Assessment of COVID-19 data reporting in 100+ websites and apps in India

India is among the top three countries in the world both in COVID-19 case and death counts. With the pandemic far from over, timely, transparent, and accessible reporting of COVID-19 data continues to be critical for India's pandemic efforts. We systematically analyze the quality of reporting of COVID-19 data in over one hundred government platforms (web and mobile) from India. Our analyses reveal a lack of granular data in the reporting of COVID-19 surveillance, vaccination, and vacant bed availability. As of 5 June 2021, age and gender distribution are available for less than 22% of cases and deaths, and comorbidity distribution is available for less than 30% of deaths. Amid rising concerns of undercounting cases and deaths in India, our results highlight a patchy reporting of granular data even among the reported cases and deaths. Furthermore, total vaccination stratified by healthcare workers, frontline workers, and age brackets is reported by only 14 out of India's 36 subnationals (states and union territories). There is no reporting of adverse events following immunization by vaccine and event type. By showing what, where, and how much data is missing, we highlight the need for a more responsible and transparent reporting of granular COVID-19 data in India.

Development and Clinical Evaluation of an Artificial Intelligence Support Tool for Improving Telemedicine Photo Quality.

Importance: Telemedicine use accelerated during the COVID-19 pandemic, and skin conditions were a common use case. However, many images submitted may be of insufficient quality for making a clinical determination. Objective: To determine whether an artificial intelligence (AI) decision support tool, a machine learning algorithm, could improve the quality of images submitted for telemedicine by providing real-time feedback and explanations to patients. Design, Setting, and Participants: This quality improvement study with an AI performance component and single-arm clinical pilot study component was conducted from March 2020 to October 2021. After training, the AI decision support tool was tested on 357 retrospectively collected telemedicine images from Stanford telemedicine from March 2020 to June 2021. Subsequently, a single-arm clinical pilot study was conducted to assess feasibility with 98 patients in the Stanford Department of Dermatology across 2 clinical sites from July 2021 to October 2021. For the clinical pilot study, inclusion criteria for patients included being adults (aged ≥18 years), presenting to clinic for a skin condition, and being able to photograph their own skin with a smartphone. Interventions: During the clinical pilot study, patients were given a handheld smartphone device with a machine learning algorithm interface loaded and were asked to take images of any lesions of concern. Patients were able to review and retake photos prior to submitting, so each submitted photo met the patient's assumed standard of clinical acceptability. A machine learning algorithm then gave the patient feedback on whether the image was acceptable. If the image was rejected, the patient was provided a reason by the AI decision support tool and allowed to retake the photos. Main Outcomes and Measures: The main outcome of the retrospective image analysis was the receiver operator curve area under the curve (ROC-AUC). The main outcome of the clinical pilot study was the image quality difference between the baseline images and the images approved by AI decision support. Results: Of the 98 patients included, the mean (SD) age was 49.8 (17.6) years, and 50 (51%) of the patients were male. On retrospective telemedicine images, the machine learning algorithm effectively identified poor-quality images (ROC-AUC of 0.78) and the reason for poor quality (blurry ROC-AUC of 0.84; lighting issues ROC-AUC of 0.70). The performance was consistent across age and sex. In the clinical pilot study, patient use of the machine learning algorithm was associated with improved image quality. An AI algorithm was associated with reduction in the number of patients with a poor-quality image by 68.0%. Conclusions and Relevance: In this quality improvement study, patients use of the AI decision support with a machine learning algorithm was associated with improved quality of skin disease photographs submitted for telemedicine use.

Assessment of COVID-19 data reporting in 100+ websites and apps in India.

India is among the top three countries in the world both in COVID-19 case and death counts. With the pandemic far from over, timely, transparent, and accessible reporting of COVID-19 data continues to be critical for India's pandemic efforts. We systematically analyze the quality of reporting of COVID-19 data in over one hundred government platforms (web and mobile) from India. Our analyses reveal a lack of granular data in the reporting of COVID-19 surveillance, vaccination, and vacant bed availability. As of 5 June 2021, age and gender distribution are available for less than 22% of cases and deaths, and comorbidity distribution is available for less than 30% of deaths. Amid rising concerns of undercounting cases and deaths in India, our results highlight a patchy reporting of granular data even among the reported cases and deaths. Furthermore, total vaccination stratified by healthcare workers, frontline workers, and age brackets is reported by only 14 out of India's 36 subnationals (states and union territories). There is no reporting of adverse events following immunization by vaccine and event type. By showing what, where, and how much data is missing, we highlight the need for a more responsible and transparent reporting of granular COVID-19 data in India.

AI reflections in 2021

For a third year in a row, we followed up with authors of several recent Comments and Perspectives in Nature Machine Intelligence about what happened after their article was published: how did the topic they wrote about develop, did they gain new insights, and what are their hopes and expectations for AI in 2022?

Disparity in the quality of COVID-19 data reporting across India.

BACKGROUND: Transparent and accessible reporting of COVID-19 data is critical for public health efforts. Each Indian state has its own mechanism for reporting COVID-19 data, and the quality of their reporting has not been systematically evaluated. We present a comprehensive assessment of the quality of COVID-19 data reporting done by the Indian state governments between 19 May and 1 June, 2020. METHODS: We designed a semi-quantitative framework with 45 indicators to assess the quality of COVID-19 data reporting. The framework captures four key aspects of public health data reporting - availability, accessibility, granularity, and privacy. We used this framework to calculate a COVID-19 Data Reporting Score (CDRS, ranging from 0-1) for each state. RESULTS: Our results indicate a large disparity in the quality of COVID-19 data reporting across India. CDRS varies from 0.61 (good) in Karnataka to 0.0 (poor) in Bihar and Uttar Pradesh, with a median value of 0.26. Ten states do not report data stratified by age, gender, comorbidities or districts. Only ten states provide trend graphics for COVID-19 data. In addition, we identify that Punjab and Chandigarh compromised the privacy of individuals under quarantine by publicly releasing their personally identifiable information. The CDRS is positively associated with the state's sustainable development index for good health and well-being (Pearson correlation: r=0.630,p=0.0003). CONCLUSIONS: Our assessment informs the public health efforts in India and serves as a guideline for pandemic data reporting. The disparity in CDRS highlights three important findings at the national, state, and individual level. At the national level, it shows the lack of a unified framework for reporting COVID-19 data in India, and highlights the need for a central agency to monitor or audit the quality of data reporting done by the states. Without a unified framework, it is difficult to aggregate the data from different states, gain insights, and coordinate an effective nationwide response to the pandemic. Moreover, it reflects the inadequacy in coordination or sharing of resources among the states. The disparate reporting score also reflects inequality in individual access to public health information and privacy protection based on the state of residence.

Variation in COVID-19 Data Reporting Across India: 6 Months into the Pandemic.

India reported its first case of COVID-19 on January 30, 2020. Six months since then, COVID-19 continues to be a growing crisis in India with over 1.6 million reported cases. In this communication, we assess the quality of COVID-19 data reporting done by the state and union territory governments in India between July 12 and July 25, 2020. We compare our findings with those from an earlier assessment conducted in May 2020. We conclude that 6 months into the pandemic, the quality of COVID-19 data reporting across India continues to be highly disparate, which could hinder public health efforts.

TrueImage: A Machine Learning Algorithm to Improve the Quality of Telehealth Photos.

Telehealth is an increasingly critical component of the health care ecosystem, especially due to the COVID-19 pandemic. Rapid adoption of telehealth has exposed limitations in the existing infrastructure. In this paper, we study and highlight photo quality as a major challenge in the telehealth workflow. We focus on teledermatology, where photo quality is particularly important; the framework proposed here can be generalized to other health domains. For telemedicine, dermatologists request that patients submit images of their lesions for assessment. However, these images are often of insufficient quality to make a clinical diagnosis since patients do not have experience taking clinical photos. A clinician has to manually triage poor quality images and request new images to be submitted, leading to wasted time for both the clinician and the patient. We propose an automated image assessment machine learning pipeline, TrueImage, to detect poor quality dermatology photos and to guide patients in taking better photos. Our experiments indicate that TrueImage can reject ~50% of the sub-par quality images, while retaining ~80% of good quality images patients send in, despite heterogeneity and limitations in the training data. These promising results suggest that our solution is feasible and can improve the quality of teledermatology care.

RNA-GPS Predicts SARS-CoV-2 RNA Residency to Host Mitochondria and Nucleolus.

SARS-CoV-2 genomic and subgenomic RNA (sgRNA) transcripts hijack the host cell's machinery. Subcellular localization of its viral RNA could, thus, play important roles in viral replication and host antiviral immune response. We perform computational modeling of SARS-CoV-2 viral RNA subcellular residency across eight subcellular neighborhoods. We compare hundreds of SARS-CoV-2 genomes with the human transcriptome and other coronaviruses. We predict the SARS-CoV-2 RNA genome and sgRNAs to be enriched toward the host mitochondrial matrix and nucleolus, and that the 5' and 3' viral untranslated regions contain the strongest, most distinct localization signals. We interpret the mitochondrial residency signal as an indicator of intracellular RNA trafficking with respect to double-membrane vesicles, a critical stage in the coronavirus life cycle. Our computational analysis serves as a hypothesis generation tool to suggest models for SARS-CoV-2 biology and inform experimental efforts to combat the virus. A record of this paper's Transparent Peer Review process is included in the Supplemental Information.