["Dark patterns": manipulative design strategies in digital health applications]

Among other things, digital health applications offer users support in better understanding their physical and mental health through digital data, thereby promoting positive health behavior. In addition to state-approved digital health applications (DiGA) and digital care applications (DiPA), there is a wide array of other commercial health applications available to users. Particularly in non-approved applications, developers often deploy manipulative design strategies (dark patterns), intentionally or unintentionally, to deceive users into making specific decisions. This article provides an overview of current and widespread dark patterns and assesses the risks posed by them in digital health applications.In the future, "light" should be shed on dark patterns by creating more transparency for users, providing regulators with a more accurate understanding of dark patterns, and paying more attention to the implementation of guidelines. Thus, users may gain autonomy using healthcare applications and their data can be better protected.

Ontology patterns for the representation of quality changes of cells in time

Background

Cell tracking experiments, based on time-lapse microscopy, have become an important tool in biomedical research. The goal is the reconstruction of cell migration patterns, shape and state changes, and, comprehensive genealogical information from these data. This information can be used to develop process models of cellular dynamics. However, so far there has been no structured, standardized way of annotating and storing the tracking results, which is critical for comparative analysis and data integration. The key requirement to be satisfied by an ontology is the representation of a cell’s change over time. Unfortunately, popular ontology languages, such as Web Ontology Language (OWL), have limitations for the representation of temporal information. The current paper addresses the fundamental problem of modeling changes of qualities over time in biomedical ontologies specified in OWL.

Results

The presented analysis is a result of the lessons learned during the development of an ontology, intended for the annotation of cell tracking experiments. We present, discuss and evaluate various representation patterns for specifying cell changes in time. In particular, we discuss two patterns of temporally changing information: n-ary relation reification and 4d fluents. These representation schemes are formalized within the ontology language OWL and are aimed at the support for annotation of cell tracking experiments. We analyze the performance of each pattern with respect to standard criteria used in software engineering and data modeling, i.e. simplicity, scalability, extensibility and adequacy. We further discuss benefits, drawbacks, and the underlying design choices of each approach.

Conclusions

We demonstrate that patterns perform differently depending on the temporal distribution of modeled information. The optimal model can be constructed by combining two competitive approaches. Thus, we demonstrate that both reification and 4d fluents patterns can work hand in hand in a single ontology. Additionally, we have found that 4d fluents can be reconstructed by two patterns well known in the computer science community, i.e. state modeling and actor-role pattern.

On the impact of service-oriented patterns on software evolvability: a controlled experiment and metric-based analysis

BACKGROUND

Design patterns are supposed to improve various quality attributes of software systems. However, there is controversial quantitative evidence of this impact. Especially for younger paradigms such as service- and Microservice-based systems, there is a lack of empirical studies.

OBJECTIVE

In this study, we focused on the effect of four service-based patterns-namely Process Abstraction, Service Façade, Decomposed Capability, and Event-Driven Messaging-on the evolvability of a system from the viewpoint of inexperienced developers.

METHOD

We conducted a controlled experiment with Bachelor students (N = 69). Two functionally equivalent versions of a service-based web shop-one with patterns (treatment group), one without (control group)-had to be changed and extended in three tasks. We measured evolvability by the effectiveness and efficiency of the participants in these tasks. Additionally, we compared both system versions with nine structural maintainability metrics for size, granularity, complexity, cohesion, and coupling.

RESULTS

Both experiment groups were able to complete a similar number of tasks within the allowed 90 min. Median effectiveness was 1/3. Mean efficiency was 12% higher in the treatment group, but this difference was not statistically significant. Only for the third task, we found statistical support for accepting the alternative hypothesis that the pattern version led to higher efficiency. In the metric analysis, the pattern version had worse measurements for size and granularity while simultaneously having slightly better values for coupling metrics. Complexity and cohesion were not impacted.

INTERPRETATION

For the experiment, our analysis suggests that the difference in efficiency is stronger with more experienced participants and increased from task to task. With respect to the metrics, the patterns introduce additional volume in the system, but also seem to decrease coupling in some areas.

CONCLUSIONS

Overall, there was no clear evidence for a decisive positive effect of using service-based patterns, neither for the student experiment nor for the metric analysis. This effect might only be visible in an experiment setting with higher initial effort to understand the system or with more experienced developers.

Design patterns for the development of electronic health record-driven phenotype extraction algorithms

BACKGROUND

Design patterns, in the context of software development and ontologies, provide generalized approaches and guidance to solving commonly occurring problems, or addressing common situations typically informed by intuition, heuristics and experience. While the biomedical literature contains broad coverage of specific phenotype algorithm implementations, no work to date has attempted to generalize common approaches into design patterns, which may then be distributed to the informatics community to efficiently develop more accurate phenotype algorithms.

METHODS

Using phenotyping algorithms stored in the Phenotype KnowledgeBase (PheKB), we conducted an independent iterative review to identify recurrent elements within the algorithm definitions. We extracted and generalized recurrent elements in these algorithms into candidate patterns. The authors then assessed the candidate patterns for validity by group consensus, and annotated them with attributes.

RESULTS

A total of 24 electronic Medical Records and Genomics (eMERGE) phenotypes available in PheKB as of 1/25/2013 were downloaded and reviewed. From these, a total of 21 phenotyping patterns were identified, which are available as an online data supplement.

CONCLUSIONS

Repeatable patterns within phenotyping algorithms exist, and when codified and cataloged may help to educate both experienced and novice algorithm developers. The dissemination and application of these patterns has the potential to decrease the time to develop algorithms, while improving portability and accuracy.