FOR D ELIVERING Q UESTIONNAIRES , E DUCATIONAL M ATERIAL AND C - PDF document

G- QUEST : A S INGLE P LATFORM FOR D ELIVERING Q UESTIONNAIRES , E DUCATIONAL M ATERIAL AND C HECKLISTS ON M OBILE D EVICES Giordano Lanzola Dept. of Electrical, Computer and Biomedical Engineering University of Pavia Via Ferrata 1, 27100 Pavia Italy UNIVERSITÀ DI P AVIA

Summary • Introduction / Motivation • G-quest Design and Implementation • Results • Conclusions Giordano Lanzola Angelo Nuzzo IIT@SEMM, Milan, 2011 MIE 2014 - Istanbul

EU Project MobiGuide VII FP EU Project involving 11 partners in Europe and 2 in Israel Implement a Patient Guidance System • tighter interaction between the patient and his care providers • recommendations concerning the therapy anytime and anywhere • use of Smartphones / Tablets (Android OS) Main components decision support system, body area network Validation areas • atrial fibrillation • gestational diabetes • hypertensive disorders of pregnancy Giordano Lanzola Angelo Nuzzo IIT@SEMM, Milan, 2011 MIE 2014 - Istanbul

EU Project MobiGuide VII FP EU Project involving 11 partners in Europe and 2 in Israel A snapshot of EuroQol 5D-5L Questionnaire A snapshot of the AFEQT Questionnaire Implement a Patient Guidance System • tighter interaction between the patient and his care providers • recommendations concerning the therapy anytime and anywhere • use of Smartphones (Android OS) Main components decision support system, body area network Validation areas • atrial fibrillation • gestational diabetes • hypertensive disorders of pregnancy Giordano Lanzola Angelo Nuzzo IIT@SEMM, Milan, 2011 MIE 2014 - Istanbul

Missing Features in Commercial Tools The simplest tools • Poor question composition capabilities • Unable (or limited support) to operate offline • Unable (or limited support) to navigate across questions The more complex ones • Unavailable on Android • No integration with TTS and speech recognition modules • Do not allow the evaluation of user-defined arithmetics • Adopt the Platform as a Service paradigm Giordano Lanzola Angelo Nuzzo IIT@SEMM, Milan, 2011 MIE 2014 - Istanbul

Summary • Introduction / Motivation • G-quest Design and Implementation • Results • Conclusions Giordano Lanzola Angelo Nuzzo IIT@SEMM, Milan, 2011 MIE 2014 - Istanbul

Question Assembly Model a question is a group of information which must be shown all together on the screen Giordano Lanzola Angelo Nuzzo IIT@SEMM, Milan, 2011 MIE 2014 - Istanbul

Question Assembly Model Questions include a title, answer lines, labels and input elements Giordano Lanzola Angelo Nuzzo IIT@SEMM, Milan, 2011 MIE 2014 - Istanbul

Question Assembly Model Questions include a title, answer lines, labels and input elements Giordano Lanzola Angelo Nuzzo IIT@SEMM, Milan, 2011 MIE 2014 - Istanbul

Question Assembly Model Questions include a title, answer lines, labels and input elements Giordano Lanzola Angelo Nuzzo IIT@SEMM, Milan, 2011 MIE 2014 - Istanbul

Question Assembly Model Questions include a title, answer lines, labels and input elements Inputs can be textboxes , checkboxes, radios , multichoice , yes-no Giordano Lanzola Angelo Nuzzo IIT@SEMM, Milan, 2011 MIE 2014 - Istanbul

Constraint Model Allows the definition of consistency checks enforcing the correctness of the user input On a local basis: • prevent the introduction of wrong values • implemented through the GUI type-checking primitives Each hierarchy element (i.e. question, answer, input) declares: On a contextual basis: • whether filling in the element is required or not (i.e. fillrequired ) • how many contained elements should be filled (i.e. fillcount ) • enforce consistency considering the question as a whole In the example shown: • prevent the acquisition of misleading or mismatched • all inputs have fillrequired =no information • the first two answers have fillrequired =no, fillcount =4 • the last answer has fillrequired =no, fillcount =5 • question has fillrequired =yes Giordano Lanzola Angelo Nuzzo IIT@SEMM, Milan, 2011 MIE 2014 - Istanbul

Navigation Model Allows the definition of Navigation Rules for implementing branches and cycles across questions • questions are enclosed in blocks which drive their sequential administration onblan k onfill • questions may specify both onfill / onblank action, forcing a jump to a different block depending on the fill status please D C any visit? describe • answers may specifiy an onfill action, forcing a jump to onfill another block if the answer is filled Giordano Lanzola Angelo Nuzzo IIT@SEMM, Milan, 2011 MIE 2014 - Istanbul

Functional Architecture • textual help •speech synthesis •speech recognition Design Download Deploy Synchro • Select Analysis •Fill •Review •Modify • Close • Delete Giordano Lanzola Angelo Nuzzo IIT@SEMM, Milan, 2011 MIE 2014 - Istanbul

Summary • Introduction / Motivation • G-quest Design and Implementation • Results • Conclusions Giordano Lanzola Angelo Nuzzo IIT@SEMM, Milan, 2011 MIE 2014 - Istanbul

Questionnaire: Preterm Newborns • Any user provided input is stored locally and synchronized when the the questionnaire is finished Giordano Lanzola Angelo Nuzzo IIT@SEMM, Milan, 2011 MIE 2014 - Istanbul

Questionnaire: AFEQT G-quest has been positively validated administering the EuroQol and AFEQT questionnaires to selected patients in a pilot study [Lanzola et al.] Gquest: modeling patient questionnaires and administering them through a mobile platform. Comput Meth Prog Bio doi: 10.1016/j.cmpb.2014.07.010 Giordano Lanzola Angelo Nuzzo IIT@SEMM, Milan, 2011 MIE 2014 - Istanbul

Educational Material: AmyGuide • The original constructs of the model have been overturned to deliver educational material: ● the patient is now asked about which information he wishes to receive and plays an active role instead of a passive one • We implemented a guide to promote self-management in patients affected by the rare disease amyloidosis . • A questionnaire has also been embedded into the application to assess the patient perception Giordano Lanzola Angelo Nuzzo IIT@SEMM, Milan, 2011 MIE 2014 - Istanbul

Educational Material: AmyGuide AmyGuide has been validated in the waiting room of a national amyloidois referral center [Lanzola et al.] Delivering and assessing learning material through Gquest: a case study on patient education. Int J Mobile Blended Learn , 2014, 3 (to appear) Giordano Lanzola Angelo Nuzzo IIT@SEMM, Milan, 2011 MIE 2014 - Istanbul

Checklists: Atrial Fibrillation Calculate CHADS2 score [CHADS2 = 0] [CHADS2 >= 1] Assess individual conditions Evaluate risk mitigation Assess monitoring requirements No Aspirin Calculate CHA2DS2- Treatment Treatment VASc for better assessment Select Anticoagulant A guide to starting oral anticoagulants in atrial fibrillation (non-valvular patients) From: NPS MedicineWise (funded by the Australian Gov Dept of Health) http:://www.nps.org.au MIE 2014 - Istanbul Giordano Lanzola Angelo Nuzzo IIT@SEMM, Milan, 2011

Checklists: Atrial Fibrillation • Design of a checklist library for emergency and first aid • Speech recognition also for commands (handless operation) • Match checklist instances with outcomes coming from patient records MIE 2014 - Istanbul Giordano Lanzola Angelo Nuzzo IIT@SEMM, Milan, 2011

Summary • Introduction / Motivation • G-quest Design and Implementation • Results • Conclusions Giordano Lanzola Angelo Nuzzo IIT@SEMM, Milan, 2011 MIE 2014 - Istanbul

Conclusions The model developed not only fits the scenarios of complex questionnaires but also applies to different contexts ● dialog adaptivity, constraints on input, consistency rules, score calculation The platform manages the full module delivery round-trip ● anywhere / anytime availability, even without carrier coverage ● combines the pros of paper and web based administration The pilot validations accomplished proved the effectiveness of G-Quest in different areas Giordano Lanzola Angelo Nuzzo IIT@SEMM, Milan, 2011 MIE 2014 - Istanbul

Thank you for your attention Credits: • Giordano LANZOLA, PhD • Germana GINARDI, MSc • Paola RUSSO, MD • Silvana QUAGLINI, PhD Dept. of Electrical, Computer and Biomedical Engineering University of Pavia Via Ferrata 1, 27100 Pavia Italy UNIVERSITÀ DI P AVIA MIE 2014 - Istanbul