Chronodes: Interactive Multifocus Exploration of Event Sequences

mHealth Technology Experiences of Middle-Aged and Older Individuals With Visual Impairments: Cross-Sectional Interview Study

BACKGROUND

Current mobile health (mHealth) technology is predominantly designed with a visual orientation, often resulting in user interfaces that are inaccessible to visually impaired users. While mHealth technology offers potential for facilitating chronic illness management and enhancing health behaviors among visually impaired older populations, understanding its usage remains limited.

OBJECTIVE

This qualitative research aimed to explore the mHealth technology experiences of middle-aged and older individuals with visual impairments including the accessibility and usability issues they faced.

METHODS

The qualitative exploration was structured using the mHealth for Older Users framework. Cross-sectional interviews were conducted via Zoom between June 1 and July 31, 2023, using an interview protocol for data collection. A thematic analysis approach was employed to analyze the transcribed interview scripts.

RESULTS

Of the 7 participants who took part in the Zoom interviews, 3 were men and 4 were women, with ages ranging from 53 to 70 years. Most participants adopted mHealth apps and wearable devices for promoting health. They exhibited 3 distinct adoption patterns. Seven themes were emerged from the perceived challenges in using mHealth technologies: (1) a scarcity of accessible user manuals, (2) user interfaces that are not visually impaired-friendly, (3) health data visualizations that are not accessible, (4) unintuitive arrangement of app content, (5) health information that is challenging to comprehend, (6) cognitive overload caused by an excess of audible information, and (7) skepticism regarding the accuracy of health records. mHealth technologies seem to positively affect the health and health management of participants.

CONCLUSIONS

Design considerations for mHealth technologies should consider individuals' disabilities and chronic conditions and should emphasize the importance of providing accessible manuals and training opportunities when introducing new mHealth solutions.

Survey on Visual Analysis of Event Sequence Data

Event sequence data record series of discrete events in the time order of occurrence. They are commonly observed in a variety of applications ranging from electronic health records to network logs, with the characteristics of large-scale, high-dimensional and heterogeneous. This high complexity of event sequence data makes it difficult for analysts to manually explore and find patterns, resulting in ever-increasing needs for computational and perceptual aids from visual analytics techniques to extract and communicate insights from event sequence datasets. In this paper, we review the state-of-the-art visual analytics approaches, characterize them with our proposed design space, and categorize them based on analytical tasks and applications. From our review of relevant literature, we have also identified several remaining research challenges and future research opportunities.

Visualization Techniques of Time-Oriented Data for the Comparison of Single Patients With Multiple Patients or Cohorts: Scoping Review

BACKGROUND

Visual analysis and data delivery in the form of visualizations are of great importance in health care, as such forms of presentation can reduce errors and improve care and can also help provide new insights into long-term disease progression. Information visualization and visual analytics also address the complexity of long-term, time-oriented patient data by reducing inherent complexity and facilitating a focus on underlying and hidden patterns.

OBJECTIVE

This review aims to provide an overview of visualization techniques for time-oriented data in health care, supporting the comparison of patients. We systematically collected literature and report on the visualization techniques supporting the comparison of time-based data sets of single patients with those of multiple patients or their cohorts and summarized the use of these techniques.

METHODS

This scoping review used the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist. After all collected articles were screened by 16 reviewers according to the criteria, 6 reviewers extracted the set of variables under investigation. The characteristics of these variables were based on existing taxonomies or identified through open coding.

RESULTS

Of the 249 screened articles, we identified 22 (8.8%) that fit all criteria and reviewed them in depth. We collected and synthesized findings from these articles for medical aspects such as medical context, medical objective, and medical data type, as well as for the core investigated aspects of visualization techniques, interaction techniques, and supported tasks. The extracted articles were published between 2003 and 2019 and were mostly situated in clinical research. These systems used a wide range of visualization techniques, most frequently showing changes over time. Timelines and temporal line charts occurred 8 times each, followed by histograms with 7 occurrences and scatterplots with 5 occurrences. We report on the findings quantitatively through visual summarization, as well as qualitatively.

CONCLUSIONS

The articles under review in general mitigated complexity through visualization and supported diverse medical objectives. We identified 3 distinct patient entities: single patients, multiple patients, and cohorts. Cohorts were typically visualized in condensed form, either through prior data aggregation or through visual summarization, whereas visualization of individual patients often contained finer details. All the systems provided mechanisms for viewing and comparing patient data. However, explicitly comparing a single patient with multiple patients or a cohort was supported only by a few systems. These systems mainly use basic visualization techniques, with some using novel visualizations tailored to a specific task. Overall, we found the visual comparison of measurements between single and multiple patients or cohorts to be underdeveloped, and we argue for further research in a systematic review, as well as the usefulness of a design space.

DPVis: Visual Analytics With Hidden Markov Models for Disease Progression Pathways

Clinical researchers use disease progression models to understand patient status and characterize progression patterns from longitudinal health records. One approach for disease progression modeling is to describe patient status using a small number of states that represent distinctive distributions over a set of observed measures. Hidden Markov models (HMMs) and its variants are a class of models that both discover these states and make inferences of health states for patients. Despite the advantages of using the algorithms for discovering interesting patterns, it still remains challenging for medical experts to interpret model outputs, understand complex modeling parameters, and clinically make sense of the patterns. To tackle these problems, we conducted a design study with clinical scientists, statisticians, and visualization experts, with the goal to investigate disease progression pathways of chronic diseases, namely type 1 diabetes (T1D), Huntington's disease, Parkinson's disease, and chronic obstructive pulmonary disease (COPD). As a result, we introduce DPVis which seamlessly integrates model parameters and outcomes of HMMs into interpretable and interactive visualizations. In this article, we demonstrate that DPVis is successful in evaluating disease progression models, visually summarizing disease states, interactively exploring disease progression patterns, and building, analyzing, and comparing clinically relevant patient subgroups.

Understanding User Behaviour through Action Sequences: From the Usual to the Unusual

Action sequences, where atomic user actions are represented in a labelled, timestamped form, are becoming a fundamental data asset in the inspection and monitoring of user behaviour in digital systems. Although the analysis of such sequences is highly critical to the investigation of activities in cyber security applications, existing solutions fail to provide a comprehensive understanding due to the complex semantic and temporal characteristics of these data. This paper presents a visual analytics approach that aims to facilitate a user-involved, multi-faceted decision making process during the identification and the investigation of "unusual" action sequences. We first report the results of the task analysis and domain characterisation process. Then we describe the components of our multi-level analysis approach that comprises of constraint-based sequential pattern mining and semantic distance based clustering, and multi-scalar visualisations of users and their sequences. Finally, we demonstrate the applicability of our approach through a case study that involves tasks requiring effective decision-making by a group of domain experts. Although our solution here is tightly informed by a user-centred, domain-focused design process, we present findings and techniques that are transferable to other applications where the analysis of such sequences is of interest.

Automated sensing of daily activity: A new lens into development

Rapidly maturing technologies for sensing and activity recognition can provide unprecedented access to the complex structure daily activity and interaction, promising new insight into the mechanisms by which experience shapes developmental outcomes. Motion data, autonomic activity, and "snippets" of audio and video recordings can be conveniently logged by wearable sensors (Lazer et al., 2009). Machine learning algorithms can process these signals into meaningful markers, from child and parent behavior to outcomes such as depression or teenage drinking. Theoretically motivated aspects of daily activity can be combined and synchronized to examine reciprocal effects between children's behaviors and their environments or internal processes. Captured over longitudinal time, such data provide a new opportunity to study the processes by which individual differences emerge and stabilize. This paper introduces the reader to developments in sensing and activity recognition with implications for developmental phenomena across the lifespan, sketching a framework for leveraging mobile sensors for transactional analyses that bridge micro- and longitudinal- timescales of development. It finishes by detailing resources and best practices to facilitate the next generation of developmentalists to contribute to this emerging area.

Exploratory Visual Sequence Mining Based on Pattern-Growth

Sequential pattern mining finds applications in numerous diverging fields. Due to the problem's combinatorial nature, two main challenges arise. First, existing algorithms output large numbers of patterns many of which are uninteresting from a user's perspective. Second, as datasets grow, mining large number of patterns gets computationally expensive. There is, thus, a need for mining approaches that make it possible to focus the pattern search towards directions of interest. This work tackles this problem by combining interactive visualization with sequential pattern mining in order to create a "transparent box" execution model. We propose a novel approach to interactive visual sequence mining that allows the user to guide the execution of a pattern-growth algorithm at suitable points through a powerful visual interface. Our approach (1) introduces the possibility of using local constraints during the mining process, (2) allows stepwise visualization of patterns being mined, and (3) enables the user to steer the mining algorithm towards directions of interest. The use of local constraints significantly improves users' capability to progressively refine the search space without the need to restart computations. We exemplify our approach using two event sequence datasets; one composed of web page visits and another composed of individuals' activity sequences.