Philip Makedonski

Sources of Information and Behavioral Patterns in Online Health Forums: Observational Study

Background Increasing numbers of patients are raising their voice in online forums. This shift is welcome as an act of patient autonomy, reflected in the term “expert patient”. At the same time, there is considerable concern that patients can be easily misguided by pseudoscientific research and debate. Little is known about the sources of information used in health-related online forums, how users apply this information, and how they behave in such forums. Objective The intent of the study was to identify (1) the sources of information used in online health-related forums, and (2) the roles and behavior of active forum visitors in introducing and disseminating this information. Methods This observational study used the largest German multiple sclerosis (MS) online forum as a database, analyzing the user debate about the recently proposed and controversial Chronic Cerebrospinal Venous Insufficiency (CCSVI) hypothesis. After extracting all posts and then filtering relevant CCSVI posts between 01 January 2008 and 17 August 2012, we first identified hyperlinks to scientific publications and other information sources used or referenced in the posts. Employing k-means clustering, we then analyzed the users’ preference for sources of information and their general posting habits. Results Of 139,912 posts from 11,997 threads, 8628 posts discussed or at least mentioned CCSVI. We detected hyperlinks pointing to CCSVI-related scientific publications in 31 posts. In contrast, 2829 different URLs were posted to the forum, most frequently referring to social media, such as YouTube or Facebook. We identified a total of 6 different roles of hyperlink posters including Social Media Fans, Organization Followers, and Balanced Source Users. Apart from the large and nonspecific residual category of the “average user”, several specific behavior patterns were identified, such as the small but relevant groups of CCSVI-Focused Responders or CCSVI Activators. Conclusions The bulk of the observed contributions were not based on scientific results, but on various social media sources. These sources seem to contain mostly opinions and personal experience. A small group of people with distinct behavioral patterns played a core role in fuelling the discussion about CCSVI.

Adressing problems with external validity of repository mining studies through a smart data platform

Research in software repository mining has grown considerably the last decade. Due to the data-driven nature of this venue of investigation, we identified several problems within the current state-of-the-art that pose a threat to the external validity of results. The heavy re-use of data sets in many studies may invalidate the results in case problems with the data itself are identified. Moreover, for many studies data and/or the implementations are not available, which hinders a replication of the results and, thereby, decreases the comparability between studies. Even if all information about the studies is available, the diversity of the used tooling can make their replication even then very hard. Within this paper, we discuss a potential solution to these problems through a cloud-based platform that integrates data collection and analytics. We created the prototype SmartSHARK that implements our approach. Using SmartSHARK, we collected data from several projects and created different analytic examples. Within this article, we present SmartSHARK and discuss our experiences regarding the use of SmartSHARK and the mentioned problems.

Scientific Versus Experiential Evidence: Discourse Analysis of the Chronic Cerebrospinal Venous Insufficiency Debate in a Multiple Sclerosis Forum.

Background The vascular hypothesis of multiple sclerosis (MS), called chronic cerebrospinal venous insufficiency (CCSVI), and its treatment (known as liberation therapy) was immediately rejected by experts but enthusiastically gripped by patients who shared their experiences with other patients worldwide by use of social media, such as patient online forums. Contradictions between scientific information and lay experiences may be a source of distress for MS patients, but we do not know how patients perceive and deal with these contradictions. Objective We aimed to understand whether scientific and experiential knowledge were experienced as contradictory in MS patient online forums and, if so, how these contradictions were resolved and how patients tried to reconcile the CCSVI debate with their own illness history and experience. Methods By using critical discourse analysis, we studied CCSVI-related posts in the patient online forum of the German MS Society in a chronological order from the first post mentioning CCSVI to the time point when saturation was reached. For that time period, a total of 117 CCSVI-related threads containing 1907 posts were identified. We analyzed the interaction and communication practices of and between individuals, looked for the relation between concrete subtopics to identify more abstract discourse strands, and tried to reveal discourse positions explaining how users took part in the CCSVI discussion. Results There was an emotionally charged debate about CCSVI which could be generalized to 2 discourse strands: (1) the “downfall of the professional knowledge providers” and (2) the “rise of the nonprofessional treasure trove of experience.” The discourse strands indicated that the discussion moved away from the question whether scientific or experiential knowledge had more evidentiary value. Rather, the question whom to trust (ie, scientists, fellow sufferers, or no one at all) was of fundamental significance. Four discourse positions could be identified by arranging them into the dimensions “trust in evidence-based knowledge,” “trust in experience-based knowledge,” and “subjectivity” (ie, the emotional character of contributions manifested by the use of popular rhetoric that seemed to mask a deep personal involvement). Conclusions By critical discourse analysis of the CCSVI discussion in a patient online forum, we reconstruct a lay discourse about the evidentiary value of knowledge. We detected evidence criteria in this lay discourse that are different from those in the expert discourse. But we should be cautious to interpret this dissociation as a sign of an intellectual incapability to understand scientific evidence or a naïve trust in experiential knowledge. Instead, it might be an indication of cognitive dissonance reduction to protect oneself against contradictory information.

Towards a Model-based Software Mining Infrastructure

Software mining is concerned with two primary goals: the extraction of basic facts from software repositories and the derivation of knowledge resulting from the assessment of the basic facts. Facts extraction approaches rely on custom and task-specific infrastructures and tools. The resulting facts assets are usually represented in heterogeneous formats at a low level of abstraction. Due to this, facts extracted from different sources are also not well integrated, even if they are related. To manage this, existing infrastructures often aim at supporting an all-in-one information meta-structures which try to integrate all facts in one connected whole. We propose a generic infrastructure that translates extracted facts to homogeneous high-level representations conforming to domain-specific metamodels, and then transforms these high-level model instances to instances of domain-specific models related to a particular assessment task, which can be incrementally enriched with additional facts as these become available or necessary. This allows researchers and practitioners to focus on the assessment task at hand, without being concerned with low-level representation details or complex data models containing large amounts of often irrelevant data. We present an example scenario with a concrete instantiation of the proposed infrastructure targeting the assessment of developer behaviour.

Addressing problems with replicability and validity of repository mining studies through a smart data platform

The usage of empirical methods has grown common in software engineering. This trend spawned hundreds of publications, whose results are helping to understand and improve the software development process. Due to the data-driven nature of this venue of investigation, we identified several problems within the current state-of-the-art that pose a threat to the replicability and validity of approaches. The heavy re-use of data sets in many studies may invalidate the results in case problems with the data itself are identified. Moreover, for many studies data and/or the implementations are not available, which hinders a replication of the results and, thereby, decreases the comparability between studies. Furthermore, many studies use small data sets, which comprise of less than 10 projects. This poses a threat especially to the external validity of these studies. Even if all information about the studies is available, the diversity of the used tooling can make their replication even then very hard. Within this paper, we discuss a potential solution to these problems through a cloud-based platform that integrates data collection and analytics. We created SmartSHARK, which implements our approach. Using SmartSHARK, we collected data from several projects and created different analytic examples. Within this article, we present SmartSHARK and discuss our experiences regarding the use of it and the mentioned problems. Additionally, we show how we have addressed the issues that we have identified during our work with SmartSHARK.

Quantifying the evolution of TTCN-3 as a language

Ten years of maintenance, nine published revisions of the standards for the Testing and Test Control Notation version 3 (TTCN-3), more than 500 change requests since 2006, and 10 years of activity on the official TTCN-3 mailing list add up to a rich history, not unlike that of many successful Open Source Software (OSS) projects. In this article, we contemplate TTCN-3 in the context of software evolution and examine its history quantitatively. We mined the changes in the textual content of the standards, the data in change requests from the past 5 years, and the mailing list archives from the past 10 years. In addition, to characterize the use of the TTCN-3 we investigated the meta-data of the contributions at the TTCN-3 User Conference, and the use of language constructs in a large-scale TTCN-3 test suite. Based on these data sets, we first analyze the amount, density, and location of changes within the different parts of the standard. Then, we analyze the activity and focus of the user community and the maintenance team in both the change request management system and the official TTCN-3 mailing list. Finally, we analyze the distribution of contributions at the TTCN-3 User Conference across different topics over the past 8 years and construct use anomalies during the development of a large-scale test suite. Our findings indicate that the TTCN-3 is becoming increasingly stable as the overall change density and intensity, as well as the number of change requests are decreasing, despite the monotonous increase in the size of the standards.

Validating the Behavioral Equivalence of TTCN-3 Test Cases

Refactoring has been proven as useful means to improve the quality of source code. However, when improperly applied, it may introduce undesired changes to the observable behavior of the software. In this paper, an equivalence checking approach is presented to validate the behavior preservation after the application of refactoring in the domain of test cases specified using the Testing and Test Control Notation Version 3 (TTCN-3). The approach is based on bisimulation and incrementally checks the observable behavior of two test cases at runtime for equivalence. The approach is implemented prototypically and sample experiments are conducted to evaluate the effectiveness of the approach.

Evolving the ETSI Test Description Language

Increasing software and system complexity due to the integration of more and more diverse sub-systems presents new testing challenges. Standardisation and certification requirements in certain domains such as telecommunication, automotive, aerospace, and health-care contribute further challenges for testing systems operating in these domains. Consequently, there is a need for suitable methodologies, processes, languages, and tools to address these testing challenges. To address some of these challenges, the Test Description Language (TDL) has been developed at the European Telecommunications Standards Institute (ETSI) over the past three years. TDL bridges the gap between declarative test purposes and imperative test cases by offering a standardised language for the specification of test descriptions. TDL started as a standardised meta-model, subsequently enriched with a graphical syntax, exchange format, and a UML profile. A reference implementation of TDL has been developed as a common platform to accelerate the adoption of TDL and lower the barrier to entry for both end-users and tool-vendors. This article tells the story of the evolution of TDL from its conception.

Title Correction: Sources of Information and Behavioral Patterns in Online Health Forums: Observational Study

[This corrects the article DOI: .].

Sources of Information and Behavioral Patterns in Online Health Forums: Qualitative Study

Background Increasing numbers of patients are raising their voice in online forums. This shift is welcome as an act of patient autonomy, reflected in the term “expert patient”. At the same time, there is considerable concern that patients can be easily misguided by pseudoscientific research and debate. Little is known about the sources of information used in health-related online forums, how users apply this information, and how they behave in such forums. Objective The intent of the study was to identify (1) the sources of information used in online health-related forums, and (2) the roles and behavior of active forum visitors in introducing and disseminating this information. Methods This observational study used the largest German multiple sclerosis (MS) online forum as a database, analyzing the user debate about the recently proposed and controversial Chronic Cerebrospinal Venous Insufficiency (CCSVI) hypothesis. After extracting all posts and then filtering relevant CCSVI posts between 01 January 2008 and 17 August 2012, we first identified hyperlinks to scientific publications and other information sources used or referenced in the posts. Employing k-means clustering, we then analyzed the users’ preference for sources of information and their general posting habits. Results Of 139,912 posts from 11,997 threads, 8628 posts discussed or at least mentioned CCSVI. We detected hyperlinks pointing to CCSVI-related scientific publications in 31 posts. In contrast, 2829 different URLs were posted to the forum, most frequently referring to social media, such as YouTube or Facebook. We identified a total of 6 different roles of hyperlink posters including Social Media Fans, Organization Followers, and Balanced Source Users. Apart from the large and nonspecific residual category of the “average user”, several specific behavior patterns were identified, such as the small but relevant groups of CCSVI-Focused Responders or CCSVI Activators. Conclusions The bulk of the observed contributions were not based on scientific results, but on various social media sources. These sources seem to contain mostly opinions and personal experience. A small group of people with distinct behavioral patterns played a core role in fuelling the discussion about CCSVI.