of 6.5%, performing significantly better on Android phones (Android: 9.7%, iPhone: 2.7%, P<.001). When validated against the EMR, RTLS tags had a sensitivity of 96.9% and specificity of 83.1% while “TraceTogether” detected only two patient contacts with physicians who did not attend to them. CONCLUSIONS “TraceTogether” had a much lower sensitivity compared with tag-based RTLS in identifying patient contacts in a clinical setting. Although tag-based RTLS tags performed well for contact tracing in the clinical setting, implementation and technology enforcement would be challenging in the community compared with “TraceTogether”. Given the uncertainty on the adoption and capabilities contact tracing apps, policy makers should be cautioned against the over-reliance on an app for contact tracing. Nonetheless, leveraging on technology to augment conventional manual contact tracing was a necessary move for life to return to some normalcy over the long haul of COVID-19.
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