Kapil Chalil Madathil

Healthcare information on YouTube: A systematic review

This article reviews the peer-reviewed literature addressing the healthcare information available on YouTube. Inclusion and exclusion criteria were determined, and the online databases PubMed and Web of Knowledge were searched using the search phrases: (1) YouTube* AND Health* and (2) YouTube* AND Healthcare*. In all, 18 articles were reviewed, with the results suggesting that (1) YouTube is increasingly being used as a platform for disseminating health information; (2) content and frame analysis were the primary techniques employed by researchers to analyze the characteristics of this information; (3) YouTube contains misleading information, primarily anecdotal, that contradicts the reference standards and the probability of a lay user finding such content is relatively high; (4) the retrieval of relevant videos is dependent on the search term used; and (5) videos from government organizations and professional associations contained trustworthy and high-quality information. YouTube is used as a medium for promoting unscientific therapies and drugs that are yet to be approved by the appropriate agencies and has the potential to change the beliefs of patients concerning controversial topics such as vaccinations. This review recognizes the need to design interventions to enable consumers to critically assimilate the information posted on YouTube with more authoritative information sources to make effective healthcare decisions.

An investigation of the efficacy of electronic consenting interfaces of research permissions management system in a hospital setting

PURPOSE Ethical and legal requirements for healthcare providers in the United States, stipulate that patients sign a consent form prior to undergoing medical treatment or participating in a research study. Currently, the majority of the hospitals obtain these consents using paper-based forms, which makes patient preference data cumbersome to store, search and retrieve. To address these issues, Health Sciences of South Carolina (HSSC), a collaborative of academic medical institutions and research universities in South Carolina, is developing an electronic consenting system, the Research Permissions Management System (RPMS). This article reports the findings of a study conducted to investigate the efficacy of the two proposed interfaces for this system - an iPad-based and touchscreen-based by comparing them to the paper-based and Topaz-based systems currently in use. METHODS This study involved 50 participants: 10 hospital admission staff and 40 patients. The four systems were compared with respect to the time taken to complete the consenting process, the number of errors made by the patients, the workload experienced by the hospital staff and the subjective ratings of both patients and staff on post-test questionnaires. RESULTS The results from the empirical study indicated no significant differences in the time taken to complete the tasks. More importantly, the participants found the new systems more usable than the conventional methods with the registration staff experiencing the least workload in the iPad and touchscreen-based conditions and the patients experiencing more privacy and control during the consenting process with the proposed electronic systems. In addition, they indicated better comprehension and awareness of what they were signing using the new interfaces. DISCUSSION The results indicate the two methods proposed for capturing patient consents are at least as effective as the conventional methods, and superior in several important respects. While more research is needed, these findings suggest the viability of cautious adoption of electronic consenting systems, especially because these new systems appear to address the challenge of identifying the participants required for the complex research being conducted as the result of advances in the biomedical sciences.

Synchronous remote usability testing: a new approach facilitated by virtual worlds

This study proposes a new methodology for conducting synchronous remote usability studies using a three-dimensional virtual usability testing laboratory built using the Open Wonderland toolkit. This virtual laboratory method is then compared with two other commonly used synchronous usability test methods: the traditional lab approach and WebEx, a web-based conferencing and screen sharing approach. A study was conducted with 48 participants in total, 36 test participants and 12 test facilitators. The test participants completed 5 tasks on a simulated e-commerce website. The three methodologies were compared with respect to the following dependent variables: the time taken to complete the tasks; the usability defects identified; the severity of these usability defects; and the subjective ratings from NASA-TLX, presence and post-test subjective questionnaires. The three methodologies agreed closely in terms of the total number defects identified, number of high severity defects identified and the time taken to complete the tasks. However, there was a significant difference in the workload experienced by the test participants and facilitators, with the traditional lab condition imposing the least and the virtual lab and the WebEx conditions imposing similar levels. It was also found that the test participants experienced greater involvement and a more immersive experience in the virtual world condition than the WebEx condition. These ratings were not significantly different from those in the traditional lab condition. The results of this study suggest that participants were productive and enjoyed the virtual lab condition, indicating the potential of a virtual world based approach as an alternative to the conventional approaches for synchronous usability testing.

Lessons learned from the usability assessment of home-based telemedicine systems.

At-home telemedicine visits are quickly becoming an acceptable alternative for in-person patient visits. However, little work has been done to understand the usability of these home-based telemedicine solutions. It is critical for user acceptance and real-world applicability to evaluate available telemedicine solutions within the context-specific needs of the users of this technology. To address this need, this study evaluated the usability of four home-based telemedicine software platforms: Doxy.me, Vidyo, VSee, and Polycom. Using a within-subjects experimental design, twenty participants were asked to complete a telemedicine session involving several tasks using the four platforms. Upon completion of these tasks for each platform, participants completed the IBM computer system usability questionnaire (CSUQ) and the NASA Task Load Index test. Upon completing the tasks on all four platforms, the participants completed a final post-test subjective questionnaire ranking the platforms based on their preference. Of the twenty participants, 19 completed the study. Statistically significant differences among the telemedicine software platforms were found for task completion time, total workload, mental demand, effort, frustration, preference ranking and computer system usability scores. Usability problems with installation and account creation led to high mental demand and task completion time, suggesting the participants preferred a system without such requirements. Majority of the usability issues were identified at the telemedicine initiation phase. The findings from this study can be used by software developers to develop user-friendly telemedicine systems.

Modeling and Control of Trust in Human-Robot Collaborative Manufacturing

Human-Robot Collaboration (HRC) on the factory floor has opened a new realm of manufacturing in real-world settings. In such applications, a human and robot work together with each other as coworkers while HRC plays a critical role in safety, productivity, and flexibility. In particular, human-robot trust determines his/her acceptance and hence allocation of autonomy to a robot, which alter the overall task efficiency and human workload. Inspired by well-known human factors research, we develop a time-series trust model for human-robot collaboration tasks, which is a function of prior trust, robot performance, and human performance. The robot performance is evaluated by its flexibility to keep pace with the human coworker and is molded as the difference between human and robot speed. The human performance in doing physical tasks is directly related to his/her muscle fatigue level. We use the muscle fatigue and recovery dynamics to capture the fatigue level of the human body when performing repetitive kinesthetic tasks, which are typical types of human motions in manufacturing. The robot speed can be controlled in three different modes: manually by the associate, autonomously through robust intelligence algorithms, or collaboratively by the combination of manual and autonomous inputs. We first simulate a typical 9-h work day for human robot collaborative tasks and implement the proposed trust model and the three control schemes. Furthermore, we experimentally validate our model and control schemes by conducting a series of human-in-the-loop experiments using the Rethink Robotics Baxter robot.

Managing clinical research permissions electronically: A novel approach to enhancing recruitment and managing consents

Background One mechanism to increase participation in research is to solicit potential research participants’ general willingness to be recruited into clinical trials. Such research permissions and consents typically are collected on paper upon patient registration. We describe a novel method of capturing this information electronically. Purpose The objective is to enable the collection of research permissions and informed consent data electronically to permit tracking of potential research participants’ interest in current and future research involvement and to provide a foundation for facilitating the research workflow. Methods The project involved systematic analysis focused on key areas, including existing business practices, registration processes, and permission collection workflows, and ascertaining best practices for presenting consent information to users via tablet technology and capturing permissions data. Analysis was followed by an iterative software development cycle with feedback from subject matter experts and users. Results An initial version of the software was piloted at one institution in South Carolina for a period of 1 year, during which consents and permission were collected during 2524 registrations of patients. The captured research permission data were transmitted to a clinical data warehouse. The software was later released as an open-source package that can be adopted for use by other institutions. Limitations There are significant ethical, legal, and informatics challenges that must be addressed at an institution to deploy such a system. We have not yet assessed the long-term impact of the system on recruitment of patients to clinical trials. Conclusions We propose that by improving the ability to track willing potential research participants, we can improve recruitment into clinical trials and, in the process, improve patient education by introducing multimedia to informed consent documents.

Evaluating the usability of CAPTCHAs on a mobile device with voice and touch input

The usability of text-based CAPTCHAs, featuring distorted letters, and image-based CAPTCHAs, featuring pictures, was explored on an Apple iPad. Five conditions were explored: Confident CAPTCHA with either voice or touch input, ESP-PIX with voice or touch input, and Google’s CAPTCHA with touch input. Usability was analyzed in terms of performance, perceived usability, workload, and preference rankings. Results showed that CAPTCHAs involving touch input scored better in almost every measure than CAPTCHAs involving voice input. In particular, Confident Touch is recommended based on preference and perceived performance, whereas ESP-PIX Touch is recommended for its short completion time. When image-based CAPTCHAs are not feasible, Google’s CAPTCHA is a satisfactory alternative based on usability ratings.

An Empirical Study of the Usability of Consenting Systems: iPad, Touchscreen and Paper-based Systems

While much research has been conducted on the software system architecture needed for capturing and managing patient consents and research permissions in health care facilities, limited information is available on the usability of such capture systems. Typically, a general consenting process involves the patients indicating their choices and then signing/initialing to verify these preferences. This study proposes four new ways of capturing these consents/research permissions using Apple iPad and touchscreen-based systems, investigating their feasibility and usability by comparing them to the conventional paper-based consenting process. Fifteen participants completed the consenting process using five capture systems: iPad-based system with pagination and scrolling interfaces, touchscreen-based system with pagination and scrolling interfaces and the paper-based system. After each consenting condition, the participants completed the NASA Task Load Index (NASA-TLX), the computer system usability questionnaire (CSUQ), and a post-test subjective questionnaire ranking the consenting systems based on preference. Statistically significant differences among the consent capture systems were found for all dependent variables except for task completion time. The iPad and touchscreen systems with pagination interfaces were preferred.

An Investigation of the Informational Needs of Ovarian Cancer Patients and Their Supporters

Numerous Internet-based peer support groups exist to support the informational needs of patients with chronic illnesses. By analyzing the discussions available in the forum of a major ovarian cancer support group, the Ovarian Cancer National Alliance (OCNA), this study investigates the type of information that newly diagnosed ovarian cancer patients and their supporters seek. Using content analysis, 206 publicly available discussion posts exchanged on OCNA were analyzed by two researchers. Each discussion point was classified into one of the three broad themes that emerged: ovarian cancer-specific, treatment-related, or coping information. The discussion points were further analyzed using a multinomial logit model to predict the type of the desired information based on the role of the person looking for the information, the disease phase in which the information was sought, the emotional status of the information seeker, and the stage of the cancer. The results suggest that there is a wide variety of information seekers with divergent goals. Treatment-related material was the most sought-after information by patients, while coping information was most sought by supporters. When forum posts were negative in tone, the information seekers were more likely to be looking for ovarian cancer-specific information than either treatment-related information or coping information. This suggests that the presentation of ovarian cancer-specific information should be particularly sensitive to the negative emotional state of the people seeking this information.

An investigation of format modifications on the comprehension of information in consent form when presented on mobile devices

A major challenge associated with converting paper-based consent to electronic versions is to assure that the level of comprehension offered by the electronic consenting systems is not reduced. A randomized between-subject trial comparing patient comprehension with four different electronic consenting formats of the same consent information presented on an Apple iPad was conducted using a non-clinical sample of 32 participants. The formats were Text-Based, text-based with Text Being Read out, Video-Based and Video-Based with Subtitles. The participants were asked to read and complete a consent form in one of the formats. The participants were subsequently asked to complete a semantic comprehension quiz, the NASA Task Load Index and the computer system usability questionnaire (CSUQ). Upon completing the questionnaires, the participants took part in a retrospective think-aloud session to understand any difficulties they had using the consent forms. Statistically significant differences among the formats were found for task completion time, the mental demand and frustration sub-components of the NASA-TLX, and the comprehension quiz. Video with subtitles to convey consent information appears to be the best format among the formats tested for electronic consent presentation.