Martin Wiesner

Adapting recommender systems to the requirements of personal health record systems

In the future many people in industrialized countries will manage their personal health data electronically in centralized, reliable and trusted repositories - so-called personal health record systems (PHR). At this stage PHR systems still fail to satisfy the individual medical information needs of their users. Personalized recommendations could solve this problem. A first approach of integrating recommender system (RS) methodology into personal health records - termed health recommender system (HRS) - is presented. By exploitation of existing semantic networks like Wikipedia a health graph data structure is obtained. The data kept within such a graph represent health related concepts and are used to compute semantic distances among pairs of such concepts. A ranking procedure based on the health graph is outlined which enables a match between entries of a PHR system and health information artifacts. This way a PHR user will obtain individualized health information he might be interested in.

Patient guidelines in oncology: objectives, procedures and first experiences with this format

For several years patient versions of guidelines have become mandatory in the German Guidelines Program in Oncology (GGPO). Based on the methodology that has been developed for the German National Disease Management Guidelines Program, patient versions of guidelines translate the recommendations of clinical practice guideline into plain language and provide information about the harms and benefits of the interventions being addressed in the guideline. They are developed by a group of guideline authors (experts as well as patients), they are consensus-based and aim to create transparency in recommendations for physicians and their rationales. An automated analysis of readability shows that patient versions of guidelines are specific to the target group of educated lay people. Moreover, the responses to a reader feedback questionnaire indicate that comprehensibility, level of detail and depth of information are considered highly relevant and positive by users. Thus, patient versions of guidelines meet the needs of a specific target group. Nevertheless, the development of other formats for readers with low levels of health literacy or cognitive competencies is desirable. Currently it remains unclear if these simplified formats are able to reflect the complexity of high quality clinical practice guidelines.

Accuracy and adoption of wearable technology used by active citizens: a marathon event field study

Background Today, runners use wearable technology such as global positioning system (GPS)–enabled sport watches to track and optimize their training activities, for example, when participating in a road race event. For this purpose, an increasing amount of low-priced, consumer-oriented wearable devices are available. However, the variety of such devices is overwhelming. It is unclear which devices are used by active, healthy citizens and whether they can provide accurate tracking results in a diverse study population. No published literature has yet assessed the dissemination of wearable technology in such a cohort and related influencing factors. Objective The aim of this study was 2-fold: (1) to determine the adoption of wearable technology by runners, especially “smart” devices and (2) to investigate on the accuracy of tracked distances as recorded by such devices. Methods A pre-race survey was applied to assess which wearable technology was predominantly used by runners of different age, sex, and fitness level. A post-race survey was conducted to determine the accuracy of the devices that tracked the running course. Logistic regression analysis was used to investigate whether age, sex, fitness level, or track distance were influencing factors. Recorded distances of different device categories were tested with a 2-sample t test against each other. Results A total of 898 pre-race and 262 post-race surveys were completed. Most of the participants (approximately 75%) used wearable technology for training optimization and distance recording. Females (P=.02) and runners in higher age groups (50-59 years: P=.03; 60-69 years: P<.001; 70-79 year: P=.004) were less likely to use wearables. The mean of the track distances recorded by mobile phones with combined app (mean absolute error, MAE=0.35 km) and GPS-enabled sport watches (MAE=0.12 km) was significantly different (P=.002) for the half-marathon event. Conclusions A great variety of vendors (n=36) and devices (n=156) were identified. Under real-world conditions, GPS-enabled devices, especially sport watches and mobile phones, were found to be accurate in terms of recorded course distances.

Leveraging semantic networks for personalized content in health recommender systems

Since the emergence of the Internet in the early 90s of the last century medical knowledge is spreading around the globe increasingly fast. Though publicly available, it is a difficult task to determine individual relevance for most non professionals. Additionally, relationships between medical terms are hard to discover even for professionals. In this paper we present an approach on how semantic query expansion can be exploited to enhance classic information retrieval (IR) techniques in order to gather health information artifacts for consumers. The approach is based on health related semantic networks which are automatically generated from public resources such as Wikipedia. A scenario for integrating such networks is a so-called health recommender systems (HRS) which can be embedded into a personal health record system (PHRS). This way, relevant personalized medical content can be delivered automatically to end users and owners of health records.

Understandability of Patient Information Booklets for Patients with Cancer

The improvement of health literacy in general and the information of individual patient is a major concern of the German national cancer plan and similar initiatives in other western countries. The aim of our study was to assess the readability and understandability of information booklets for cancer patients available at German Web sites. A support vector machine (SVM) was used to discriminate between laymen- and expert-centric patient information booklets about nine most common tumor types. All booklets had to be available for free at the Internet. A total of 52 different patient booklets were downloaded and assessed. Overall, the assessment of all booklets showed that an understandability level L of 4.6 and therefore increased medical background knowledge is required to understand a random text selected from the sample. The assessed information booklets on cancer show very limited suitability for laymen. We were able to demonstrate that a medical background is necessary to understand the examined booklets. The current study highlights the need to create information material adjusted to the needs of laymen. Assessing understandability before publication, especially for laymen with low health literacy, could ensure the suitability and thus quality of the information material.

Satisfying health information needs: A German health exhibition example

Though medical knowledge is spreading around the globe increasingly fast, it is a difficult task to determine individual relevance for most non-professionals. In this paper we describe our findings and experiences on how interactive touchscreen-based software can support the general public in exploring and understanding the health related domain. A health related Semantic Network is used to visualize relationships among topics of interest. A field test of our browser-based UI was conducted at a public health exhibition, which toured throughout Germany and Austria during 2011.

Computer-Based Readability Testing of Information Booklets for German Cancer Patients

Understandable health information is essential for treatment adherence and improved health outcomes. For readability testing, several instruments analyze the complexity of sentence structures, e.g., Flesch-Reading Ease (FRE) or Vienna-Formula (WSTF). Moreover, the vocabulary is of high relevance for readers. The aim of this study is to investigate the agreement of sentence structure and vocabulary-based (SVM) instruments. A total of 52 freely available German patient information booklets on cancer were collected from the Internet. The mean understandability level L was computed for 51 booklets. The resulting values of FRE, WSTF, and SVM were assessed pairwise for agreement with Bland–Altman plots and two-sided, paired t tests. For the pairwise comparison, the mean L values are LFRE = 6.81, LWSTF = 7.39, LSVM = 5.09. The sentence structure-based metrics gave significantly different scores (P < 0.001) for all assessed booklets, confirmed by the Bland–Altman analysis. The study findings suggest that vocabulary-based instruments cannot be interchanged with FRE/WSTF. However, both analytical aspects should be considered and checked by authors to linguistically refine texts with respect to the individual target group. Authors of health information can be supported by automated readability analysis. Health professionals can benefit by direct booklet comparisons allowing for time-effective selection of suitable booklets for patients.