55
Quantified Self: de zin en onzin van het zelfmeten door patiënten Dr. Martijn de Groot Lezing 2 apr 2016 Huisartsbeurs Jaarbeurs, Utrecht
Quantified Self: de zin en onzin van het zelfmeten door patiëntenDr. Martijn de Groot
Lezing 2 apr 2016HuisartsbeursJaarbeurs, Utrecht
12-2-2016
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
12-2-2016 3
4
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
12-2-2016
Gnothi seauton
12-2-2016
Self Experimentation
• 17de eeuw Sanctorius of Padua; weighed himself for 30 years (food andexcrements)
• 1750 Alan Storck; drank hemlock• ca. 1810 Friedrich Sertürner; morphine• 1929 Werner Fossman; heart catheder,
angiocardiography, Nobel prize
29-8-2016
Introduction into Quantified Self
Self management / Tracking
• 70’s Diabetics (paradox)
• Computing• Miniaturisation• Self management
812-2-2016
The rise of the Quantified Self
12-2-2016
Spits 7 mei 2013
9
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
17-3-2016 10
12-2-2016
...to support new discoveries about ourselves and our communities that are grounded in accurate observation and elivened by a spirit of friendship.
Principle questions
• What did you do?• How did you do it?• What did you learn?
www.meetup.com/qsgroningenwww.meetup.com/qsamsterdam
!! Next Meetup!!WednesdayJuni 15 at 1.30 p.m. @ Hanze University Groningen
17-3-2016 12
Self-tracking health data• ~50% Dutch adults
source (2012): Survey by Motivaction/Quantified Self Institute (n=1.045)
• ~70% U.S. Adultssource (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 tosource (2014): the accenture survey (n=24.000)
1329-8-2016 Introduction into Quantified Self
Self-tracking areas
Source: health data exploration project 2014 (www.calit2.net)29-8-2016 Introduction into Quantified Self
Motives for self tracking
• Curiosity• Self improvement• Problem solving• Gagdet freaks and data fetisjists
Adaptor styles
Fewer people stashing wearable devices in sock drawer
29-8-2016
Availability
12-2-2016 18
Reliability
12-2-2016
Dontje et al. Measuring steps with the Fitbit activity tracker: an inter-device reliability study. J Med Eng Technol. 2015 May 27:1-5
19
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
12-2-2016
Kooiman et al. Reliability and validity of ten consumer activity trackers BMC Sports Science, Medicine and Rehabilitation 2015, 7:24
20
1= Fitbit Zip2= Misfit Shine3= Nike+Fuelband4= Omron5 = Withings Pulse6 = Fitbit Flex7 = Digiwalker SW-200 8 = Lumoback9 = Jawbone Up10 = Moves app
Reliability and Validity of ten consumeractivity trackers.
12-2-2016
Results – Lab conditionMean number of steps walked (95 % CI), measured in the Lab condition.
12-2-2016 22
Results – free-living conditionMean number of steps (95% CI) walked in the free-living condition
12-2-2016 23
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
12-2-2016
* P < .05, ** P < .01
24
Validity and reliabilityAt three different walking speeds (tredmill only)
12-2-2016
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
25
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
12-2-2016 26
Apps
2729-8-2016 Introduction into Quantified Self
Medische App CheckerSinds 25 februari 2016
2812-2-2016
Octobre 2014
2929-8-2016 Introduction into Quantified Self
Number of appsavailable in leading app stores as of July 2015
3012-2-2016
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.
Current research limitedBig 5 for healthy life
12-2-2016
29-8-2016 Introduction into Quantified Self
29-8-2016 Introduction into Quantified Self
29-8-2016 Introduction into Quantified Self
Feedback loops (n=42)
0
10000
20000
30000
40000
50000
60000
70000
80000
90000
100000
1 2 3 4 5 6 7 8
Stap
pen
Weken
Feedback
Non-feedback
17-3-2016 36
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…
12-2-2016
Teaching Quantified Self SInternational Minor and Summerschool Global Health & QS
12-2-2016 38
12-2-2016
http://www.digitalezorggids.nl/blog/quantified-self-quantified-us-quantified-other
12-2-2016
Patients like meQuantified Us
4112-2-2016
• 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 patientsparticipiated in a study todemonstrate lithium does not slow progress of disease
New Research Strategies
29-8-2016
New Research Strategies
29-8-2016
N=1 versus RCT
Rise of Personal Science
Dr. Seth Roberts (1953-2014)Requirements for useful discoveryPersonal scientists versus professional scientistsThe probability of useful discovery is a function of• (material resources)• (knowledge)• (time)• (freedom)• (desire to be useful)
29-8-2016
Introduction into Quantified Self
The Single-Subject Design
Method• Continuous assessment• Baseline assessment• Internal control• “Multiple crossover”• Blinding and
randomization where possible
• Baseline, intervention and reversal
10-3-2016
Points of interest and debate
• Quality of the data (validity and reliability)
• Data acces and control (Privacy and safety)
• Data sharing(usability, interoperabilityand incentives)
• Medicalisation
12-2-2016 46
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
4712-2-2016
https://www.youtube.com/watch?v=oqnmpg2JmzM
Digital Health Landscape
12-2-2016 48
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…
4929-8-2016 Titel presentatie (via kop- en voettekst)
Quantified Selfis a gamechanger…
Digital HealthcareFear for technology...
Bijdragen van ICT
Digital Healthcare...or time for change: more time for human interaction
Bijdragen van ICT
29-8-2016
The day before tomorrow
• Preventive and predictive• Personalised • Participatory
Source: www.p4mi.org
12-2-2016
