Quantified Self: de zin en onzin van het zelfmeten door patiënten

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Quantified Self: de zin en onzin van het zelfmeten door patiënten

Dr. Martijn de Groot

Lezing 2 apr 2016 Huisartsbeurs

Jaarbeurs, Utrecht

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12-2-2016

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Project program

• Self quantification methods and technology

• ‘the big five for healthy life’

– Physical activity & sports – Food & drinks

– Sleep & rest – Stress

– Social interaction

• Availability,Validity, Efficacy, Creativity

• Applied research, higher education & new business development

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Source: Johnson, L., Adams Becker, S., Estrada, V., Freeman, A. (2014).

NMC Horizon Report: 2014 Higher Education Edition.

Austin, Texas: The New Media Consortium.

Education

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Gnothi seauton

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Self Experimentation

• 17

de

eeuw Sanctorius of Padua;

weighed himself for 30 years (food and excrements)

• 1750 Alan Storck; drank hemlock

• ca. 1810 Friedrich Sertürner; morphine

• 1929 Werner Fossman; heart catheder, angiocardiography, Nobel prize

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on into Quantified Self

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Self management / Tracking

• 70’s Diabetics (paradox)

• Computing

• Miniaturisation

• Self management

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The rise of the Quantified Self

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Spits 7 mei 2013

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3

QS Community

2010: TED talk by Gary Wolf (778 k views)

2011: Two International Conferences, first in California, then in Europe

March 2016: 220 Meetup groups, approximately >64 k people active worldwide

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...to support new discoveries about ourselves and our communities that are grounded in accurate observation and elivened by a spirit of friendship.

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Principle questions

What did you do?

How did you do it?

What did you learn?

www.meetup.com/qsgroningen www.meetup.com/qsamsterdam

!! Next Meetup!!

Wednesday

Juni 15 at 1.30 p.m.

@ Hanze University Groningen

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Self-tracking health data

• ~50% Dutch adults

source (2012): Survey by Motivaction/

Quantified Self Institute (n=1.045)

• ~70% U.S. Adults

source (2013): Survey by Pew Internet/

CHCF (n=3.014)

21% of individuals who track use at least one form of technology such as apps or devices

• ~8% own wearable, 12% plan to

source (2014): the accenture survey (n=24.000)

13 29-8-2016 Introduction into Quantified Self

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Self-tracking areas

Source: health data exploration project 2014 (www.calit2.net)

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Motives for self tracking

Curiosity

Self improvement

Problem solving

Gagdet freaks and data fetisjists Adaptor styles

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Fewer people stashing wearable devices

in sock drawer

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Availability

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Reliability

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Dontje et al. Measuring steps with the Fitbit

activity tracker: an inter-device reliability study. J Med Eng Technol. 2015 May 27:1-5

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Validity

• Lab condition

– 30 minutes walking on a treadmill, 2 times.

– N=33

– Gold standard: Optogait system.

• Free-living condition

– One day (9:00-16:30).

– N=56

– Gold standard: ActivPal.

Two conditions

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Kooiman et al. Reliability and validity of ten

consumer activity trackers BMC Sports Science, Medicine and Rehabilitation 2015, 7:24

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1= Fitbit Zip 2= Misfit Shine 3= Nike+Fuelband 4= Omron

5 = Withings Pulse 6 = Fitbit Flex

7 = Digiwalker SW-200 8 = Lumoback

9 = Jawbone Up 10 = Moves app

Reliability and Validity of ten consumer activity trackers.

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Results – Lab condition

Mean number of steps walked (95 % CI), measured in the Lab condition.

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Results – free-living condition

Mean number of steps (95% CI) walked in the free-living condition

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Test-retest reliability

Activity tracker Intraclass Correlation

Coefficient

95% confidence Interval

Optogait .92** .85 - .96

ActivPAL .96** .90 - .99

Lumoback .90** .79 - .95

Fitbit Flex .81** .64 - .91

Jawbone UP .83** .66 - .91

Nike+ Fuelband .53** .22 - .75

Misfit Shine .86** .73 - .93

Withings Pulse .92** .83 - .96

Fitbit Zip .90** .80 - .95

Omron .14 -.24 - .47

Digiwalker .71 ** .47 - .86

Moves app .37* .02 - .64

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* P < .05, ** P < .01

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Validity and reliability

At three different walking speeds (tredmill only)

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1.

Jawbone Move(clip)

2.

Misfit Flash (clip)

3.

Flyfit (enkel)

4.

Fitbit Charge HR (pols)

5.

Polar Loop (pols)

6.

Garmin Vivosmart (pols)

7.

Apple watch (pols)

8.

Pebble smartwatch (pols)

9.

Samsung Gear (pols)

10.

Moves App

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Conclusion

• Most trackers show high reliability

• Many trackers have acceptable validity

• Trackers worn on the body have higher validity than trackers worn at the wrist

• Fitbit Zip (high validity/reliability, low pricing) In writing

• Apple Watch (high validity/reliability, high pricing)

Kooiman et al. Reliability and validity of ten consumer activity trackers BMC Sports Science, Medicine and Rehabilitation 2015, 7:24

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Apps

27 29-8-2016 Introduction into Quantified Self

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Medische App Checker

Sinds 25 februari 2016

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Octobre 2014

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Number of apps

available in leading app stores as of July 2015

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Food applications

Ned Tijdschr voor Voeding & Dietetiek | 2013;68(3)

113 (Dec 2012)

4417 (Dec 2014)

Survey

N = 15

87.6%of the respondents becomes more aware of their food behaviour thanks to the app.

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Current research limited

Big 5 for healthy life

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29-8-2016 Introduction into Quantified Self

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29-8-2016 Introduction into Quantified Self

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Feedback loops (n=42)

0 10000 20000 30000 40000 50000 60000 70000 80000 90000 100000

1 2 3 4 5 6 7 8

Stappen

Weken

Feedback Non-feedback

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1 2

3 4

Bring Data Self-tracking;

for personal reason

Self-tracking;

at request of health care provider

Care/cure Lifestyle, health/wellness

Bring Data

Adapted from:

www.nictiz.nl

All about data…

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Teaching Quantified Self S

International Minor and Summerschool Global Health & QS

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http://www.digitalezorggids.nl/blog/quantified-self-quantified-us-quantified-other

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Patients like me

Quantified Us

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• Three studies demonstrate the

platform improves patient outcomes New research strategy

• In 2008 small scientific paper

stated lithium carbonate could slow progression of ALS

• In 9 months 348 ALS patients participiated in a study to

demonstrate lithium does not slow progress of disease

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New Research Strategies

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New Research Strategies

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N=1 versus RCT

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Rise of Personal Science

Dr. Seth Roberts (1953-2014)

Requirements for useful discovery

Personal scientists versus professional scientists The probability of useful discovery is a function of

• (material resources)

• (knowledge)

• (time)

• (freedom)

• (desire to be useful)

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on into Quantified Self

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The Single-Subject Design

Method

• Continuous assessment

• Baseline assessment

• Internal control

• “Multiple crossover”

• Blinding and

randomization where possible

• Baseline, intervention and reversal

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Points of interest and debate

• Quality of the data

(validity and reliability)

• Data acces and control (Privacy and safety)

• Data sharing

(usability, interoperability and incentives)

• Medicalisation

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Digital Health

Digital health is the

convergence of the digital and genomic revolutions with health, healthcare, living, and society.

Digital health is empowering people to better track, manage, and improve their own and their family’s health, live better, more productive lives, and improve

society. It’s also helping to reduce inefficiencies in healthcare delivery, improve access, reduce costs, increase quality, and make medicine more

personalized and precise.

www.storyofdigital.com

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https://www.youtube.com/watch?v=oqnmpg2JmzM

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Digital Health Landscape

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Digital disruption as we go

• …largest taxi company owns no cars (Uber)

• …largest hotel company owns no accomodations (Airbnb)

• …largest text messaging companies own no phones (Whatsapp, Skype)

• …most valuable retailer has no inventory (Alibaba)

• …most popular media owner creates no content (Facebook)

• …largest movie hous owns cinemas (Netflix)

• …largest software vendors don’t write software (Apple and Google)

World’s…

49 29-8-2016 Titel presentatie (via kop- en voettekst)

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Quantified Self

is a gamechanger…

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Digital Healthcare

Fear for technology...

Bijdragen van ICT

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Digital Healthcare

...or time for change: more time for human interaction

Bijdragen van ICT

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The day before tomorrow

• Preventive and predictive

• Personalised

• Participatory

Source: www.p4mi.org

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Dr. Martijn de Groot

ma.de.groot@pl.hanze.nl

@grootm75

www.qsinstitute.org

12-2-2016

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