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BACKGROUND: While online health social networks (OHSNs) serve as an effective platform for patients to fulfill their various social support needs, predicting the needs of users and providing tailored information remains a challenge. OBJECTIVE: The objective of this study was to discriminate important features for identifying users' social support needs based on knowledge gathered from survey data. This study also provides guidelines for a technical framework, which can be used to predict users' social support needs based on raw data collected from OHSNs. METHODS: We initially conducted a Web-based survey with 184 OHSN users. From this survey data, we extracted 34 features based on 5 categories: (1) demographics, (2) reading behavior, (3) posting behavior, (4) perceived roles in OHSNs, and (5) values sought in OHSNs. Features from the first 4 categories were used as variables for binary classification. For the prediction outcomes, we used features from the last category: the needs for emotional support, experience-based information, unconventional information, and medical facts. We compared 5 binary classifier algorithms: gradient boosting tree, random forest, decision tree, support vector machines, and logistic regression. We then calculated the scores of the area under the receiver operating characteristic (ROC) curve (AUC) to understand the comparative effectiveness of the used features. RESULTS: The best performance was AUC scores of 0.89 for predicting users seeking emotional support, 0.86 for experience-based information, 0.80 for unconventional information, and 0.83 for medical facts. With the gradient boosting tree as our best performing model, we analyzed the strength of individual features in predicting one's social support need. Among other discoveries, we found that users seeking emotional support tend to post more in OHSNs compared with others. CONCLUSIONS: We developed an initial framework for automatically predicting social support needs in OHSNs using survey data. Future work should involve nonsurvey data to evaluate the feasibility of the framework. Our study contributes to providing personalized social support in OHSNs.
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Rede Social , Apoio Social , Telemedicina/métodos , Feminino , Comportamentos Relacionados com a Saúde , Humanos , MasculinoRESUMO
Many researchers and practitioners use online health communities (OHCs) to influence health behavior and provide patients with social support. One of the biggest challenges in this approach, however, is the rate of attrition. OHCs face similar problems as other social media platforms where user migration happens unless tailored content and appropriate socialization is supported. To provide tailored support for each OHC user, we developed personas in OHCs illustrating users' needs and requirements in OHC use. To develop OHC personas, we first interviewed 16 OHC users and administrators to qualitatively understand varying user needs in OHC. Based on their responses, we developed an online survey to systematically investigate OHC personas. We received 184 survey responses from OHC users, which informed their values and their OHC use patterns. We performed open coding analysis with the interview data and cluster analysis with the survey data and consolidated the analyses of the two datasets. Four personas emerged-Caretakers, Opportunists, Scientists, and Adventurers. The results inform users' interaction behavior and attitude patterns with OHCs. We discuss implications for how these personas inform OHCs in delivering personalized informational and emotional support.
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Internet , Mídias Sociais , Apoio Social , Análise por Conglomerados , HumanosRESUMO
We present Roslingifier, a data-driven storytelling method for animated scatterplots. Like its namesake, Hans Rosling (1948-2017), a professor of public health and a spellbinding public speaker, Roslingifier turns a sequence of entities changing over time-such as countries and continents with their demographic data-into an engaging narrative elling the story of the data. This data-driven storytelling method with an in-person presenter is a new genre of storytelling technique and has never been studied before. In this article, we aim to define a design space for this new genre-data presentation-and provide a semi-automated authoring tool for helping presenters create quality presentations. From an in-depth analysis of video clips of presentations using interactive visualizations, we derive three specific techniques to achieve this: natural language narratives, visual effects that highlight events, and temporal branching that changes playback time of the animation. Our implementation of the Roslingifier method is capable of identifying and clustering significant movements, automatically generating visual highlighting and a narrative for playback, and enabling the user to customize. From two user studies, we show that Roslingifier allows users to effectively create engaging data stories and the system features help both presenters and viewers find diverse insights.
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As online news increasingly include data journalism, there is a corresponding increase in the incorporation of visualization in article thumbnail images. However, little research exists on the design rationale for visualization thumbnails, such as resizing, cropping, simplifying, and embellishing charts that appear within the body of the associated article. Therefore, in this paper we aim to understand these design choices and determine what makes a visualization thumbnail inviting and interpretable. To this end, we first survey visualization thumbnails collected online and discuss visualization thumbnail practices with data journalists and news graphics designers. Based on the survey and discussion results, we then define a design space for visualization thumbnails and conduct a user study with four types of visualization thumbnails derived from the design space. The study results indicate that different chart components play different roles in attracting reader attention and enhancing reader understandability of the visualization thumbnails. We also find various thumbnail design strategies for effectively combining the charts' components, such as a data summary with highlights and data labels, and a visual legend with text labels and Human Recognizable Objects (HROs), into thumbnails. Ultimately, we distill our findings into design implications that allow effective visualization thumbnail designs for data-rich news articles. Our work can thus be seen as a first step toward providing structured guidance on how to design compelling thumbnails for data stories.
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Traditional deep learning interpretability methods which are suitable for model users cannot explain network behaviors at the global level and are inflexible at providing fine-grained explanations. As a solution, concept-based explanations are gaining attention due to their human intuitiveness and their flexibility to describe both global and local model behaviors. Concepts are groups of similarly meaningful pixels that express a notion, embedded within the network's latent space and have commonly been hand-generated, but have recently been discovered by automated approaches. Unfortunately, the magnitude and diversity of discovered concepts makes it difficult to navigate and make sense of the concept space. Visual analytics can serve a valuable role in bridging these gaps by enabling structured navigation and exploration of the concept space to provide concept-based insights of model behavior to users. To this end, we design, develop, and validate CONCEPTEXPLAINER, a visual analytics system that enables people to interactively probe and explore the concept space to explain model behavior at the instance/class/global level. The system was developed via iterative prototyping to address a number of design challenges that model users face in interpreting the behavior of deep learning models. Via a rigorous user study, we validate how CONCEPTEXPLAINER supports these challenges. Likewise, we conduct a series of usage scenarios to demonstrate how the system supports the interactive analysis of model behavior across a variety of tasks and explanation granularities, such as identifying concepts that are important to classification, identifying bias in training data, and understanding how concepts can be shared across diverse and seemingly dissimilar classes.
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In our previous data-driven analysis of evolving patterns of islet autoantibodies (IAb) against insulin (IAA), GAD (GADA), and islet antigen 2 (IA-2A), we discovered three trajectories, characterized according to multiple IAb (TR1), IAA (TR2), or GADA (TR3) as the first appearing autoantibodies. Here we examined the evolution of IAb levels within these trajectories in 2,145 IAb-positive participants followed from early life and compared those who progressed to type 1 diabetes (n = 643) with those remaining undiagnosed (n = 1,502). With use of thresholds determined by 5-year diabetes risk, four levels were defined for each IAb and overlaid onto each visit. In diagnosed participants, high IAA levels were seen in TR1 and TR2 at ages <3 years, whereas IAA remained at lower levels in the undiagnosed. Proportions of dwell times (total duration of follow-up at a given level) at the four IAb levels differed between the diagnosed and undiagnosed for GADA and IA-2A in all three trajectories (P < 0.001), but for IAA dwell times differed only within TR2 (P < 0.05). Overall, undiagnosed participants more frequently had low IAb levels and later appearance of IAb than diagnosed participants. In conclusion, while it has long been appreciated that the number of autoantibodies is an important predictor of type 1 diabetes, consideration of autoantibody levels within the three autoimmune trajectories improved differentiation of IAb-positive children who progressed to type 1 diabetes from those who did not.
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Diabetes Mellitus Tipo 1 , Ilhotas Pancreáticas , Criança , Humanos , Pré-Escolar , Diabetes Mellitus Tipo 1/diagnóstico , Glutamato Descarboxilase , Insulina , AutoanticorposRESUMO
Development of islet autoimmunity precedes the onset of type 1 diabetes in children, however, the presence of autoantibodies does not necessarily lead to manifest disease and the onset of clinical symptoms is hard to predict. Here we show, by longitudinal sampling of islet autoantibodies (IAb) to insulin, glutamic acid decarboxylase and islet antigen-2 that disease progression follows distinct trajectories. Of the combined Type 1 Data Intelligence cohort of 24662 participants, 2172 individuals fulfill the criteria of two or more follow-up visits and IAb positivity at least once, with 652 progressing to type 1 diabetes during the 15 years course of the study. Our Continuous-Time Hidden Markov Models, that are developed to discover and visualize latent states based on the collected data and clinical characteristics of the patients, show that the health state of participants progresses from 11 distinct latent states as per three trajectories (TR1, TR2 and TR3), with associated 5-year cumulative diabetes-free survival of 40% (95% confidence interval [CI], 35% to 47%), 62% (95% CI, 57% to 67%), and 88% (95% CI, 85% to 91%), respectively (p < 0.0001). Age, sex, and HLA-DR status further refine the progression rates within trajectories, enabling clinically useful prediction of disease onset.
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Diabetes Mellitus Tipo 1 , Ilhotas Pancreáticas , Autoanticorpos , Autoimunidade , Criança , Progressão da Doença , Genótipo , Antígenos HLA-DR/genética , HumanosRESUMO
Rapid advances in artificial intelligence (AI) and availability of biological, medical, and healthcare data have enabled the development of a wide variety of models. Significant success has been achieved in a wide range of fields, such as genomics, protein folding, disease diagnosis, imaging, and clinical tasks. Although widely used, the inherent opacity of deep AI models has brought criticism from the research field and little adoption in clinical practice. Concurrently, there has been a significant amount of research focused on making such methods more interpretable, reviewed here, but inherent critiques of such explainability in AI (XAI), its requirements, and concerns with fairness/robustness have hampered their real-world adoption. We here discuss how user-driven XAI can be made more useful for different healthcare stakeholders through the definition of three key personas-data scientists, clinical researchers, and clinicians-and present an overview of how different XAI approaches can address their needs. For illustration, we also walk through several research and clinical examples that take advantage of XAI open-source tools, including those that help enhance the explanation of the results through visualization. This perspective thus aims to provide a guidance tool for developing explainability solutions for healthcare by empowering both subject matter experts, providing them with a survey of available tools, and explainability developers, by providing examples of how such methods can influence in practice adoption of solutions.
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Prediction models are commonly used to estimate risk for cardiovascular diseases, to inform diagnosis and management. However, performance may vary substantially across relevant subgroups of the population. Here we investigated heterogeneity of accuracy and fairness metrics across a variety of subgroups for risk prediction of two common diseases: atrial fibrillation (AF) and atherosclerotic cardiovascular disease (ASCVD). We calculated the Cohorts for Heart and Aging in Genomic Epidemiology Atrial Fibrillation (CHARGE-AF) score for AF and the Pooled Cohort Equations (PCE) score for ASCVD in three large datasets: Explorys Life Sciences Dataset (Explorys, n = 21,809,334), Mass General Brigham (MGB, n = 520,868), and the UK Biobank (UKBB, n = 502,521). Our results demonstrate important performance heterogeneity across subpopulations defined by age, sex, and presence of preexisting disease, with fairly consistent patterns across both scores. For example, using CHARGE-AF, discrimination declined with increasing age, with a concordance index of 0.72 [95% CI 0.72-0.73] for the youngest (45-54 years) subgroup to 0.57 [0.56-0.58] for the oldest (85-90 years) subgroup in Explorys. Even though sex is not included in CHARGE-AF, the statistical parity difference (i.e., likelihood of being classified as high risk) was considerable between males and females within the 65-74 years subgroup with a value of - 0.33 [95% CI - 0.33 to - 0.33]. We also observed weak discrimination (i.e., < 0.7) and suboptimal calibration (i.e., calibration slope outside of 0.7-1.3) in large subsets of the population; for example, all individuals aged 75 years or older in Explorys (17.4%). Our findings highlight the need to characterize and quantify the behavior of clinical risk models within specific subpopulations so they can be used appropriately to facilitate more accurate, consistent, and equitable assessment of disease risk.
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Aterosclerose , Fibrilação Atrial , Doenças Cardiovasculares , Aterosclerose/epidemiologia , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/epidemiologia , Fibrilação Atrial/genética , Doenças Cardiovasculares/epidemiologia , Feminino , Fatores de Risco de Doenças Cardíacas , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco/métodos , Fatores de RiscoRESUMO
Biologists often perform clustering analysis to derive meaningful patterns, relationships, and structures from data instances and attributes. Though clustering plays a pivotal role in biologists' data exploration, it takes non-trivial efforts for biologists to find the best grouping in their data using existing tools. Visual cluster analysis is currently performed either programmatically or through menus and dialogues in many tools, which require parameter adjustments over several steps of trial-and-error. In this article, we introduce Geono-Cluster, a novel visual analysis tool designed to support cluster analysis for biologists who do not have formal data science training. Geono-Cluster enables biologists to apply their domain expertise into clustering results by visually demonstrating how their expected clustering outputs should look like with a small sample of data instances. The system then predicts users' intentions and generates potential clustering results. Our study follows the design study protocol to derive biologists' tasks and requirements, design the system, and evaluate the system with experts on their own dataset. Results of our study with six biologists provide initial evidence that Geono-Cluster enables biologists to create, refine, and evaluate clustering results to effectively analyze their data and gain data-driven insights. At the end, we discuss lessons learned and implications of our study.
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Gráficos por Computador , Análise por Conglomerados , Interpretação Estatística de DadosRESUMO
Clinical researchers use disease progression models to understand patient status and characterize progression patterns from longitudinal health records. One approach for disease progression modeling is to describe patient status using a small number of states that represent distinctive distributions over a set of observed measures. Hidden Markov models (HMMs) and its variants are a class of models that both discover these states and make inferences of health states for patients. Despite the advantages of using the algorithms for discovering interesting patterns, it still remains challenging for medical experts to interpret model outputs, understand complex modeling parameters, and clinically make sense of the patterns. To tackle these problems, we conducted a design study with clinical scientists, statisticians, and visualization experts, with the goal to investigate disease progression pathways of chronic diseases, namely type 1 diabetes (T1D), Huntington's disease, Parkinson's disease, and chronic obstructive pulmonary disease (COPD). As a result, we introduce DPVis which seamlessly integrates model parameters and outcomes of HMMs into interpretable and interactive visualizations. In this article, we demonstrate that DPVis is successful in evaluating disease progression models, visually summarizing disease states, interactively exploring disease progression patterns, and building, analyzing, and comparing clinically relevant patient subgroups.
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BACKGROUND: Polygenic scores-which quantify inherited risk by integrating information from many common sites of DNA variation-may enable a tailored approach to clinical medicine. However, alongside considerable enthusiasm, we and others have highlighted a lack of standardized approaches for score disclosure. Here, we review the landscape of polygenic score reporting and describe a generalizable approach for development of a polygenic score disclosure tool for coronary artery disease. METHODS: We assembled a working group of clinicians, geneticists, data visualization specialists, and software developers. The group reviewed existing polygenic score reports and then designed a two-page mock report for coronary artery disease. We then conducted a qualitative user-experience study with this report using an interview guide focused on comprehension, experience, and attitudes. Interviews were transcribed and analyzed for themes identification to inform report revision. RESULTS: Review of nine existing polygenic score reports from commercial and academic groups demonstrated significant heterogeneity, reinforcing the need for additional efforts to study and standardize score disclosure. Using a newly developed mock score report, we conducted interviews with ten adult individuals (50% females, 70% without prior genetic testing experience, age range 20-70 years) recruited via an online platform. We identified three themes from interviews: (1) visual elements, such as color and simple graphics, enable participants to interpret, relate to, and contextualize their polygenic score, (2) word-based descriptions of risk and polygenic scores presented as percentiles were the best recognized and understood, (3) participants had varying levels of interest in understanding complex genomic information and therefore would benefit from additional resources that can adapt to their individual needs in real time. In response to user feedback, colors used for communicating risk were modified to minimize unintended color associations and odds ratios were removed. All 10 participants expressed interest in receiving a polygenic score report based on their personal genomic information. CONCLUSIONS: Our findings describe a generalizable approach to develop a polygenic score report understandable by potential patients. Although additional studies are needed across a wider spectrum of patient populations, these results are likely to inform ongoing efforts related to polygenic score disclosure within clinical practice.
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Doença da Artéria Coronariana/genética , DNA/genética , Herança Multifatorial , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Pesquisa Qualitativa , Adulto JovemRESUMO
BACKGROUND: Diet-tracking mobile apps have gained increased interest from both academic and clinical fields. However, quantity-focused diet tracking (eg, calorie counting) can be time-consuming and tedious, leading to unsustained adoption. Diet quality-focusing on high-quality dietary patterns rather than quantifying diet into calories-has shown effectiveness in improving heart disease risk. The Healthy Heart Score (HHS) predicts 20-year cardiovascular risks based on the consumption of foods from quality-focused food categories, rather than detailed serving sizes. No studies have examined how mobile health (mHealth) apps focusing on diet quality can bring promising results in health outcomes and ease of adoption. OBJECTIVE: This study aims to design a mobile app to support the HHS-informed quality-focused dietary approach by enabling users to log simplified diet quality and view its real-time impact on future heart disease risks. Users were asked to log food categories that are the main predictors of the HHS. We measured the app's feasibility and efficacy in improving individuals' clinical and behavioral factors that affect future heart disease risks and app use. METHODS: We recruited 38 participants who were overweight or obese with high heart disease risk and who used the app for 5 weeks and measured weight, blood sugar, blood pressure, HHS, and diet score (DS)-the measurement for diet quality-at baseline and week 5 of the intervention. RESULTS: Most participants (30/38, 79%) used the app every week and showed significant improvements in DS (baseline: mean 1.31, SD 1.14; week 5: mean 2.36, SD 2.48; 2-tailed t test t29=-2.85; P=.008) and HHS (baseline: mean 22.94, SD 18.86; week 4: mean 22.15, SD 18.58; t29=2.41; P=.02) at week 5, although only 10 participants (10/38, 26%) checked their HHS risk scores more than once. Other outcomes, including weight, blood sugar, and blood pressure, did not show significant changes. CONCLUSIONS: Our study showed that our logging tool significantly improved dietary choices. Participants were not interested in seeing the HHS and perceived logging diet categories irrelevant to improving the HHS as important. We discuss the complexities of addressing health risks and quantity- versus quality-based health monitoring and incorporating secondary behavior change goals that matter to users when designing mHealth apps.
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Dieta , Cardiopatias , Aplicativos Móveis , Peso Corporal , Dieta/normas , Dieta/estatística & dados numéricos , Cardiopatias/prevenção & controle , Humanos , Obesidade/prevenção & controleRESUMO
Analyzing disease progression patterns can provide useful insights into the disease processes of many chronic conditions. These analyses may help inform recruitment for prevention trials or the development and personalization of treatments for those affected. We learn disease progression patterns using Hidden Markov Models (HMM) and distill them into distinct trajectories using visualization methods. We apply it to the domain of Type 1 Diabetes (T1D) using large longitudinal observational data from the T1DI study group. Our method discovers distinct disease progression trajectories that corroborate with recently published findings. In this paper, we describe the iterative process of developing the model. These methods may also be applied to other chronic conditions that evolve over time.
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Progressão da Doença , Modelos Estatísticos , Doença Crônica , Humanos , Cadeias de MarkovRESUMO
Clustering, the process of grouping together similar items into distinct partitions, is a common type of unsupervised machine learning that can be useful for summarizing and aggregating complex multi-dimensional data. However, data can be clustered in many ways, and there exist a large body of algorithms designed to reveal different patterns. While having access to a wide variety of algorithms is helpful, in practice, it is quite difficult for data scientists to choose and parameterize algorithms to get the clustering results relevant for their dataset and analytical tasks. To alleviate this problem, we built Clustervision, a visual analytics tool that helps ensure data scientists find the right clustering among the large amount of techniques and parameters available. Our system clusters data using a variety of clustering techniques and parameters and then ranks clustering results utilizing five quality metrics. In addition, users can guide the system to produce more relevant results by providing task-relevant constraints on the data. Our visual user interface allows users to find high quality clustering results, explore the clusters using several coordinated visualization techniques, and select the cluster result that best suits their task. We demonstrate this novel approach using a case study with a team of researchers in the medical domain and showcase that our system empowers users to choose an effective representation of their complex data.
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We have recently seen many successful applications of recurrent neural networks (RNNs) on electronic medical records (EMRs), which contain histories of patients' diagnoses, medications, and other various events, in order to predict the current and future states of patients. Despite the strong performance of RNNs, it is often challenging for users to understand why the model makes a particular prediction. Such black-box nature of RNNs can impede its wide adoption in clinical practice. Furthermore, we have no established methods to interactively leverage users' domain expertise and prior knowledge as inputs for steering the model. Therefore, our design study aims to provide a visual analytics solution to increase interpretability and interactivity of RNNs via a joint effort of medical experts, artificial intelligence scientists, and visual analytics researchers. Following the iterative design process between the experts, we design, implement, and evaluate a visual analytics tool called RetainVis, which couples a newly improved, interpretable, and interactive RNN-based model called RetainEX and visualizations for users' exploration of EMR data in the context of prediction tasks. Our study shows the effective use of RetainVis for gaining insights into how individual medical codes contribute to making risk predictions, using EMRs of patients with heart failure and cataract symptoms. Our study also demonstrates how we made substantial changes to the state-of-the-art RNN model called RETAIN in order to make use of temporal information and increase interactivity. This study will provide a useful guideline for researchers that aim to design an interpretable and interactive visual analytics tool for RNNs.
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The Information Visualization community has begun to pay attention to visualization literacy; however, researchers still lack instruments for measuring the visualization literacy of users. In order to address this gap, we systematically developed a visualization literacy assessment test (VLAT), especially for non-expert users in data visualization, by following the established procedure of test development in Psychological and Educational Measurement: (1) Test Blueprint Construction, (2) Test Item Generation, (3) Content Validity Evaluation, (4) Test Tryout and Item Analysis, (5) Test Item Selection, and (6) Reliability Evaluation. The VLAT consists of 12 data visualizations and 53 multiple-choice test items that cover eight data visualization tasks. The test items in the VLAT were evaluated with respect to their essentialness by five domain experts in Information Visualization and Visual Analytics (average content validity ratio = 0.66). The VLAT was also tried out on a sample of 191 test takers and showed high reliability (reliability coefficient omega = 0.76). In addition, we demonstrated the relationship between users' visualization literacy and aptitude for learning an unfamiliar visualization and showed that they had a fairly high positive relationship (correlation coefficient = 0.64). Finally, we discuss evidence for the validity of the VLAT and potential research areas that are related to the instrument.
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Sampling is becoming an essential tool for scalable interactive visual analysis. After outlining prior work by the database community on sampling for visualization of aggregation queries, this article considers how these results might be improved and extended to a broader setting. The goal is to better understand how users interact with sampling to enable wider adoption of sampling for scalable visual analytics.
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Visual analytics techniques help users explore high-dimensional data. However, it is often challenging for users to express their domain knowledge in order to steer the underlying data model, especially when they have little attribute-level knowledge. Furthermore, users' complex, high-level domain knowledge, compared to low-level attributes, posits even greater challenges. To overcome these challenges, we introduce a technique to interpret a user's drawings with an interactive, nonlinear axis mapping approach called AxiSketcher. This technique enables users to impose their domain knowledge on a visualization by allowing interaction with data entries rather than with data attributes. The proposed interaction is performed through directly sketching lines over the visualization. Using this technique, users can draw lines over selected data points, and the system forms the axes that represent a nonlinear, weighted combination of multidimensional attributes. In this paper, we describe our techniques in three areas: 1) the design space of sketching methods for eliciting users' nonlinear domain knowledge; 2) the underlying model that translates users' input, extracts patterns behind the selected data points, and results in nonlinear axes reflecting users' complex intent; and 3) the interactive visualization for viewing, assessing, and reconstructing the newly formed, nonlinear axes.
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Presents corrections for the paper, "Guidelines for effective usage of text highlighting techniques," (Strobelt, H., et al), IEEE Trans. Vis. Comput.Graph., vol. 22, no. 1, pp. 489-498, Jan. 2016.