Methods for Handling Unobserved Covariates in a Bayesian Update of a Cost-effectiveness Model

Health economic decision models often involve a wide-ranging and complicated synthesis of evidence from a number of sources, making design and implementation of such models resource-heavy. When new data become available and reassessment of treatment recommendations is warranted, it may be more efficient to perform a Bayesian update of an existing model than to construct a new model. If the existing model depends on many, possibly correlated, covariates, then an update may produce biased estimates of model parameters if some of these covariates are completely absent from the new data. Motivated by the need to update a cost-effectiveness analysis comparing diagnostic strategies for coronary heart disease, this study develops methods to overcome this obstacle by either introducing additional data or using results from previous studies. We outline a framework to handle unobserved covariates, and use our motivating example to illustrate both the flexibility of the proposed methods and some potential difficulties in applying them

The experience of couples being given an oxygen concentrator to use at home: A longitudinal interpretative phenomenological analysis

This longitudinal study explores the lived experience of four couples where one person from each couple is prescribed an oxygen concentrator to use at home. Transcripts were analysed using interpretative phenomenological analysis. The findings reported here focus on two super-ordinate themes: ‘the journey of acceptance’ and ‘negotiating changing relationships’. Participants described a gradual process of accepting the device into their lives, the impact on couple’s relationships and the role that expectations have in mediating that process. These themes suggest that patient education that considers the psychological and social issues may prove useful in facilitating the acceptance process

Workload alerts - using physiological measures of mental workload to provide feedback during tasks

Feedback is valuable for allowing us to improve on tasks. While retrospective feedback can help us improve for next time, feedback “in action” can allow us to improve the outcome of on-going tasks. In this paper, we use data from functional Near InfraRed Spectroscopy to provide participants with feedback about their Mental Workload levels during high-workload tasks. We evaluate the impact of this feedback on task performance and perceived task performance, in comparison to industry standard mid-task self assessments, and explore participants’ perceptions of this feedback. In line with previous work, we confirm that deploying self-reporting methods affect both perceived and actual performance. Conversely, we conclude that our objective concurrent feedback correlated more closely with task demand, supported reflection in action, and did not negatively affect performance. Future work, however, should focus on the design of this feedback and the potential behaviour changes that will result

Examining the reliability of using fNIRS in realistic HCI settings for spatial and verbal tasks

Recent efforts have shown that functional near-infrared spectroscopy (fNIRS) has potential value for brain sensing in HCI user studies. Research has shown that, although large head movement significantly affects fNIRS data, typical keyboard use, mouse movement, and non-task-related verbalisations do not affect measurements during Verbal tasks. This work aims to examine the Reliability of fNIRS, by 1) confirming these prior findings, and 2) significantly extending our understanding of how artefacts affect recordings during Spatial tasks, since much of user interfaces and interaction is inherently spatial. Our results show that artefacts have a significantly different impact during Verbal and Spatial tasks. We contribute clearer insights into using fNIRS as a tool within HCI user studies

Examining the reliability of using fNIRS in realistic HCI settings for spatial and verbal tasks

Recent efforts have shown that functional near-infrared spectroscopy (fNIRS) has potential value for brain sensing in HCI user studies. Research has shown that, although large head movement significantly affects fNIRS data, typical keyboard use, mouse movement, and non-task-related verbalisations do not affect measurements during Verbal tasks. This work aims to examine the Reliability of fNIRS, by 1) confirming these prior findings, and 2) significantly extending our understanding of how artefacts affect recordings during Spatial tasks, since much of user interfaces and interaction is inherently spatial. Our results show that artefacts have a significantly different impact during Verbal and Spatial tasks. We contribute clearer insights into using fNIRS as a tool within HCI user studies

Medical device design for adolescent adherence and developmental goals: a case study of a cystic fibrosis physiotherapy device

Purpose: This study investigates the psychosocial aspects of adolescent medical device use and the impact on adolescent adherence and goals for the transitional years between child and adulthood. Patients and methods: Interviews were carried out with 20 adolescents with cystic fibrosis, investigating adolescent medical device use and experiences in relation to their personal and social lives and development through the adolescent years. The qualitative dataset was thematically examined using a content analysis method. Results: The results show that adolescent users of medical technologies want their independence and capabilities to be respected. Adolescent adherence to medical device use was associated with short- and long-term motivations, where older adolescents were able to comprehend the longer-term benefits of use against short-term inconvenience more acutely than younger adolescents. It was suggested that medical devices could provide a tool for communication with families and clinicians and could support adolescents as they take responsibility for managing their condition. Themes of “fitting into teenage life” and “use in the community” were associated with adolescents' needs to form their own identity and have autonomy. Conclusion: This study shows that adolescent needs regarding medical device use are complex. It provides evidence to suggest that devices designed inclusively for adolescents may lead to improved adherence and also facilitate transition through the adolescent years and achievement of adolescent goals

How stress affects functional near-infrared spectroscopy (fNIRS) measurements of mental workload

Recent work has demonstrated that functional Near-Infrared Spectroscopy has the potential to measure changes in Mental Workload with increasing ecological validity. It is not clear, however, whether these measurements are affected by anxiety and stress of the workload, where our informal observations see some participants enjoying the workload and succeeding in tasks, while others worry and struggle with the tasks. This research evaluated the effects of stress on fNIRS measurements and performance, using the Montreal Imaging Stress Task to manipulate the experience of stress. While our results largely support this hypothesis, our conclusions were undermined by data from the Rest condition, which indicated that Mental Workload and Stress were often higher than during tasks. We hypothesize that participants were experiencing anxiety in anticipation of subsequent stress tasks. We discuss this hypothesis and present a revised study designed to better control for this result