1
|
Li H, Li T, Fan Y, Zheng B, Zhao Y. A survey on the willingness of outpatients to participate in fundus examination procedures conducted by ophthalmology training residents in China: A cross-sectional study. Health Sci Rep 2024; 7:e1870. [PMID: 38357492 PMCID: PMC10864684 DOI: 10.1002/hsr2.1870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 01/09/2024] [Accepted: 01/17/2024] [Indexed: 02/16/2024] Open
Abstract
Background and Aims The National Standardized Training for Resident Doctors (STRD) in mainland China encounters many challenges in its implementation. To investigate whether outpatients are willing to undergo indirect ophthalmoscopy examination conducted by ophthalmology residents in the ophthalmology STRD program in China. Methods This study conducted a cross-sectional survey at the Eye Hospital of Wenzhou Medical University between September 2021 and September 2023. A cohort of 300 initial outpatients requiring indirect ophthalmoscopy examinations were enlisted from the outpatient department. Based on whether the patients are willing to undergo an indirect ophthalmoscopy examination by resident doctors, patients were divided into two groups: Group 1 (willing) and Group 2 (unwilling), and their questionnaire responses were comparatively analyzed. Results A total of 261/300 (87%) valid questionnaires were returned in the survey, which included 149 males and 112 females. No notable gender difference (p = 0.400) or disparity in medical expense categories (p = 0.786) was observed between the two groups. However, variables such as outpatient marital status (p = 0.002), the presence of training faculty during fundus examinations with residents and outpatients (p < 0.001), the demeanor of training residents toward patients (p < 0.001), and the quality of doctor-patient communication (p < 0.001) significantly varied between the groups. Conclusion The level of outpatients' cooperation with ophthalmology residents during fundus examinations in the Chinese ophthalmology STRD program was observed to be low. Enhancing the presence of training faculty during examinations and enhancing the communication skills of training residents could significantly improve this situation.
Collapse
Affiliation(s)
- Haidong Li
- National Clinical Research Center for Ocular Diseases, Eye HospitalWenzhou Medical UniversityWenzhouChina
| | - Tiankun Li
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, School of MedicineNankai UniversityTianjinChina
| | - Yuanyuan Fan
- National Clinical Research Center for Ocular Diseases, Eye HospitalWenzhou Medical UniversityWenzhouChina
| | - Bin Zheng
- National Clinical Research Center for Ocular Diseases, Eye HospitalWenzhou Medical UniversityWenzhouChina
| | - Yun‐e Zhao
- National Clinical Research Center for Ocular Diseases, Eye HospitalWenzhou Medical UniversityWenzhouChina
| |
Collapse
|
2
|
Vahia IV, Sava RN, Cray HV, Kim HJ, Dickinson RA, Ressler KJ, Trueba AF. Digital Collateral Information Through Electronic and Social Media in Psychotherapy: Comparing Clinician-reported Trends Before and During the COVID-19 Pandemic. J Psychiatr Pract 2023; 29:367-372. [PMID: 37678366 PMCID: PMC10798232 DOI: 10.1097/pra.0000000000000727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
BACKGROUND Patient clinical collateral information is critical for providing psychiatric and psychotherapeutic care. With the shift to primarily virtual care triggered by the COVID-19 pandemic, psychotherapists may have received less clinical information than they did when they were providing in-person care. This study assesses whether the shift to virtual care had an impact on therapists' use of patients' electronic and social media to augment clinical information that may inform psychotherapy. METHODS In 2018, we conducted a survey of a cohort of psychotherapists affiliated with McLean Hospital. We then reapproached the same cohort of providers for the current study, gathering survey responses from August 10, 2020, to September 1, 2020, for this analysis. We asked clinicians whether they viewed patients' electronic and social media in the context of their psychotherapeutic relationship, what they viewed, how much they viewed it, and their attitudes about doing so. RESULTS Of the 99 respondents, 64 (64.6%) had viewed at least 1 patient's social media and 8 (8.1%) had viewed a patient's electronic media. Of those who reported viewing patients' media, 70 (97.2%) indicated they believed this information helped them provide more effective treatment. Compared with the 2018 prepandemic data, there were significantly more clinicians with>10 years of experience reporting media use in therapy. There was also a significant increase during the pandemic in the viewing of media of adult patients and a trend toward an increase in viewing of media of older adult patients. CONCLUSIONS Review of patients' electronic and social media in therapy became more common among clinicians at a large psychiatric teaching hospital during the COVID-19 pandemic. These findings support continuing research about how reviewing patients' media can inform and improve clinical care.
Collapse
|
3
|
Wyant K, Moshontz H, Ward SB, Fronk GE, Curtin JJ. Acceptability of Personal Sensing Among People With Alcohol Use Disorder: Observational Study. JMIR Mhealth Uhealth 2023; 11:e41833. [PMID: 37639300 PMCID: PMC10495858 DOI: 10.2196/41833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 03/14/2023] [Accepted: 07/25/2023] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND Personal sensing may improve digital therapeutics for mental health care by facilitating early screening, symptom monitoring, risk prediction, and personalized adaptive interventions. However, further development and the use of personal sensing requires a better understanding of its acceptability to people targeted for these applications. OBJECTIVE We aimed to assess the acceptability of active and passive personal sensing methods in a sample of people with moderate to severe alcohol use disorder using both behavioral and self-report measures. This sample was recruited as part of a larger grant-funded project to develop a machine learning algorithm to predict lapses. METHODS Participants (N=154; n=77, 50% female; mean age 41, SD 11.9 years; n=134, 87% White and n=150, 97% non-Hispanic) in early recovery (1-8 weeks of abstinence) were recruited to participate in a 3-month longitudinal study. Participants were modestly compensated for engaging with active (eg, ecological momentary assessment [EMA], audio check-in, and sleep quality) and passive (eg, geolocation, cellular communication logs, and SMS text message content) sensing methods that were selected to tap into constructs from the Relapse Prevention model by Marlatt. We assessed 3 behavioral indicators of acceptability: participants' choices about their participation in the study at various stages in the procedure, their choice to opt in to provide data for each sensing method, and their adherence to a subset of the active methods (EMA and audio check-in). We also assessed 3 self-report measures of acceptability (interference, dislike, and willingness to use for 1 year) for each method. RESULTS Of the 192 eligible individuals screened, 191 consented to personal sensing. Most of these individuals (169/191, 88.5%) also returned 1 week later to formally enroll, and 154 participated through the first month follow-up visit. All participants in our analysis sample opted in to provide data for EMA, sleep quality, geolocation, and cellular communication logs. Out of 154 participants, 1 (0.6%) did not provide SMS text message content and 3 (1.9%) did not provide any audio check-ins. The average adherence rate for the 4 times daily EMA was .80. The adherence rate for the daily audio check-in was .54. Aggregate participant ratings indicated that all personal sensing methods were significantly more acceptable (all P<.001) compared with neutral across subjective measures of interference, dislike, and willingness to use for 1 year. Participants did not significantly differ in their dislike of active methods compared with passive methods (P=.23). However, participants reported a higher willingness to use passive (vs active) methods for 1 year (P=.04). CONCLUSIONS These results suggest that active and passive sensing methods are acceptable for people with alcohol use disorder over a longer period than has previously been assessed. Important individual differences were observed across people and methods, indicating opportunities for future improvement.
Collapse
Affiliation(s)
- Kendra Wyant
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, United States
| | - Hannah Moshontz
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, United States
| | - Stephanie B Ward
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, United States
| | - Gaylen E Fronk
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, United States
| | - John J Curtin
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, United States
| |
Collapse
|
4
|
Nguyen VC, Lu N, Kane JM, Birnbaum ML, De Choudhury M. Cross-Platform Detection of Psychiatric Hospitalization via Social Media Data: Comparison Study. JMIR Ment Health 2022; 9:e39747. [PMID: 36583932 PMCID: PMC9840099 DOI: 10.2196/39747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 10/06/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Previous research has shown the feasibility of using machine learning models trained on social media data from a single platform (eg, Facebook or Twitter) to distinguish individuals either with a diagnosis of mental illness or experiencing an adverse outcome from healthy controls. However, the performance of such models on data from novel social media platforms unseen in the training data (eg, Instagram and TikTok) has not been investigated in previous literature. OBJECTIVE Our study examined the feasibility of building machine learning classifiers that can effectively predict an upcoming psychiatric hospitalization given social media data from platforms unseen in the classifiers' training data despite the preliminary evidence on identity fragmentation on the investigated social media platforms. METHODS Windowed timeline data of patients with a diagnosis of schizophrenia spectrum disorder before a known hospitalization event and healthy controls were gathered from 3 platforms: Facebook (254/268, 94.8% of participants), Twitter (51/268, 19% of participants), and Instagram (134/268, 50% of participants). We then used a 3 × 3 combinatorial binary classification design to train machine learning classifiers and evaluate their performance on testing data from all available platforms. We further compared results from models in intraplatform experiments (ie, training and testing data belonging to the same platform) to those from models in interplatform experiments (ie, training and testing data belonging to different platforms). Finally, we used Shapley Additive Explanation values to extract the top predictive features to explain and compare the underlying constructs that predict hospitalization on each platform. RESULTS We found that models in intraplatform experiments on average achieved an F1-score of 0.72 (SD 0.07) in predicting a psychiatric hospitalization because of schizophrenia spectrum disorder, which is 68% higher than the average of models in interplatform experiments at an F1-score of 0.428 (SD 0.11). When investigating the key drivers for divergence in construct validities between models, an analysis of top features for the intraplatform models showed both low predictive feature overlap between the platforms and low pairwise rank correlation (<0.1) between the platforms' top feature rankings. Furthermore, low average cosine similarity of data between platforms within participants in comparison with the same measurement on data within platforms between participants points to evidence of identity fragmentation of participants between platforms. CONCLUSIONS We demonstrated that models built on one platform's data to predict critical mental health treatment outcomes such as hospitalization do not generalize to another platform. In our case, this is because different social media platforms consistently reflect different segments of participants' identities. With the changing ecosystem of social media use among different demographic groups and as web-based identities continue to become fragmented across platforms, further research on holistic approaches to harnessing these diverse data sources is required.
Collapse
Affiliation(s)
- Viet Cuong Nguyen
- School of Interactive Computing, Georgia Institute of Technology, Atlanta, GA, United States
| | - Nathaniel Lu
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, United States.,The Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, United States
| | - John M Kane
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, United States.,The Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, United States.,The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - Michael L Birnbaum
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, United States.,The Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, United States.,The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - Munmun De Choudhury
- School of Interactive Computing, Georgia Institute of Technology, Atlanta, GA, United States
| |
Collapse
|
5
|
Götzl C, Hiller S, Rauschenberg C, Schick A, Fechtelpeter J, Fischer Abaigar U, Koppe G, Durstewitz D, Reininghaus U, Krumm S. Artificial intelligence-informed mobile mental health apps for young people: a mixed-methods approach on users' and stakeholders' perspectives. Child Adolesc Psychiatry Ment Health 2022; 16:86. [PMID: 36397097 PMCID: PMC9672578 DOI: 10.1186/s13034-022-00522-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 11/05/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Novel approaches in mobile mental health (mHealth) apps that make use of Artificial Intelligence (AI), Ecological Momentary Assessments, and Ecological Momentary Interventions have the potential to support young people in the achievement of mental health and wellbeing goals. However, little is known on the perspectives of young people and mental health experts on this rapidly advancing technology. This study aims to investigate the subjective needs, attitudes, and preferences of key stakeholders towards an AI-informed mHealth app, including young people and experts on mHealth promotion and prevention in youth. METHODS We used a convergent parallel mixed-method study design. Two semi-structured online focus groups (n = 8) and expert interviews (n = 5) to explore users and stakeholders perspectives were conducted. Furthermore a representative online survey was completed by young people (n = 666) to investigate attitudes, current use and preferences towards apps for mental health promotion and prevention. RESULTS Survey results show that more than two-thirds of young people have experience with mHealth apps, and 60% make regular use of 1-2 apps. A minority (17%) reported to feel negative about the application of AI in general, and 19% were negative about the embedding of AI in mHealth apps. This is in line with qualitative findings, where young people displayed rather positive attitudes towards AI and its integration into mHealth apps. Participants reported pragmatic attitudes towards data sharing and safety practices, implying openness to share data if it adds value for users and if the data request is not too intimate, however demanded transparency of data usage and control over personalization. Experts perceived AI-informed mHealth apps as a complementary solution to on-site delivered interventions in future health promotion among young people. Experts emphasized opportunities in regard with low-threshold access through the use of smartphones, and the chance to reach young people in risk situations. CONCLUSIONS The findings of this exploratory study highlight the importance of further participatory development of training components prior to implementation of a digital mHealth training in routine practice of mental health promotion and prevention. Our results may help to guide developments based on stakeholders' first recommendations for an AI-informed mHealth app.
Collapse
Affiliation(s)
- Christian Götzl
- Department of Psychiatry II, University of Ulm and BKH Guenzburg, Lindenallee 2, Guenzburg, 89312, Ulm, Germany. .,Department of Forensic Psychiatry and Psychotherapy, University of Ulm and BKH Guenzburg, Ulm, Germany.
| | - Selina Hiller
- grid.6582.90000 0004 1936 9748Department of Psychiatry II, University of Ulm and BKH Guenzburg, Lindenallee 2, Guenzburg, 89312 Ulm, Germany
| | - Christian Rauschenberg
- grid.7700.00000 0001 2190 4373Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Anita Schick
- grid.7700.00000 0001 2190 4373Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Janik Fechtelpeter
- grid.7700.00000 0001 2190 4373Department of Theoretical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Unai Fischer Abaigar
- grid.7700.00000 0001 2190 4373Department of Theoretical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Georgia Koppe
- grid.7700.00000 0001 2190 4373Department of Theoretical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany ,grid.7700.00000 0001 2190 4373Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Daniel Durstewitz
- grid.7700.00000 0001 2190 4373Department of Theoretical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Ulrich Reininghaus
- grid.7700.00000 0001 2190 4373Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany ,grid.13097.3c0000 0001 2322 6764Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK ,grid.13097.3c0000 0001 2322 6764ESRC Centre for Society and Mental Health, King’s College London, London, UK
| | - Silvia Krumm
- grid.6582.90000 0004 1936 9748Department of Psychiatry II, University of Ulm and BKH Guenzburg, Lindenallee 2, Guenzburg, 89312 Ulm, Germany
| |
Collapse
|
6
|
Rifkin-Zybutz R, Turner N, Derges J, Bould H, Sedgewick F, Gooberman-Hill R, Linton MJ, Moran P, Biddle L. Original Research - Digital technology use and the mental health consultation: a survey of the views and experiences of clinicians and young people (Preprint). JMIR Ment Health 2022; 10:e44064. [PMID: 37067869 PMCID: PMC10152330 DOI: 10.2196/44064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 02/19/2023] [Accepted: 02/20/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Digital technologies play an increasingly important role in the lives of young people and have important effects on their mental health. OBJECTIVE We aimed to explore 3 key areas of the intersection between digital technology and mental health: the views and experiences of young people and clinicians about digital technology and mental health; implementation and barriers to the UK national guidance recommendation-that the discussion of digital technology use should form a core part of mental health assessment; and how digital technology might be used to support existing consultations. METHODS Two cross-sectional web-based surveys were conducted in 2020 between June and December, with mental health clinicians (n=99) and young people (n=320). Descriptive statistics were used to summarize the proportions. Multilinear regression was used to explore how the answers varied by gender, sexuality, and age. Thematic analysis was used to explore the contents of the extended free-text answers. Anxiety was measured using the Generalized Anxiety Disorder Questionnaire-7 (GAD-7). RESULTS Digital technology use was ubiquitous among young people, with positive and negative aspects acknowledged by both clinicians and young people. Negative experiences were common (131/284, 46.1%) and were associated with increased anxiety levels among young people (GAD-7 3.29; 95% CI 1.97-4.61; P<.001). Although the discussion of digital technology use was regarded as important by clinicians and acceptable by young people, less than half of clinicians (42/85, 49.4%) routinely asked about the use of digital technology and over a third of young people (48/121, 39.6%) who had received mental health care had never been asked about their digital technology use. The conversations were often experienced as unhelpful. Helpful conversations were characterized by greater depth and exploration of how an individual's digital technology use related to mental health. Despite most clinicians (59/83, 71.1%) wanting training, very few (21/86, 24.4%) reported receiving training. Clinicians were open to viewing mental health data from apps or social media to help with consultations. Although young people were generally, in theory, comfortable sharing such data with health professionals, when presented with a binary choice, most reported not wanting to share social media (84/117, 71.8%) or app data (67/118, 56.8%) during consultations. CONCLUSIONS Digital technology use was common, and negative experiences were frequent and associated with anxiety. Over a third of young people were not asked about their digital technology use during mental health consultations, and potentially valuable information about relevant negative experiences on the web was not being captured during consultations. Clinicians would benefit from having access to training to support these discussions with young people. Although young people recognized that app data could be helpful to clinicians, they appeared hesitant to share their own data. This finding suggests that data sharing has barriers that need to be further explored.
Collapse
Affiliation(s)
- Raphael Rifkin-Zybutz
- Centre for Academic Mental Health, Bristol University Medical School, Bristol, United Kingdom
| | - Nicholas Turner
- Population Health Sciences, Bristol University Medical School, Bristol, United Kingdom
| | - Jane Derges
- Centre for Academic Mental Health, Bristol University Medical School, Bristol, United Kingdom
- Population Health Sciences, Bristol University Medical School, Bristol, United Kingdom
| | - Helen Bould
- Centre for Academic Mental Health, Bristol University Medical School, Bristol, United Kingdom
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Gloucestershire Health and Care National Health Service Foundation Trust, Gloucester, United Kingdom
| | | | | | - Myles-Jay Linton
- Population Health Sciences, Bristol University Medical School, Bristol, United Kingdom
- School of Education, University of Bristol, Bristol, United Kingdom
| | - Paul Moran
- Centre for Academic Mental Health, Bristol University Medical School, Bristol, United Kingdom
- The National Institute for Health Research Applied Research Collaboration West, University Hospitals Bristol and Weston National Health Service Foundation Trust, Bristol, United Kingdom
- Biomedical Research Centre, University Hospitals Bristol and Weston National Health Service Foundation Trust, Bristol, United Kingdom
| | - Lucy Biddle
- Population Health Sciences, Bristol University Medical School, Bristol, United Kingdom
- The National Institute for Health Research Applied Research Collaboration West, University Hospitals Bristol and Weston National Health Service Foundation Trust, Bristol, United Kingdom
| |
Collapse
|
7
|
Ren B, Xia CH, Gehrman P, Barnett I, Satterthwaite T. Measuring Daily Activity Rhythms in Young Adults at Risk of Affective Instability Using Passively Collected Smartphone Data: Observational Study. JMIR Form Res 2022; 6:e33890. [PMID: 36103225 PMCID: PMC9520392 DOI: 10.2196/33890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 01/18/2022] [Accepted: 07/19/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Irregularities in circadian rhythms have been associated with adverse health outcomes. The regularity of rhythms can be quantified using passively collected smartphone data to provide clinically relevant biomarkers of routine. OBJECTIVE This study aims to develop a metric to quantify the regularity of activity rhythms and explore the relationship between routine and mood, as well as demographic covariates, in an outpatient psychiatric cohort. METHODS Passively sensed smartphone data from a cohort of 38 young adults from the Penn or Children's Hospital of Philadelphia Lifespan Brain Institute and Outpatient Psychiatry Clinic at the University of Pennsylvania were fitted with 2-state continuous-time hidden Markov models representing active and resting states. The regularity of routine was modeled as the hour-of-the-day random effects on the probability of state transition (ie, the association between the hour-of-the-day and state membership). A regularity score, Activity Rhythm Metric, was calculated from the continuous-time hidden Markov models and regressed on clinical and demographic covariates. RESULTS Regular activity rhythms were associated with longer sleep durations (P=.009), older age (P=.001), and mood (P=.049). CONCLUSIONS Passively sensed Activity Rhythm Metrics are an alternative to existing metrics but do not require burdensome survey-based assessments. Low-burden, passively sensed metrics based on smartphone data are promising and scalable alternatives to traditional measurements.
Collapse
Affiliation(s)
- Benny Ren
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Cedric Huchuan Xia
- Penn Lifespan Informatics and Neuroimaging Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Philip Gehrman
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
- Michael J Crescenz VA Medical Center, Philadelphia, PA, United States
| | - Ian Barnett
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Theodore Satterthwaite
- Penn Lifespan Informatics and Neuroimaging Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| |
Collapse
|
8
|
Leightley D, Bye A, Carter B, Trevillion K, Branthonne-Foster S, Liakata M, Wood A, Ougrin D, Orben A, Ford T, Dutta R. Maximizing the positive and minimizing the negative: Social media data to study youth mental health with informed consent. Front Psychiatry 2022; 13:1096253. [PMID: 36704745 PMCID: PMC9872114 DOI: 10.3389/fpsyt.2022.1096253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 12/16/2022] [Indexed: 01/12/2023] Open
Abstract
Social media usage impacts upon the mental health and wellbeing of young people, yet there is not enough evidence to determine who is affected, how and to what extent. While it has widened and strengthened communication networks for many, the dangers posed to at-risk youth are serious. Social media data offers unique insights into the minute details of a user's online life. Timely consented access to data could offer many opportunities to transform understanding of its effects on mental wellbeing in different contexts. However, limited data access by researchers is preventing such advances from being made. Our multidisciplinary authorship includes a lived experience adviser, academic and practicing psychiatrists, and academic psychology, as well as computational, statistical, and qualitative researchers. In this Perspective article, we propose a framework to support secure and confidential access to social media platform data for research to make progress toward better public mental health.
Collapse
Affiliation(s)
- Daniel Leightley
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Amanda Bye
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Ben Carter
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Kylee Trevillion
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | | | - Maria Liakata
- School of Electronic Engineering and Computer Science, Queens Mary University of London, London, United Kingdom
| | | | - Dennis Ougrin
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Amy Orben
- MRC Cognition and Brain Sciences Unit, Cambridge, United Kingdom
| | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Rina Dutta
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
- *Correspondence: Rina Dutta ✉
| |
Collapse
|
9
|
Yoo DW, Ernala SK, Saket B, Weir D, Arenare E, Ali AF, Van Meter AR, Birnbaum ML, Abowd GD, De Choudhury M. Clinician Perspectives on Using Computational Mental Health Insights From Patients' Social Media Activities: Design and Qualitative Evaluation of a Prototype. JMIR Ment Health 2021; 8:e25455. [PMID: 34783667 PMCID: PMC8663497 DOI: 10.2196/25455] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 02/11/2021] [Accepted: 06/22/2021] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Previous studies have suggested that social media data, along with machine learning algorithms, can be used to generate computational mental health insights. These computational insights have the potential to support clinician-patient communication during psychotherapy consultations. However, how clinicians perceive and envision using computational insights during consultations has been underexplored. OBJECTIVE The aim of this study is to understand clinician perspectives regarding computational mental health insights from patients' social media activities. We focus on the opportunities and challenges of using these insights during psychotherapy consultations. METHODS We developed a prototype that can analyze consented patients' Facebook data and visually represent these computational insights. We incorporated the insights into existing clinician-facing assessment tools, the Hamilton Depression Rating Scale and Global Functioning: Social Scale. The design intent is that a clinician will verbally interview a patient (eg, How was your mood in the past week?) while they reviewed relevant insights from the patient's social media activities (eg, number of depression-indicative posts). Using the prototype, we conducted interviews (n=15) and 3 focus groups (n=13) with mental health clinicians: psychiatrists, clinical psychologists, and licensed clinical social workers. The transcribed qualitative data were analyzed using thematic analysis. RESULTS Clinicians reported that the prototype can support clinician-patient collaboration in agenda-setting, communicating symptoms, and navigating patients' verbal reports. They suggested potential use scenarios, such as reviewing the prototype before consultations and using the prototype when patients missed their consultations. They also speculated potential negative consequences: patients may feel like they are being monitored, which may yield negative effects, and the use of the prototype may increase the workload of clinicians, which is already difficult to manage. Finally, our participants expressed concerns regarding the prototype: they were unsure whether patients' social media accounts represented their actual behaviors; they wanted to learn how and when the machine learning algorithm can fail to meet their expectations of trust; and they were worried about situations where they could not properly respond to the insights, especially emergency situations outside of clinical settings. CONCLUSIONS Our findings support the touted potential of computational mental health insights from patients' social media account data, especially in the context of psychotherapy consultations. However, sociotechnical issues, such as transparent algorithmic information and institutional support, should be addressed in future endeavors to design implementable and sustainable technology.
Collapse
Affiliation(s)
- Dong Whi Yoo
- School of Interactive Computing, Georgia Institute of Technology, Atlanta, GA, United States
| | - Sindhu Kiranmai Ernala
- School of Interactive Computing, Georgia Institute of Technology, Atlanta, GA, United States
| | - Bahador Saket
- School of Interactive Computing, Georgia Institute of Technology, Atlanta, GA, United States
| | - Domino Weir
- School of Interactive Computing, Georgia Institute of Technology, Atlanta, GA, United States
| | - Elizabeth Arenare
- The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, United States
| | - Asra F Ali
- The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, United States
| | - Anna R Van Meter
- The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, United States
- The Feinstein Institutes for Medical Research, Manhasset, NY, United States
- The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - Michael L Birnbaum
- The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, United States
- The Feinstein Institutes for Medical Research, Manhasset, NY, United States
- The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - Gregory D Abowd
- School of Interactive Computing, Georgia Institute of Technology, Atlanta, GA, United States
- College of Engineering, Northeastern University, Boston, MA, United States
| | - Munmun De Choudhury
- School of Interactive Computing, Georgia Institute of Technology, Atlanta, GA, United States
| |
Collapse
|
10
|
Nunes Vilaza G, Coyle D, Bardram JE. Public Attitudes to Digital Health Research Repositories: Cross-sectional International Survey. J Med Internet Res 2021; 23:e31294. [PMID: 34714253 PMCID: PMC8590194 DOI: 10.2196/31294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 09/16/2021] [Accepted: 09/20/2021] [Indexed: 12/05/2022] Open
Abstract
Background Digital health research repositories propose sharing longitudinal streams of health records and personal sensing data between multiple projects and researchers. Motivated by the prospect of personalizing patient care (precision medicine), these initiatives demand broad public acceptance and large numbers of data contributors, both of which are challenging. Objective This study investigates public attitudes toward possibly contributing to digital health research repositories to identify factors for their acceptance and to inform future developments. Methods A cross-sectional online survey was conducted from March 2020 to December 2020. Because of the funded project scope and a multicenter collaboration, study recruitment targeted young adults in Denmark and Brazil, allowing an analysis of the differences between 2 very contrasting national contexts. Through closed-ended questions, the survey examined participants’ willingness to share different data types, data access preferences, reasons for concern, and motivations to contribute. The survey also collected information about participants’ demographics, level of interest in health topics, previous participation in health research, awareness of examples of existing research data repositories, and current attitudes about digital health research repositories. Data analysis consisted of descriptive frequency measures and statistical inferences (bivariate associations and logistic regressions). Results The sample comprises 1017 respondents living in Brazil (1017/1600, 63.56%) and 583 in Denmark (583/1600, 36.44%). The demographics do not differ substantially between participants of these countries. The majority is aged between 18 and 27 years (933/1600, 58.31%), is highly educated (992/1600, 62.00%), uses smartphones (1562/1600, 97.63%), and is in good health (1407/1600, 87.94%). The analysis shows a vast majority were very motivated by helping future patients (1366/1600, 85.38%) and researchers (1253/1600, 78.31%), yet very concerned about unethical projects (1219/1600, 76.19%), profit making without consent (1096/1600, 68.50%), and cyberattacks (1055/1600, 65.94%). Participants’ willingness to share data is lower when sharing personal sensing data, such as the content of calls and texts (1206/1600, 75.38%), in contrast to more traditional health research information. Only 13.44% (215/1600) find it desirable to grant data access to private companies, and most would like to stay informed about which projects use their data (1334/1600, 83.38%) and control future data access (1181/1600, 73.81%). Findings indicate that favorable attitudes toward digital health research repositories are related to a personal interest in health topics (odds ratio [OR] 1.49, 95% CI 1.10-2.02; P=.01), previous participation in health research studies (OR 1.70, 95% CI 1.24-2.35; P=.001), and awareness of examples of research repositories (OR 2.78, 95% CI 1.83-4.38; P<.001). Conclusions This study reveals essential factors for acceptance and willingness to share personal data with digital health research repositories. Implications include the importance of being more transparent about the goals and beneficiaries of research projects using and re-using data from repositories, providing participants with greater autonomy for choosing who gets access to which parts of their data, and raising public awareness of the benefits of data sharing for research. In addition, future developments should engage with and reduce risks for those unwilling to participate.
Collapse
Affiliation(s)
- Giovanna Nunes Vilaza
- Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark
| | - David Coyle
- School of Computer Science, University College Dublin, Dublin, Ireland
| | - Jakob Eyvind Bardram
- Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark
| |
Collapse
|
11
|
Feasibility and acceptability of monitoring personal air pollution exposure with sensors for asthma self-management. Asthma Res Pract 2021; 7:13. [PMID: 34482835 PMCID: PMC8420032 DOI: 10.1186/s40733-021-00079-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 08/08/2021] [Indexed: 11/18/2022] Open
Abstract
Background Exposure to fine particulate matter (PM2.5) increases the risk of asthma exacerbations, and thus, monitoring personal exposure to PM2.5 may aid in disease self-management. Low-cost, portable air pollution sensors offer a convenient way to measure personal pollution exposure directly and may improve personalized monitoring compared with traditional methods that rely on stationary monitoring stations. We aimed to understand whether adults with asthma would be willing to use personal sensors to monitor their exposure to air pollution and to assess the feasibility of using sensors to measure real-time PM2.5 exposure. Methods We conducted semi-structured interviews with 15 adults with asthma to understand their willingness to use a personal pollution sensor and their privacy preferences with regard to sensor data. Student research assistants used HabitatMap AirBeam devices to take PM2.5 measurements at 1-s intervals while walking in Philadelphia neighborhoods in May–August 2018. AirBeam PM2.5 measurements were compared to concurrent measurements taken by three nearby regulatory monitors. Results All interview participants stated that they would use a personal air pollution sensor, though the consensus was that devices should be small (watch- or palm-sized) and light. Patients were generally unconcerned about privacy or sharing their GPS location, with only two stating they would not share their GPS location under any circumstances. PM2.5 measurements were taken using AirBeam sensors on 34 walks that extended through five Philadelphia neighborhoods. The range of sensor PM2.5 measurements was 0.6–97.6 μg/mL (mean 6.8 μg/mL), compared to 0–22.6 μg/mL (mean 9.0 μg/mL) measured by nearby regulatory monitors. Compared to stationary measurements, which were only available as 1-h integrated averages at discrete monitoring sites, sensor measurements permitted characterization of fine-scale fluctuations in PM2.5 levels over time and space. Conclusions Patients were generally interested in using sensors to monitor their personal exposure to PM2.5 and willing to share personal sensor data with health care providers and researchers. Compared to traditional methods of personal exposure assessment, sensors captured personalized air quality information at higher spatiotemporal resolution. Improvements to currently available sensors, including more reliable Bluetooth connectivity, increased portability, and longer battery life would facilitate their use in a general patient population. Supplementary Information The online version contains supplementary material available at 10.1186/s40733-021-00079-9.
Collapse
|
12
|
Bessenyei K, Suruliraj B, Bagnell A, McGrath P, Wozney L, Huguet A, Elger BS, Meier S, Orji R. Comfortability with the passive collection of smartphone data for monitoring of mental health: An online survey. COMPUTERS IN HUMAN BEHAVIOR REPORTS 2021. [DOI: 10.1016/j.chbr.2021.100134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
13
|
Resnik P, Foreman A, Kuchuk M, Musacchio Schafer K, Pinkham B. Naturally occurring language as a source of evidence in suicide prevention. Suicide Life Threat Behav 2021; 51:88-96. [PMID: 32914479 DOI: 10.1111/sltb.12674] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
We discuss computational language analysis as it pertains to suicide prevention research, with an emphasis on providing non-technologists with an understanding of key issues and, equally important, considering its relation to the broader enterprise of suicide prevention. Our emphasis here is on naturally occurring language in social media, motivated by its non-intrusive ability to yield high-value information that in the past has been largely unavailable to clinicians.
Collapse
Affiliation(s)
| | - April Foreman
- American Association of Suicidology, Washington, District of Columbia, USA
| | - Michelle Kuchuk
- Vibrant Emotional Health, New York, New York, USA.,National Suicide Prevention Lifeline, New York, New York, USA
| | | | - Beau Pinkham
- American Association of Suicidology, Washington, District of Columbia, USA.,National Suicide Prevention Lifeline, New York, New York, USA.,International Council for Helplines, Nashville, Tennessee, USA
| |
Collapse
|
14
|
Kelly DL, Spaderna M, Hodzic V, Coppersmith G, Chen S, Resnik P. Can language use in social media help in the treatment of severe mental illness? CURRENT RESEARCH IN PSYCHIATRY 2021; 1:1-4. [PMID: 34532718 PMCID: PMC8442995 DOI: 10.46439/psychiatry.1.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Affiliation(s)
- Deanna L. Kelly
- University of Maryland Baltimore, School of Medicine, Baltimore, MD, USA
| | - Max Spaderna
- University of Maryland Baltimore, School of Medicine, Baltimore, MD, USA
| | - Vedrana Hodzic
- University of Maryland Baltimore, School of Medicine, Baltimore, MD, USA
| | | | - Shuo Chen
- University of Maryland Baltimore, School of Medicine, Baltimore, MD, USA
| | | |
Collapse
|
15
|
Jayakumar P, Lin E, Galea V, Mathew AJ, Panda N, Vetter I, Haynes AB. Digital Phenotyping and Patient-Generated Health Data for Outcome Measurement in Surgical Care: A Scoping Review. J Pers Med 2020; 10:E282. [PMID: 33333915 PMCID: PMC7765378 DOI: 10.3390/jpm10040282] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 12/08/2020] [Accepted: 12/11/2020] [Indexed: 12/13/2022] Open
Abstract
Digital phenotyping-the moment-by-moment quantification of human phenotypes in situ using data related to activity, behavior, and communications, from personal digital devices, such as smart phones and wearables-has been gaining interest. Personalized health information captured within free-living settings using such technologies may better enable the application of patient-generated health data (PGHD) to provide patient-centered care. The primary objective of this scoping review is to characterize the application of digital phenotyping and digitally captured active and passive PGHD for outcome measurement in surgical care. Secondarily, we synthesize the body of evidence to define specific areas for further work. We performed a systematic search of four bibliographic databases using terms related to "digital phenotyping and PGHD," "outcome measurement," and "surgical care" with no date limits. We registered the study (Open Science Framework), followed strict inclusion/exclusion criteria, performed screening, extraction, and synthesis of results in line with the PRISMA Extension for Scoping Reviews. A total of 224 studies were included. Published studies have accelerated in the last 5 years, originating in 29 countries (mostly from the USA, n = 74, 33%), featuring original prospective work (n = 149, 66%). Studies spanned 14 specialties, most commonly orthopedic surgery (n = 129, 58%), and had a postoperative focus (n = 210, 94%). Most of the work involved research-grade wearables (n = 130, 58%), prioritizing the capture of activity (n = 165, 74%) and biometric data (n = 100, 45%), with a view to providing a tracking/monitoring function (n = 115, 51%) for the management of surgical patients. Opportunities exist for further work across surgical specialties involving smartphones, communications data, comparison with patient-reported outcome measures (PROMs), applications focusing on prediction of outcomes, monitoring, risk profiling, shared decision making, and surgical optimization. The rapidly evolving state of the art in digital phenotyping and capture of PGHD offers exciting prospects for outcome measurement in surgical care pending further work and consideration related to clinical care, technology, and implementation.
Collapse
Affiliation(s)
- Prakash Jayakumar
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX 78712, USA; (E.L.); (A.J.M.); (A.B.H.)
| | - Eugenia Lin
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX 78712, USA; (E.L.); (A.J.M.); (A.B.H.)
| | - Vincent Galea
- School of Medicine, New York Medical College, Valhalla, NY 10595, USA;
| | - Abraham J. Mathew
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX 78712, USA; (E.L.); (A.J.M.); (A.B.H.)
| | - Nikhil Panda
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA;
| | - Imelda Vetter
- Department of Medical Education, Dell Medical School, The University of Texas at Austin, Austin, TX 78712, USA;
| | - Alex B. Haynes
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX 78712, USA; (E.L.); (A.J.M.); (A.B.H.)
| |
Collapse
|
16
|
Hochheiser H, Valdez RS. Human-Computer Interaction, Ethics, and Biomedical Informatics. Yearb Med Inform 2020; 29:93-98. [PMID: 32823302 PMCID: PMC7442500 DOI: 10.1055/s-0040-1701990] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Objectives
: To provide an overview of recent work at the intersection of Biomedical Informatics, Human-Computer Interaction, and Ethics.
Methods
: Search terms for Human-Computer Interaction, Biomedical Informatics, and Ethics were used to identify relevant papers published between 2017 and 2019.Relevant papers were identified through multiple methods, including database searches, manual reviews of citations, recent publications, and special collections, as well as through peer recommendations. Identified articles were reviewed and organized into broad themes.
Results
: We identified relevant papers at the intersection of Biomedical Informatics, Human-Computer Interactions, and Ethics in over a dozen journals. The content of these papers was organized into three broad themes: ethical issues associated with systems in use, systems design, and responsible conduct of research.
Conclusions
: The results of this overview demonstrate an active interest in exploring the ethical implications of Human-Computer Interaction concerns in Biomedical Informatics. Papers emphasizing ethical concerns associated with patient-facing tools, mobile devices, social media, privacy, inclusivity, and e-consent reflect the growing prominence of these topics in biomedical informatics research. New questions in these areas will likely continue to arise with the growth of precision medicine and citizen science.
Collapse
Affiliation(s)
- Harry Hochheiser
- Department of Biomedical Informatics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania USA
| | - Rupa S Valdez
- Public Health Sciences & Engineering Systems and Environment, University of Virginia, Charlottesville, Virginia USA
| |
Collapse
|
17
|
Yoo DW, Birnbaum ML, Van Meter AR, Ali AF, Arenare E, Abowd GD, De Choudhury M. Designing a Clinician-Facing Tool for Using Insights From Patients' Social Media Activity: Iterative Co-Design Approach. JMIR Ment Health 2020; 7:e16969. [PMID: 32784180 PMCID: PMC7450381 DOI: 10.2196/16969] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 06/27/2020] [Accepted: 07/09/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Recent research has emphasized the need for accessing information about patients to augment mental health patients' verbal reports in clinical settings. Although it has not been introduced in clinical settings, computational linguistic analysis on social media has proved it can infer mental health attributes, implying a potential use as collateral information at the point of care. To realize this potential and make social media insights actionable to clinical decision making, the gaps between computational linguistic analysis on social media and the current work practices of mental health clinicians must be bridged. OBJECTIVE This study aimed to identify information derived from patients' social media data that can benefit clinicians and to develop a set of design implications, via a series of low-fidelity (lo-fi) prototypes, on how to deliver the information at the point of care. METHODS A team of clinical researchers and human-computer interaction (HCI) researchers conducted a long-term co-design activity for over 6 months. The needs-affordances analysis framework was used to refine the clinicians' potential needs, which can be supported by patients' social media data. On the basis of those identified needs, the HCI researchers iteratively created 3 different lo-fi prototypes. The prototypes were shared with both groups of researchers via a videoconferencing software for discussion and feedback. During the remote meetings, potential clinical utility, potential use of the different prototypes in a treatment setting, and areas of improvement were discussed. RESULTS Our first prototype was a card-type interface that supported treatment goal tracking. Each card included attribute levels: depression, anxiety, social activities, alcohol, and drug use. This version confirmed what types of information are helpful but revealed the need for a glanceable dashboard that highlights the trends of these information. As a result, we then developed the second prototype, an interface that shows the clinical state and trend. We found that focusing more on the changes since the last visit without visual representation can be more compatible with clinicians' work practices. In addition, the second phase of needs-affordances analysis identified 3 categories of information relevant to patients with schizophrenia: symptoms related to psychosis, symptoms related to mood and anxiety, and social functioning. Finally, we developed the third prototype, a clinical summary dashboard that showed changes from the last visit in plain texts and contrasting colors. CONCLUSIONS This exploratory co-design research confirmed that mental health attributes inferred from patients' social media data can be useful for clinicians, although it also revealed a gap between computational social media analyses and clinicians' expectations and conceptualizations of patients' mental health states. In summary, the iterative co-design process crystallized design directions for the future interface, including how we can organize and provide symptom-related information in a way that minimizes the clinicians' workloads.
Collapse
Affiliation(s)
- Dong Whi Yoo
- School of Interactive Computing, Georgia Institute of Technology, Atlanta, GA, United States
| | - Michael L Birnbaum
- The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, United States
- The Feinstein Institutes for Medical Research, Manhasset, NY, United States
- The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - Anna R Van Meter
- The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, United States
- The Feinstein Institutes for Medical Research, Manhasset, NY, United States
- The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - Asra F Ali
- The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, United States
| | - Elizabeth Arenare
- The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, United States
| | - Gregory D Abowd
- School of Interactive Computing, Georgia Institute of Technology, Atlanta, GA, United States
| | - Munmun De Choudhury
- School of Interactive Computing, Georgia Institute of Technology, Atlanta, GA, United States
| |
Collapse
|