Fig. 5: TWIST Trial definitions and processes.

a The intervention schemata which demonstrates the process of the digital health intervention. This outlines how the clinical team was alerted whenever a patient response was submitted (whether patient-initiated or a routine request on days 3, 7, of 15), and the communication to patients when a clinical decision on the risk of surgical-site infection was made. This also depicts the criteria for assessing secondary outcomes in the smartphone arm: b how adherence to routine requests for completion of smartphone tool was determined, and c how diagnostic accuracy of clinical assessments of responses submitted using the smartphone tool was determined.