Marilyn Rose McGee-Lennon

Evaluation of a mobile phone-based, advanced symptom management system (ASyMS©) in the management of chemotherapy-related toxicity

ObjectivesTo evaluate the impact of a mobile phone-based, remote monitoring, advanced symptom management system (ASyMS©) on the incidence, severity and distress of six chemotherapy-related symptoms (nausea, vomiting, fatigue, mucositis, hand–foot syndrome and diarrhoea) in patients with lung, breast or colorectal cancer.DesignA two group (intervention and control) by five time points (baseline, pre-cycle 2, pre-cycle 3, pre-cycle 4 and pre-cycle 5) randomised controlled trial.SettingSeven clinical sites in the UK; five specialist cancer centres and two local district hospitals.ParticipantsOne hundred and twelve people with breast, lung or colorectal cancer receiving outpatient chemotherapy.InterventionsA mobile phone-based, remote monitoring, advanced symptom management system (ASyMS©).Main outcome measuresChemotherapy-related morbidity of six common chemotherapy-related symptoms (nausea, vomiting, fatigue, mucositis, hand–foot syndrome and diarrhoea).ResultsThere were significantly higher reports of fatigue in the control group compared to the intervention group (odds ratio = 2.29, 95%CI = 1.04 to 5.05, P = 0.040) and reports of hand–foot syndrome were on average lower in the control group (odds ratio control/intervention = 0.39, 95%CI = 0.17 to 0.92, P = 0.031).ConclusionThe study demonstrates that ASyMS© can support the management of symptoms in patients with lung, breast and colorectal cancer receiving chemotherapy.

User-centred multimodal reminders for assistive living

While there has been a lot of research on the usability of reminders and alarms in the work context, the home has been somewhat neglected despite the importance of reminder systems for telecare and assistive living systems. We conducted a comprehensive mixed-methods study into the requirements for useable and acceptable reminders in the home. The study consisted of a questionnaire (N=379), 6 focus groups, and 7 home tour interviews. Our results highlight the need for highly flexible and contextualized multimodal and multi-device reminder solutions that build on existing successful strategies for remembering in and around the home. We suggest that developers of home care reminder systems should design for diversity, context, priorities, autonomy, shared spaces, and optimal care.

The efficacy of cognitive prosthetic technology for people with memory impairments: A systematic review and meta-analysis

Technology can compensate for memory impairment. The efficacy of assistive technology for people with memory difficulties and the methodology of selected studies are assessed. A systematic search was performed and all studies that investigated the impact of technology on memory performance for adults with impaired memory resulting from acquired brain injury (ABI) or a degenerative disease were included. Two 10-point scales were used to compare each study to an ideally reported single case experimental design (SCED) study (SCED scale; Tate et al., 2008) or randomised control group study (PEDro-P scale; Maher, Sherrington, Herbert, Moseley, & Elkins, 2003). Thirty-two SCED (mean = 5.9 on the SCED scale) and 11 group studies (mean = 4.45 on the PEDro-P scale) were found. Baseline and intervention performance for each participant in the SCED studies was re-calculated using non-overlap of all pairs (Parker & Vannest, 2009) giving a mean score of 0.85 on a 0 to 1 scale (17 studies, n = 36). A meta-analysis of the efficacy of technology vs. control in seven group studies gave a large effect size (d = 1.27) (n = 147). It was concluded that prosthetic technology can improve performance on everyday tasks requiring memory. There is a specific need for investigations of technology for people with degenerative diseases.

Requirements engineering for home care technology

The focus of this work is the requirements engineering process in the home care domain. The overall aim is to design and document a flexible methodology to facilitate the elicitation of complex, dynamic, multi-stakeholder requirements and needs. This paper details the complexity and uniqueness of the home care domain and outlines the features of home care that demand a new or tailored approach to requirements engineering. It concludes by presenting a consolidated list of features that must be available or supported in requirements engineering methods in the home care domain.

Delivering Digital Health and Well-Being at Scale: Lessons Learned during the Implementation of the dallas Program in the United Kingdom

Abstract Objective To identify implementation lessons from the United Kingdom Delivering Assisted Living Lifestyles at Scale (dallas) program—a large-scale, national technology program that aims to deliver a broad range of digital services and products to the public to promote health and well-being. Materials and Methods Prospective, longitudinal qualitative research study investigating implementation processes. Qualitative data collected includes semi-structured e-Health Implementation Toolkit–led interviews at baseline/mid-point ( n = 38), quarterly evaluation, quarterly technical and barrier and solutions reports, observational logs, quarterly evaluation alignment interviews with project leads, observational data collected during meetings, and ethnographic data from dallas events ( n > 200 distinct pieces of qualitative data). Data analysis was guided by Normalization Process Theory, a sociological theory that aids conceptualization of implementation issues in complex healthcare settings. Results Five key challenges were identified: 1) The challenge of establishing and maintaining large heterogeneous, multi-agency partnerships to deliver new models of healthcare; 2) The need for resilience in the face of barriers and set-backs including the backdrop of continually changing external environments; 3) The inherent tension between embracing innovative co-design and achieving delivery at pace and at scale ; 4) The effects of branding and marketing issues in consumer healthcare settings; and 5) The challenge of interoperability and information governance, when commercial proprietary models are dominant. Conclusions The magnitude and ambition of the dallas program provides a unique opportunity to investigate the macro level implementation challenges faced when designing and delivering digital health and wellness services at scale. Flexibility, adaptability, and resilience are key implementation facilitators when shifting to new digitally enabled models of care.

The role of modality in notification performance

The primary users of home care technology often have significant sensory impairments. Multimodal interaction can make home care technology more accessible and appropriate, yet most research in the field of multimodal notifications is not aimed at the home but at office or high-pressure environments. This paper presents an experiment that compared the disruptiveness and effectiveness of visual, auditory, tactile and olfactory notifications. The results showed that disruption in the primary task was the same regardless of the notification modality. It was also found that differences in notification effectiveness were due to the inherent traits of a modality, e.g.olfactory notifications were slowest to deliver. The results of this experiment allow researchers and developers to capitalize on the different properties of multimodal techniques, with significant implications for home care technology and technology targeted at users with sensory impairments.

Name that tune: musicons as reminders in the home

In this paper we argue that Musicons, short samples from pieces of music are a useful way to present private but memorable reminder messages. We investigated accuracy, memorability and response times for short, medium, and long Musicons. User performance on the Musicons was also compared to short spoken reminders. The study consisted of two sessions a week apart. Quantitative measures were augmented with qualitative questions about associations and memories. Overall, participants achieved a high level of accuracy (89%) on the Musicons. Recognition was stable at 90% or better across sessions for users who were able to construct meaningful links between Musicons and the associated tasks. Optimal response times were achieved for medium-length 0.5 sec. Musicons. We conclude that Musicons are a viable option for alarms and notifications that combine the high learnability of Auditory Icons with the more private nature of Earcons.

Multiple notification modalities and older users

Multimodal interaction can make home care reminder systems more accessible to their users, most of whom are older and/or have sensory impairments. Existing research into the properties of different notification modalities have used younger participants rather than members of the older population at which they are aimed. This paper presents the results of a user study with older adults that examined how different notification modalities affected (a) performance in a card matching game and (b) how effective the different modalities were at delivering information. Participants were all aged over 50 and notifications were delivered using textual, pictographic, abstract visual, speech, Earcon, Auditory Icon, tactile and olfactory modalities while playing the game. The results showed that older users were influenced by the same factors as younger users, yet there were subjective differences. The implications for the design of multimodal reminder systems for home care are discussed.

The impact of unwanted multimodal notifications

Multimodal interaction can be used to make home care technology more effective and appropriate, particularly for people with sensory impairments. Previous work has revealed how disruptive notifications in different modalities are to a home-based task, but has not investigated how disruptive unwanted notifications might be. An experiment was conducted which evaluated the disruptive effects of unwanted notifications when delivered in textual, pictographic, abstract visual, speech, earcon, auditory icon, tactile and olfactory modalities. It was found that for all the modalities tested, both wanted and unwanted notifications produced similar reductions in error rate and task success, independent of modality. The results demonstrate the need to control and limit the number of unwanted notifications delivered in the home and contribute to a large body of work advocating the inclusion of multiple interaction modalities.

Pervasive healthcare: from orange alerts to mindcare

This purpose of this article is to help the reader understand the research area of pervasive healthcare and pervasive healthcare computing. It defines the term, and discusses the 2011 conference on Pervasive Computing Technologies for Healthcare, held in Dublin, Ireland. In particular, it examines the workshops proposed for the conference, highlighting the current exploratory research on the fringe of the area of pervasive computing, before discussing the implications for mainstream healthcare.