Continuous physical activity recording - Consumer-based activity trackers in epidemiological studies

Physical activity is an important modifiable lifestyle factor that can improve general health and reduce the risk of disease. Currently, collecting data on physical activity in epidemiological studies are generally limited to long-term but self-reported and inaccurate physical activity questionnaires and/or using short-term but objective and more accurate accelerometers. Consumer-based activity trackers are designed for long-term objective data collection and can therefore potentially be used to close this gap. The objective of this dissertation was therefore to explore and develop new methods for collecting data on physical activity in epidemiological studies using consumer-based activity trackers. The four included papers apply different methods to explore the objective from multiple angles. Results includes an overview of how activity tracker sensor support has changed over time, recommendations when choosing an activity tracker model for future physical activity research, recommendations for increasing activity tracker wear time among participants in clinical studies, as well as knowledge about activity tracker validity and physical activity trends during the Norwegian COVID-19 lockdown in 2020. Finally, the dissertation describes a system for automatic and continuous data collection using consumer-based activity trackers from multiple providers. We show the usability of this system by accessing and analysing historic activity tracker data from participants who wore a tracker before-, during-, and after the COVID-19 lockdown period. The proposed system can be a valuable addition to existing methods for physical activity assessment by contributing to closing the above-mentioned method gap

Älykellojen käyttöliittymien ja käytettävyyden tutkimus

Tiivistelmä. Puettava teknologia on lisääntynyt kiihtyvää vauhtia ihmisten päivittäisessä käytössä. Älykellojen ja aktiivisuusrannekkeiden avulla voidaan tukea ihmisten liikkuvuutta ja ne voivat tuoda apuvälineitä päivittäisiin askareihin. Älykellot ovat suunniteltu kaikille ikäryhmille käytettäviksi. Pienen näytön ja vähäisten ohjaus metodien vuoksi niiden käyttöliittymät pitäisi olla helppokäyttöisiä kaikille. Uusia ominaisuuksia ja aplikaatioita tuotetaan älykelloille valmistajien toimesta jatkuvasti. Tässä kandidaatintyössä tutkitaan viimeisten vuosien aikana tapahtunutta kehitystä älykellojen käytettävyydessä ja käyttöliittymien suunnittelussa. Tutkielmassa käydään läpi uusia kehitettyjä älykellojen käyttöliittymä tyyppejä ja älykellojen käytettävyydestä tehtyjä tutkimuksia. Tarkoituksena on tutkia, millä tavoin käytettävyyttä on parannettu. Tutkielmassa analysoidaan, millaiset elementit käyttöliittymissä tekevät älykelloista helppokäyttöisiä ja millaiset aiheuttavat ongelmia käyttäjille. Työssä myös otetaan selvää, miten käytettävyysongelmia on ratkaistu ja mitä niistä on opittu. Käymme myös läpi tutkimusten avulla tehtyjä havaintoja käytettävyydestä ja esittelimme uusia innovaatioita, joilla käyttöä tuetaan. Tutkielmassa löysimme tapoja, joilla älykellon näyttöä, nappeja, liike-eleitä ja muita liitettäviä lisäosia voidaan hyödyntää käyttöliittymän kehittämiseen. Saimme selville, että 4–8 kuvaketta on paras elementtien määrä älykellon näytöllä. Kuitenkin opimme, että älykello ei välttämättä vaadi näyttöä tarjotakseen tarvittavan informaation. Totesimme myös, että älykellon näyttö soveltuu hyvin muiden suurempien laitteiden ohjaukseen. Parhaaksi mekaaniseksi syötteeksi valitsimme digitaalisen kruunun. Kosketusnäytön osoitimme olevan hyödyllinen, sillä käyttäjä voi kirjoittaa näppäimistöä hyödyntäen. Esittelemme useita liike-eleitä käyttäviä prototyyppejä, jotka helpottavat käyttöä. Osoitamme, kuinka pienillä käden liikkeillä saadaan annettua komentoja kellolle. Toteamme myös äänieleiden ja sormuslisäosien helpottavan käyttöä. Päädyimme selkeään johtopäätökseen kellojen käyttötarkoituksesta tutkimuksia analysoidessa. Älykellot soveltuvat vain ilmoitusten katsomiseen, puheluiden hallitsemiseen, musiikin soittamiseen ja muihin yksinkertaisiin tehtäviin. Käyttötapahtumat ovat lyhyitä ja niitä on tihein välein. Tämän vuoksi niiden käyttöliittymät tulisi suunnitella näitä varten. Kävimme läpi myös käyttäjäryhmiin tehtyjä tutkimuksia ja löysimme niihin liittyviä käyttöongelmia, joista on tehty suunnittelua tukevia käytettävyyskehyksiä. Löysimme käyttöliittymiin parannusehdotuksiksi kuvakkeiden koon kasvatuksen, valikkojen selkeytyksen ja näyttöjen kosketusherkkyyden lisäämisen.Smartwatch user interface and usability study. Abstract. The use of wearable technology has increased at an accelerating pace in people’s daily life. Smartwatches and activity bracelets can support people’s mobility and provide tools to help with daily chores. Smart watches are made for all ages. User interface must be easy to use for everyone because smartwatches have small screens and minimal control methods. New improvements and applications for smartwatches are continually produced by manufacturers. This bachelor thesis examines the development that has happened over the last five years in the use of smartwatches and in the design of smartwatch user interfaces. This thesis goes through the different types of smartwatch user interfaces that have been developed in recent years and studies on the usability of smartwatches. The aim is to examine the way usability has the advanced. In this thesis we try to find the elements in the interfaces which make smartwatches easy to use and which create problems for the users. In this study we explore how usage problems have been solved and what we have learned from them. We go through studies on the smartwatch usability and introduce new innovations that help their usage. Analysing the studies we found ways that smartwatches screen, buttons, movement based gestures and other add-ons can be used for developing easier user interfaces. We found out that 4–8 icons to be correct number of elements on the screen. However, we learned that a smartwatch does not necessarily require a display to provide the necessary information. We also found that the smartwatch’s display is well suited for controlling other larger devices. We chose the digital crown as the best mechanical input. We proved the touch screen to be useful by showing how it can be used for typing on a keyboard. We present several prototypes that use movement based gestures to improve the usability. By using their hand movement the user can give commands to the smartwatch. We also prove sound gestures and ring accessories to be useful. We also found out the ways people use smartwatches. Smartwatches are suitable for viewing notifications, managing calls, playing music and other simple tasks. Usage sessions are short and occur at frequent intervals. That is why we recommend their user interfaces should be designed for these tasks. In the thesis we also go through studies made on the user groups and find the types of user problems connected to them. We show how these user problems have been implemented for making usability frameworks which support usable smartwatch interface design. We found suggestions for improvements in user interfaces. Suggestions are to increase the size of the icons, clarify the menus, and increase the sensitivity of the screens

Design Principles of Mobile Information Systems in the Digital Transformation of the Workplace - Utilization of Smartwatch-based Information Systems in the Corporate Context

During the last decades, smartwatches emerged as an innovative and promising technology and hit the consumer market due to the accessibility of affordable devices and predominant acceptance caused by the considerable similarity to common wristwatches. With the unique characteristics of permanent availability, unobtrusiveness, and hands-free operation, they can provide additional value in the corporate context. Thus, this thesis analyzes use cases for smartwatches in companies, elaborates on the design of smartwatch-based information systems, and covers the usability of smartwatch applications during the development of smartwatch-based information systems. It is composed of three research complexes. The first research complex focuses on the digital assistance of (mobile) employees who have to execute manual work and have been excluded so far from the benefits of the digitalization since they cannot operate hand-held devices. The objective is to design smartwatch-based information systems to support workflows in the corporate context, facilitate the daily work of numerous employees, and make processes more efficient for companies. During a design science research approach, smartwatch-based software artifacts are designed and evaluated in use cases of production, support, security service, as well as logistics, and a nascent design theory is proposed to complement theory according to mobile information system research. The evaluation shows that, on the one hand, smartwatches have enormous potential to assist employees with a fast and ubiquitous exchange of information, instant notifications, collaboration, and workflow guidance while they can be operated incidentally during manual work. On the other hand, the design of smartwatch-based information systems is a crucial factor for successful long-term deployment in companies, and especially limitations according to the small form-factor, general conditions, acceptance of the employees, and legal regulations have to be addressed appropriately. The second research complex addresses smartwatch-based information systems at the office workplace. This broadens and complements the view on the utilization of smartwatches in the corporate context in addition to the mobile context described in the first research complex. Though smartwatches are devices constructed for mobile use, the utilization in low mobile or stationary scenarios also has benefits due they exhibit the characteristic of a wearable computer and are directly connected to the employee’s body. Various sensors can perceive employee-, environment- and therefore context-related information and demand the employees’ attention with proactive notifications that are accompanied by a vibration. Thus, a smartwatch-based and gamified information system for health promotion at the office workplace is designed and evaluated. Research complex three provides a closer look at the topic of usability concerning applications running on smartwatches since it is a crucial factor during the development cycle. As a supporting element for the studies within the first and second research complex, a framework for the usability analysis of smartwatch applications is developed. For research, this thesis contributes a systemization of the state-of-the-art of smartwatch utilization in the corporate context, enabling and inhibiting influence factors of the smartwatch adoption in companies, and design principles as well as a nascent design theory for smartwatch-based information systems to support mobile employees executing manual work. For practice, this thesis contributes possible use cases for smartwatches in companies, assistance in decision-making for the introduction of smartwatch-based information systems in the corporate context with the Smartwatch Applicability Framework, situated implementations of a smartwatch-based information system for typical use cases, design recommendations for smartwatch-based information systems, an implementation of a smartwatch-based information system for the support of mobile employees executing manual work, and a usability-framework for smartwatches to automatically access usability of existing applications providing suggestions for usability improvement

Usability analysis of contending electronic health record systems

In this paper, we report measured usability of two leading EHR systems during procurement. A total of 18 users participated in paired-usability testing of three scenarios: ordering and managing medications by an outpatient physician, medicine administration by an inpatient nurse and scheduling of appointments by nursing staff. Data for audio, screen capture, satisfaction rating, task success and errors made was collected during testing. We found a clear difference between the systems for percentage of successfully completed tasks, two different satisfaction measures and perceived learnability when looking at the results over all scenarios. We conclude that usability should be evaluated during procurement and the difference in usability between systems could be revealed even with fewer measures than were used in our study. © 2019 American Psychological Association Inc. All rights reserved.Peer reviewe

Automatic Generation of Personalized Recommendations in eCoaching

Denne avhandlingen omhandler eCoaching for personlig livsstilsstøtte i sanntid ved bruk av informasjons- og kommunikasjonsteknologi. Utfordringen er å designe, utvikle og teknisk evaluere en prototyp av en intelligent eCoach som automatisk genererer personlige og evidensbaserte anbefalinger til en bedre livsstil. Den utviklede løsningen er fokusert på forbedring av fysisk aktivitet. Prototypen bruker bærbare medisinske aktivitetssensorer. De innsamlede data blir semantisk representert og kunstig intelligente algoritmer genererer automatisk meningsfulle, personlige og kontekstbaserte anbefalinger for mindre stillesittende tid. Oppgaven bruker den veletablerte designvitenskapelige forskningsmetodikken for å utvikle teoretiske grunnlag og praktiske implementeringer. Samlet sett fokuserer denne forskningen på teknologisk verifisering snarere enn klinisk evaluering.publishedVersio

Quantifying Quality of Life

Describes technological methods and tools for objective and quantitative assessment of QoL Appraises technology-enabled methods for incorporating QoL measurements in medicine Highlights the success factors for adoption and scaling of technology-enabled methods This open access book presents the rise of technology-enabled methods and tools for objective, quantitative assessment of Quality of Life (QoL), while following the WHOQOL model. It is an in-depth resource describing and examining state-of-the-art, minimally obtrusive, ubiquitous technologies. Highlighting the required factors for adoption and scaling of technology-enabled methods and tools for QoL assessment, it also describes how these technologies can be leveraged for behavior change, disease prevention, health management and long-term QoL enhancement in populations at large. Quantifying Quality of Life: Incorporating Daily Life into Medicine fills a gap in the field of QoL by providing assessment methods, techniques and tools. These assessments differ from the current methods that are now mostly infrequent, subjective, qualitative, memory-based, context-poor and sparse. Therefore, it is an ideal resource for physicians, physicians in training, software and hardware developers, computer scientists, data scientists, behavioural scientists, entrepreneurs, healthcare leaders and administrators who are seeking an up-to-date resource on this subject

Quantifying Quality of Life

Describes technological methods and tools for objective and quantitative assessment of QoL Appraises technology-enabled methods for incorporating QoL measurements in medicine Highlights the success factors for adoption and scaling of technology-enabled methods This open access book presents the rise of technology-enabled methods and tools for objective, quantitative assessment of Quality of Life (QoL), while following the WHOQOL model. It is an in-depth resource describing and examining state-of-the-art, minimally obtrusive, ubiquitous technologies. Highlighting the required factors for adoption and scaling of technology-enabled methods and tools for QoL assessment, it also describes how these technologies can be leveraged for behavior change, disease prevention, health management and long-term QoL enhancement in populations at large. Quantifying Quality of Life: Incorporating Daily Life into Medicine fills a gap in the field of QoL by providing assessment methods, techniques and tools. These assessments differ from the current methods that are now mostly infrequent, subjective, qualitative, memory-based, context-poor and sparse. Therefore, it is an ideal resource for physicians, physicians in training, software and hardware developers, computer scientists, data scientists, behavioural scientists, entrepreneurs, healthcare leaders and administrators who are seeking an up-to-date resource on this subject

Smart Sensing Technologies for Personalised Coaching

People living in both developed and developing countries face serious health challenges related to sedentary lifestyles. It is therefore essential to find new ways to improve health so that people can live longer and can age well. With an ever-growing number of smart sensing systems developed and deployed across the globe, experts are primed to help coach people toward healthier behaviors. The increasing accountability associated with app- and device-based behavior tracking not only provides timely and personalized information and support but also gives us an incentive to set goals and to do more. This book presents some of the recent efforts made towards automatic and autonomous identification and coaching of troublesome behaviors to procure lasting, beneficial behavioral changes

Methodological challenges in the evidence synthesis of health outcomes of digital health technologies [védés előtt]

Medical devices and pharmaceuticals are worlds apart, but healthcare would be impossible without them. Digital biomarkers are the subject of this thesis defined as objective, measurable, physiological, and behavioural parameters collected using wearable, portable, implantable, or digestible digital devices. Since the 1970s, systematic reviews and meta-analyses have dominated medical evidence synthesis. They provide medical decision-making evidence. To avoid biases and maintain methodological quality, the Cochrane Handbook recommends systematic reviews follow certain procedures during study stages. This thesis comprises six hypotheses related to digital biomarkers. The first hypothesis aimed to evaluate the suitability of using tools provided by the World Health Organization (WHO), including ICD-11 (International Classification of Diseases, 11th Revision), ICHI (International Classification of Health Interventions), and ICF (International Classification of Functioning, Disability and Health), for categorizing populations, interventions, outcomes, and behavioral/physiological data in studies involving digital biomarkers. The results indicated that these tools were not applicable for categorizing digital biomarker studies as a whole. However, further analysis revealed that these tools were suitable for categorizing digital biomarker studies involving non-general populations or populations with specific diseases. The second hypothesis focused on comparing the statistical power of direct and indirect digital biomarkers. The results indicated that there was no significant difference in power between these two types of digital biomarkers (p-value > 0.05). The next three hypotheses compared the characteristics of systematic reviews and meta-analyses of digital biomarker-based interventions with those of non-digital biomarkers or pharmaceuticals. The comparisons were made in terms of methodological quality, quality of evidence, and publication bias. Although all these hypotheses revealed non-significant differences between the two groups (p-values > 0.05), the results showed that both digital biomarkers and non-digital biomarkers or pharmaceuticals systematic reviews did not exhibit high methodological quality or quality of evidence. The Medical Device Regulation (MDR) has significantly improved European medical device regulatory standards, addressing the above concerns and improving clinical evidence. Despite MDR implementation delays, digital health technology evidence requirements are rising. Companies that achieve these higher clinical requirements will survive and obtain access to large interconnected markets, while those that fail may lose their market authorisation. Thus, medical technology enterprises may gain a competitive edge by strategically planning and executing extensive clinical investigations to provide high-quality clinical data. Developing these essential skills needs immediate attention and effort. Digital health investors should actively monitor industry players' evidence quality and clinical trial competence, since these characteristics may significantly increase company risk