Personal Health Manager – Designing an intermediary sys-tem supporting health education and exercise programs

The Personal Health Manager (PHM) is an IT-based product-service system (combining face to face, automated and computer-mediated services, hardware, software) supporting health exercise programs in workplace health promotion. Major HCI design challenges are different target groups, unstructured tasks, various hardware and service components, and finding the limit between face to face and automated services –ranging from top quality human supervision to cheap, scalable automated services in hedonic systems. We present an iterative development and test design as well as first design ideas. Through this case we try to highlight that traditional MIS and HCI approaches „as is‟ are hardly applicable for designing IT-based product-service systems and that new approaches are necessary

Problem solving patterns in design science research - Learning from engineering

Inactivity is the most widespread health risk factor in modern societies today, causing not only individual health problems but also immense costs for the healthcare systems. This emphasizes the need for improving population-wide impact of activity interventions, with particular attention to costeffectiveness, scalability, and delivery channels. In this paper, we present the theory-motivated design (drawing on the transtheoretical model) and empirical test of an IT-based physical activity programme (Personal Health Manager, PHM). In order to be as cost-effective as possible, the PHM was designed to have only few face-to-face contacts and to deliver supervision through the internet. Our design and implementation proved to be successful in a pilot test with 88 employees of an automotive company. The PHM increased participants’ activity, motivational readiness for change, functional capacity and transported the feeling of being well taken care of. Enhanced supervision did not increase performance. The results are first evidence that internet-mediated supervision can be successful in promoting physical activity and provide a starting point for investigating the role of faceto-face-contact and service levels in physical activity programs. The PHM and similar designs are also relevant to practice as the semi-automation makes them eligible for large-scale corporate or public health programs

Exploring Mobile Information Systems for Adolescent Cancer Patients

Abstract 1 Adolescent cancer patients have to deal with many dependencies and obligations. Very often they are torn out of their social environment and become isolated because of changing therapy cycles and different treatment locations. This causes significant social and economic damages. The objective of this article is to present the first steps of an empirical exploration of the possibilities of mobile IT-support for communication and coordination for this target group during treatment and aftercare. Special emphasis is put on the effects of mobile systems on the patient's perceived quality of life. The background here fore is a four-month field experiment conducted together with the cancer station of the hospital of Heidelberg University. We focus on particularities of and challenges for mobile information systems for patients in Germany and outline necessary future research aspects in this field

Myocardial Work Assessment for the Prediction of Prognosis in Advanced Heart Failure

Objectives: The aim of this study was to investigate whether echocardiographic assessment of myocardial work is a predictor of outcome in advanced heart failure. Background: Global work index (GWI) and global constructive work (GCW) are calculated bymeans of speckle tracking, blood pressuremeasurement, and a normalized reference curve. Their prognostic value in advanced heart failure is unknown. Methods: Cardiopulmonary exercise testing and echocardiography with assessment of GWI and GCW was performed in patients with advanced heart failure caused by ischemic heart disease or dilated cardiomyopathy (n = 105). They were then followed up repeatedly. The combined endpoint was all-cause death, implantation of a left ventricular assist device, or heart transplantation. Results: The median patient age was 54 years (interquartile range [IQR]: 48–59.9). The mean left ventricular ejection fraction was 27.8 ± 8.2%, the median NT-proBNP was 1,210 pg/ml (IQR: 435–3,696). The mean GWI was 603 ± 329 mmHg% and the mean GCW was 742 ± 363 mmHg%. The correlation between peak oxygen uptake and GWI as well as GCW was strongest in patients with ischemic cardiomyopathy (r = 0.56, p = 0.001 and r = 0.53, p = 0.001, respectively). The median follow-up was 16 months (IQR: 12–18.5). Thirty one patients met the combined endpoint: Four patients died, eight underwent transplantation, and 19 underwent implantation of a left ventricular assist device. In themultivariate Cox regression analysis, only NYHA class, NT-proBNP and GWI (hazard ratio [HR] for every 50 mmHg%: 0.85; 95% CI: 0.77–0.94; p = 0.002) as well as GCW (HR for every 50 mmHg%: 0.86; 95% CI: 0.79–0.94; p = 0.001) were identified as independent predictors of the endpoint. The cut-off value for predicting the outcome was 455 mmHg% for GWI (AUC: 0.80; p < 0.0001; sensitivity 77.4%; specificity 71.6%) and 530 mmHg% for GCW (AUC: 0.80; p < 0.0001; sensitivity 74.2%; specificity 78.4%). Conclusions: GWI and GCW are powerful predictors of outcome in patients with advanced heart failure

Expression of 3q Oncogene SEC62 Predicts Survival in Head and Neck Squamous Cell Carcinoma Patients Treated with Primary Chemoradiation

Primary chemoradiotherapy (CRT) is an established treatment option for locally advanced head and neck squamous cell carcinomas (HNSCC) usually combining intensity modified radiotherapy with concurrent platinum-based chemotherapy. Though the majority of patients can be cured with this regimen, treatment response is highly heterogeneous and can hardly be predicted. SEC62 represents a metastasis stimulating oncogene that is frequently overexpressed in various cancer entities and is associated with poor outcome. Its role in HNSCC patients undergoing CRT has not been investigated so far. A total of 127 HNSCC patients treated with primary CRT were included in this study. The median follow-up was 5.4 years. Pretherapeutic tissue samples of the primary tumors were used for immunohistochemistry targeting SEC62. SEC62 expression, clinical and histopathological parameters, as well as patient outcome, were correlated in univariate and multivariate survival analyses. High SEC62 expression correlated with a significantly shorter overall survival (p = 0.015) and advanced lymph node metastases (p = 0.024). Further significant predictors of poor overall and progression-free survival included response to therapy (RECIST1.1), nodal status, distant metastases, tobacco consumption, recurrence of disease, and UICC stage. In a multivariate Cox hazard proportional regression analysis, only SEC62 expression (p = 0.046) and response to therapy (p < 0.0001) maintained statistical significance as independent predictors of the patients’ overall survival. This study identified SEC62 as an independent prognostic biomarker in HNSCC patients treated with primary CRT. The role of SEC62 as a potential therapeutic target and its interaction with radiation-induced molecular alterations in head and neck cancer cells should further be investigated