About

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Purpose and primary audience

This application aims to support general practitioners and primary care teams to assess and triage patients presenting with potential COVID-19. It provides access to key findings from the evidence review by SIGN and researchers in primary care in the University of Glasgow on the identification of symptoms, characteristics, comorbidities and clinical signs which may indicate a higher risk of progression to severe disease. 

The application is available as a website and as downloadable mobile applications, via the following links: 

This software is an informational and educational resource. It is not a medical device as defined by the Medical Devices Directive. 

Why was this app developed

Since the outbreak of coronavirus, there has been an abundance of rapid and systematic reviews published on the diagnosis and management of people with symptoms of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), known as COVID-19, mostly from a secondary care (hospital) perspective. Most people with COVID-19 have symptoms that have been described as mild (no pneumonia manifestations/hospitalisation) or asymptomatic. Others develop severe disease (defined as requiring admission to hospital and most severe requiring admission to an intensive care unit. Antivirals or neutralising monoclonal antibodies (nMABs) are now available as a treatment option in primary care for non-hospitalised adults with COVID-19 who are at high risk of severe illness. Further guidance on eligibility and use of antivirals and neutralising monoclonal antibodies is available here.

The challenge for primary care practitioners is to identify, risk assess, triage and offer treatment to patients presenting with potential COVID-19, a disease in which the pattern and duration of symptoms is heterogeneous. 

SIGN and primary care researchers conducted a search for new evidence on prognostic indicators, risk factors and clinical measures to identify people self managing symptoms of COVID-19 in the community whose symptoms may change or worsen, and therefore may require monitoring or clinical intervention after their initial presentation to primary care.

Information on the possible impact of specific pharmacological therapies on COVID-19 outcomes was not included, as this is complex and varies by drug class. However, some therapies, in particular immunosuppressive therapies, may pose a greater risk of adverse outcomes with COVID-19.

The research questions and methodology can be found in section 9 of the evidence review

Organisations involved in this app/website

SIGN (Scottish Intercollegiate Guidelines Network)SIGN was formed in 1993. Its objective is to improve the quality of health care for patients in Scotland by reducing variation in practice and outcome, through the development and dissemination of national clinical guidelines containing recommendations for effective practice based on current evidence. 

The membership of SIGN includes all the medical specialties, nursing, pharmacy, dentistry, professions allied to medicine, patients, health service managers, social services, and researchers. The work of SIGN is supported by an Executive. 

SIGN is part of the Evidence Directorate of Healthcare Improvement Scotland and core funding from Healthcare Improvement Scotland supports the SIGN Executive, and expenses and costs associated with guideline development projects. SIGN is editorially independent from Healthcare Improvement Scotland and the Scottish Government which ultimately funds Healthcare Improvement Scotland.  

The Institute of Health and Wellbeing at the University of Glasgow partnered with SIGN to author the Evidence Review: Assessment of COVID-19 in Primary Care.   

Digital Health and Care Institute (DHI)The Digital Health and Care Institute is a health and care innovation centre based in the University of Strathclyde. It is  funded jointly by Scottish Government Digital Health and Care and the Scottish Funding Council. DHI plays a pivotal role in inspiring, enabling and combining industry and academic expertise with service, business and technical innovation to create person-centred digital health and care innovations. DHI focuses on shifting the balance of care from a traditional treatment model, through the development of digital health and care innovations that focus on prevention, early detection, post event care and independent assisted living.  

DHI leads and manages the national Decision Support Programme on behalf of Scottish Government, as a core objective within Scotland’s Digital Health and Care StrategyThe app and website have been built using the Right Decision Service tools which DHI has developed as a key deliverable for the national programme. 

NHS Greater Glasgow and Clyde Library Network:  The NHSGGC Library Network provides library and information services to all staff working within NHSGGC and its partner organisations. 

As part of the National Decision Support Programme, NHS GGC Knowledge Services provide knowledge management expertise to support use of Right Decision Service tools. 

Tactuum Ltd –Tactuum is a software company based in Glasgow, with an office in the US. Tactuum’s mission is to improve healthcare services through the delivery of digital services supporting healthcare providers and patients. Tactuum provides  the technology and digital expertise to deliver Right Decision Service tools for the National Decision Support Programme. 

Disclaimer

We (Healthcare Improvement Scotland) hope that the information in this app/website will be useful to you, but we accept no responsibility and offer no warranties for the content or your use of it, as far as the law allows us to exclude such liability. 

Clinical knowledge is constantly changing. As new information become available, changes in treatment, procedures, equipment and the use of drugs become necessary. The developers and contributors have taken care to ensure that the information given is correct and current. However, users of this resource are strongly advised to confirm that the information complies with the latest legislation and standards of practice. 

All use of this resource is subject to Scots law and the jurisdiction of the Scottish courts and is subject to this disclaimer. Any views given on the site are not necessarily those of Healthcare Improvement Scotland or anyone connected with us. 

Healthcare Improvement Scotland is not responsible for the content of external websites which link to or are linked to by this application. This is because: 

  • Healthcare Improvement Scotland does not produce or maintain them 
  • Healthcare Improvement Scotland cannot change them, and 
  • they can be changed without Healthcare Improvement Scotland knowledge or permission. 

Some external links may be to websites that also offer commercial services. If a link to a particular website is included on our site, it does not mean that Healthcare Improvement Scotland officially endorses that website, its owners, products or services. 

 

Copyright

Copyright information for the content within this app/website is shown below.

Scottish Intercollegiate Guidelines Network (SIGN) and University of Glasgow. Evidence review: assessment of COVID-19 in primary care. Edinburgh: SIGN; 2022. (SIGN publication no. 162) 

Copyright of this evidence review is retained by SIGN. Users may download or print copies for their own use and may photocopy guidelines for the purpose of implementation.  

The review is licensed under the Creative Commons Attribution-Noncommercial-NoDerivatives 4.0 International Licence. This allows for the copy and redistribution of SIGN guidelines as long as SIGN is fully acknowledged and given credit. The material must not be remixed, transformed or built upon in any way. To view a copy of this licence, visit https://creativecommons.org/licenses/by-nc-nd/4.0/  

Scottish Intercollegiate Guidelines Network (SIGN) and the University of Glasgow. Guideline title. Edinburgh: SIGN; Year.  (SIGN publication no. xxx). [cited dd mmm yyyy]. Available from URL: http://www.sign.ac.uk  

Users wishing to use reproduce or republish SIGN material for commercial purposes must seek prior approval for reproduction in any medium by completing the  form at https://www.sign.ac.uk/media/1392/sign-copyright-request.pdf. Applicants for such permission should be aware that:  

  • SIGN resources do not endorse specific products.  
  • Reproduction of SIGN material must be verbatim.  
  • Within marketing material there must be a clear separation between any SIGN material and product specific information or marketing.  
  • SIGN does not endorse in any way derivative or excerpted materials based on these guidelines, and it cannot be held liable for the content or use of any such adapted products.  
  • The use of the SIGN name or logo for the purposes of advertising or implied endorsement of any derived product or service is strictly forbidden. 

Updating

The SIGN/University of Glasgow evidence review was first published in May 2020, and updated in July 2020, and February 2021. This version is based on the update published on 28 March 2022.

The review and the app will be updated if new evidence emerges which changes the current conclusions.

Technical maintenance and updating of the app is carried out by Tactuum Ltd and funded through the national decision support programme led by the Digital Health and Care Institute.   

Accessibility

The app is compliant with:

  • Android and Apple accessibility standards for native mobile apps
  • From September 2020, the website will be compliant with WC3A 2.0 Standards

Browser and operating system compatibility

  • The app is supported by Android 4.4 or later and iOS 8.0 or later devices.
  • The website is optimised for use on both desktop and mobile devices in the following browsers - IE9+, Chrome, Edge and Safari.

Last reviewed: 08 December 2020

Next review: 20 January 2022

Version: 5