@article{PrakashUnnikrishnanPryssetal.2021, author = {Prakash, Subash and Unnikrishnan, Vishnu and Pryss, R{\"u}diger and Kraft, Robin and Schobel, Johannes and Hannemann, Ronny and Langguth, Berthold and Schlee, Winfried and Spiliopoulou, Myra}, title = {Interactive system for similarity-based inspection and assessment of the well-being of mHealth users}, series = {Entropy}, volume = {23}, journal = {Entropy}, number = {12}, issn = {1099-4300}, doi = {10.3390/e23121695}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-252333}, year = {2021}, abstract = {Recent digitization technologies empower mHealth users to conveniently record their Ecological Momentary Assessments (EMA) through web applications, smartphones, and wearable devices. These recordings can help clinicians understand how the users' condition changes, but appropriate learning and visualization mechanisms are required for this purpose. We propose a web-based visual analytics tool, which processes clinical data as well as EMAs that were recorded through a mHealth application. The goals we pursue are (1) to predict the condition of the user in the near and the far future, while also identifying the clinical data that mostly contribute to EMA predictions, (2) to identify users with outlier EMA, and (3) to show to what extent the EMAs of a user are in line with or diverge from those users similar to him/her. We report our findings based on a pilot study on patient empowerment, involving tinnitus patients who recorded EMAs with the mHealth app TinnitusTips. To validate our method, we also derived synthetic data from the same pilot study. Based on this setting, results for different use cases are reported.}, language = {en} } @article{KraftBirkReichertetal.2020, author = {Kraft, Robin and Birk, Ferdinand and Reichert, Manfred and Deshpande, Aniruddha and Schlee, Winfried and Langguth, Berthold and Baumeister, Harald and Probst, Thomas and Spiliopoulou, Myra and Pryss, R{\"u}diger}, title = {Efficient processing of geospatial mHealth data using a scalable crowdsensing platform}, series = {Sensors}, volume = {20}, journal = {Sensors}, number = {12}, issn = {1424-8220}, doi = {10.3390/s20123456}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-207826}, year = {2020}, abstract = {Smart sensors and smartphones are becoming increasingly prevalent. Both can be used to gather environmental data (e.g., noise). Importantly, these devices can be connected to each other as well as to the Internet to collect large amounts of sensor data, which leads to many new opportunities. In particular, mobile crowdsensing techniques can be used to capture phenomena of common interest. Especially valuable insights can be gained if the collected data are additionally related to the time and place of the measurements. However, many technical solutions still use monolithic backends that are not capable of processing crowdsensing data in a flexible, efficient, and scalable manner. In this work, an architectural design was conceived with the goal to manage geospatial data in challenging crowdsensing healthcare scenarios. It will be shown how the proposed approach can be used to provide users with an interactive map of environmental noise, allowing tinnitus patients and other health-conscious people to avoid locations with harmful sound levels. Technically, the shown approach combines cloud-native applications with Big Data and stream processing concepts. In general, the presented architectural design shall serve as a foundation to implement practical and scalable crowdsensing platforms for various healthcare scenarios beyond the addressed use case.}, language = {en} } @article{KraftSchleeStachetal.2020, author = {Kraft, Robin and Schlee, Winfried and Stach, Michael and Reichert, Manfred and Langguth, Berthold and Baumeister, Harald and Probst, Thomas and Hannemann, Ronny and Pryss, R{\"u}diger}, title = {Combining Mobile Crowdsensing and Ecological Momentary Assessments in the Healthcare Domain}, series = {Frontiers in Neuroscience}, volume = {14}, journal = {Frontiers in Neuroscience}, number = {164}, issn = {1662-453X}, doi = {10.3389/fnins.2020.00164}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-200220}, year = {2020}, abstract = {The increasing prevalence of smart mobile devices (e.g., smartphones) enables the combined use of mobile crowdsensing (MCS) and ecological momentary assessments (EMA) in the healthcare domain. By correlating qualitative longitudinal and ecologically valid EMA assessment data sets with sensor measurements in mobile apps, new valuable insights about patients (e.g., humans who suffer from chronic diseases) can be gained. However, there are numerous conceptual, architectural and technical, as well as legal challenges when implementing a respective software solution. Therefore, the work at hand (1) identifies these challenges, (2) derives respective recommendations, and (3) proposes a reference architecture for a MCS-EMA-platform addressing the defined recommendations. The required insights to propose the reference architecture were gained in several large-scale mHealth crowdsensing studies running for many years and different healthcare questions. To mention only two examples, we are running crowdsensing studies on questions for the tinnitus chronic disorder or psychological stress. We consider the proposed reference architecture and the identified challenges and recommendations as a contribution in two respects. First, they enable other researchers to align our practical studies with a baseline setting that can satisfy the variously revealed insights. Second, they are a proper basis to better compare data that was gathered using MCS and EMA. In addition, the combined use of MCS and EMA increasingly requires suitable architectures and associated digital solutions for the healthcare domain.}, language = {en} } @article{AllgaierSchleeProbstetal.2022, author = {Allgaier, Johannes and Schlee, Winfried and Probst, Thomas and Pryss, R{\"u}diger}, title = {Prediction of tinnitus perception based on daily life mHealth data using country origin and season}, series = {Journal of Clinical Medicine}, volume = {11}, journal = {Journal of Clinical Medicine}, number = {15}, issn = {2077-0383}, doi = {10.3390/jcm11154270}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-281812}, year = {2022}, abstract = {Tinnitus is an auditory phantom perception without external sound stimuli. This chronic perception can severely affect quality of life. Because tinnitus symptoms are highly heterogeneous, multimodal data analyses are increasingly used to gain new insights. MHealth data sources, with their particular focus on country- and season-specific differences, can provide a promising avenue for new insights. Therefore, we examined data from the TrackYourTinnitus (TYT) mHealth platform to create symptom profiles of TYT users. We used gradient boosting engines to classify momentary tinnitus and regress tinnitus loudness, using country of origin and season as features. At the daily assessment level, tinnitus loudness can be regressed with a mean absolute error rate of 7.9\% points. In turn, momentary tinnitus can be classified with an F1 score of 93.79\%. Both results indicate differences in the tinnitus of TYT users with respect to season and country of origin. The significance of the features was evaluated using statistical and explainable machine learning methods. It was further shown that tinnitus varies with temperature in certain countries. The results presented show that season and country of origin appear to be valuable features when combined with longitudinal mHealth data at the level of daily assessment.}, language = {en} } @article{SchobelProbstReichertetal.2020, author = {Schobel, Johannes and Probst, Thomas and Reichert, Manfred and Schlee, Winfried and Schickler, Marc and Kestler, Hans A. and Pryss, R{\"u}diger}, title = {Measuring mental effort for creating mobile data collection applications}, series = {International Journal of Environmental Research and Public Health}, volume = {17}, journal = {International Journal of Environmental Research and Public Health}, number = {5}, issn = {1660-4601}, doi = {10.3390/ijerph17051649}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-203176}, year = {2020}, abstract = {To deal with drawbacks of paper-based data collection procedures, the QuestionSys approach empowers researchers with none or little programming knowledge to flexibly configure mobile data collection applications on demand. The mobile application approach of QuestionSys mainly pursues the goal to mitigate existing drawbacks of paper-based collection procedures in mHealth scenarios. Importantly, researchers shall be enabled to gather data in an efficient way. To evaluate the applicability of QuestionSys, several studies have been carried out to measure the efforts when using the framework in practice. In this work, the results of a study that investigated psychological insights on the required mental effort to configure the mobile applications are presented. Specifically, the mental effort for creating data collection instruments is validated in a study with N=80 participants across two sessions. Thereby, participants were categorized into novices and experts based on prior knowledge on process modeling, which is a fundamental pillar of the developed approach. Each participant modeled 10 instruments during the course of the study, while concurrently several performance measures are assessed (e.g., time needed or errors). The results of these measures are then compared to the self-reported mental effort with respect to the tasks that had to be modeled. On one hand, the obtained results reveal a strong correlation between mental effort and performance measures. On the other, the self-reported mental effort decreased significantly over the course of the study, and therefore had a positive impact on measured performance metrics. Altogether, this study indicates that novices with no prior knowledge gain enough experience over the short amount of time to successfully model data collection instruments on their own. Therefore, QuestionSys is a helpful instrument to properly deal with large-scale data collection scenarios like clinical trials.}, language = {en} } @article{UnnikrishnanSchleicherShahetal.2020, author = {Unnikrishnan, Vishnu and Schleicher, Miro and Shah, Yash and Jamaludeen, Noor and Pryss, Ruediger and Schobel, Johannes and Kraft, Robin and Schlee, Winfried and Spiliopoulou, Myra}, title = {The effect of non-personalised tips on the continued use of self-monitoring mHealth applications}, series = {Brain Sciences}, volume = {10}, journal = {Brain Sciences}, number = {12}, issn = {2076-3425}, doi = {10.3390/brainsci10120924}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-219435}, year = {2020}, abstract = {Chronic tinnitus, the perception of a phantom sound in the absence of corresponding stimulus, is a condition known to affect patients' quality of life. Recent advances in mHealth have enabled patients to maintain a 'disease journal' of ecologically-valid momentary assessments, improving patients' own awareness of their disease while also providing clinicians valuable data for research. In this study, we investigate the effect of non-personalised tips on patients' perception of tinnitus, and on their continued use of the application. The data collected from the study involved three groups of patients that used the app for 16 weeks. Groups A \& Y were exposed to feedback from the start of the study, while group B only received tips for the second half of the study. Groups A and Y were run by different supervisors and also differed in the number of hospital visits during the study. Users of Group A and B underwent assessment at baseline, mid-study, post-study and follow-up, while users of group Y were only assessed at baseline and post-study. It is seen that the users in group B use the app for longer, and also more often during the day. The answers of the users to the Ecological Momentary Assessments are seen to form clusters where the degree to which the tinnitus distress depends on tinnitus loudness varies. Additionally, cluster-level models were able to predict new unseen data with better accuracy than a single global model. This strengthens the argument that the discovered clusters really do reflect underlying patterns in disease expression.}, language = {en} } @article{MehdiDodePryssetal.2020, author = {Mehdi, Muntazir and Dode, Albi and Pryss, R{\"u}diger and Schlee, Winfried and Reichert, Manfred and Hauck, Franz J.}, title = {Contemporary review of smartphone apps for tinnitus management and treatment}, series = {Brain Sciences}, volume = {10}, journal = {Brain Sciences}, number = {11}, issn = {2076-3425}, doi = {10.3390/brainsci10110867}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-219367}, year = {2020}, abstract = {Tinnitus is a complex and heterogeneous psycho-physiological disorder responsible for causing a phantom ringing or buzzing sound albeit the absence of an external sound source. It has a direct influence on affecting the quality of life of its sufferers. Despite being around for a while, there has not been a cure for tinnitus, and the usual course of action for its treatment involves use of tinnitus retaining and sound therapy, or Cognitive Behavioral Therapy (CBT). One positive aspect about these therapies is that they can be administered face-to-face as well as delivered via internet or smartphone. Smartphones are especially helpful as they are highly personalized devices, and offer a well-established ecosystem of apps, accessible via respective marketplaces of differing mobile platforms. Note that current therapeutic treatments such as CBT have shown to be effective in suppressing the tinnitus symptoms when administered face-to-face, their effectiveness when being delivered using smartphones is not known so far. A quick search on the prominent market places of popular mobile platforms (Android and iOS) yielded roughly 250 smartphone apps offering tinnitus-related therapies and tinnitus management. As this number is expected to steadily increase due to high interest in smartphone app development, a contemporary review of such apps is crucial. In this paper, we aim to review scientific studies validating the smartphone apps, particularly to test their effectiveness in tinnitus management and treatment. We use the PRISMA guidelines for identification of studies on major scientific literature sources and delineate the outcomes of identified studies.}, language = {en} } @article{SchleeNeffSimoesetal.2022, author = {Schlee, Winfried and Neff, Patrick and Simoes, Jorge and Langguth, Berthold and Schoisswohl, Stefan and Steinberger, Heidi and Norman, Marie and Spiliopoulou, Myra and Schobel, Johannes and Hannemann, Ronny and Pryss, R{\"u}diger}, title = {Smartphone-guided educational counseling and self-help for chronic tinnitus}, series = {Journal of Clinical Medicine}, volume = {11}, journal = {Journal of Clinical Medicine}, number = {7}, issn = {2077-0383}, doi = {10.3390/jcm11071825}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-267295}, year = {2022}, abstract = {Tinnitus is an auditory phantom perception in the ears or head in the absence of a corresponding external stimulus. There is currently no effective treatment available that reliably reduces tinnitus. Educational counseling is a treatment approach that aims to educate patients and inform them about possible coping strategies. For this feasibility study, we implemented educational material and self-help advice in a smartphone app. Participants used the educational smartphone app unsupervised during their daily routine over a period of four months. Comparing the tinnitus outcome measures before and after smartphone-guided treatment, we measured changes in tinnitus-related distress, but not in tinnitus loudness. Improvements on the Tinnitus Severity numeric rating scale reached an effect size of 0.408, while the improvements on the Tinnitus Handicap Inventory (THI) were much smaller with an effect size of 0.168. An analysis of user behavior showed that frequent and intensive use of the app is a crucial factor for treatment success: participants that used the app more often and interacted with the app intensively reported a stronger improvement in the tinnitus. Between study allocation and final assessment, 26 of 52 participants dropped out of the study. Reasons for the dropouts and lessons for future studies are discussed in this paper.}, language = {en} } @article{PryssSchleeHoppenstedtetal.2020, author = {Pryss, R{\"u}diger and Schlee, Winfried and Hoppenstedt, Burkhard and Reichert, Manfred and Spiliopoulou, Myra and Langguth, Berthold and Breitmayer, Marius and Probst, Thomas}, title = {Applying Machine Learning to Daily-Life Data From the TrackYourTinnitus Mobile Health Crowdsensing Platform to Predict the Mobile Operating System Used With High Accuracy: Longitudinal Observational Study}, series = {Journal of Medical Internet Research}, volume = {22}, journal = {Journal of Medical Internet Research}, number = {6}, doi = {10.2196/15547}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-229517}, year = {2020}, abstract = {Background: Tinnitus is often described as the phantom perception of a sound and is experienced by 5.1\% to 42.7\% of the population worldwide, at least once during their lifetime. The symptoms often reduce the patient's quality of life. The TrackYourTinnitus (TYT) mobile health (mHealth) crowdsensing platform was developed for two operating systems (OS)-Android and iOS-to help patients demystify the daily moment-to-moment variations of their tinnitus symptoms. In all platforms developed for more than one OS, it is important to investigate whether the crowdsensed data predicts the OS that was used in order to understand the degree to which the OS is a confounder that is necessary to consider.}, language = {en} } @article{SchleeSimoesPryss2021, author = {Schlee, Winfried and Simoes, Jorge and Pryss, R{\"u}diger}, title = {Auricular acupressure combined with self-help intervention for treating chronic tinnitus: a longitudinal observational study}, series = {Journal of Clinical Medicine}, volume = {10}, journal = {Journal of Clinical Medicine}, number = {18}, issn = {2077-0383}, doi = {10.3390/jcm10184201}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-246209}, year = {2021}, abstract = {Tinnitus is a phantom sound perception in the ears or head and can arise from many different medical disorders. Currently, there is no standard treatment for tinnitus that reliably reduces tinnitus. Individual patients reported that acupressure at various points around the ear can help to reduce tinnitus, which was investigated here. With this longitudinal observational study, we report a systematic evaluation of auricular acupressure on 39 tinnitus sufferers, combined with a self-help smartphone app. The participants were asked to report on tinnitus, stress, mood, neck, and jaw muscle tensions twice a day using an ecological momentary assessment study design for six weeks. On average, 123.6 questionnaires per person were provided and used for statistical analysis. The treatment responses of the participants were heterogeneous. On average, we observed significant negative trends for tinnitus loudness (Cohen's d effect size: -0.861), tinnitus distress (d = -0.478), stress (d = -0.675), and tensions in the neck muscles (d = -0.356). Comparison with a matched control group revealed significant improvements for tinnitus loudness (p = 0.027) and self-reported stress level (p = 0.003). The positive results of the observational study motivate further research including a randomized clinical trial and long-term assessment of the clinical improvement.}, language = {en} } @article{AllgaierSchleeLangguthetal.2021, author = {Allgaier, Johannes and Schlee, Winfried and Langguth, Berthold and Probst, Thomas and Pryss, R{\"u}diger}, title = {Predicting the Gender of Individuals with Tinnitus based on Daily Life Data of the TrackYourTinnitus mHealth Platform}, series = {Scientific Reports}, volume = {11}, journal = {Scientific Reports}, number = {1}, doi = {10.1038/s41598-021-96731-8}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-261753}, year = {2021}, abstract = {Tinnitus is an auditory phantom perception in the absence of an external sound stimulation. People with tinnitus often report severe constraints in their daily life. Interestingly, indications exist on gender differences between women and men both in the symptom profile as well as in the response to specific tinnitus treatments. In this paper, data of the TrackYourTinnitus platform (TYT) were analyzed to investigate whether the gender of users can be predicted. In general, the TYT mobile Health crowdsensing platform was developed to demystify the daily and momentary variations of tinnitus symptoms over time. The goal of the presented investigation is a better understanding of gender-related differences in the symptom profiles of users from TYT. Based on two questionnaires of TYT, four machine learning based classifiers were trained and analyzed. With respect to the provided daily answers, the gender of TYT users can be predicted with an accuracy of 81.7\%. In this context, worries, difficulties in concentration, and irritability towards the family are the three most important characteristics for predicting the gender. Note that in contrast to existing studies on TYT, daily answers to the worst symptom question were firstly investigated in more detail. It was found that results of this question significantly contribute to the prediction of the gender of TYT users. Overall, our findings indicate gender-related differences in tinnitus and tinnitus-related symptoms. Based on evidence that gender impacts the development of tinnitus, the gathered insights can be considered relevant and justify further investigations in this direction.}, language = {en} } @article{HolfelderMulanskySchleeetal.2021, author = {Holfelder, Marc and Mulansky, Lena and Schlee, Winfried and Baumeister, Harald and Schobel, Johannes and Greger, Helmut and Hoff, Andreas and Pryss, R{\"u}diger}, title = {Medical device regulation efforts for mHealth apps during the COVID-19 pandemic — an experience report of Corona Check and Corona Health}, series = {J — Multidisciplinary Scientific Journal}, volume = {4}, journal = {J — Multidisciplinary Scientific Journal}, number = {2}, issn = {2571-8800}, doi = {10.3390/j4020017}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-285434}, pages = {206 -- 222}, year = {2021}, abstract = {Within the healthcare environment, mobile health (mHealth) applications (apps) are becoming more and more important. The number of new mHealth apps has risen steadily in the last years. Especially the COVID-19 pandemic has led to an enormous amount of app releases. In most countries, mHealth applications have to be compliant with several regulatory aspects to be declared a "medical app". However, the latest applicable medical device regulation (MDR) does not provide more details on the requirements for mHealth applications. When developing a medical app, it is essential that all contributors in an interdisciplinary team — especially software engineers — are aware of the specific regulatory requirements beforehand. The development process, however, should not be stalled due to integration of the MDR. Therefore, a developing framework that includes these aspects is required to facilitate a reliable and quick development process. The paper at hand introduces the creation of such a framework on the basis of the Corona Health and Corona Check apps. The relevant regulatory guidelines are listed and summarized as a guidance for medical app developments during the pandemic and beyond. In particular, the important stages and challenges faced that emerged during the entire development process are highlighted.}, language = {en} } @article{BeierleSchobelVogeletal.2021, author = {Beierle, Felix and Schobel, Johannes and Vogel, Carsten and Allgaier, Johannes and Mulansky, Lena and Haug, Fabian and Haug, Julian and Schlee, Winfried and Holfelder, Marc and Stach, Michael and Schickler, Marc and Baumeister, Harald and Cohrdes, Caroline and Deckert, J{\"u}rgen and Deserno, Lorenz and Edler, Johanna-Sophie and Eichner, Felizitas A. and Greger, Helmut and Hein, Grit and Heuschmann, Peter and John, Dennis and Kestler, Hans A. and Krefting, Dagmar and Langguth, Berthold and Meybohm, Patrick and Probst, Thomas and Reichert, Manfred and Romanos, Marcel and St{\"o}rk, Stefan and Terhorst, Yannik and Weiß, Martin and Pryss, R{\"u}diger}, title = {Corona Health — A Study- and Sensor-Based Mobile App Platform Exploring Aspects of the COVID-19 Pandemic}, series = {International Journal of Environmental Research and Public Health}, volume = {18}, journal = {International Journal of Environmental Research and Public Health}, number = {14}, issn = {1660-4601}, doi = {10.3390/ijerph18147395}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-242658}, year = {2021}, abstract = {Physical and mental well-being during the COVID-19 pandemic is typically assessed via surveys, which might make it difficult to conduct longitudinal studies and might lead to data suffering from recall bias. Ecological momentary assessment (EMA) driven smartphone apps can help alleviate such issues, allowing for in situ recordings. Implementing such an app is not trivial, necessitates strict regulatory and legal requirements, and requires short development cycles to appropriately react to abrupt changes in the pandemic. Based on an existing app framework, we developed Corona Health, an app that serves as a platform for deploying questionnaire-based studies in combination with recordings of mobile sensors. In this paper, we present the technical details of Corona Health and provide first insights into the collected data. Through collaborative efforts from experts from public health, medicine, psychology, and computer science, we released Corona Health publicly on Google Play and the Apple App Store (in July 2020) in eight languages and attracted 7290 installations so far. Currently, five studies related to physical and mental well-being are deployed and 17,241 questionnaires have been filled out. Corona Health proves to be a viable tool for conducting research related to the COVID-19 pandemic and can serve as a blueprint for future EMA-based studies. The data we collected will substantially improve our knowledge on mental and physical health states, traits and trajectories as well as its risk and protective factors over the course of the COVID-19 pandemic and its diverse prevention measures.}, language = {en} }